Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia / The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia

Objetivos Establecer la prevalencia del resultado de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en mujeres del departamento del Cauca, Colombia. Metodología Después de la Arma voluntaria del consentimiento informado, las mujeres fueron entrevistadas a través de un cuestionario para colectar variables de tipo sociodemográfico y clínico, incluyendo historia reproductiva, actividad sexual, historia de citología y hábito de fumar. Posteriormente, se procedió a la toma de la citología para su análisis y clasificación según el sistema Bethesda 2001. Un total de 1735 mujeres fueron reclutadas para este estudio. Resultados Acorde con el resultado de citología, 1061 mujeres presentaron citología normal (61 %), 36 citología anormal (2 %) y 638 cambios celulares reactivos asociados a inflamación (37 %). Los resultados indican que tener relaciones sexuales a temprana edad, la multiparidad, el uso de anticonceptivos hormonales y no realizarse la citología anualmente fueron factores de riesgo asociados a citología anormal. Conclusiones Estos resultados brindan información valiosa a las instituciones de salud pública para desarrollar mejores programas de cribado para la prevención de neoplasias del cuello uterino en mujeres de la región y el país.

Objectives Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. Methodology After signing a consent-form, females were interviewed using a questionnaire to collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. Results According to the cytology report, 1061 women had normal cytology (61 %), 36 abnormal cytology (2 %) and 638 reactive cellular changes associated with inflammation (37 %). The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. Conclusions These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Simultaneous detection of Neisseria gonorrhoeae and Chlamydia trachomatis by PCR in genitourinary specimens from men and women attending an STD clinic.

Neisseria gonorrhoeae and Chlamydia trachomatis are the two most common bacterial sexually transmitted infections that manifest primarily as urethritis in males and endocervicitis in females, though the infection may be asymptomatic especially in women. Since complications may occur in untreated symptomatic and asymptomatic infected individuals, early diagnosis and treatment of infected individuals is required to prevent severe sequelae and spread of these diseases. Recently molecular amplification assays like Polymerase Chain Reaction (PCR) and Ligase Chain Reaction (LCR) have been found to be highly sensitive and specific methods for detection of N. gonorrhoeae and C. trachonmatis not only in urethral and cervical specimens but also in urine. The objective of this study was to screen male and female Sexually Transmitted Disease (STD) clinic attenders, with and without symptoms suggestive of urethritis and cervicitis for presence of N. gonorrhoeae and C. trachomatis using a multiplex PCR based assay, to compare its performance with culture for N. gonorrhoeae and Direct Fluorescent Antibody (DFA) staining for C. trachomatis and also to compare the efficacy of PCR test performed on urine and genital swab specimens collected from this high risk group. Genital specimens and urine was collected from STD clinic attenders. N. gonorrhoeae and C. trachomatis was detected in genital specimens by culture and DFA respectively. Multiplex PCR was used to detect N. gonorrhoeae and C. trachomatis infection in both genital and urine specimens. Among men with urethritis, N. gonorrhoeae was detected in 70% by culture and 77% by PCR, while C. trachomatis as detected in 7.5% by DFA and 17.5% by PCR. Among females with endocervicitis, N. gonorrhoeae was detected in 7.7% by culture and 30.7% by PCR, while C. trachomatis was detected in 7.7% by DFA and in 15.4% by PCR. None of the asymptomatic males were positive for N. gonorrhoeae and C. trachomatis by conventional methods, while 43.9% were positive for N. gonorrhoeae and 7.5% for C. trachomatis by PCR. Fifty per cent of asymptomatic women were positive for C. trachomatis by PCR alone. We encountered PCR positive but culture/DFA negative results and also PCR negative but culture/DFA positive results. In view of this a single PCR test cannot be used for diagnosis and treatment of N. gonorrhoeae and C. trachomatis infection unless confirmed by a second test.

Etiologic agents of cervicovaginitis in Turkish women

To investigate the distribution of microbiologic agents causing cervicovaginitis. We conducted the study between October 2002 and December 2004 in Abant Izzet Baysal University, Duzce School of Medicine Hospital, Turkey. The samples were obtained from the posterior vaginal fornix and cervix by swabs in 828 patients. Direct microscopic examination, culture and enzyme immune assay [EIA] methods were performed in all patients for diagnosis of microbiologic agents. Gardnerella vaginalis [G. vaginalis] were diagnosed in 254 [30.7%] patients, Candida albicans [C. albicans] in 152 [18.4%], Candida glabrata [C. glabrata] in 36 [4.3%], Candida species in 52 [6.3%], Staphylococcus aureus [S. aureus] in 62 [7.5%], Streptococcus group B in 28 [3.4%], Escherichia coli [E. coli] in 42 [5.1%], Klebsiella species in 24 [2.9%], and Streptococcus group D in 8 [1%] patients in culture. Less frequent enterobacteria in 30 [3.6%] were: Pseudomonas species, Proteus species Enterobacter species, Hafnia alvei and Nonfermenter species. Neisseria gonorrheae [N. gonorrheae] was detected in one patient [0.1%] in culture. The Chlamydia trachomatis [C. trachomatis] antigen was detected by EIA methods in 130 [15.7%] patients and Trichomonas vaginalis [T. vaginalis] was observed in 8 [1%] patients by direct microscopic examination. Performing the etiologic diagnosis of cervicovaginitis is necessary in order to take appropriate therapeutic and preventive measures. Therefore, we recommend G. vaginalis, C. albicans and C. trachomatis should be investigated in patients having a diagnosis of cervicovaginitis in our population, since these were detected in a considerable number of cases. Additionally, C. glabrata and T. vaginalis should be kept in mind as possible pathogens

Chlamydia and fertility

Chlamydia trachomatis infection is the most common sexually transmitted disease all around the world. For a long time, Chlamydia trachomatis has been recognized as the common cause of urethritis, cervicitis, and other complications such as pelvic inflammatory disease [PID], ectopic pregnancy, etc. However, today there is more concern on its role in male and female fertility and infertility and many studies have concentrated on this issue all over the world. There is good evidence based on seroepidemiologic studies on relationship between serum Chlamydial antibodies and infertility due to tubal factor in women with or without PID. However, there are many questions about Chlamydia trachomatis and its influence on IVF outcome and the exsisting information is controversial. The impact of Chlamydia trachomatis on male infetility is under investigation and it seems able to cause destruction of different parts of male genital tract in addition to high rate of transmission to women. With regard to these data, it seems that prevention, early diagnosis and treatment of Chlamydial infections are importart and cost effective

Citodiagnóstico em gestantes e puérperas atendidas no Hospital Universitário - UFAL / Cytodiagnosis in care pregnancy and puerperium at University Hospital of UFAL

O objetivo deste trabalho foi estabelecer a prevalência de infecções cervicovaginais em gestantes e puérperas atendidas no Hospital Universiário - UFAL, entre 1996 e 1197. Foram analisados os resultados das colpocitologias de 39 gestantes e 67 puérperas. Dentre as gestantes, 87,17 por cento apresentaram citologia inflamatória, sendo 55,88 por cento inespecíficas e 44,12 por cento específicas (26,47 por cento bacteriana e 17,64 por cento monilíase). No puerpério, observamos 80,59 por cento de citologias inflamatórias, destas, 44,44 por cento são inespecíficas e 55,54 por cento específicas (48,14 por cento bacteriana e 7,40 por cento de monilíase). Conclusões: A taxa de exames inconclusivos ainda é bastante elevada, com maior definição etiológica entre puérperas. Prevalecem as infecções bacterianas como causas etiológicas definidas. Os autores propõem a realização do exame colpocitológico de rotina nas gestantes, aproveitando a grande oportunidade eferecida pelo pré-natal

Study of the role of cervical chilamydia infection in unexplained ingertility and mucopuruluent cervicitis

Objectives to analyse the prevalence of cervical chlamydia infection in women with unexplained infertility [VI] and its share among other aetiological factors; and in patients with mucopuruluent cervicitis [MPC] and its, place among other microorganisms correlated with it. Subjects and methods- the incidence of cervical chlamydia infection was studied, by collecting endocervical specimens and detecting chlamydial antigens using direct immunofluorescent antibody [IFA] test among three groups of cases: a group diagnosed to have UI [60 women], a group with MPC [20 women], and a control group [32 asymptomatic fertile women]. Cases found to have cervical chlamydia infection were treated with doxycyline and followed up after two weeks in MPC for evidence of cure and after 6 months in UI for evidence of pregnancy. Results- about 33% of women with UI were found to have cervical chlamydia infection. The corresponding precentage were 60% and 12.5% respectively in MPC and control cases. Yellow and red cervical swab tests had 83% and increased polymorphnuclear leucocytes [PMNS] in endocervical swabs had 67% positive prediction for cervical chlamydia infection in cases with MPC. Results of treating cases with UI having cervical clamydia infection were encourging and for cases with MPC results were satisfactory. Conclusions-the study indicates that cervical chlamydia infection is a common and a significant finding in cases with UI and MPC, thus it should be considered while investigating these cases. Treatment of C. trachomatis infection on presumptive grounds, based on finding positive cervical swab test and increased PMNS on gram stain, is recommended as these methods are available and found in this study to have a reasonable positive prediction

Abordagem do paciente com massa cervical / Approach to the patient with neck mass

Na pratica clinica e muito frequente o medico deparar-se com um paciente que apresenta uma massa cervical. Esta pode representar varias patologias, primarias ou secundarias, de etiologia variada: congenita, inflamatoria, traumatica ou neoplasica. Uma abordagem criteriosa deste paciente, incluindo uma anamnese completa, um exame fisico detalhado e uma solicitacao pertinente de exames complementares, geralmente permite o estabelecimento do diagnostico. Quando necessaria, a biopsia da massa cervical deve ser realizada, destacando-se que o procedimento mais indicado e a biopsia excisional com exame histopatologico transoperatorio programado, bem como condicoes para uma possivel cirurgia mais abrangente

Chlamydia trachomatis in cervical mucus in cases of chronic cervicitis abortion and pregnancy

Direct immunofluorescence technique was used for detecting the prevalence of Chlamydia trachomatis infection in 20 patients with chronic cervicitis, 20 women during abortion. 20 fullterm pregnant women and 20 normal healthy controls attending AI-Zahraa University Hospital. The results revealed that the prevalence of C-trachomatis was 20%, 25%, 10% and 5% among the studied groups, respectively, with significant difference only between aborted Women and controls [P<0.05]. The results also revealed that mucopurulent discharge, dysuria and backache were the most frequent symptoms noted while cervical erosion and infertility were less common, and none were asymptomatic. Chlamydia trachomatis infection was found to be inversely related to age, parity and marital duration. From the forementioned results, it is clear that Chlamydia trachomatis has an important role, especially in abortion so that strategies for the treatment of women and mothers early in pregnancy must be carried out to prevent pregnancy loss

Etiologia das infecçoes cerviço-vaginais em pacientes com indicaçao clinica / Etiology of cervic-vaginitis infections in patientes with clinical history

Com oobjetivo de estabelecer o agente etiologico de infecçoes cervico-vaginais em pacientes com indicaçao clinica, foram avaliados o exame a fresco,bacterioscopico e bacteriologico semiquantitativo, medido o pH do conteudo vaginal e realizada cultura Chlamydia trachomatis e Urealyticum a partir de material cervical de 70 pacientes. A etiologia foi definida em 62,9% dos materiais processados e em 100% dos casos com processo inflamatorio cervico-vaginal. A prevalencia de Chlamydia trachomatis foi elevada (22,6%) considerando este estudo ter sido conduzido em pacientes de consulta ginecologica geral. A solicitaçao da rotina laboratorial em pacientes onde nao se reconheceu um agente infeccioso (37,1%) foi, na maioria das vezes, em funçao de se estabelecer o diagnostico diferencial. A metodologia utilizada abrange a maioria dos agentes envolvidos na patogenia dessas infecçoes.

Prevalencia de chlamydia trachomatis y mycoplasma spp. en mujeres con DIU que asisten a la consulta de planificacion familiar en el modulo de la Candelaria, Tinaquillo, Estado Cojedes. 1992 / Prevalence of chlamydia trachomatis and mycoplast spp in women with div of the family plannino service in the Candelaria center, Tinaquillo Edo. Cojedes

Se realizó un estudio de 80 pacientes portadoras de DIU, provenientes de la consulta de planificación Familiar del Módulo la Candelaria, Tinaquillo, Estado Cojedes. A cada paciente le fue tomada muestra endocervical y se le hizo el estudio pertinentes para chlamydia trachomatis, por el método enzimoinmunoensayo (Elisa), y para mycoplasma spp. por Mycoplasma-Lyo. Los resultados arrojaron un alto porcenaje de positividad (45,2 por ciento) en aquellas mujeres cuyas edades oscilaban entre 17 y 26 años, con tiempo de DIU de 0-3 años, siendo el Uréaplasma urealyticum el género que más se aisló. En relación a Chlamydia trachomatis,nuestros resultados se ajustan a los reportados por otros autores, aunque nuestra muestra fue relativamente pequeña

Traitement des leucorrhees [actualites therapeutiques]

The leucorrhea is a frequent gynecological symptom. The clinical diagnose is easy, but the bacteriological one is the most important. and with the simples techniques. The treatement depends on the etiology and most include the part- we so as to ovoid the transmission of veneral disease. In fait the Ieucorrhea can be a signal of a S.T.D. The treatment is obligatory to the partner for the control of spread of S.T.D

Prevalencia de los agentes etiologicos de la vaginitis y la cervicitis en pacientes de consulta ginecologica general / Prevalence of etiologic agents of vaginitis and cervicitis in patients of general gynecologic clinic

Con el fin de determinar la prevalencia de los agentes etiologicos de la vaginitis y la cervicitis, estudiamos un grupo de 354 pacientes sintomaticas y asintomaticas. En la vagina la Gardnerella vaginalis fue el agente etiologico hallado con mas frecuencia en las sintomaticas 20%, aunque tambien se aislo en 7% de las asintomaticas; de los hallazgos para clínicos para su diagnostico, las celulas guia estuvieron presentes en 84% de las pacientes y su valor predictivo positivo due de 100%. La candida sp y la trichomonas vaginalis se aislaron en porcentajes de 13% y 2%. En el cervix, en los dos grupos se evidencio, con la tecnica del cultivo en celulas McCoy, una prevalencia de infeccion por Chlamydia trachomatis de 25% y de 21%. De los examenes clinicos, la fiabilidad del endocervix fue lo que permitio una mayor orientacion diagnostica. No fue posible establecer una relacion de infeccion por C. trachomatis y metodo anticonceptivo. El tratamiento especifico para la infeccion por C. trachomatis no habia sido suministrado a ninguna de las pacientes sintomaticas y demostro ser eficaz en las pacientes infectadas. Nuestros datos senalan una alta prevalencia de infeccion por C. trachomatis, constituyendose posiblemente en una de las mas importantes enfermedades de transmision sexual en nuestro medio

Estudo comparativo da incidência de Gardnerella vaginalis em usuárias de dispositivos intra-uterinos e anticoncepcionais orais / Comparative study of the incidence of Gardnerella vaginalis in users of IUD and oral contraceptives

Foi realizado estudo comparativo entre os achado colpocitológicos de células indicadoras de Gardnerella vaginalis em usuárias do dispositivo intra-uterino e anticoncepcional oral. Foi verificada incidência significativamente aumentada do microrganismo entre as usuárias do DIU, que apresentaram ainda maior ocorrência de células displásicas

Enfermedades de transmisión sexual / Sexual transmitted diseases

Las enfermedades de transmisión sexual son muy frecuentes en la mujer y sus manifestaciones clínicas son variadas dependiendo de sus agentes etiológicos, de su localización en el aparato genital y de la existencia o no de embarazo. La leucorrea es la expresión clínica no solo de vulvitis y vaginitis sino también de cervicitis y endocervicitis las que pueden constituir un reservorio de gérmenes y el punto de partida eventuales procesos inflamatorios pelvianos. Las enfermedades de transmisión sexual son causantes potenciales de esterilidad, infertilidad, infecciones puerperales así como del feto o del recién nacido. Pueden ser además uno de los factores que intervienen en la patogenia del cáncer cervicouterino. Desde el punto de vista epidemiológico es importante destacar el rol de la precocidad del inicio de las relaciones sexuales y de la promiscuidad. En el aspecto clínico conviene recalcar la necessidad de diferenciar las vulvoginitis de la cervicitis y la importancia del estudio microbiológico que permita identificar el o los agentes etiológicas que intervienen en cada caso. En cuanto a tratamiento debe enfatizarse la necesidad de asociar la terapia local a la sistémica, lo que es imperativo en las cervicitis, así como también la de tratar la pareja. Los principales agentes de enfermedades de transmisión sexual son: Gardnerella vaginalis; Candida albicans; Trichomona vaginalis, Neisseria gonorrhoeae, Chlamidia trachomatis; Mycoplasma himinis; Ureaplasma urealyticum, virus Herpex simplex, etc. Todos ellos pueden actuar aisladamente o en asociaciones que son frecuentes

Infecçöes por Clamídia / Chlamydia infections

Faz-se uma revisäo atualizada sobre a infecçöes do trato genital-feminino, causados por Chlamydia tracomatis, sendo considerada uma infecçäo sexualmente transmíssivel e de incidência cada vez maior nos países desenvolvidos. Relatam-se dados de transmissäo, quadro clínico e tratamento. A infecçäo clamídica da cérvix uterina (cervical) é a origem da contaminaçäo no homem e no neonato, assim como das complicaçöes na própria mulher portadora. Devido à cervicite clamídica ser freqüentemente assintomática, o diagnóstico e tratamento desta condiçäo säo importantes para o controle destas infecçöes na comunidade