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Sparking and Sustaining the Essential Functions of Research
Published in Thomas S. Inui, Richard M. Frankel, Enhancing the Professional Culture of Academic Health Science Centers, 2022
Eric B. Larson, Christine Tachibana, Edward H. Wagner
For academic researchers, the connection to a learning health system such as Group Health provides a conduit to moving results into practice. A good example is the collaboration of Delia Scholes and her GHRI colleagues with Walter Stamm and his infectious disease group at UW. Among other accomplishments, in the 1990s this collaboration discovered the importance of Chlamydia as a cause of sexually transmitted disease, especially pelvic inflammatory disease, which can lead to infertility and other complications.33 This research is generally credited with forming the evidence base that changed national medical practice to make screening for Chlamydia routine for sexually active women.
Infectious Disease and Foreign Travel Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Females may present with vaginal discharge, vaginal pruritus, ulceration, warts, menstrual irregularities and abdominal pain. Pelvic inflammatory disease is commonly sexually acquired (see p. 325).
SBA Answers
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
B 15–19 yearsThe highest prevalence of Chlamydia trachomatis infection is in the age group 15–19 years in women followed by 20–24 years. (BASHH, 2018 United Kingdom National Guideline for the Management of Pelvic Inflammatory Disease)
Association between hysteroscopic features of chronic endometritis and pregnancy outcomes of patients after in vitro fertilization: a retrospective cohort study
Published in Journal of Obstetrics and Gynaecology, 2022
Hui Wang, Changhong Liu, Cuifang Hao
At present, many authors believe that pathological diagnosis is the gold standard for CE, but in recent years, some studies pointed out that pathological diagnosis does not reflect the state of inflammation adequately (Cicinelli 2005; Cicinelli et al. 2014, 2005, 2015, 2019; Levi Setti et al. 2004), which could represent a bias. In a randomised controlled trial (Kasius et al. 2011), histopathological CE did not affect the IVF outcomes. Haggerty et al. (2003) implied that histopathological CE showed no association with the incidence of reproductive disorders in patients with clinical pelvic inflammatory disease symptoms. In this study, a total of 92 CE women underwent endometrial biopsy in 429 fresh embryo transfer cycles, of which 50 were CD138 positive, with a positive rate of only 54.35%. Interestingly, the clinical pregnancy rate of CE patients with CD138-positive expression was higher than that of CE patients with CD138-negative expression, although the results showed no statistical difference, suggesting that there may be no significant correlation between CE diagnosed by histology and pregnancy outcome. These results implied that the histopathological diagnosis of CE could not tell us which patients need further treatment based on pregnancy outcomes (Park et al. 2016). On the contrary, the present study showed that the hysteroscopic features of CE were independently associated with CPR. In the future, microbiome studies of CE combined with hysteroscopy might eventually replace histopathological diagnosis as the gold-standard tool (Moreno et al. 2018).
Longitudinal change in serum inflammatory markers in women with tubo-ovarian abscess after successful surgical treatment: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2022
Koray Görkem Saçıntı, Yavuz Emre Şükür, Gizem Oruç, Batuhan Özmen, Murat Sönmezer, Bülent Berker, Cem Somer Atabekoğlu, Rusen Aytaç
A total of 168 patients were admitted to the hospital with pelvic inflammatory disease (PID). 14 patients were eliminated due to a diagnosis of pelvic malignancy, and the remaining 154 patients for the study, of which 61 (39.7%) had TOA and 93 (60.3%) had PID without TOA. 47 patients (30.5%) in the TOA group required surgical treatment due to medical therapy failure (Figure 1). The mean age of the 47 patients diagnosed with TOA was 49.8, and the clinical findings on admission included the presence of pelvic pain (48.9%), fever (27.6%), uterine tenderness (12.7%) on vaginal examination, and cervical discharge (4.2%). Variables of patients with TOA on linear mixed-effect regression with TOA are described in Table 1. Of these patients, laparotomy was performed in 29 (61.7%) patients, laparoscopy was performed in 18 (38.2%) patients; 13 (27.6%) underwent only abscess drainage, 16 (34.04%) underwent abscess drainage and salpingectomy, 15 (31.9%) underwent abscess drainage and hysterectomy, and three (6.3%) underwent other surgical operation. The preferred anti biotherapy protocols were cephalosporin and metronidazole in %51.1 (n = 24), gentamycin and clindamycin in %10.6 (n = 5), other penicillin groups drugs and metronidazole in %2.1 (n = 1), other antibiotic types including imipenem, meropenem, or teicoplanin in %36.16 (n = 17).
Chlamydia trachomatis: quest for an eye-opening vaccine breakthrough
Published in Expert Review of Vaccines, 2022
Vivek P Chavda, Anjali Pandya, Erica Kypreos, Vandana Patravale, Vasso Apostolopoulos
C. trachomatis is an obligate, gram-negative intracellular bacterium that causes disease in the eyes and genital tracts of humans [1] (Table 1). Infection of the genital tract occurs via sexual transmission and is a leading cause of pelvic inflammatory disease worldwide. In addition, repeated C. trachomatis infection may lead to tubal factor infertility and ectopic pregnancy in women [2]. Infection of the eyes leads to a disease known as trachoma, which is spread via direct and indirect contact with infected ocular and nasal discharge; trachoma often spreads via contaminated flies and bedding [3]. The disease is the leading cause of infectious blindness worldwide and is characterized by repeated infection of the conjunctiva with particular C. trachomatis strains [4]. This repeated infection leads to scarring of the conjunctiva and trichiasis, the abrasive rubbing action of which may cause damage to the cornea and, eventually, blindness [3,4].