1.  Peer Reviewed Title: Cervical obstruction complicating second-trimester abortion: treatment with misoprostol. Author: Borgatta L; Sayegh R; Betstadt SJ; Stubblefield PG Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):548-50. Abstract: BACKGROUND: Cervical cone biopsy or loop electrosurgical excision procedures (LEEP) may lead to cervical scarring, agglutination, or stenosis. Leiomyomas may also obstruct the lower uterine segment such that instruments cannot be passed from the vagina to the gestation. CASE: Two women requested second trimester abortion. Both women had undergone cervical LEEP. In addition, one woman had a 10-cm leiomyoma, which seemed to be obstructing the lower segment. In both, the external cervical os was essentially obliterated. After administration of misoprostol, the cervix softened markedly in 18-24 hours. In both women, the cervix dilated readily and allowed dilation and evacuation of the uterus. CONCLUSION: Misoprostol resulted in the ability to evacuate the uterus vaginally, in a situation that might have otherwise resulted in hysterotomy. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | CERVICAL EFFECTS | CERVICAL LACERATION | GROWTH | TIME FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Diseases | Child Development | Population Dynamics Document Number: 330357 Notification |
| 2. Title: Prevalence of Chlamydia trachomatis among women attending gynecology and infertility clinics in Gaza, Palestine. Author: El Qouqa IA; Shubair ME; Al Jarousha AM; Sharif FA Source: International Journal of Infectious Diseases. 2009 May;13(3):334-41. Abstract: BACKGROUND: Chlamydia trachomatis is an obligate intracellular bacterium characterized by a biphasic developmental cycle of replication. The organism is recognized as one of the major causes of sexually transmissible human bacterial infection throughout the world. Since there have been no previous studies dealing with chlamydial diagnosis in Palestine, this study was conducted to determine the prevalence of C. trachomatis infection among women attending gynecology and infertility clinics. METHODS: Endocervical swabs were collected from 109 women, aged 18-52 years (median 29 years), attending gynecology and infertility clinics in Gaza. These specimens were processed using molecular (polymerase chain reaction, PCR) and enzyme immunoassay (EIA; IDEIA PCE Chlamydia) techniques. RESULTS: The results obtained show that the overall prevalence rate of C. trachomatis was 20.2%. The sensitivity was 73% for the EIA, 86% for the MOMP (major outer membrane protein gene)-based PCR, and 100% for the plasmid-based PCR. Meanwhile the specificity was 94% for the EIA, 98% for the plasmid-based PCR, and 100% for the MOMP-based PCR. In multivariate analysis, only cervical discharge was significantly associated with positivity for C. trachomatis (adjusted odds ratio 5.6, 95% confidence interval 2.0-15.5; p=0.001). CONCLUSIONS: The study revealed that a significant proportion of Palestinian women expressed evidence of exposure to C. trachomatis. Women with cervicitis are more likely to have been previously infected or exposed to Chlamydia infection. Furthermore, PCR proved to be superior and more efficient in the diagnosis of C. trachomatis than EIA. Language: English Keywords: GAZA | RESEARCH REPORT | CLINICAL RESEARCH | SAMPLING STUDIES | CLIENTS | WOMEN | CHLAMYDIA | PREVALENCE | INFERTILITY | CERVICAL EFFECTS | LABORATORY PROCEDURES | SIGNS AND SYMPTOMS | Middle East | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342115 |
| 3. Peer Reviewed Title: Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents. Author: Guimaraes EM; Guimaraes MD; Vieira MA; Bontempo NM; Seixas MS; Garcia MS; Daud LE; Cortes RL; Alves Mde F Source: BMC Medicine. 2009;7:8. Abstract: BACKGROUND: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiania, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS: A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS: The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | RISK ASSESSMENT | SEX BEHAVIOR | GYNECOLOGY | CERVICAL EFFECTS | PREVALENCE | CHLAMYDIA | GONORRHEA | SIGNS AND SYMPTOMS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Evaluation | Behavior | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 331079 |
| 4. Peer Reviewed Title: Cervical dilation in second-trimester abortion. Author: Hayes JL; Fox MC Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):171-8. Abstract: Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors such as gestational age and time allowed for preparation should be considered. Language: English Keywords: UNITED STATES OF AMERICA | MARYLAND | RESEARCH REPORT | CERVICAL DILATATION | RISK FACTORS | CERVICAL EFFECTS | BLEEDING | ABORTION | Developed Countries | North America | Americas | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning Document Number: 342247 Notification |
| 5. Peer Reviewed Title: Management of severe cervical stenosis after conization by detention of nylon threads tied up to intrauterine contraceptive device. Author: Nasu K; Narahara H Source: Archives of Gynecology and Obstetrics. 2009 Aug 12; Abstract: PURPOSE: To investigate the efficacy of the insertion of intrauterine contraceptive device (IUCD) tied up with nylon threads for the treatment of cervical stenosis after conization. METHODS: Dilatation of the cervical canal and insertion of IUCD tied up with nylon threads was performed in four patients with symptomatic cervical stenosis after conization. After three courses of regular menstruation, the IUCD with nylon threads was removed. RESULTS: Total relief of symptoms was achieved in all four patients without any management-related complications. There was no evidence of recurrent cervical stenosis at follow-up in any of the patients. CONCLUSIONS: Detention of nylon threads tied up to IUCD provides an easy and reliable conservative management technique for post-conization cervical stenosis. Language: English Keywords: JAPAN | SUMMARY REPORT | CASE HISTORIES | CLIENTS | CERVIX | MEDICAL PROCEDURES | GYNECOLOGY | HISTOLOGY | COMPLICATIONS | CERVICAL EFFECTS | SIGNS AND SYMPTOMS | TREATMENT | IUD | Asia, Eastern | Asia | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Contraceptive Methods | Contraception | Family Planning Document Number: 342488 |
| 6. Title: Prevalence and risk factors for human papillomavirus and cervical intraepithelial neoplasia among HIV-positive women at a tertiary level hospital in India. Author: Peedicayil A; Thiyagarajan K; Gnanamony M; Pulimood SA; Jeyaseelan V; Kannangai R; Lionel J; Abraham OC; Abraham P Source: Journal of Lower Genital Tract Disease. 2009 Jul;13(3):159-64. Abstract: OBJECTIVES: The hypothesis to be tested was that the prevalence of human papillomavirus (HPV) and cervical intraepithelial neoplasia would be significantly higher in HIV seropositive women as compared with seronegative controls. Secondary aims were to determine the risk factors for HPV and cervical intraepithelial neoplasia and the HPV types in HIV-positive women. MATERIALS AND METHODS: A cross-sectional study of women 18 to 49 years old was done. Seventy-five women who were HIV seropositive and 58 seronegative women, of whom 27 had HIV-positive partners, participated in the study. A Pap smear and a cervical swab for HPV were done. Women with Pap smear abnormality underwent colposcopy and large loop excision procedures if indicated. RESULTS: Ten (13.3%) HIV-positive women had high-grade squamous intraepithelial lesion as compared with 2 (3.4%) seronegative women (odds ratio [OR] 4.3; 95% CI = 0.9-41.7; p =.048). Among the HIV-positive women, 28 (37.3%) had high-risk HPV, whereas only 9 (15.5%) had high-risk HPV among seronegative women (OR 3.2; 95% CI = 1.3-8.3; p =.009). Among women who were positive for high-risk HPV, the HIV-positive women were significantly more likely to have more than 1 HPV type (OR 7.4; 95% CI = 1.4-43.7; p =.005). Women who had coitus at less than 18 years of age were more likely to have high-risk HPV infection (OR 2.9; 95% CI = 1.2-6.2; p =.013) even after controlling for HIV status. CONCLUSIONS: HIV-positive women have a higher risk for multiple HPV infections as compared with seronegative women. Behavioral factors dominate HIV in determining HPV infections and resultant cervical neoplasia. Language: English Keywords: INDIA | RESEARCH REPORT | CONTROL GROUPS | STATISTICAL REGRESSION | PERSONS LIVING WITH HIV/AIDS | WOMEN | HPV | PREVALENCE | RISK FACTORS | CERVICAL EFFECTS | NEOPLASMS | PAP SMEAR | Asia, Southern | Asia | Developing Countries | Research Methodology | Data Analysis | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Measurement | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342825 |
| 7. Peer Reviewed Title: Some minor female reproductive system disorders: findings in the Oxford-Family Planning Association contraceptive study. Author: Vessey M; Yeates D Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):105-10. Abstract: BACKGROUND: The Oxford-Family Planning Association (Oxford-FPA) contraceptive study has provided information on many serious diseases of the female reproductive tract. No information has been published about a number of common minor conditions. This report fills the gap with regard to uterine polyp, cervicitis, cervical erosion, and vaginitis and vulvitis. METHODS: The Oxford-FPA study includes 17 032 married women recruited at ages 25-39 years between 1968 and 1974 from clinics in England and Scotland. These women were followed up until mid-1994. Information collected during follow-up included details of contraceptive use, cervical smears taken at the clinic, pregnancies and hospital referrals. RESULTS: Oral contraceptive (OC) use was associated with a reduction in first hospital referral for uterine polyp and for vaginitis and vulvitis, which became more marked with increasing duration of use. There was a slightly increased rate of hospital referral for cervicitis in OC users. Referral for cervical erosion was markedly increased in current and recent OC users (rate ratio 2.1, 95% confidence interval 1.8-2.4). This increase in risk steadily declined after OC use was discontinued. First hospital referral for both uterine polyp and cervical erosion showed a highly significant negative association with numbers of cigarettes smoked per day. The explanation for these observations is unknown. CONCLUSIONS: It should be remembered that the OCs studied were mainly those used in the 1970s and 1980s and mostly contained 50 mug estrogen. On balance, the overall effect of OC use on the conditions considered was neutral or beneficial. The apparent protective effect of cigarette smoking against uterine polyp and cervical erosion, even if valid, counts as nothing against the overwhelming adverse effects of smoking on health. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | LONGITUDINAL STUDIES | WOMEN | CURRENTLY MARRIED | PREVALENCE | VAGINITIS | UTERUS | DISEASES | CERVICAL EFFECTS | REPRODUCTIVE TRACT INFECTIONS | CONTRACEPTIVE USAGE | PAP SMEAR | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Marital Status | Nuptiality | Measurement | Vaginal Abnormalities | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cervix | Infections | Contraception | Family Planning | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330947 |
| 8. Title: Mid-level health-care providers are a safe alternative to doctors for first-trimester abortions in developing countries. Author: World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction; World Health Organization [WHO]. Department of Reproductive Health and Research Source: Geneva, Switzerland, WHO, 2008. [2] p. (Social Science Research Policy Briefs) Abstract: In circumstances where the law permits termination of pregnancy, access to safe induced abortion may still be restricted by limited availability of trained health-care providers. In most countries where abortion is legal, only doctors are authorized to provide first-trimester abortions. To increase access to safe first-trimester abortion and conserve scarce health resources, some countries have trained nurses, midwives and mid-level health-care providers such as doctor assistants. These health-care providers are generally cost-effective and may work in areas where doctors are scarce, providing health services to underserved populations. Before this study, however, no comparative assessment of the safety of first-trimester abortion by type of provider had been conducted in developing countries. (excerpt) Language: English Keywords: VIETNAM | SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HEALTH PERSONNEL | PREGNANCY, FIRST TRIMESTER | ABORTION | SAFETY | BLEEDING | CERVICAL EFFECTS | PELVIC INFECTIONS | Developing Countries | Asia, Southeastern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Public Health | Signs and Symptoms | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections Document Number: 326305 Notification |
| 9. Peer Reviewed Title: Suppressive acyclovir therapy reduces HIV cervicovaginal shedding in HIV- and HSV-2-infected women, Chiang Rai, Thailand. Author: Dunne EF; Whitehead S; Sternberg M; Thepamnuay S; Leelawiwat W Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49(1):77-83. Abstract: BACKGROUND: Herpes simplex virus type 2 infection is important in the HIV epidemic and may contribute to increased HIV transmission. We evaluated the effect of suppressive acyclovir therapy on cervicovaginal HIV-1 shedding. METHODS: HIV-1- and herpes simplex virus type 2-coinfected women aged 18-49 years with CD4 counts >200 cells/microL were enrolled in a randomized crossover trial of suppressive acyclovir therapy (NCT00362596, http://www.clinicaltrials.gov). For each woman, monthly plasma and weekly cervicovaginal lavage specimens were collected; the mean of the monthly median cervicovaginal lavage HIV-1 viral load and plasma HIV-1 viral load was compared. RESULTS: Sixty-seven women were enrolled; at baseline, median CD4 count was 366 cells/microL, and median HIV-1 plasma viral load was 4.6 log10 copies/mL. The mean cervicovaginal lavage HIV-1 viral load was 1.9 (SD 0.8) log10 copies/mL during the acyclovir month and 2.2 (SD 0.7) log10 copies/mL during the placebo month (P < 0.0001); the mean decrease in HIV was 0.3 log10 copies/mL. The mean plasma HIV viral load during the acyclovir month (3.78 log10 copies/mL) was reduced compared with the placebo month (4.26 log10 copies/mL, P < 0.001). CONCLUSIONS: Acyclovir reduced HIV genital shedding and plasma viral load among HIV-1- and herpes simplex virus type 2-coinfected women. Further data from clinical trials will examine the effect of suppressive therapy on HIV transmission. Language: English Keywords: THAILAND | RESEARCH REPORT | CERVICAL EFFECTS | ANTIVIRAL DRUGS | HIV INFECTIONS | HERPES GENITALIS | Developing Countries | Asia, Southeastern | Asia | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 328260 |
| 10. Peer Reviewed Title: Impact of prolonged referral interval on colposcopic outcomes in women with moderate or severe dysplasia. Author: Fakokunde B; Selo-Ojeme D Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):245-247. Abstract: The objective was to ascertain the impact of long referral to first colposcopy interval on disease outcome in women with high-grade cervical smear tests. Data from 316 women categorized into Group 1 (seen 180 days after referral) and Group 2 (seen within 180 days of referral) were analyzed using 2 test with Yates correction. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. Women in Group 1 were less likely to need treatment (33.8% [25/74] vs 55.8% [135/242]; OR=0.45; 95% CI, 0.25-0.78; P=0.0004) and less likely to have high-grade disease (24.3% [18/74] vs 45.9% [111/242]); OR=0.37; 95% CI, 0.21-0.68; P=0.001) than women in Group 2. There was no significant difference between the groups in proportion of women with invasive disease. In women with high-grade smears the need for excisional treatment and the risk of invasive disease may be reduced by prolonged referral interval. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | DATA ANALYSIS | WOMEN | REFERRAL AND CONSULTATION | COLPOSCOPY | TIME FACTORS | CERVICAL CANCER | CERVICAL EFFECTS | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Cancer | Neoplasms | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 326854 |
| 11. Peer Reviewed Title: The effects of TCu-380A on cervicovaginal flora. Author: Kanat-Pektas M; Ozat M; Gungor T Source: Archives of Gynecology and Obstetrics. 2008 May;277(5):429-432. Abstract: This study aims to identify the alterations in cervicovaginal flora after insertion of TCu 380A which is a popular type of copper IUD. Among the women who visited the Department of Family Planning in our hospital during 1 month, 100 subjects who preferred IUDs for contraception and who had no history of local or systemic antibiotic use were considered eligible candidates. Anaerobic colonies, especially Gram-positive cocci and Gram-negative bacilli were isolated at significantly higher rates after the insertion of TCu-380A. Aerobic colonies were isolated relatively less. It can be suggested that copper IUD causes the predominance of anaerobic species in the cervicovaginal flora, which is consistent with the literature. This clinically insignificant condition can be attributed to the copper content or threads of the IUDs. Yet there is no evidence that the prevalance of pelvic infections is influenced by the use of IUDs. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | IUD, COPPER RELEASING | IUD SIDE EFFECTS | VAGINAL ABNORMALITIES | CERVICAL EFFECTS | PELVIC INFECTIONS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | IUD | Contraceptive Methods | Contraception | Family Planning | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections Document Number: 326106 |
| 12. Title: A model of the differentiation and relative incidence of glandular versus squamous cell neoplasia of the uterine cervix: connection between incidence and etiology. Author: Leppaluoto PA Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(8):800-3. Abstract: It has remained unclear why cervical adenocarcinoma, as observed in consecutive screening, has rapidly increased during the past decades, while at the same time both that of squamous cell carcinoma (SCC) and the combined toll of adeno- and SCC have consistently decreased. Here it is argued that this might be ascribed to coitus-related changes in the cervicovaginal milieu, where the target cells become infected through a coital act. Frequent alterations in vaginal acidity and changing sexual habits in the era after the oral contraceptive pills and even after the introduction of erectile dysfunction medication, contribute to the pathogenetic scene. Language: English Keywords: FINLAND | RESEARCH REPORT | INCIDENCE | SEXUAL INTERCOURSE | GENITAL EFFECTS, MALE | NEOPLASMS | CERVICAL EFFECTS | HPV | CONTRACEPTIVE USAGE | VAGINOSIS | Europe, Northern | Europe | Developed Countries | Measurement | Research Methodology | Reproduction | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Diseases | Cervix | Uterus | Genitalia, Female | Viral Diseases | Contraception | Family Planning | Vaginal Abnormalities Document Number: 328662 |
| 13. Title: Spontaneous perforated pyometra with an intrauterine device in menopause: a case report. Author: Li CH; Chang WC Source: Japanese Journal of Infectious Diseases. 2008 Nov;61(6):477-8. Abstract: Spontaneous perforation of the uterus is rare and only several cases have been reported in the English medical literature. Most of the patients had gynecological malignancy and almost all were associated with cervical occlusion. We report a case of diffuse peritonitis resulting from spontaneously perforated pyometra with an intrauterine device (IUD) inserted for more than two decades. This case differs from others in that the cervical canal was not occluded. In the absence of other possible causes of uterine perforation, the etiology in this case is mostly likely hemorrhagic necrosis related to the long-term IUD. Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | MENOPAUSE | UTERINE PERFORATION | IUD COMPLICATIONS | PERITONEAL DISEASES | CERVICAL EFFECTS | LONGTERM EFFECTS | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Perforations | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Time Factors | Population Dynamics | Demographic Factors | Population Document Number: 329813 |
| 14. Peer Reviewed Title: Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia. Author: Luciani S; Gonzales M; Munoz S; Jeronimo J; Robles S Source: International Journal of Gynecology and Obstetrics. 2008 May;101(2):172-177. Abstract: The objective was to assess the effectiveness of cryotherapy treatment delivered by general practitioners in primary care settings, as part of a screen-and-treat approach for cervical cancer prevention. Women aged between 25 and 49 years residing in San Martin, Peru, who were positive on visual inspection screening were treated, if eligible, with cryotherapy following biopsy. At 12 months post cryotherapy treatment the participants were evaluated for treatment effectiveness and examined by visual inspection and Papanicolaou test and, if positive, referred to a gynecologist for colposcopy and biopsy. Cryotherapy treatment was performed for 1398 women; of these, 531 (38%) had a histology result of cervical intraepithelial neoplasia (CIN). Cryotherapy effectively cured CIN in 418 (88%) women, including 49 (70%) women with a baseline diagnosis of CIN 3. Cryotherapy is an effective treatment for cervical precancerous lesions; it can easily be administered by general practitioners in primary care settings following visual inspection screening. (author's) Language: English Keywords: PERU | RESEARCH REPORT | CLINICAL RESEARCH | CERVICAL CANCER | CERVICAL EFFECTS | PREVENTION AND CONTROL | TREATMENT | PRIMARY HEALTH CARE | South America, Western | South America | Latin America | Americas | Developing Countries | Research Methodology | Cancer | Neoplasms | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325848 |
| 15. Peer Reviewed Title: Cervical dysplasia and cancer: Use of hormonal contraceptives in Jamaican women. Author: McFarlane-Anderson N; Bazuaye PE; Jackson MD; Smikle M; Fletcher HM Source: BMC Women's Health. 2008 May 30;8:9. Abstract: This study was conducted to determine whether use of hormonal contraceptives is associated with cervical dysplasia and cancer in a population where there is widespread use of hormonal contraception and the rates of cervical cancer remain high at 27.5/100,000. A case-control study was conducted among women visiting the colposcopy and gynaelogical clinics at a tertiary referral hospital. Two hundred and thirty six cases CIN I (72), II (59), III (54), cancer (51) and 102 controls, consented and were interviewed on use of contraceptives using a structured questionnaire. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of hormonal contraception in cases and controls and in low and high risk cases. Recruitment was carried out from 2001 -2002. Contraceptives used were: oral contraceptives - 35%, injections (depot medroxy progesterone acetate (Depo-provera) -10%, Intrauterine devices - 2%, combinations of these and tubal ligation - 30%. 23% reported use of 'other' methods, barrier contraceptives or no form of contraception. Barrier contraceptive use was not significantly different between cases and controls. Current and / or past exposure to hormonal contraceptives (HC) by use of the pill or injection, alone or in combination with other methods was significantly higher in the cases. In multivariate analysis with age and number of sexual partners as co-variates, use of hormonal contraception was associated both with disease, [OR, 1.92 (CI 1.11, 3.34; p = 0.02] and severity of the disease [OR, 2.22 (CI 1.05, 4.66) p = 0.036]. When parity and alcohol consumption were added to the model, hormonal contraception was no longer significant. The significant association with high risk disease was retained when the model was controlled for age and number of sexual partners. Depo-provera use (with age and number of sexual partners as covariates) was also associated with disease [OR, 2.43 (CI 1.39, 4.57), p = 0.006] and severity of disease [OR 2.51 (1.11, 5.64) p = 0.027]. With parity and alcohol added to this model, depo-provera use retained significance. Exposure to HC greater than 4years conferred more risk for disease and severity of disease. Hormonal contraception did confer some risk of dysplasia and women using HC should therefore be encouraged to do regular Pap smear screening. (author's) Language: English Keywords: JAMAICA | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | CONTRACEPTIVE AGENTS, ESTROGEN | CONTRACEPTIVE AGENTS, PROGESTIN | ORAL CONTRACEPTIVES | INJECTABLES | CERVICAL EFFECTS | CERVICAL CANCER | HPV | PAP SMEAR | Caribbean | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cancer | Neoplasms | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 326992 |
| 16. Title: Comparison of cervical os versus vaginal evidentiary findings during sexual assault exam. Author: Morgan JA Source: Journal of Emergency Nursing. 2008 Apr;34(2):102-105. Abstract: Evidence collection post sexual assault varies across the nation. The Ohio Department of Health has a standardized kit for evidence collection used during the forensic exams of sexual assault survivors. The protocol includes obtaining 4 swabs: 2 from the vaginal pooled fluid and 2 from the cervical area. The purpose is to determine if augmenting the state protocol with cervical os swabs and a comparison slide will improve evidentiary findings in adolescent and adult female rape survivors. A descriptive study of 30 months for sexual assault female survivors over the age of 13 treated at a level II emergency department by a trained sexual assault nurse examiner (SANE). The comparisons of cervical os specimens versus vaginal pool findings were analyzed by the Canton-Stark County Crime Laboratory (C-SCCL). Eighty-six cases were completed. After investigation, local law enforcement officials turned in 36 kits (42%) to be processed at the C-SCCL for the standard vaginal pool swabs and slide. The averageestimated time interval between assault and treatment time was 20.46 hours (range, 2.83 to 80.83 hours). The average age of the survivor was 23.7 years, (range, 15 to 48). Eight percent (3/36) had only cervical os semen evidentiary findings. Forty-four percent (16/36) had positive semen evidentiary findings in vaginal pool and cervical os. Successful convictions were aided by the cervical os research study, especially because vaginal pool evidence diminishes when collected after 24 hours, but may be present longer in the cervical os. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | WOMEN | SEXUAL ABUSE | RAPE | TIME FACTORS | EXAMINATIONS AND DIAGNOSES | VAGINA | CERVICAL EFFECTS | EMERGENCY SERVICES | TREATMENT | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cervix | Uterus Document Number: 326815 |
| 17. Peer Reviewed Title: Relation between vaginal and endocervical pH in patients undergoing cold-knife conization and hysterectomy. Author: Murta EF; Perfeito PB; Oliveira TM; Michelin MA; Maluf PJ Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):43-46. Abstract: This study aimed to investigate the influence of endocervical pH on vaginal pH, and also the changes in these pH values following hysterectomy and cold-knife conization. Vaginal pH is important for maintaining the equilibrium of the vaginal microflora. Two groups of women were studied: the first (n = 20, median age 45, range 33-50 years-old), before and after hysterectomy (without ovariectomy) for myomatosis; the second group (n = 18, median age 38.5, range 37-65 years-old), before and after cold-knife conization for cervical intraepithelial neoplasia (CIN) grade II or III. Four samples (before and 90 days after surgery) were collected from the women by means of swabs: (1) anterior vaginal fornix, (2) posterior vaginal fornix, (3) posterior wall of lower vagina, and (4) endocervix (except in cases after hysterectomy). The pH was measured using a digital pH-meter (Sentron). We observed that endocervical pH was less acidic than were all the vaginal locations measured, before both surgeries. After both surgeries, all vaginal pH measurements were higher, but without reaching statistical significance. Endocervical pH correlated with vaginal pH. We concluded that recent hysterectomy does not alter vaginal pH and that vaginal and endocervical pH values are related. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | CERVICAL EFFECTS | VAGINA | HYSTERECTOMY | SURGERY | MENOPAUSE | MENSTRUAL CYCLE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gynecologic Surgery | Urogenital Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Menstruation Document Number: 322614 |
| 18. Peer Reviewed Title: Baseline colposcopic findings in women entering studies on female vaginal products. Author: O'Neill E; Reeves MF; Creinin MD Source: Contraception. 2008 Aug;78(2):162-166. Abstract: Colposcopy is commonly used for genital tract assessment in safety studies on female-controlled vaginal products. However, findings that are considered "lesions" are present even without product use. We sought to categorize the type and frequency of lesions found on baseline colposcopy evaluation in healthy women to describe natural lower genital tract changes due to environmental factors. We reviewed demographic information and baseline colposcopic examination findings from subjects in 13 studies of vaginal products. All studies included an aim of identifying colposcopic changes as a means of monitoring safety of a vaginal product or device. Colposcopic evaluations were performed according to the WHO/CONRAD Manual for the Standardization of Colposcopy for the Evaluation of Vaginal Products. A total of 317 lesions were found on 569 baseline colposcopy evaluations, with 192 women (34%) having at least one lesion. The most commonly identified lesions were petechiae and erythema, accounting for 45% and 37% of lesions, respectively. Seventy-three percent of lesions were located on the cervix, whereas 15% of lesions were located on the vaginal wall or fornix. Lower genital tract colposcopic findings are common in healthy women. Such findings likely represent normal physiologic changes. Future research needs to address whether routine colposcopic examination is necessary in the evaluation of new vaginal products. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | COLPOSCOPY | VAGINAL ABNORMALITIES | CERVICAL EFFECTS | PRODUCT APPROVAL | RISK ASSESSMENT | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Legislation | Political Factors | Sociocultural Factors | Evaluation Document Number: 327970 |
19.  Peer Reviewed Title: Intracervical pge gel for cervical ripening and induction of labour. Author: Raza F; Majeed S Source: Pakistan Journal of Medical Sciences. 2008 Apr-Jun;24 Pt 1(2):241-245. Abstract: The objectives of the study were to evaluate the efficacy of interacervical gel as a cervical ripening agent in the unfavourable cervix. The changes in the Bishops score, onset of labour and its progress were secondary outcome measures. Fifty patients were enrolled in this prospective study conducted in Gynae "A" unit of Khyber Teaching Hospital, Peshawar from January to December 2004. Patients with singleton living fetus, cephalic presentation, gestational age of greater than 36 weeks completed were included. Half milligram (0.5mg) of prostaglandin E2 gel intracervical was used for intracervical application. The application was repeated after 6-12 hours if the Bishop score remained unfavourable i-e less than 5. The indications were postdates pregnancy (50%), PIH (18%), Diabetes Mellitus (18%) and Rh isoimmnization (6%). The success rate in terms of vaginal delivery was 82%. The lower segment caesarean section rate was 18%. The commonest indication for caesarean section was failure to progress. The complications side effects were minimal & the neonatal outcome was good. This study showed that intracervical application of prostaglandin E2 gel is effective, safe acceptable method for ripening of cervix in women with unfavourable cervix. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | CHILDBIRTH | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | CERVICAL EFFECTS | PREGNANCY OUTCOMES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Prostaglandins | Endocrine System | Physiology | Biology | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 327270 |
| 20. Peer Reviewed Title: Age at menarche is not an independent risk factor for high-risk human papillomavirus infections and cervical intraepithelial neoplasia. Author: Syrjanen K; Shabalova I; Petrovichev N; Kozachenko V; Zakharova T Source: International Journal of STD and AIDS. 2008 Jan;19(1):16-25. Abstract: Data are controversial as to the role of menarche age as a risk factor of high-risk human papillomavirus (HR-HPV) infections. The objective of this study was to analyse the risk estimates for age at menarche as determinant of cervical intraepithelial neoplasia (CIN) and HR-HPV infections. A cohort of 3187 women were stratified into three groups according to their age at menarche: (i) women less than 13 years of age; (ii) those between 13 and 14 years and (iii) women greater than 15 years of age. These groups were analysed for predictors of (a) HR-HPV, (b) high-grade CIN and (c) outcome of HR-HPV and cytological abnormalities during prospective follow-up. All the three groups had identical prevalence of HR-HPV, Papanicolaou smear abnormalities and CIN grades. In contrast to menarche age itself, the time from menarche to the first intercourse (TMI), to the first pregnancy (TMP) and to the first delivery (TMD) were all significant (P = 0.0001) predictors of HR-HPV (but not CIN2) in univariate analysis, but lost their significance in a multivariate model. Outcome of cervical disease and HR-HPV infection was unrelated to menarche age, the latter and the three intervals being not predictors of CIN2 in a multivariate model. In conclusion, age at menarche and the intervals between menarche and (i) onset of sexual activity, (ii) first pregnancy and iii) first delivery, are not independent predictors of HR-HPV infections and CIN2 in multivariate analysis. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | MENARCHE | FIRST INTERCOURSE | HPV | CERVICAL CANCER | CERVICAL EFFECTS | AGE FACTORS | TIME FACTORS | FIRST PREGNANCY INTERVALS | FIRST BIRTH INTERVALS | RISK FACTORS | Menstruation | Reproduction | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy Intervals | Fertility Measurements | Fertility | Birth Intervals Document Number: 324168 |
| 21. Peer Reviewed Title: Human papilloma virus-16 / 18 cervical infection among women attending a family medical clinic in Riyadh. Author: Al-Muammar T; Al-Ahdal MN; Hassan A; Kessie G; Dela Cruz DM Source: Annals of Saudi Medicine. 2007 Jan-Feb;27(1):1-5. Abstract: Prevalence information is lacking on human papillomavirus types 16 and 18 (HPV-16/18) infection in cervical tissues of women residing in Riyadh, Saudi Arabia. In addition, there are no observations on progression to cervical intraepithelial neoplasia (CIN). Pap smear and HPV-16/18 DNA detection by PCR followed by Southern blotting was performed on 120 subjects (Saudi and other Arab nationals) during routine gynecological examination. Some HPV-positive subjects were followed for 4 years, by Pap smear every 6 months and by HPV DNA detection at the end of 4 years. Overall HPV-16/18 prevalence was 31.6%. HPV-16 prevalence alone was 13.3%, HPV-16 as a mixed infection with HPV-18 was 15%, and all HPV-16 was 28.3%. HPV-18 alone was 3.3%, HPV-18 as a mixed infection with HPV-16 was 15%, and all HPV-18 was 18.3%. Ten subjects had cervical abnormalities with the Pap smear test, six of whom were HPV-16/18 positive, 1 with HPV-16, 1 with HPV-18, and 4 with a mixed infection of HPV-16/18. Of all 23 HPV-16/18-positive subjects, either as individual or mixed infection, followed for 4 years, 7 showed abnormal cytology, 6 at initial examination and 1 during follow-up. Of these 7, 6 reverted to normal without treatment and 1 was treated and became normal after 3 years. None of the subjects progressed to CIN-III. A high prevalence of HPV-16/18 was found, but with a low rate of progression to CIN. A significant association with abnormal cytology was found only in patients with HPV-16/18 mixed infection. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | HPV | CERVICAL EFFECTS | CERVICAL CANCER | PAP SMEAR | PREVALENCE | Developing Countries | Middle East | Research Methodology | Economic Development | Economic Factors | Viral Diseases | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cancer | Neoplasms | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 324450 |
| 22. Peer Reviewed Title: The influence of hormonal contraceptive use on HIV-1 transmission and disease progression. Author: Baeten JM; Lavreys L; Overbaugh J Source: Clinical Infectious Diseases. 2007 Aug;45(3):360-369. Abstract: Women account for nearly one-half of new human immunodeficiency virus type 1 (HIV-1) infections worldwide, including the majority of infections in Africa. Biological and epidemiological studies suggest that hormonal contraceptive use could influence susceptibility to HIV-1, as well as infectivity and disease progression for those who become infected. However, not all studies have shown this relationship, and many questions remain. Safe and effective contraceptive choices are essential for women with and at risk for HIV-1 infection. hormonal contraception may have biologically plausible and clinically important effects on susceptibility to HIV-1, infectiousness of HIV-1, and progression of HIV-1 disease, but the data are inconsistent, and many questions remain. Still, it is clear that hormonal contraceptives are not protective against HIV-1 infection, and potentially the most important public health message is that dual protection with condoms should be the goal for women using hormonal contraception. This emphasizes the necessity for cooperation between those working in the fields of reproductive health and prevention of STDs, as well as the needs for increased involvement of men in reproductive health and for novel prevention interventions for women. Policymakers and clinicians must carefully consider how to translate the available data into public health messages that will reach the countries hardest hit by HIV-1 infection and women who are at risk for or who are living with this disease. Acknowledgments Financial support. (excerpt) Language: English Keywords: GLOBAL | LITERATURE REVIEW | ORAL CONTRACEPTIVES | DEPO-PROVERA | HIV TRANSMISSION | EPIDEMIOLOGY | RISK FACTORS | CERVICAL EFFECTS | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | SEX BEHAVIOR | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | HIV Infections | Viral Diseases | Diseases | Public Health | Health | Biology | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Behavior Document Number: 313653 |
| 23. Title: Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: A meta-analysis. Author: de Sanjose S; Diaz M; Castellsague X; Clifford G; Bruni L Source: Lancet Infectious Diseases. 2007 Jul;7(7):453-459. Abstract: We set out to estimate the age and genotype-specific prevalence of cervical human papillomavirus (HPV) DNA in women with normal cervical cytology worldwide by meta-analysis of a systematic literature review. Reports on HPV prevalence published between January, 1995, and January, 2005, were retrieved. To be included, studies required information on cervical cytology, plus detailed descriptions of study populations, methods used to collect cervical samples, and assays used for HPV DNA detection and typing. Final analyses included 78 studies that could be separated into women with normal cytology, and of which subsets of 44 and 48 studies had data on age and type-specific HPV prevalence, respectively. Overall HPV prevalence in 157 879 women with normal cervical cytology was estimated to be 10.4% (95% CI 10.2-10.7). Corresponding estimates by region were Africa 22.1% (20.9-23.4), Central America and Mexico 20.4% (19.3-21.4), northern America 11.3% (10.6-12.1), Europe 8.1% (7.8-8.4), and Asia 8.0% (7.5-8.4). In all world regions, HPV prevalence was highest in women younger than 35 years of age, decreasing in women of older age. In Africa, the Americas, and Europe, a clear second peak of HPV prevalence was observed in women aged 45 years or older. On the basis of these estimates, around 291 million women worldwide are carriers of HPV DNA, of whom 32% are infected with HPV16 or HPV18, or both. The HPV types most commonly detected are similar to those most commonly described in pre-neoplastic and cancer cases, although the relative contribution of HPV16 and HPV18 is substantially lower in cytologically normal women. (author's) Language: English Keywords: GLOBAL | LITERATURE REVIEW | WOMEN | HPV | CERVICAL EFFECTS | PREVALENCE | GENETIC TECHNIQUES | LABORATORY EXAMINATIONS AND DIAGNOSES | GEOGRAPHIC FACTORS | AGE FACTORS | Demographic Factors | Population | Viral Diseases | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics Document Number: 318074 |
| 24. Peer Reviewed Title: Two cases of endocervical gonorrhoea and bartolin gland diseases. Author: Dezfulimaneh M Source: Pakistan Journal of Medical Sciences. 2007 Jan-Mar;23(1):135-136. Abstract: Gonorrhoea a sexually transmitted disease if left untreated can cause infertility apart from other disorders. We report two cases and feel that all pregnant women should be screened for gonorrhoea. Gonorrhoea is a sexually transmitted disease caused by Nisseria Gonorrhoea. Gonorrhoea can infect the cervix, urethra, rectum, anus and throat. Gonorrhoea is a curable STD but if left untreated can cause infertility, meningitis, septicaemia, Endocarditis, pericarditis, chronic pelvic pain in women. These infections are associated with increased risk for human immunodeficiency virus infection. In some patients genitourinary infection may result in dysuria and purulent discharge after a one to three week incubation period. Pus may be excreted from the urethra, Skene's ducts, or Bartholin's gland. In some studies, colonized pregnant patients have been reported to have an increased risk of preterm birth, premature rupture of membranes, puerperal infection and Gonococcal neonatal ophthalmia. A gram's stain of the purulent material from the genitourinary tract exudate can provide rapid identification of Nisseria Gonorrhoea. (excerpt) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | GONORRHEA | CERVICAL EFFECTS | INFERTILITY | SIGNS AND SYMPTOMS | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Economic Development | Economic Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproduction Document Number: 315608 |
| 25. Title: Progressive cervical length changes versus single cervical length measurement by transvaginal ultrasound for prediction of preterm delivery. Author: Dilek TU; Yazici G; Gurbuz A; Tasdelen B; Gulhan S Source: Gynecologic and Obstetric Investigation. 2007;64(4):175-179. Abstract: The objective was to evaluate cervical length changes as predictors of preterm delivery. Two hundred and fifty-seven pregnant women underwent transvaginal ultrasound examination at 16 and 24 weeks of gestation. Cervical length was measured and the difference between the 2 measurements was calculated. The sensitivity, specificity, positive predictive value and negative predictive value of cervical length and cervical length changes were calculated and these methods were compared by receiver-operating characteristic (ROC) curve analysis. Preterm delivery (before 37 weeks of gestation) occurred in 19 patients (7.4%). The mean cervical length was shorter in the preterm group, the area under the ROC curve for prediction of preterm delivery was 0.914, ultrasound had a sensitivity of 84.2% to predict preterm delivery with a false-positive rate of 18.5%, and the relative risk was 4.56 at the 34.3-mm cutoff value at 24 weeks of gestation. In contrast, a cervical length change on transvaginal ultrasound hada sensitivity of 73.3% to predict preterm delivery with a false-positive rate of 18.1%, and the relative risk was 4.08 at the 6.6-mm cutoff value. A single cervical length measurement obtained at 24 weeks of gestation can predict preterm delivery as accurately as cervical length change. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | ULTRASONICS | EXAMINATIONS AND DIAGNOSES | GESTATIONAL AGE | CERVICAL EFFECTS | MEASUREMENT | PREMATURE LABOR | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fetus | Pregnancy | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Pregnancy Outcomes Document Number: 322121 |
| 26. Peer Reviewed Title: Cervical cerclage for prevention of preterm birth in women with twin pregnancy. Author: Eskandar M; Shafiq H; Almushait MA; Sobande A; Bahar AM Source: International Journal of Gynecology and Obstetrics. 2007 Nov;99(2):110-112. Abstract: The objective was to compare the effect of elective cervical cerclage in women with twin pregnancy on gestational age at time of delivery. In a pragmatic fashion women in Abha Maternity Hospital, Saudi Arabia with twin gestations were allocated to receive either an elective cerclage (group I) or no cerclage (group II). Elective cerclage was performed at 12 to 14 weeks of gestation after sonographic examination of the fetus to confirm gestational age and exclude major congenital anomalies. In all cases, follow up of the pregnancy was continued until delivery. Of the 176 twin pregnancies included, cerclage was performed in 76 women, and no cerclage in 100 women. In Group I: 12 pregnancies ended in spontaneous miscarriage, 37 in preterm labor, and 27 women reached full term. There were a total of 106 live births in 62 women. In Group II: 8 women aborted, 44 women ended in preterm labor and 48 women reached full term. There were a total of 160 live births in 89 women. The gestational age at delivery ranged from 20 to 41 weeks. Multiple regression analysis did not show association between cerclage and time of delivery, although a trend was observed (P=0.056). Elective cerclage contributes little in prolongation of gestational age at the time of delivery in women with twin pregnancy, especially in women of high parity. Those with a previous history of preterm labor may be a subgroup that could benefit from elective cerclage. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | PREGNANT WOMEN | MULTIPLE BIRTH | GESTATIONAL AGE | CERVICAL EFFECTS | TREATMENT | RISK FACTORS | PREMATURE BIRTH | PREVENTION AND CONTROL | Developing Countries | Middle East | Clinical Research | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Reproduction | Fetus | Pregnancy | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Diseases Document Number: 321416 |
| 27. Peer Reviewed Title: Spontaneous viable pregnancies in cervical and rectal endometriosis: a report of two cases. Author: Ganesh AL; Chakravarty B Source: Fertility and Sterility. 2007 Mar;87(3):697.e1-697.e4. Abstract: The objective was to report two cases of advanced pelvic endometriosis, both with deep rectal involvement and one with extensive cervical involvement appearing like a carcinoma, where both patients achieved spontaneous pregnancy and delivered viable babies. Design: Case report. Setting: Institute of Reproductive Medicine. Patient(s): Two nulliparous patients, one with extensive cervical and rectal and other with deep rectal endometriosis and primary infertility. Intervention(s): Medical management. Main Outcome Measure(s): Description and treatment of two patients with advanced pelvic endometriosis and pregnancy. Result(s): Delivery of viable babies in both cases. Prolonged medical treatment may have helped to arrest the progression of the disease by restoring anatomic proximity leading to spontaneous pregnancy in both cases. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | ENDOMETRIOSIS | CERVICAL EFFECTS | TREATMENT | PREGNANCY, HIGH RISK | OBSTETRICAL SURGERY | PREGNANCY OUTCOMES | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Surgery Document Number: 313040 |
| 28. Title: Human papillomavirus (HPV) infections as risk factors for cytological and histological abnormalities in baseline PAP smear-negative women followed-up for 2 years in the LAMS study. Author: Gontijo RC; Derchain SF; Roteli-Martins C; Braganca JF; Sarian LO Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Aug;133(2):239-246. Abstract: The objective was to assess the role of HPV as determinant of the incident cytological abnormalities (SIL) and cervical lesions (CIN) during a 24-month follow-up of baseline PAP smear-negative subgroup of women included in the Latin American Screening study (LAMS). A group of 365 women with normal Pap smear and negative or positive high-risk Hybrid Capture II test were prospectively followed-up for 24 months at Campinas and Sao Paulo (Brazil). The incidence rate (IR) and risk ratio (RR and 95% CI) of developing cytological or histological abnormality during the follow-up was calculated for HPV-negative and HPV-positive women. During the 12-month follow-up, women HPV-positive at baseline had developed a significantly higher rate of incident LSIL (IR = 3.5%, RR = 1.4; 95% CI 1.1-1.7) and HSIL (IR = 0.7%, RR = 1.5; 95% CI 1.4-1.7) abnormality. For HSIL, the IR increased to 2.1% and the RR increased to 1.7 (95% CI 1.5-1.9) among those followed for 24 months. Similarly, women with positive HPV tests were at a higher risk of developing CIN 2-3 (IR = 2.6%, RR = 1.5; 95% CI 1.4-1.6) during the first 12 months of follow-up, and for those followed for 24 months, this RR increased further to 1.7 (95% CI 1.5-1.9) although the IR was 0.7%. Oncogenic HPV infections comprise a significant risk factor for incident cervical abnormalities, and HPV test is a useful adjunct to cytology in detecting the high-risk patients among baseline PAP smear-negative women. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | FOLLOW-UP STUDIES | WOMEN | HPV | RISK FACTORS | CERVICAL EFFECTS | LABORATORY EXAMINATIONS AND DIAGNOSES | SCREENING | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Biology | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 313718 |
| 29. Title: Thickness of the cervical epithelium of autopsied patients with acquired immunodeficiency syndrome. Author: Guimaraes JV; Salge AK; Penha DS; Murta EF; Saldanha JC Source: Annals of Diagnostic Pathology. 2007 Aug;11(4):258-261. Abstract: Several general pathologic processes that affect the uterine cervix have been described in Brazil and in the world. The aim of the current study was to evaluate morphometrically the cervical epithelium of autopsied patients with AIDS. This is a cross-sectional study of the cervix of 38 women autopsied from 1993 to 2003. We evaluated the cervix of women aged 20 to 40 years, 20 with AIDS (52.63%) and 18 without (47.37%). The inflammatory infiltrate found in the AIDS patients was more accentuated and predominantly composed of monocytes, which is characteristic of chronic inflammation. In addition, necrosis, fibrosis, and metaplasia were also more frequent in these patients. The cervical epithelium was considerably thinner in the AIDS patients. This hypotrophy occurred because of a significantly accentuated reduction in the number and surface area of cells (P < .01). There was still a significant correlation between the thickness of the epithelium and the nutritional status of AIDS patients. General pathologic processes, which affect the cervices of patients with AIDS, especially hypotrophy, could facilitate the penetration of other infectious agents. We suggest that the nutritional status of these patients and the adherence to antiretroviral therapy be routinely evaluated and the use of condoms stimulated even between HIV-positive partners to prevent possible increases in the viral load and reinfections that contribute to the aggravation of the disease. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | AUTOPSY | CERVICAL EFFECTS | CHRONIC DISEASES | INFECTIONS | AIDS | HIV INFECTIONS | NUTRITION INDEXES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Demographic Factors | Population | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | |