复发性假丝酵母菌性外阴阴道炎与肠道假丝酵母菌感染的同源性研究

目的:探讨复发性假丝酵母菌性外阴阴道炎与肠道假丝酵母菌感染的同源性。方法:分别采集和鉴定假丝酵母菌性外阴阴道炎(VVC)和复发性假丝酵母菌性外阴阴道炎(RVVC)感染者阴道和肠道的菌株,采用PCR方法进行阴道和肠道菌株同源性分析。结果:203例患者中VVC组158人,RVVC组45人。共有66例患者经菌株鉴定为阴道和肠道同时感染假丝酵母菌,其中VVC患者21例(13.29%),RVVC患者45例(100%)(χ2=120.013,P<0.01);肠道和阴道标本同源性占94.44%。结论:复发性假丝酵母菌性外阴阴道炎与肠道假丝酵母菌感染之间关系密切。     

老年阴道炎症患者阴道假丝酵母菌和阴道毛滴虫感染状况分析

目的:通过对老年阴道炎症患者阴道分泌物的检测,了解老年阴道炎症患者阴道假丝酵母菌和阴道毛滴虫感染状况。方法:对19087例阴道炎症患者的阴道分泌物进行毛滴虫感染和假丝酵母菌感染检测,分析61～70岁组、71～80岁组和≥81岁不同年龄组的感染情况。结果:发现老年阴道炎症患者82例,占阴道炎症患者的0.43%(82/19087),其中检出假丝酵母菌18例,阴道毛滴虫1例,无假丝酵母菌和阴道毛滴虫双重感染,感染率分别为21.95%(18/82)、1.22%(1/82)和0,老年阴道炎症患者非细菌总体感染率为23.17%(19/82)。不同年龄老年阴道炎症患者假丝酵母菌感染率61～70岁组高于71～80岁组,71～80岁组高于≥81岁组,差异有统计学意义(P<0.05)及高度统计学意义(P<0.01)。结论:老年阴道炎症患者非细菌性感染主要病原体为假丝酵母菌,并且年龄低者感染率高于年长者。     

健康体检妇女阴道菌群状况及相关知识问卷调查分析

目的 了解健康体检妇女阴道菌群状况及其对下生殖道感染相关知识的认知度和个人卫生习惯、就医行为等特点.方法 对1660例健康体检妇女的阴道分泌物行常规镜检、pH值测定及细菌培养,并随机选择其中的875例进行问卷调查,内容涉及生殖道感染相关知识及个人卫生习惯和就医行为.结果 (1)阴道菌群状况:1660例健康体健妇女阴道pH值平均为4.16±0.21,阴道分泌物常规镜检假丝酵母菌的阳性率为3.86%(64/1660);细菌培养结果显示,需氧菌阳性率为7.71%(128/1660),其中自假丝酵母菌、光滑假丝酵母菌和克柔假丝酵母菌阳性率分别为78.9%(101/128)、7.8%(10/128)、7.0%(9/128).阴道菌群中以甲型溶血性链球菌为主,检出率达63.80%(1059/1660),其次是表皮葡萄球菌和粪肠球菌(D)群,检出率各达14.28%(237/1660)和11.44%(190/1660).(2)问卷调查结果:875份调查问卷中,收回合格调查问卷860份,其中88.4%(760/860)的妇女对生殖道感染有积极的认知,在感到不适时即自觉就诊;92.1%(792/860)的妇女有良好的卫生习惯;50.0%(430/860)的妇女渴望通过医院门诊咨询途径获得生殖健康知识.结论 外阴阴道假丝酵母菌感染居各类阴道炎之首,其中仍以白假丝酵母菌感染为主,其次是光滑假丝酵母菌和克柔假丝酵母菌.健康体检女性阴道菌群分布以甲型溶血性链球菌和表皮葡萄球菌等正常菌群为主,被调查妇女的卫生保健意识较强,医院门诊应加强对生殖道感染相关知识的宣传.     

外阴阴道假丝酵母菌病（ＶＶＣ）诊治规范修订稿

外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)曾称为霉菌性阴道炎、外阴阴道念珠菌病等,其病原菌是以白假丝酵母菌为主的酵母菌,其他如光滑假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌等占少数。1VVC的分类VVC分为单纯性VVC和复杂性VVC。     

外阴阴道假丝酵母菌病( VVC) 诊治规范修订稿

<正>外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)曾称为霉菌性阴道炎、外阴阴道念珠菌病等,其病原菌是以白假丝酵母菌为主的酵母菌,其他如光滑假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌等占少数。1VVC的分类VVC分为单纯性VVC和复杂性VVC。     

阴道微生态的形态学诊断

文章综述正常和异常阴道微生态的显微镜诊断方法,包括细菌性阴道病、需氧性阴道炎、溶细胞性阴道病、外阴阴道假丝酵母菌病和脱屑性炎性阴道炎的阴道涂片革兰染色显微镜特征、盐水湿片下线索细胞和10%氢氧化钾湿片下真菌孢子和假菌丝特征。     

两性霉素B阴道栓剂是治疗难治性非白色假丝酵母菌阴道炎的有效方法

在美国，假丝酵母菌阴道炎是发病率处于第二位的阴道炎症，每年约有1000万人发病。致病菌种包括白色假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌、光滑假丝酵母菌、克柔假丝酵母菌等。近几年，由非白色假丝酵母菌感染导致的阴道炎症比例正在不断升高，其引起的难治性非白色假丝酵母菌阴道炎也呈逐年增加趋势。作者介绍了两性霉素B阴道栓剂可以用作治疗难治性非白色假丝酵母菌阴道炎的有效方法。     

外阴阴道假丝酵母菌病致病菌株调查及药敏分析

目的探讨外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)致病菌株分布和药敏情况。方法对2003年12月至2005年12月,天津医科大学总医院、天津市中心妇产科医院及天津人民医院妇产科门诊390例有症状且真菌培养阳性的VVC患者进行菌株调查及药敏分析。结果VVC致病菌株白假丝酵母菌占94.4%(368/390),非白假丝酵母菌占5.6%,白假丝酵母菌菌株与非白假丝酵母菌菌株药敏无明显差异,氟康唑药物敏感率100%,VVC初发组与再发组菌株分布及药敏无差别。结论VVC致病菌株仍以白假丝酵母菌占优势。非白假丝酵母菌菌株对氟康唑耐药率无增加。     

外阴阴道假丝酵母菌病患者阴道局部免疫环境状态研究

外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）,也称外阴阴道念珠菌病,是一种由假丝酵母菌引起的机会性真菌感染,是常见的妇产科感染性疾病,约占微生物所致阴道炎的1/4～1/3.研究显示,VVC和复发性VVC（RVVC）的发生可能与局部免疫功能异常有关,但关于细胞免疫及体液免疫在抗假丝酵母菌感染中的作用还不明确,国外关于这方面的研究观点及结论不一,而国内关于此的研究甚少.     

抗白色假丝酵母菌IgY的应用研究

目的探讨抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染的治疗作用,及抗白色假丝酵母菌IgY泡腾片的安全性和对外阴阴道假丝酵母菌病的治疗效果。方法2001年5月至2003年5月于南昌大学医学院免疫学教研室应用抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染进行保护性研究;观察抗白色假丝酵母菌IgY泡腾片对新西兰兔的急性皮肤刺激试验、阴道局部黏膜刺激试验的结果及对外阴阴道假丝酵母菌病患者的临床效果。结果(1)小鼠阴道冲洗液白色假丝酵母菌培养结果(菌落数)抗白色假丝酵母菌IgY中剂量组与制霉菌素阳性对照组之间差异无显著性意义(0.3947±0.3265对0.3336±0.4634)。(2)新西兰兔试验部位皮肤、阴道黏膜及周围皮肤无红斑、水肿等,全身情况未见异常;阴道黏膜亦未见病理改变。(3)抗白色假丝酵母菌IgY泡腾片对外阴阴道假丝酵母菌病有效率88.9%,与硝酸咪康唑栓对照组(82.5%)比较差异无显著性意义。结论抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染有明显的保护作用;抗白色假丝酵母菌IgY泡腾片对皮肤、阴道黏膜无刺激作用;对外阴阴道假丝酵母菌病有很好的治疗效果。     

Recognition of and response to postpartum hemorrhage in rural northern India

This study describes the results of a Morbidity and Performance Assessment (MAP) conducted to provide insight into the medical factors contributing to maternal and newborn morbidity and mortality in a rural district of northern India, and to use these insights to develop a locally appropriate, community-based safe motherhood program The MAP study was based on verbal autopsy method. Five hundred ninety-nine women (or in the case of 9 maternal deaths, a family member) participated in the study. This article describes a subsample of women who reported signs or symptoms suggesting excessive bleeding (n = 159). Findings include a poor knowledge of danger signs; poor problem recognition during labor, birth, and the immediate postpartum period; and a low level of health seeking that was consistent with poor recognition. Maternal sociodemographic characteristics, antenatal care use, and knowledge of danger signs were generally not associated with problem recognition and health seeking. The case fatality rate was 4%. These findings suggest an urgent need to understand the phenomenon of problem recognition and to integrate this into the design of interventions to reduce delays in health seeking.     

Low postnatal care rates in two rural counties in Anhui Province, China: Perceptions of key stakeholders

Objective

to explore the perceptions of stakeholders on postnatal care and to describe the rate of postnatal home visits in two rural counties in Anhui Province, China.

Design

this was a mixed methods study which uses mainly qualitative methods including focus group discussions, in- depth interviews and key informant interviews. A household survey of postpartum women was used to calculate the rates of postnatal home visits.

Setting

two rural counties in Anhui Province, China.

Participants

qualitative study participants: officials responsible for maternal health care at county level, health providers at township and village level and maternal health-care users. Household survey participants: 2326 women who gave birth in the two counties from January 2005 to December 2006.

Findings

the survey of postpartum women revealed that only 4.2% and 4.5% of women received one or more postnatal visits at home in County A and County B. Qualitative interviews revealed a range of perceived reasons for this low rate of provision and utilisation of postnatal care, including: inadequate funding for maternal health care; limited human resources; lack of transport in township hospitals; and limited value placed on postnatal care by women and providers. In addition, where services were provided, a number of factors were likely to restrict health providers from delivering high-quality postnatal health service, such as: weak skills and knowledge of staff; inadequate in-service training; lack of equipment in township hospitals; and poor supervision and monitoring.

Key conclusions

the rate of postnatal visits was extremely low in two counties in rural China. Understaffing and inadequate funding are the main factors that affect provision of postnatal health care.

Implications for practice

more emphasis should be attached to political support and funding for postnatal care. Research into feasible ways to provide quality postnatal care needs to be conducted.     

The relation between vaginal pH and the microbiological status in vaginitis

The vaginal pH, microbial flora and presence of clue cells were investigated in 89 women who were seen at a sexually transmitted diseases clinic with a vaginal discharge or because they were contacts of men with gonococcal or non-gonococcal urethritis or because they were seeking a routine examination. None of the women had received antibiotics for at least 4 weeks before examination. A clinically normal vaginal secretion was found in 21 (55%) of 38 women who had a vaginal pH of 5.0-5.5, while such a secretion was found in only 7 (14%) of 51 women who had a pH value of 6.0-7.5. Clue cells, Chlamydia trachomatis and Mycoplasma hominis were found two to three times more often in women with the higher pH value than in those with the lower value and Ureaplasma urealyticum and Trichomonas vaginalis also occurred more frequently in the former group. Furthermore, large numbers of M. hominis organisms (greater than or equal to 10(6) colour changing units/ml) were associated significantly with the higher pH value. However, there was no appreciable difference in the distribution of Candida albicans between the two groups. C. trachomatis but not the other micro-organisms was isolated most often from women who were taking oral contraceptives. The results indicate that a pH of greater than or equal to 6.0 is strongly predictive of infection and may be more useful than the type of discharge in suggesting a need for confirmatory microbiological tests.     

The relation between vaginal pH and the microbiological status in vaginitis

Summary. The vaginal pH, microbial flora and presence of clue cells were investigated in 89 women who were seen a t a sexually transmitted diseases clinic with a vaginal discharge or because they were contacts of men with gonococcal or non-gonococcal urethritis or because they were seeking a routine examination. None of the women had received antibiotics for at least 4 weeks before examination. A clinically normal vaginal secretion was found in 21 (55%) of 38 women who had a vaginal pH of 5.0–5.5. while such a secretion was found in only 7 (14%) of 51 women who had a pH value of 6·0–7·5. Clue cells, Chlatmydia trachomatis and Mycoplasrna hominis were found two to three times more often in women with the higher pH value than in those with the lower value and Ureaplasma urealyticum and Trichomonas vaginalis also occurred more frequently in the former group. Furthermore. large numbers of M. hominis organisms ( 10⁶colour changing units/ml) were associated significantly with the higher pH value. However, there was no appreciable difference in the distribution of Candida albicans between the two groups. C. trachomatis but not the other micro-organisms was isolated most often from women who were taking oral contraceptives. The results indicate that a pH of 2.6.0 is strongly predictive of infection and may be more useful than the type of discharge in suggesting a need for confirmatory microbiological tests.     

Social costs of skilled attendance at birth in rural Ghana.

OBJECTIVE: To examine the social costs to women of skilled attendance at birth in rural Ghana. METHOD: Ethnographic data were obtained through participant observation, interviews, case histories, and focus groups and were analyzed alongside data from a birth cohort of 2878 singletons born in the Kintampo study district between July 2003 and June 2004. RESULTS: Most women delivered at home. Home delivery raises a woman's status in her community, while seeking skilled attendance lowers it. Women feel that seeking assistance in childbirth wastes other people's time and they value secrecy in labor. Negative treatment by health providers and expensive supplies needed for delivery also act as barriers. CONCLUSION: The social costs of obtaining skilled attendance at birth must be offset by community level strategies such as mobilization of older women and husbands, and ensuring health providers extend professional, humane care to laboring women.     

Postpartum Depression and Help‐Seeking Behavior

The objective of this analysis was to investigate the demographic differences between women who report postpartum depression symptoms (PPDS) and seek help versus those who report symptoms but who do not seek help, using data from the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) 2004 dataset. Overall, 14.7% of Utah women reported experiencing PPDS in 2004. Sixty percent of the women who reported having PPDS did not seek help Seeking help for depression during pregnancy was associated with help‐seeking behavior postpartum (adjusted odds ratio [aOR] = 0.1; 95% confidence interval [CI], 0.04–0.2). Other factors associated with seeking help included having an infant admitted to the intensive care unit (aOR = 0.4; 95% CI, 0.2–0.9) and rural residency (aOR = 0.3; 95% CI, 0.2–0.7). Nonwhite women were 12.1 times (95% CI, 3.0–48.5) more likely to not seek help for depression compared to white women. Further, Hispanic women (aOR = 3.2; 95% CI, 1.3–8.1) and women who experienced emotional abuse had increased odds of not seeking help (aOR = 2.9; 95% CI, 1.3–6.2). Nearly 15% of Utah women in this study reported PPDS, yet fewer than half sought help. Target populations, such as nonwhite, Hispanic, emotionally abused, and urban women, have been identified for public health interventions.     

已婚育龄妇女人工流产史及避孕知识态度和行为现况的相关研究

目的：了解育龄妇女的人工流产史及其原因和有关避孕的知识、态度和行为现状,探讨如何提高避孕知识知晓率和改善相关的态度和行为,以及降低非意愿妊娠率及人工流产率,提高育龄妇女的生殖健康水平。方法：对2012年1月至2013年5月在龙岗区龙城街道计生服务中心行人工流产术的510名已婚已育妇女进行有关人工流产和避孕知识、态度和行为的问卷调查,数据应用SPSS／PC10．0软件进行统计分析。结果：53．5％的妇女有人工流产史,其中人工流产3次及以上者达13．7％;未避孕者占32．6％,避孕失败者占46．8％,其中安全期避孕居首位,占避孕失败者的38．5％,其次放置IUD,占避孕失败者的48．2％。54．8％的人不知道任何一种避孕方法的避孕原理：有49．7％的妇女不知道人工流产手术对身体健康有不良影响;83．5％的人不知道有紧急避孕法。结论：迫切需要加强有关避孕知识的健康教育,并将其作为提供优质生殖健康服务的内容,促进合理有效避孕措施的安全使用,减少非意愿妊娠的发生,避免反复流产给育龄妇女身心带来的损害。     

Information–Seeking and its Predictors in Low-Income Pregnant Women

This study examined information‐seeking and its predictors (information needs and barriers) in low‐income pregnant women. Eighty‐four pregnant women from a prenatal clinic were interviewed using three scales that measured the frequency of information‐seeking from eight different sources, information needs for 20 pregnancy health topics, and 15 barriers to seeking information, respectively. Most women were black, unmarried, between 20 and 29 years of age, high school educated or less, multigravidas, and in their third trimester of pregnancy. Information needs and barriers were significant predictors of information‐seeking. Together, they explained 26% of the variance in the seeking outcome. High information needs and low barriers predicted more frequent information‐seeking. First pregnancy and asthma during pregnancy were significant covariates for information‐seeking. Information needs and barriers are related to information‐seeking among low‐income pregnant women. To facilitate pregnant women's information‐seeking, health care providers may assess a woman's need for information and barriers that the woman experiences when seeking information, and factors such as first pregnancy and asthma.     

Why Do Women Seek Antenatal Care Late? Perspectives From Rural South Africa

Despite the widespread availability of free antenatal care services, most women in rural South Africa attend their first antenatal clinic late in pregnancy and fail to return for any followup care, potentially leading to avoidable perinatal and maternal complications. Using interviews with pregnant women from the rural Hlabisa district of South Africa, we documented perceptions of health and health care during pregnancy and investigated factors shaping the utilization of antenatal care. Our findings indicate that most women in this setting do not perceive significant health threats during pregnancy, and in turn view more than one antenatal care visit as unnecessary. In contrast, women perceive labour and delivery as a time of significant health risks that require biomedical attention, and most women prefer to give birth in a health facility. This paradox, in which health care is important for childbirth but not during pregnancy, is embodied in most women's primary reason for seeking antenatal care in this setting: to receive an antenatal attendance card that is required to deliver at a health facility. Health education programs promoting antenatal care are required to explain the importance of effective antenatal care toward maternal and child health.