某院妇产科住院患者的无乳链球菌感染情况及耐药性研究

目的研究本院产科、妇科住院患者中的无乳链球菌感染情况,尤其在首胎产妇和二胎产妇中的无乳链球菌感染情况,并对培养出的阳性菌株进行药敏试验,了解其耐药情况。方法将阴道拭子标本接种于血平板上,用Vitek2compact全自动细菌鉴定及药敏分析系统对异常菌落进行鉴定,并对培养出的无乳链球菌进行药敏分析。结果培养产科孕妇阴道拭子标本共730份,其中无乳链球菌培养阳性为12例,阳性率为1.64%;培养妇科患者阴道拭子标本共583份,其中无乳链球菌培养阳性为6例,阳性率为1.03%。首胎孕妇为505例,无乳链球菌培养阳性为8例,阳性率1.59%;二胎孕妇为227例,无乳链球菌培养阳性为4例,阳性率1.76%。首胎孕妇与二胎孕妇的无乳链球菌感染率进行比较,差异无统计学意义(P0.05)。所有无乳链球菌阳性菌株对头孢菌素类抗菌药物有较高的敏感性,未出现头孢哌酮、头孢呋辛钠、头孢曲松的耐药菌株,敏感率为100%。无乳链球菌阳性菌株对环丙沙星和左旋氧氟沙星的耐药率较高,分别为38.89%、27.78%。结论产科患者的无乳链球菌感染率较妇科患者的高,临床上仍需加强对孕产妇的无乳链球菌感染监测。无乳链球菌培养阳性的菌株对头孢菌素类抗菌药物有较高敏感性,对喹诺酮类抗菌药物有较高的耐药性。     

孕妇静脉血麻疹IgG抗体水平的影响因素研究

目的研究不同年龄、麻疹病史及麻疹疫苗接种史对孕妇静脉血麻疹病毒(MV)IgG抗体水平的影响,为预测母传抗体对其婴幼儿的保护作用提供科学的理论依据。方法选取2013年2月至2015年2月来广东省深圳市福田区妇幼保健院产科分娩,且符合纳入排除标准的217例孕妇作为研究对象,采用酶联免疫吸附试验(ELISA)定量检测孕妇静脉血中MV IgG抗体水平。结果不同年龄组之间的麻疹IgG抗体几何平均浓度(GMC)均高于阳性值同时均低于有效保护值,且差异均无统计学意义(P0.05);不同年龄组之间的MV IgG抗体的阳性率与保护率经比较差异均无统计学意义(P0.05)。有MV疫苗接种史的孕妇其血清MV IgG抗体的GMC明显低于有MV病史的孕妇其血清MV IgG抗体的GMC,且两组GMC差异有统计学意义(P0.05);MV疫苗接种史组的保护率(37.9%)明显低于MV病史组的保护率(85.7%),且差异具有统计学意义(P0.05);其余指标检测差异均无统计学意义(P0.05)。结论年龄对孕妇体内MV IgG抗体无显著影响;不论是具有麻疹病史或麻疹疫苗接种史,其孕妇静脉血麻疹IgG抗体GMC对婴儿的保护率低,建议育龄妇女孕前再次接种麻疹疫苗。     

甲状腺疾病孕妇尿碘及超氧化物歧化酶与妊娠结局的关系

目的分析甲状腺疾病孕妇尿碘、超氧化物歧化酶(SOD)及甲状腺激素的关系,探讨甲状腺疾病与氧化应激的关系,为甲状腺疾病孕妇预防不良妊娠结局提供依据。方法随机选取禅城区中心医院门诊产检孕妇450例,其中疾病组300例、对照组150例,分别抽取静脉血5mL及随机收集一次晨尿。采用电化学发光法检测甲状腺激素及甲状腺自身抗体,采用碘催化砷铈反应检测尿碘,采用邻苯三酚自氧化法检测SOD浓度。结果450例研究对象结果分析发现,对照组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)及SOD浓度明显高于疾病组,两者差异有统计学意义(P0.05);碘适量组SOD浓度明显高于碘异常组,两者比较差异有统计学意义(P0.05);甲状腺疾病孕妇不良妊娠结局明显高于对照组,两者比较差异有统计学意义(P0.05);不良妊娠结局孕妇SOD浓度明显低于正常者,两者比较差异有统计学意义(P0.05)。结论甲状腺疾病孕妇尿碘、SOD及甲状腺疾病三者之间具有密切关系,及时处理甲状腺疾病与氧化应激反应对预防甲状腺疾病孕妇不良妊娠的发生具有重要意义。     

甲状腺疾病孕妇尿碘、SOD与甲状腺激素的关系及对妊娠结局的影响

目的研究甲状腺疾病孕妇尿碘、超氧化物歧化酶及甲状腺激素的关系,探讨甲状腺疾病与氧化应激的关系,为预防甲状腺疾病孕妇不良妊娠提供依据。方法随机选取佛山市禅城区中心医院门诊产检孕妇450例,其中疾病组300例、对照组150例,分别抽取静脉血5mL并随机收集1次晨尿。采用电化学发光法检测甲状腺激素及甲状腺自身抗体,采用碘催化砷铈反应原理检测尿碘,采用邻苯三酚自氧化法检测超氧化物歧化酶活力。结果对照组超氧化物歧化酶水平显著高于疾病组,差异有统计学意义(P0.05);碘充足组超氧化物歧化酶水平显著高于碘异常组,差异有统计学意义(P0.05);甲状腺疾病孕妇不良妊娠结局显著高于对照组,差异有统计学意义(P0.05)。结论甲状腺疾病孕妇尿碘、超氧化物歧化酶及甲状腺激素间具有密切关系,及时处理甲状腺疾病与氧化应激反应,对预防甲状腺疾病孕妇不良妊娠的发生具有重要意义。     

Stigma in HIV-Positive Women

PURPOSE: To present a metasynthesis of qualitative findings on stigma in HIV-positive women. METHOD: Metasummary and metasynthesis techniques were used to integrate findings on stigma in 93 reports of qualitative studies conducted between 1991 and 2002 with a total of 1,780 women, mostly from minority groups. FINDINGS: Both perceived and enacted stigma were pervasive in the lives of HIV-positive women. HIV-related stigma was intensified in women because they were women. Stigma management largely involved efforts to control information in the service of preserving social relations and maintaining moral identity. DISCUSSION: This metasynthesis reprises and clarifies the connections between recurring themes in primary quantitative studies and metastudies of HIV-positive people and of stigmatizing diseases and conditions. This work also shows how affected people's location on key axes of difference can both facilitate and complicate efforts to manage stigma. CONCLUSIONS: HIV-positive women experience stigmatization in relationships with others. HIV-related stigma is as much a reflection of these others as it is central to the experience of HIV-positive people themselves. Even those not infected with HIV are still affected by it and are thus appropriate targets for interventions to reduce its negative effects.     

Effects of experimental potassium depletion on renal function and urinary prostanoid excretion in normal women during moderate anti-diuresis

Summary. The hypothesis that potassium depletion (KD) might play a role in stimulating the renal synthesis of prostanoids, and that these materials can contribute to hypokalaemic renal dysfunction, has been tested. Healthy women were studied either in normal potassium balance (N, n= 14), or in experimental KD. KD was induced by low dietary potassium intake (10 mmol day^-1) and natriuretic treatment, associated with replacement of net NaCl and water loss. By using different depletive patterns, two groups with estimated cumulative potassium deficits of 160 ± 43 mmol (KD1, n= 8) and 198±22 mmol (KD2, n= 6), respectively, were obtained. Renal function by the clearance (cl.) method and urinary PGE₂, 6-keto-PGF_lä, TxB₂ concentrations by the RIA method were measured during hypotonic polyuria (oral water load) and subsequent moderate antidiuresis induced by the infusion of low-dose lysine-8-vasopressin (LVP). Compared to the N group, only in the KD2 group do glomerular and tubular dysfunctions typical of hypokalaemia and reduced prostanoid excretions (significant for 6-keto-PGF_lä and TxB₂ but not for PGE₂) appear during polyuria besides the significant reductions of plasma potassium concentration, urinary potassium excretion and the significant increase in plasma renin activity. During LVP infusion the urinary prostanoid excretions were all significantly lower in absence of significant differences in urinary flow rate. Concerning its renal effects, LVP lost its ability to reduce the creatinine cl., while expressing a trend towards reduction in fractional chloride excretion. Indomethacin pretreatment restored the LVP effect on creatinine cl. and increased the antichloruretic LVP effect (although not significantly). To the extent that urinary prostanoid excretions reflect their intrarenal synthesis, our data demonstrate that KD inhibits this biosynthesis. A depressed production of prostanoids endowed with vasodilating and chloruretic activity probably played a role in attenuating the renal vascular hyporeactivity and the urinary chloride dispersion induced by KD.     

Variables of the insulin resistance syndrome are associated with reduced arterial distensibility in healthy non-diabetic middle-aged women

Aims/hypothesis. The insulin resistance syndrome is related to arterial stiffness in diabetic subjects. Whether the insulin resistance syndrome is also related to arterial stiffness in non-diabetic subjects is less clear. We studied the association between variables of the insulin resistance syndrome in relation to arterial distensibility in healthy middle-aged non-diabetic women. Methods. This study was done in 180 non-diabetic women, aged 43–55, selected from the general population. Arterial distensibility was assessed in the carotid artery. The associations were evaluated using linear regression analyses. Results. Strong associations were found between arterial distensibility and the variables of the insulin resistance syndrome: body mass index, waist-to-hip ratio, high-density-lipoprotein-cholesterol, triglycerides, glucose, insulin, apolipoprotein A1, plasminogen activator inhibitor-1-antigen and tissue-type plasminogen activator-antigen. After additional adjustment for mean arterial pressure, common carotid arterial distensibility remained associated with body mass index: β-coefficient (95 % confidence interval) per kg/m²: –0.24 (–0.42; –0.06); waist-to-hip ratio: –26.62 (–40.59; –12.65) per m/m; triglycerides: –1.42(–2.77; –0.08) per mmol/l; plasminogen activator inhibitor–1-antigen: –0.01 (–0.02; –0.00) per ng/ml and borderline significant associated with high-density-lipoprotein-cholesterol: 1.93 (–0.01; 3.87; p = 0.07) per mmol/l. Clustering of variables of the insulin resistance syndrome was strongly related to decreased arterial distensibility which remained after adjustment for mean arterial pressure. No association was found between arterial distensibility and variables that are not part of the insulin resistance syndrome: total cholesterol, LDL-cholesterol and apolipoprotein B. Conclusion/interpretation. The results of this study show that variables of the insulin resistance syndrome are associated with decreased arterial distensibility of the common carotid artery in healthy non-diabetic subjects. [Diabetologia (2000) 43: 665–672] Received: 17 November 1999 and in revised form: 24 January 2000     

Alternative items for identifying hierarchical levels of physical disability by using physical performance tests in women aged 75 years and older

Aim: To identify individuals at hierarchical levels of physical disability by using physical performance tests and to determine threshold values for the discriminating of levels of physical disability in women aged 75 years or older. Methods: A cross‐sectional observational study was conducted on 306 community‐dwelling women aged 75 years or order (range, 75–99 years). Physical disability was categorized into no disability, mobility disability and activities of daily living (ADL) disability, by evaluating selected ADL and mobility‐related functional tasks. Physical function tests comprised nine items (such as strength, balance, mobility and walking ability). To assess the observed threshold values, receiver–operator curves were prepared for all the scales. Results: The results revealed significant differences among all the pairwise group comparisons in all the performance tests, except in the one‐legged stance, tandem stance and tandem walk tests. The individuals with ADL disability were unable to perform the one‐legged stance (28.9%), tandem stance (32.5%), functional reach (19.3%), tandem walk (61.4%), alternate step (53.0%) and 5‐chair sit‐to‐stand (31.3%) tests. The observed thresholds for discriminating between the no disability and mobility disability groups and between the mobility disability and ADL disability groups were as follows: timed Up & Go test, 8.5 s and 12.7 s; usual gait speed, 1.05 m/s and 0.79 m/s; and grip strength, 19.5 kg and 16.3 kg, respectively. Conclusion: Tests for balance and lower extremity strength can be used together to identify or monitor the characteristics of the hierarchical levels of physical disability in women aged 75 years or older. Geriatr Gerontol Int 2010; 10: 302–310.