Cytopathology of sexually transmitted disease

Although other methods exist for routine identification of most sexually transmitted diseases, the pathologist can often recognize the etiologic agents or their cytologic effects on Papanicolaou (Pap) smear. Useful clinical information requires both the ability to recognize these effects and knowledge of their limitations. Pap smear changes characteristic of Trichomonas vaginalis, Chlamydia trachomatis, herpes simplex virus, Gardnerella vaginalis, Candida sp., and human papillomavirus infections are described and their diagnostic accuracy evaluated.     

性传播疾病感染病原体检测分析

目的了解本地区性传播疾病（STD）中几种病原体的感染及药敏情况。方法淋球菌采用桂梅培养基培养法,沙眼衣原体采用单克隆抗体快速免疫法,支原体应用Mycoplasma IST试剂盒进行培养及药敏试验。结果887例检测标本中,病原体检测阳性者349例,检出率39．3％,其中单种病原体阳性者246例,占总阳性者的70．5％：混合阳性者103例,占29．5％。共检出各种病原体456株,药敏支原体较敏感药物有原始霉素、交沙霉素（Jos）、强力霉素（Dox）和氧氟沙星,分别为100％、94．4％、83．5％和73．9％。淋球菌（NG）对壮观霉素32例菌株全部敏感。结论解脲支原体、沙眼衣原体和淋球菌是性传播疾病的主要病原体,且混合感染不能忽视。对STD患者应尽可能做多种病原体检测和治疗。支原体和NG感染可旨选Jos、Dox和壮观霉索治疗。     

Improving care for patients with sexually transmitted infections in South Africa

AIM: To assess the quality of integrated sexually transmitted infection (STI) services in primary health care. METHOD: A two-page questionnaire, in collaboration with district health service supervisors, was developed to assess the quality of care and health services for STIs in individual clinics. RESULTS: The data suggest that the quality-assessment instrument used has the potential to promote the improvement of STI care delivery at district and clinic levels. CONCLUSION: The quality-assessment instrument proved easy to use, can be adapted to local requirements and is appropriate for use in developing countries. The authors maintain that using this instrument in various district clinics could help supervisors identify the main impediments to the delivery of high quality services, and give them a platform from which to set priorities in training, infrastructure, equipment and supplies.     

Guidelines to reduce sexually transmitted infections at primary health care centres--part 2

Sexually transmitted diseases are the second highest cause of death among women aged 15-44 years. The incidence and prevalence of sexually transmitted diseases is on the increase at many health care centres despite their dreadfulness and many preventative measures. According to the Scope of Practice of registered professional nurses working in a community health clinic, the registered professional nurse has a responsibility to prevent disease and promote health as well as do research. This paper aims to describe guidelines to reduce sexually transmitted infections at primary health care centres based on research done to investigate the community specific knowledge, attitudes and perceptions regarding sexually transmitted infections. Structured interviews were used to collect data from 1694 participants (males and females) who were consulted at a primary health care clinic in Mamelodi, Gauteng province. Existing patients' records were also utilised to calculate the incidence rate of sexually transmitted infections. Data were computerised and analysed quantitatively to reflect the results in frequencies and percentages as reported in Part 1 of this research. Guidelines to direct the practice of registered professional nurse were developed based on the findings of the results. These guidelines must underpin community specific interventions to reduce the incidence of sexually.     

Georgia prenatal care providers' perceptions of barriers to sexually transmitted disease screening

BACKGROUND: Evidence suggests that sexually transmitted disease (STD) screening during pregnancy is not optimal. No published studies have systematically examined barriers that hinder routine STD screening. This study examines prenatal care providers' perceptions about barriers to routine STD screening of pregnant women. METHODS: Using a conceptual framework, four a priori barrier categories were developed: provider, patient, organizational, and structural. Responses to a question on barriers to STD screening in a 1998 mail survey of Georgia prenatal care providers were qualitatively classified into one of these categories. RESULTS: Of the 293 providers who responded, 71% identified structural barriers, with 52% citing inadequate reimbursement. These respondents were most likely to name barriers categorized as structural, not patient, provider, or organization issues. CONCLUSION: Efforts to improve STD screening of pregnant women should include a focus on structural level interventions, such as instituting health care policies that provide adequate reimbursement for routine STD screening during pregnancy.     

Primary care management of sexually transmitted urethritis in adolescent males

PURPOSE: To describe current knowledge about diagnosis, screening, and treatment of sexually transmitted urethritis among adolescent and young adult males. DATA SOURCES: Current research, systematic reviews, consensus guidelines and the author's clinical experience. CONCLUSIONS: Urethritis, the most common sexually transmitted syndrome in young males, is most frequently caused by Chlamydia trachomatis and/or Neisseria gonorrhea. Symptoms include dysuria and penile discharge, although up to 50% of males are asymptomatic. Risky sexual behaviors and lack of access to healthcare increase incidence of this infection. Transmission to female partners can lead to pelvic inflammatory disease, infertility, and neonatal infection. IMPLICATIONS FOR PRACTICE: Young males with urethritis must be treated as soon as diagnosis is established. Consensus guidelines exist for diagnosis and treatment of gonococcal and non-gonococcal urethritis. Careful patient education is necessary to ensure successful treatment. Prevention of repeat infections requires partner treatment and detailed education about safer sexual practices. Improved access to preventive services for young males should be a healthcare priority.     

Care of the patient with a sexually transmitted disease

Practice profiles are reflective pieces written by nurses in practice and based on continuing professional development articles. This week Alison Woodland discusses sexually transmitted diseases. Article NS 2. Wright S (1999) Sexually transmitted diseases. Nursing Standard. 13, 46, 37-42.     

淮北地区性传播疾病感染情况调查分析

目的探讨安徽淮北地区的性传播疾病（STD）感染特征。方法对558例患者的淋病奈瑟菌（NG）、沙眼衣原体（CT）、解脲支原体（Uu）、快速血浆反应素环状卡片试验（RPR）、梅毒螺旋体抗体检测法（TPPA）检测结果进行分析。结果阳性检出率为：梅毒10.4%（58/558＞NG6.8%（38/558）＞CT5.4%（30/558）＞Uu3.4%（19/558）,梅毒感染占首位,Uu检出率偏低。结论淮北地区的STD感染情况符合我国沿海城市的特征,梅毒感染显著升高应引起重视。Uu检出率偏低,可能与试剂质量有关,应加强试剂的质量监控。     

浙江省三门县性病门诊男性患者艾滋病病毒感染和知晓率调查

目的了解性病门诊男性患者HIV感染情况以及相关知识知晓率。方法利用浙江省三门县2009-2013年艾滋病哨点监测中性病门诊男性就诊者人群调查和血清学检测数据进行分析,共调查1862人并采集血样1862份。结果性病门诊男性就诊者以在婚为主,占76.05%,年龄集中在20~49岁,占所有调查人数的87.17%;艾滋病知识总知晓率为75.94%,绝大多数就诊者未接受过相关的艾滋病预防服务;最近3个月与暗娼发生性行为的比例为61.38%,最近3个月与临时性伴性行为发生率为36.17%,"最近1年被诊断患性病"的比例为45.98%。2009-2013年不同年份之间与暗娼、临时性伴发生率以及曾患性病率差异均具有统计学意义(P0.001);HIV抗体检测共发现10名阳性感染者,2009-2013年阳性检出率呈逐年升高趋势,趋势检验显示差异有统计学意义(P0.05)。结论浙江省三门县性病门诊男性就诊者HIV抗体检出率呈逐年升高趋势,而该人群艾滋病相关知识知晓率较低,接受相关预防服务的比例偏低,与暗娼和临时性伴发生性行为的比例较高。疾病预防控制部门和医疗机构应相互配合,利用性病门诊在就诊者就医时提供高效的艾滋病预防知识宣传和干预服务。     

1460例男性患者性传播疾病病原体荧光定量聚合酶链反应检测分析

目的 了解宁夏某医院门诊男性患者淋球菌(NGH)、沙眼衣原体(CT)、解脲支原体(Uu)、单纯疱疹病毒(HSV-Ⅱ)、人乳头瘤病毒(HPV6,11)5种性传播疾病(STD)病原体的检出情况,为临床预防提供依据.方法 采用实时荧光定量聚合酶链反应法对1 460例患者进行NGH、CT、Uu、HSV-Ⅱ、HPV6,11病原体DNA定量检测.结果 STD病原体总阳性率为20.34%,HPV6,11、HSVⅡ、Uu、CT和NGH阳性率分别为69.57%、30.00%、24.21%、19.15%和6.32%;21～40岁年龄段患者占86.20%.结论 HPV6,11为男性STD的主要感染因素,应引起全社会的高度重视.     

Raising the awareness of primary care providers about postpartum depression

About 13% of women experience depression in the first year after childbirth. Postpartum depression has deleterious effects on the woman's relationships, her functional status, and her ability to care for her infant. Primary care providers have the most contact with postpartum women, but may be unable or unwilling to screen, treat, and/or refer the women. Thus, many women with postpartum depression are not receiving mental health services. The purpose of this article is to describe methods to raise the awareness of primary care providers about postpartum depression, thereby eliminating a major barrier to mental health treatments of postpartum women.     

女性性传播疾病的预防与相关影响因素

阐述了女性性传播疾病的流行及其危害和"三级预防"现状,从个人、家庭、社会文化方面分析了影响女性对性传播疾病自我预防的因素.目的在于调动个人、家庭、社会各方面支持力量共同预防女性性传播疾病.     

女性性传播疾病的预防与相关影响因素

阐述了女性性传播疾病的流行及其危害和“三级预防”现状,从个人、家庭、社会文化方面分析了影响女性对性传播疾病自我预防的因素。目的在于调动个人、家庭、社会各方面支持力量共同预防女性性传播疾病。     

健康教育路径在门诊性病患者中的应用

目的探讨健康教育路径在门诊性病患者中的应用效果。方法将246例门诊性病患者按病历号的单双号分为对照组和实验组,对照组采用常规健康教育,实验组采用健康教育路径。比较两组患者的健康教育效果、治疗依从性、疾病复发或再感染率。结果实施健康教育路径6个月后,实验组患者健康教育效果和治疗依从性均高于对照组(P0.01),疾病复发或再感染率低于对照组(P0.05)。结论应用健康教育路径可以提高患者的治疗依从性,降低疾病复发或再感染率,促进患者心身健康,从而达到预防控制性病传播的目的。     

The emergence of hepatitis B as a sexually transmitted disease

In the United States, approximately 300,000 cases of hepatitis B virus infection occur annually, and heterosexual activity is one of the most commonly reported risk factors for acquiring disease. Until the number of infections transmitted through heterosexual contact can be reduced through hepatitis B vaccination, there is little chance of controlling this infection.     

健康教育对性病患者知识及行为的影响研究

目的探讨健康教育对性病患者疾病相关知识掌握及安全性行为的影响。方法对7名专职宣教护士进行专业知识及技能培训,培训后护士在"悄悄话诊室"对362例患者进行一对一的性病相关知识教育、健康性行为指导、加强心理干预及随访等。结果干预后患者对疾病复发相关知识、危险因素、预防常识和严重后果的知识掌握率显著提高(P<0.01);性行为时每次使用安全套意愿从干预前的8.01%提高到干预后的51.66%,选择配偶的比例从15.19%提高到40.88%,选择固定性伴的比例从23.48%提高到33.98%,与交易性伴发生性关系的比例从31.49%降低至11.05%,干预前后比较,差异有统计学意义(P<0.01)。结论对性病患者实施健康教育,可有效提高性病患者对性病相关知识的认知,促进其高危行为的改变和安全套的使用。