The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis.

BACKGROUND: There are few studies on coinfection with genital mycoplasmas and ureaplasmas in men with gonococcal urethritis (GU). The role of these species in postgonococcal urethritis (PGU) is poorly understood. Thus, we conducted a study to determine the prevalence of coinfection with genital mycoplasmas and ureaplasmas among men with GU and to assess the role of these pathogens in PGU. METHODS: Three hundred ninety men infected with culture-confirmed Neisseria gonorrhoeae participated in the study. Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum biovar 1, and Ureaplasma urealyticum biovar 2 in first-voided urine samples were detected by polymerase chain reaction-based assay at the patients' initial visits. PGU was judged to be present if the urethral smear was positive for polymorphonuclear leucocytes 7-14 days after treatment for gonorrhea. The association between each microorganism and PGU, measured by the odds ratio, was estimated by multivariate logistic regression analysis. RESULTS: C. trachomatis, M. genitalium, M. hominis, U. parvum biovar 1, and U. urealyticum biovar 2 were detected in 85 (21.8%), 16 (4.1%), 8 (2.1%), and 33 men (8.5%), respectively. In patients with chlamydia-negative GU, coinfection with M. genitalium was associated with a 14.54-fold greater risk of PGU (95% confidence interval, 2.91-72.74), and coinfection with U. urealyticum biovar 2 was associated with a 3.64-fold greater risk of PGU (95% confidence interval, 1.24-10.63). CONCLUSIONS: Coinfection with M. genitalium or U. ureaplasma biovar 2 in men with GU was significantly associated with PGU, independent of C. trachomatis. Men with GU should be treated presumptively with antibiotics that are active against C. trachomatis, M. genitalium, and U. urealyticum biovar 2.     

妊娠期高血糖患者代谢特征及妊娠结局分析

目的 研究妊娠期高血糖患者临床代谢特征及妊娠结局.方法 2005年8月至2006年12月来我院就诊的130例孕妇据75 g口服葡萄糖耐量试验结果 分为葡萄糖耐最正常组(NGT组,n=26)、匍萄糖耐量受损组(IGT组,n=42)及妊娠糖尿病组(GDM组,n=62).测定空腹血糖、空腹胰岛素、糖化血红蛋白(HbA1c)、血脂谱及C反应蛋白,计算孕前体重指数、高龄孕妇比率、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-B)和胰岛素敏感性指数(ISI),记录糖尿病家族史和妊娠不良结局.数据分析采用方差分析、卡方检验及Logistic回归分析.结果 GDM组、IGT组和NGT组空腹血糖[分别为(5.1±1.0)、(4.7±1.0)及(4.0±0.5)mmol/L]、空腹胰岛素[分别为(9±4)、(9±4)及(6±4)Mu/L]、HbAIc[分别为(5.67±0.76)%、(5.62±0.61)%及(4.03±0.27)%]、总胆固醇[分别为(5.5±1.3)、(5.1±1.2)及(4.2±1.1)mmol/L]、低密度脂蛋白胆固醇[分别为(3.1±1.0)、(2.8±0.8)及(2.3±0.8)mmol/L]、C反应蛋白(分别为2.7、3.8及1.8 mg/L)、HOMA-IR(分别为1.9、1.8及0.9)、孕前体重指数[分别为(24.4±4.0)、(24.3±2.8)及(22.2±2.8)kg/m2]、剖宫产率(分别为71.0%、52.4%、19.2%)、新生儿体重[分别为(3304±608)、(3345±463)及(2988±672)g]、孕妇并发症率(分别为69.4%、54.8%及23.1%)、新,丰儿并发症率(分别为29.0%、28.6%及3.8%)比较,GDM组和IGT组均高于NGT组,而GDM组及IGT组ISI(分别为0.023及0.024)均低于NGT组(0.052),差异有统计学意义(P<0.05).NGT组、IGT组和GDM组HOMA-B指数(分别为295.75、168.76及126.25)差异有统计学意义(F=11.932,P<0.05).GDM组糖尿病家族史阳性率(38.7%)高于NGT组(11.5%).Logistic回归分析显示,孕前体重指数、孕妇年龄和HbAIc是妊娠糖尿病妇女发生母儿并发症的危险因素.结论 重度胰岛素抵抗、胰岛β细胞分泌功能障碍、孕前体重指数过高、脂代谢异常、遗传易感性是妊娠期高血糖患者的主要代谢特征.孕前体重指数?     

HBV携带孕妇与正常孕妇雌激素水平及妊娠结局的对比性研究

目的　探讨HBV携带孕妇与正常孕妇雌激素水平及妊娠结局的差异,为临床HBV携带孕妇正常妊娠提供参考依据。方法　选取2015年1月—2018年1月本院收治的226例孕妇作为研究对象,将其中116例正常孕妇作为对照组,其余110例HBV携带孕妇作为观察组,检测2组体内雌激素水平,并分析对妊娠结局产生的影响。结果　观察组雌酮、雌二醇、雌三醇水平均显著高于对照组（P均＜0.05）。观察组胎儿窘迫、新生儿窒息、剖宫产及早产等妊娠结局的发生率均显著高于对照组,顺产率显著低于对照组（P均＜0.05）。观察组蛋白尿、尿WBC阳性、妊娠期高血压及产后出血等并发症的发生率均显著高于对照组（P均＜0.05）。Logistic多元回归分析结果显示,雌激素水平高、年龄大、携带HBV时间长、有既往治疗史、病毒载量高、ALT水平高均为妊娠不良结局的危险因素（P均＜0.05）。结论　HBV携带孕妇机体分泌的雌激素水平显著升高,进一步增加肝脏的负荷,导致肝功能出现明显异常,增加了妊娠不良结局及妊娠并发症的发生率,临床应加强对HBV携带孕妇相关指标检测,并做好相关并发症的预防。     

妊娠期肝内胆汁淤积症孕妇临床特点及妊娠结局分析

目的分析妊娠期肝内胆汁淤积症(ICP)孕妇临床特点及妊娠结局。方法回顾性分析2015-01~2016-01产科收治的135例ICP孕妇(观察组)和同期分娩的135例非ICP孕妇(对照组),比较两组孕妇临床生化指标和羊水污染率、早产率、胎儿窘迫发生率、围产儿病死率、剖宫产率及孕妇产后出血量。结果(1)观察组总胆汁酸(TBA)、总胆红素(TB)、直接胆红素(DB)、丙氨酸转氨酶(ALT)和门冬氨酸转氨酶(AST)表达水平均明显高于对照组,差异有统计学意义(P0.05);(2)观察组羊水污染率、早产率、胎儿窘迫发生率、围产儿病死率、剖宫产率及产后出血率均明显高于对照组,且产后出血量明显多于对照组,差异均有统计学意义(P0.05)。结论 ICP患者血清总胆汁酸水平明显升高,且妊娠结局常有明显不良预后,胎儿尤为明显,所以临床上应定时监测其TBA水平,及时予以相应治疗措施,减少或避免胎儿不良预后的发生,改善妊娠结局。     

不同青霉素治疗妊娠梅毒患者的妊娠不良结局及随诊情况

目的探讨普鲁卡因青霉素与苄星青霉素治疗妊娠梅毒患者的妊娠结局不良率及随诊率有无差异。方法收集2009年3月至2011年3月门诊159例妊娠梅毒患者,根据患者处理方式的不同,分组进行比较。结果 A组为普鲁卡因青霉素治疗组,有效病例53例,普鲁卡因青霉素80万单位肌肉注射,每日1次,连续15日;B组为苄星青霉素治疗组,有效病例75例,苄星青霉素240万单位肌肉注射,每周1次,连续3周;C组为未治疗组,有效病例9例,D组为快速血浆反应素环状卡片试验（RPR）及梅毒螺旋体血球凝集试验（TPHA）均阴性的正常孕妇159例。A、B、C、D组妊娠结局异常率分别为18.87%（10/53）、17.33%（13/75）、66.67%（6/9）、15.72%（25/159）,C、D组间,A、C组间,B、C组间差异均有统计学意义;A、D组间,B、D组间,A、B组间,差异均无统计学意义。A、B组随诊率分别为76.81%、92.59%,两组间随诊率差异有统计学意义。结论未治疗组妊娠梅毒的妊娠结局不良率远高于治疗组及正常孕妇组,治疗组的妊娠结局不良率与正常孕妇组无明显差异,且2种青霉素治疗组间无明显差异,但2治疗组间随诊率有差异。     

Hypertensive disorders of pregnancy associated with adverse pregnant outcomes in patients with systemic lupus erythematosus: a multicenter retrospective study

Clinical Rheumatology - Hypertension disorders in pregnancy (HDP) were common complications in women with systemic lupus erythematosus (SLE). However, the impact of HDP and the measures to prevent...     

Clinical features associated with pregnancy outcomes in women with positive antiphospholipid antibodies and previous adverse pregnancy outcomes: a real-world prospective study

Clinical Rheumatology - This study aims to analyze factors related to pregnancy outcomes in women with positive antiphospholipid antibodies and previous adverse pregnancy outcomes (APOs)...     

孕妇弓形虫感染妊娠结局及危险因素调查

目的 目的 了解孕妇感染弓形虫感染后的妊娠结局及其危险因素。 方法 方法 2010-2013年采用酶联免疫吸附试验 （ELISA） 对在涿州市妇幼保健院行孕前检查的2 740例孕期妇女进行弓形虫IgM和IgG抗体检测并追踪随访, 观察其妊娠 结局; 采用问卷调查孕妇弓形虫感染的危险因素。 结果 结果 2 740例被调查的孕期妇女中, 弓形虫抗体检测阳性195例, 抗体 阳性率为7.12%, 其中IgM抗体阳性44例 （占22.56%）, IgG抗体阳性151例 （占77.44%）。随访结果表明, 195例感染弓形虫 的孕妇中41例出现不良妊娠结局 （占21.02%）, 包括32例IgM抗体阳性孕妇 （占78.05%） 和9例IgG抗体阳性 （占21.95%）; 未感染弓形虫孕妇6例出现不良妊娠结局 （占2.86%）, 两者差异有统计学意义 （P ＜ 0.05）。问卷调查表明, 与动物密切接 触、 喜吃生肉、 喜吃火锅或烧烤、 品尝生肉馅等是孕妇感染弓形虫的重要危险因素 （与未感染组比较, P ＜0.01）。 结论 结论 孕 妇感染弓形虫可导致不良妊娠结局的发生, 养成良好的生活卫生习惯是避免不良妊娠结局的有效途径。     

Metabolic characteristics and adverse pregnancy outcomes for women with hyperglycaemia in pregnancy as a function of insulin resistance

Aim. Recent studies have shown that women with hyperglycaemia in pregnancy and insulin resistance have a greater risk of adverse pregnancy outcomes than women with normoglycaemic pregnancies. This study aimed to determine adverse pregnancy outcomes of women with hyperglycaemia in pregnancy only as a function of insulin resistance.Methods. From a prospective cohort study, we included 1,423 women with hyperglycaemia in pregnancy whose insulin resistance was evaluated using homoeostatic model assessment for insulin resistance (HOMA-IR) when care was first provided for this condition. We compared the adverse pregnancy outcomes for different tertiles of HOMA-IR (intertertile range 1.9 and 3.3).Results. Increasing HOMA-IR tertiles were positively associated with the rate of insulin therapy (tertile 1, 2 and 3: 32.7, 47.0 and 58.7%, P < 0.0001), caesarean section (23.7, 26.0 and 32.2%, respectively, P < 0.01), gestational hypertension (1.3, 2.8 and 5.4% respectively, P < 0.01), preeclampsia (1.5, 2.8 and 4.5% respectively, P < 0.05), large-for-gestational-age infant (13.3, 10.4 and 17.6% respectively, P < 0.05), and neonatal hypoglycaemia (0.8, 1.5 and 3.2% respectively, P < 0.05). Women in the 3rd HOMA-IR tertile were more likely to have insulin therapy (odds ratio 2.09 (95% interval confidence 1.61–2.71)), hypertensive disorders (2.26 (1.42–3.36)), and large-for-gestational-age infant (1.42 (1.01–1.99)) than those in the 1st and 2nd tertiles combined in multivariable logistic regression analyses adjusted for gestational age at HOMA-IR measurement, glycaemic status, age, body mass index, family history of diabetes, parity and ethnicity.Conclusion. Despite suitable care and increased rates of insulin therapy during pregnancy, higher insulin resistance in women with hyperglycaemia in pregnancy was associated with a greater risk of adverse pregnancy outcomes.     

Prevention,management and extent of adverse pregnancy outcomes in women with hereditary antithrombin deficiency

Antithrombin (AT) deficiency is a rare hereditary thrombophilia with a mean prevalence of 0.02 % in the general population, associated with a more than ten-fold increased risk of venous thromboembolism (VTE). Within this multicenter retrospective clinical analysis, female patients with inherited AT deficiency were evaluated concerning the type of inheritance and extent of AT deficiency, medical treatment during pregnancy and postpartally, VTE risk as well as maternal and neonatal outcome. Statistical analysis was performed with SPPS for Windows (19.0). A total of 18 pregnancies in 7 patients were evaluated, including 11 healthy newborns ≥37th gestational weeks (gw), one small for gestational age premature infant (25th gw), two late-pregnancy losses (21st and 28th gw) and four early miscarriages. Despite low molecular weight heparin (LMWH) administration, three VTE occurred during pregnancy and one postpartally. Several adverse pregnancy outcomes occurred including fetal and neonatal death, as well as severe maternal neurologic disorders occurred. Patients with substitution of AT during pregnancy in addition to LMWH showed the best maternal and neonatal outcome. Close monitoring with appropriate anticoagulant treatment including surveillance of AT levels might help to optimize maternal and fetal outcome in patients with hereditary AT deficiency.     

The role of Chlamydia trachomatis and Ureaplasma urealyticum in patients with acute epididymitis

1. Fifty-eight patients suffering from acute epididymitis were investigated to assess the etiologic role of Chlamydia trachomatis and Ureaplasma urealyticum. Sixteen (42.1%) of the thirty-eight patients without underlying diseases yielded C. trachomatis from the urethral swabs, but no bacteriuria (greater than or equal to 10(4) CFU/ml) was recovered. C. trachomatis was isolated from epididymal aspirates in 4 out of 10 patients in whom C. trachomatis was isolated from the urethral swabs. Of the twenty patients having underlying diseases, 11 men were associated with urinary tract infections, but C. trachomatis was not isolated from the urethral swabs from any of these patients. 2. The antibodies to C. trachomatis in 21 sera was determined by micro-immunofluorescence test. IgG antibodies to C. trachomatis were found in 88.9% (8/9) of the men with chlamydial infections and in 25% (3/12) of the men without chlamydial infections. IgM antibodies to C. trachomatis were not demonstrated in any case. 3. U. urealyticum was isolated from urethral swabs in 15 (25.9%) patients with acute epididymitis, but was not isolated from epididymal aspirates in any of the cases. In conclusion, C. trachomatis was regarded as the major pathogen in acute epididymitis, especially in patients without underlying diseases. But, the significance of U. urealyticum in acute epididymitis was not certain.     

Serologic studies of human genital mycoplasmas: distribution of titers of mycoplasmacidal antibody to Ureaplasma urealyticum and Mycoplasma hominis in pregnant women

Titers of mycoplasmacidal antibody to the human genital mycoplasmas Ureaplasma urealyticum and Mycoplasma hominis were determined using genital isolates from pregnant patients as antigens and comparing these isolates with the 11 prototypic reference strains for U. urealyticum and the seven reference strains for M. hominis. Virtually all titers that were detected with use of the patient's own isolates were detected by the 11 reference strains of U. urealyticum and by the seven reference strains of M. hominis. Serologic surveys of pregnant women who harbored either or both mycoplasmas in vaginal cultures indicated that antibody to M. hominis was found more commonly than antibody to U. urealyticum. It was demonstrated that significant postpartum rises in titers of antibody to M. hominis were correlated with the presence of these mycoplasmas in genital cultures. Postpartum rises in titer of antibody were particularly likely to occur in women with low titers of mycoplasmacidal antibody in serum at the time of delivery. Approximately 88% of the women who were colonized with M. hominis showed significant changes in titer of antibody to M. hominis throughout an apparently normal pregnancy; only 40% of the women who were colonized with U. urealyticum showed such changes in titers to U. urealyticum. Statistical analysis showed that mean log titers of antibody to both mycoplasmas at the first prenatal visit were significantly associated with the number of pregnancies experienced by these women.     

不孕患者解脲支原体和细菌性阴道感染治疗前后的检测研究

解脲支原体 (Ureaplasmaurealyticum ,简称Uu)是引起不孕症的重要病因 ,临床治疗疗程较长 ,在治疗后期经常发现患者并发细菌性阴道病 (bacterialvaginosis,简称BV) ,而治疗前阴道涂片没有检出线索细胞。为了探究是Uu感染治疗疗程长引起阴道菌群紊乱 ,导致BV ?还是早在治疗前患者阴道就潜伏BV的致病菌株 ?本研究对Uu感染的不孕患者作了治疗前后阴道线索细胞和阴道加德纳菌致病菌株基因 (G vag -DNA)检测和治疗前后的比较 ,现报道如下。1　对象和方法1 1　对象　 14 4例不孕患者系来自 2 0 0 2年 4月～ 2 0 0 3年 2月云南省第一人民医院…     

Risk factors for adverse pregnancy outcomes in women with rheumatoid arthritis and follow-up of their offspring

Clinical Rheumatology - To explore the risk factors for adverse pregnancy outcomes (APOs) in women with rheumatoid arthritis (RA) and the influence on their offspring health. Pregnant women with RA...     

Excess risk of adverse pregnancy outcomes in women with porphyria: a population-based cohort study

The porphyrias comprise a heterogeneous group of rare, primarily hereditary, metabolic diseases caused by a partial deficiency in one of the eight enzymes involved in the heme biosynthesis. Our aim was to assess whether acute or cutaneous porphyria has been associated with excess risks of adverse pregnancy outcomes. A population-based cohort study was designed by record linkage between the Norwegian Porphyria Register, covering 70% of all known porphyria patients in Norway, and the Medical Birth Registry of Norway, based on all births in Norway during 1967–2006. The risks of the adverse pregnancy outcomes preeclampsia, delivery by caesarean section, low birth weight, premature delivery, small for gestational age (SGA), perinatal death, and congenital malformations were compared between porphyric mothers and the rest of the population. The 200 mothers with porphyria had 398 singletons during the study period, whereas the 1,100,391 mothers without porphyria had 2,275,317 singletons. First-time mothers with active acute porphyria had an excess risk of perinatal death [adjusted odds ratio (OR) 4.9, 95% confidence interval (CI) 1.5–16.0], as did mothers with the hereditable form of porphyria cutanea tarda (PCT) (3.0, 1.2–7.7). Sporadic PCT was associated with an excess risk of SGA [adjusted relative risk (RR) 2.0, 1.2–3.4], and for first-time mothers, low birth weight (adjusted OR 3.4, 1.2–10.0) and premature delivery (3.5, 1.2–10.5) in addition. The findings suggest women with porphyria should be monitored closely during pregnancy.     

妊娠早期双侧子宫动脉血流参数和舒张早期切迹评估复发性流产孕妇不良妊娠结局的效能分析

目的 探讨妊娠早期双侧子宫动脉血流参数和舒张早期切迹评估复发性流产孕妇发生不良妊娠结局的效能。方法 选择2020年8月至2021年8月莆田市妇幼保健院收治的复发性流产者40例为观察组,另选择同期正常妊娠者40名为对照组。均使用Voluson 730 Pro彩色多普勒超声诊断仪进行检查,获取双侧子宫动脉血流参数[双侧子宫动脉收缩期峰值流速/舒张末期流速(S/D)值、子宫动脉搏动指数(PI)值、子宫动脉阻力指数(RI)值],并观察舒张早期切迹的出现情况。比较两组双侧子宫动脉血流参数水平和舒张早期切迹发生率。分析舒张早期切迹与不良妊娠结局的关联性。采用ROC曲线法评估双侧子宫动脉血流参数预测复发性流产孕妇发生不良妊娠结局的效能。结果 观察组S/D值、PI值和RI值均高于对照组,差异有统计学意义(P<0.05),出现舒张早期切迹的人数比例大于对照组(90.00%vs 10.00%;χ²=48.050,P=0.000)。出现舒张早期切迹者的妊娠期高血压、妊娠期糖尿病、子痫和早产发生率均显著高于无舒张早期切迹者,差异有统计学意义(P<0.05)。ROC分析结果显示...