Sexually transmitted infections among pregnant women attending antenatal clinics in Mongolia: potential impact on the Mongolian HIV epidemic

We conducted Mongolia's first nation-wide cross-sectional survey of sexually transmitted infections (STIs) among pregnant women attending prenatal care. Among our 2000 participants, 386 (19.3%) were infected with Chlamydia trachomatis, 133 (6.7%) with Trichomonas vaginalis, 121 (6.1%) with Neisseria gonorrhoeae, and 128 (6.4%) were seropositive for Treponemal antibodies. None of our participants were seropositive for HIV infection. Additionally, 605 (30.3%) of the women had at least one STI, 133 (6.7%) had a double infection, and 15 (0.8%) had a triple infection. Our results suggest that STIs are a serious problem in Mongolia. Pregnant women represent a lower-risk general population; these high STI rates suggest that at this nascent stage, the identification, treatment, and prevention of STIs as risk factors for HIV transmission are crucial in the prevention of the emerging Mongolian HIV epidemic.     

Aortic valve stenosis: fatal natural history despite normal left ventricular function and low invasive peak-to-peak pressure gradients

For many years, the severity of valvular aortic stenosis (AS) was evaluated mainly on the basis of cardiac catheterization. In many centers, the handy peak-to-peak transvalvular pressure difference or 'peak-to-peak gradient' in relation to left ventricular function was used as a crucial feature in taking a decision regarding valve substitution. In a prospective study during the period 1994-1997, 150 consecutive patients with AS were examined systematically using cardiac catherization as well as transthoracic (TTE) and transesophageal echocardiography. The study was performed in order to compare the diagnostic accuracy and reproducibility of the three modalities with the purpose of improving our evaluation strategy. We found that the three methods were able to determine the aortic valve area with similar accuracy and reproducibility. The data thus support earlier papers and the currently recommended strategy of managing most patients on the basis of TTE since this approach is more rapid and gentle to the patients. In accordance with the past policy of our department, however, considerable weight was put on the invasive data during the study period. Thus, 12 patients with invasive peak-to-peak gradient <50 mm Hg and no severe depression of left ventricular function were not offered valve replacement, despite symptoms and significant valve area reductions. At 2.5 years of follow-up, 6 had died, 3 of severe heart failure, 2 while awaiting scheduled valve replacement, and 1 during aortocoronary bypass surgery. Another 3 patients later experienced further symptom progression and underwent successful aortic valve replacement. In the remaining 3 patients, all free from coronary stenoses and other valvular heart disease than AS, heart failure symptoms had worsened considerably during continued medical therapy. In conclusion, we do not recommend consideration of the peak-to-peak gradient in the process of deciding whether or not AS patients should receive valve replacement. A low peak-to-peak gradient does not exclude severe AS, even in the presence of preserved left ventricular function.     

Bacampicillin in the treatment of pelvic inflammatory disease: A study of two dosage regimens

Summary In order to evaluate a twice daily dosage regimen of bacampicillin a multicenter clinical trial was performed in patients suffering from pelvic inflammatory disease (PID). A total of 75 patients were allocated at random to treatment with 800 mg bacampicillin twice daily or 400 mg three times daily for fourteen days (PID). The study was performed double-blind. The therapeutic effect was assessed in 70 patients. The therapeutic response was judged on the basis of clinical symptoms and bacteriology. There was no significant difference in the overall efficacy of the two dosages in the patient groups studied. Good response was obtained in 93% of the patients, and 7% were improved. Gastrointestinal side-effects were infrequent (three cases out of 75). Exanthema occurred in six patients.

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Die Verwendung von Bacampicillin bei entzündlichen Erkrankungen der Beckenorgane: Eine Studie mit zwei verschiedenen Dosierungen

Zusammenfassung Zur Beurteilung einer zweimal täglichen Dosierung von Bacampicillin wurde bei Patienten mit entzündlichen Erkrankungen der Organe des kleinen Beckens eine klinische multizentrische Studie durchgeführt. Insgesamt 75 Patienten wurden zufallsgemäß mit entweder 800 mg Bacampicillin zweimal täglich oder 400 mg dreimal täglich über vierzehn Tage behandelt. Die Studie wurde nach klinischen Symptomen und bakteriologischen Befunden bei insgesamt 70 Patienten beurteilt. Es konnte kein signifikanter Unterschied zwischen den beiden Dosierungen festgestellt werden. Gute Resultate wurden bei 93% der Patienten erreicht, 7% wurden gebessert. Zu gastrointestinalen Beschwerden kam es selten (bei drei von 75 Patienten). In sechs Fällen trat ein Exanthem auf.

     

Do we undertreat hypertensive smokers? A comparison between smoking and non-smoking hypertensives

The acute effect of smoking is a rise in blood pressure and heart rate. Nevertheless, in several epidemiologic studies, smokers tend to have a slightly lower office blood pressure than non-smokers. We studied the 24 h ambulatory blood pressure consecutively in hypertensive smokers (> or = 10 cigarettes per day, n = 26) and hypertensive non-smokers (n = 26) to test the hypothesis that smoking is associated with a rise in ambulatory blood pressure. There was no difference between smokers and non-smokers in office blood pressure (153.8 +/- 22.2/98.5 +/- 10.6 vs 149.0 +/- 16.1/96.9 +/- 11.6 mmHg). However, we found a statistically significant higher daytime systolic and diastolic blood pressure in smokers (153.7 +/- 16.2/96.1 +/- 9.5 vs 145.0 +/- 12.1/90.1 +/- 10.0 mmHg) than in non-smokers. Differences were also found for office-daytime differences and when studying patients on pharmacological antihypertensive treatment separately. Daytime heart rate was also significantly higher in smokers (86.6 +/- 9.4 vs 76.0 +/- 10.9). We conclude that smokers tend to be undertreated in that they have a higher daytime blood pressure than do non-smokers, a difference that is not recognized by measuring office blood pressure alone. We therefore recommend 24h ambulatory blood pressure measurement in smokers with essential hypertension.     

Mental distress and job satisfaction in Palestinian nurses exposed to workplace aggression: a cross-sectional study

Background

Nurses who are exposed to workplace aggression from patients, patient relatives, or colleagues are at risk for mental health disorders and job dissatisfaction. The aim of this study was to assess the prevalence of exposure to workplace aggression and the association between mental distress and job satisfaction in nurses working in the Hebron district of the occupied Palestinian territory.

Synthesis and Structure–Activity Relationships of N-Benzyl Phenethylamines as 5-HT2A/2C Agonists

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