Infection sexuellement transmissible

  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    确定可能参与盆腔炎(PID)的微生物以及PID的不同诊断方法。
    PubMed和国际指南搜索。
    PID具有各种微生物原因。性传播感染(STIs)的主要病原体的致病作用,沙眼衣原体,淋病奈瑟氏球菌和生殖支原体得到充分证实(NP1)。沙眼衣原体是PID(NP1)中最常见的细菌,尤其是30岁以下的女性。PID也发生在降低子宫颈微生物锁的有效性的情况下,比如细菌性阴道病,允许兼性阴道细菌,如大肠杆菌,无乳链球菌和厌氧菌上升到子宫腔。然而,阴道微生物群的多种细菌的参与,特别是厌氧菌,和PID的多微生物特性仍然有不同的认识。在不复杂的PID的情况下,为了获得微生物学诊断,在妇科检查期间,建议在窥器下进行宫颈采样(B级)。第一个拭子允许在载玻片上涂片以进行直接检查(克,MGG)。第二个拭子,在适应的运输介质中,可用于淋病奈瑟菌的标准培养和兼性阴道菌群细菌培养,抗生素药敏试验.第三个拭子,在适当的运输介质中,可以搜索淋病奈瑟菌,C.沙眼,如果可能的话,通过核酸扩增技术(NAAT),(NP1)。可以在适合于(i)细菌存活和(ii)NAAT的运输培养基中仅使用一个拭子。当PID的诊断在临床上是一致的,生殖器样本中3种STI相关细菌中一种或多种的NAAT阳性支持PID诊断(NP1).另一方面,NAAT阴性不允许排除用于PID诊断的STI药物(NP1).在无法使用窥器的情况下,默认情况下将进行阴道采样。如果是复杂的IGH,肾小管腹膜样本可以通过放射学或外科手术进行。因为这些部位是无菌的,任何存在的细菌都将被认为是致病性的(NP2)。沙眼衣原体血清学作为PID诊断的一线诊断工具并不有趣,并且对于监测PID(NP1)的演变也没有用。
    To determine the microorganisms potentially involved in pelvic inflammatory diseases (PIDs) and the different diagnostic methods of PID.
    PubMed and International Guidelines search.
    PIDs have various microbial causes. The pathogenic role of the main agents of sexually transmitted infections (STIs), Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium is well demonstrated (NP1). C. trachomatis is the most commonly described bacterium in PID (NP1), especially in women under 30 years old. PIDs also occur in situations that decrease the effectiveness of the cervix microbiological lock, such as bacterial vaginosis, allowing facultative vaginal bacteria such as Escherichia coli, Streptococcus agalactiae and anaerobes to ascend to the uterine cavity. Nevertheless, participation of the diverse bacteria of the vaginal microbiota, in particular anaerobes, and the polymicrobial character of PIDs are still differently appreciated. In the case of uncomplicated PID, to obtain a microbiological diagnosis, endocervical sampling is recommended during gynecological examination under speculum (grade B). A first swab allows for a smear on a slide for direct examination (Gram, MGG). A second swab, in an adapted transport medium, is useful for standard culture with N. gonorrhoeae and facultative vaginal flora bacteria cultures, with antibiotic susceptibility testing. A third swab, in an appropriate transport medium, allows for the search for N. gonorrhoeae, C. trachomatis, and if possible M. genitalium by nucleic acid amplification techniques (NAATs), (NP1). It is possible to only use one swab in a transport medium suitable for (i) survival of bacteria and (ii) NAATs. When the diagnosis of PID is clinically compatible, a positive NAAT for one or more of the three STI-associated bacteria on a genital sample supports the PID diagnosis (NP1). On the other hand, a negative NAAT does not allow the exclusion of an STI agent for PID diagnosis (NP1). In situations where speculum use is not possible, vaginal sampling will be performed by default. In case of complicated IGH, tuboperitoneal samples can be performed either radiologically or surgically. Since these sites are sterile, any bacteria present will be considered pathogenic (NP2). C. trachomatis serology is not interesting as a first line diagnostic tool for PID diagnosis and is not useful for monitoring the evolution of PID (NP1).
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  • 文章类型: Journal Article
    背景:在Nanterre医院(法国)的移民和难民医学人类学部分,在撒哈拉以南非洲国家记录了三例“处女清洗”。
    方法:这些方法包括性传播感染患者(主要是艾滋病毒,梅毒)希望它们可以因此被治愈。
    结论:不幸的是,这些基于神奇论点的特别残暴的异性恋性行为是普遍的,并不局限于特定的文化。在医学人类学层面,处女清洗的信念是基于这样一种观念,即病人是肮脏和不纯的。以同样的方式,催吐剂和/或泻药在肠道疾病的情况下规定(以“消除”疾病),一些受试者使用利尿剂治疗泌尿异常或,字面上,\“清洁阴道(或肛门)\”清除自己的miasma。人口迁徙潮的上升(其中一些人携带慢性感染),难民营,长期监禁,等。,使得对这种现象的观察越来越频繁。相信处女清洗(及其致命后果)将很难根除。人口和卫生专业人员的教育应促进对儿童身体的绝对尊重,and,更一般地说,其他人,特别是因为在这个移民流动越来越明显的时候,可悲的是,这个问题有可能变得普遍。
    BACKGROUND: In the medical anthropology section of the Nanterre Hospital (France) for migrants and refugees, three cases were recorded of \"virgin cleansing\" in sub-Saharan African countries.
    METHODS: These consisted of sexual assaults (2 instances of rape and 1 of sexual interference) on sexually immature females (young girls) by patients with sexually transmitted infections (mainly HIV, syphilis) hoping they might thereby be cured.
    CONCLUSIONS: These particularly atrocious hetero-aggressive sexual practices based on magical arguments are unfortunately universal and are not limited to a specific culture. At the medical anthropology level, the belief in cleansing by virgins is based on the notion that the patient is dirty and impure. In the same way that emetics and/or laxatives are prescribed in the case of intestinal disorders (to \"eliminate\" the disease), some subjects use diuretics for urinary abnormalities or, literally, \"clean vaginas (or anuses)\" to purge their own miasma. The rising tide of population migrations (some of whom carry chronic infections), refugee camps, prolonged incarcerations, etc., makes observations of such phenomena increasingly frequent. Belief in cleansing by virgins (and the fatal consequences thereof) will be difficult to eradicate. The education of populations and health professionals should promote absolute respect for the body of children, and, more generally, of others, particularly since at this time of increasingly marked migratory flows, this problem sadly risks becoming widespread.
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  • 文章类型: Journal Article
    Intra-uterine device (IUD) is one of the birth control methods, which is available for nulliparous women, even though misconceptions still remain in medical or popular opinion. Only 1.3 % of nulliparous have a IUD as contraception in France while it is the second methods used by all women, after pill. The best contraception is the one chosen by women; however, the choice for a nulliparous of an IUD may be really difficult, despite the increasing number of women wishing to use it. Long-acting reversible contraceptives utilization, including IUD, is probably one of the issues to decrease the unintended pregnancies. An exhaustive and clear information about IUD is necessary to allow an informed and real choice. This prescription must consider contraindications and medical conditions for safe insertion, especially to avoid infection by screening STD (Chlamydia trachomatis and Nesseria gonorrhoeae) in nulliparous women<25 years old. Insertion must be effected with usual precautions and short or SL IUD preferred. Even if side effects such as expulsion, pelvic pains or dysmenorrhea are more frequent by nulliparous, IUD is a first intention choice for contraception to be consider, that women could obtain easily, including in emergency contraception situation.
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  • 文章类型: Journal Article
    The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry.
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  • 文章类型: Journal Article
    OBJECTIVE: To estimate the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG) in patients under 31 years of age admitted to the emergency department of the University Hospital of Montpellier, for which a urinalysis was performed.
    METHODS: CT, NG and MG specific real-time PCRs were performed in the urine samples from 301 patients between July 2010 and January 2011.
    RESULTS: CT DNA was detected in 11% of patients, NG DNA in 3.7% of patients and MG DNA in one patient. Seventy-five percent of male patients and only 13% of women were diagnosed with sexually transmitted infection (STI). No patient with leucocyturia below 10(4)/mL had a positive PCR result for one of the three bacteria. Of the patients with leucocyturia greater or equal to 10(4)/mL, CT was detected in 23.4% of men and 11% of women, NG in 19.2% of men and 1% of women, and MG in 2.1% of men.
    CONCLUSIONS: The prevalence of NG and CT detection in our population was high while that of MG was low. The diagnosis was facilitated by the use of PCR on the urine sample although this sample is not recommended for the molecular detection of bacterial agents of STIs and may explain the low detection of MG. The study allowed diagnosing STIs in 14.3% of our patient population.
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