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1.
Clinical aspects of pelvic inflammatory disease 总被引:2,自引:0,他引:2
Pelvic inflammatory disease (PID) is a common and poorly managed condition.
Untreated or inadequately treated, it leads to tubal infertility, ectopic
pregnancy and chronic pelvic pain. Diagnostic difficulties are compounded
by the wide variety of clinical presentations and the insensitivity and
poor specificity of laboratory tests. Better recognition of mild and
atypical disease needs a high index of suspicion whenever young, sexually
active women present with gynaecological symptoms. Laparoscopy supplemented
by microbiological tests and fimbrial minibiopsy should be regarded as the
diagnostic 'gold standard' for research studies; new studies are required
to identify techniques which might reduce under- and over-diagnosis. Early
treatment reduces the risk of an adverse effect on fertility. Any
therapeutic regimen selected should be effective against the common
aetiological agents Chlamydia trachomatis, Neisseria gonorrhoeae, genital
mycoplasmas and aerobic and anaerobic bacteria. Since at least 60% of cases
of PID can be attributed to infection with a sexually transmitted organism,
partner notification forms an essential part of management.
相似文献
2.
Screening for early ovarian cancer 总被引:5,自引:0,他引:5
3.
Marcello Valassina Melissa Valentini Agostino Pugliese Pier Egisto Valensin Maria Grazia Cusi 《Clinical and Vaccine Immunology : CVI》2003,10(3):483-484
Toscana virus is the most important agent responsible for meningitis in central Italy. We report a serosurveillance study, using an immunoenzymatic assay, of 360 serum samples harvested from a high-risk population occupationally exposed to Toscana virus in two regions of Italy, Tuscany and Piedmont. The results indicates a seroprevalence of Toscana virus of 77.2% in the forestry workers, particularly in the Tuscany region. This fact is strictly correlated with the ecological niches specific for the survival of Toscana virus arthropod vector. 相似文献
4.
Incidence and determinants of moderate COPD (GOLD II) in male smokers aged 40–65 years: 5-year follow up 下载免费PDF全文
Roeland MM Geijer Alfred PE Sachs Theo JM Verheij Philippe L Salom Jan-Willem J Lammers Arno W Hoes 《The British journal of general practice》2006,56(530):656-661
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major health problem with an estimated prevalence of 10-15% among smokers. The incidence of moderate COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), is largely unknown. AIM: To determine the cumulative incidence of moderate COPD (forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC] <0.7 and FEV1 <80% predicted) and its association with patient characteristics in a cohort of male smokers. DESIGN: Prospective cohort study. SETTING: The city of IJsselstein, a small town in the Netherlands. METHOD: Smokers aged 40-65 years who were registered with local GPs, participated in a study to identify undetected COPD. Baseline measurements were taken in 1998 of 399 smokers with normal spirometry (n = 292) or mild COPD (FEV1/FVC <0.7 and FEV1 >or=80% predicted, n = 107) and follow-up measurements were conducted in 2003. RESULTS: After a mean follow-up of 5.2 years, 33 participants developed moderate COPD (GOLD II). This showed an estimated cumulative incidence of 8.3% (95% CI = 5.8 to 11.4) and a mean annual incidence of 1.6%. No participant developed severe airflow obstruction. The risk of developing moderate COPD in smokers with baseline mild COPD (GOLD I) was five times higher than in those with baseline normal spirometry (one in five versus one in 25). CONCLUSIONS: In a cohort of middle-aged male smokers, the estimated cumulative incidence of moderate COPD (GOLD II) over 5 years was relatively high (8.3%). Age, childhood smoking, cough, and one or more GP contacts for lower respiratory tract problems were independently associated with incident moderate COPD. 相似文献
5.
Chest radiography in general practice: indications, diagnostic yield and consequences for patient management 下载免费PDF全文
Anouk M Speets Yolanda van der Graaf Arno W Hoes Sandra Kalmijn Alfred PE Sachs Matthieu JCM Rutten Jan Willem C Gratama Alexander D Montauban van Swijndregt Willem PThM Mali 《The British journal of general practice》2006,56(529):574-578
BACKGROUND: Chest radiography (CXR) is frequently performed in Western societies. There is insufficient knowledge of its diagnostic value in terms of changes in patient management decisions in primary care. AIM: To assess the influence of CXR on patient management in general practice. DESIGN OF STUDY: Prospective cohort study. SETTING: Seventy-eight GPs and three general hospitals in the Netherlands. METHOD: Patients (n = 792) aged > or =18 years referred by their GPs for CXR were included. The main outcome was change in patient management assessed by means of questionnaires filled in by GPs before and after CXR. RESULTS: Mean age of the patients was 57.3+/-16.2 years and 53% were male. Clinically relevant abnormalities were found in 24% of the CXRs. Patient management changed in 60% of the patients following CXR. Main changes included: fewer referrals to a medical specialist (from 26 to 12%); reduction in initiation or change in therapy (from 24 to 15%); and more frequent reassurance (from 25 to 46%). However, this reassurance was not perceived as such in a quarter of these patients. A change in patient management occurred significantly more frequently in patients with complaints of cough (67%), those who exhibited abnormalities during physical examination (69%), or those with a suspected diagnosis of pneumonia (68%). CONCLUSION: Patient management by the GP changed in 60% of patients following CXR. CXR substantially reduced the number of referrals and initiation or change in therapy, and more patients were reassured by their GP. Thus, CXR is an important diagnostic tool for GPs and seems a cost-effective diagnostic test. 相似文献
6.
Low human immunodeficiency virus type 1 (HIV-1) DNA burden as a major cause for failure to detect HIV-1 DNA in clinical specimens by PCR. 下载免费PDF全文
M Zazzi L Romano M Catucci A De Milito P Almi A Gonnelli M Rubino P E Valensin 《Journal of clinical microbiology》1995,33(1):205-208
To determine the sensitivity of a nested PCR procedure for detecting human immunodeficiency virus type 1 DNA in clinical specimens, 553 peripheral blood mononuclear cell samples obtained from 268 human immunodeficiency virus type 1-seropositive subjects were assayed by use of two independent primer sets for each sample. Overall, 1,088 of 1,106 (98.37%) reactions were positive. Investigation of the negative reactions showed that a low viral burden in some infected subjects, rather than primer-template mismatches, was the primary cause for the false-negative PCR results. 相似文献
7.
8.
Rapid identification of Toscana virus by nested PCR during an outbreak in the Siena area of Italy. 总被引:1,自引:1,他引:1 下载免费PDF全文
The sand fly-transmitted Toscana virus is recognized as an etiologic agent of an aseptic meningitis with a long convalescence. This infection has been reported overall in many tourists or in a seronegative population circulating in endemic Mediterranean areas (Italy, Portugal, Egypt, and Cyprus). We report a cluster of acute Toscana virus infections in the local population during the summer of 1995. Twenty-one clinical cases of meningitis were investigated for the presence of Toscana virus by nested PCR performed on the S segment of the virus RNA extracted from cerebrospinal fluid samples. 相似文献
9.
L Bracci G Antoni M G Cusi L Lozzi N Niccolai S Petreni M Rustici A Santucci P Soldani P E Valensin 《Molecular immunology》1988,25(9):881-888
It has been reported that binding to muscle nicotinic acetylcholine receptor at the post-synaptic membrane is an important event of the rabies virus neurotropism. The binding site can be located within the 190-203 region of the virus glycoprotein sharing a high degree of homology with the "toxic loop" of the curare-mimetic snake neurotoxins. We have synthesized a tetradecapeptide corresponding to this glycoprotein region and used it, following conjugation with an immunogenic carrier to raise MAbs. We found that some MAbs raised against the peptide were able to recognize both the virus glycoprotein and the snake neurotoxin alpha-bungarotoxin; moreover, they can inhibit the binding of rabies virus glycoprotein and alpha-bungarotoxin to the nicotinic acetylcholine receptor extracted from the electric organs of Torpedo marmorata. On the basis of this cross-reactivity, we suggest that rabies virus glycoprotein and curare-mimetic snake neurotoxins share three-dimensionally similar structures in order to bind to the nicotinic cholinergic receptor. The potential use of the immunogenic properties of the peptide for the rational design of a synthetic vaccine against rabies is proposed. 相似文献
10.
A study of 11 patients with "double pylorus" revealed that a second channel between the gastric antrum and the duodenal bulb is the result of ulcer penetration. The fistula can be a sign of spontaneous recovery from ulcerative disease; the fistula occurred in conjunction with clinical improvement in the majority of the patients. The advantages of radiological vs. endoscopic diagnostic procedures are discussed. 相似文献