ISRN infectious diseases最新文献

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Surgical, Ultrasound Guided Drainage, and Medical Management of Tuboovarian Abscesses. 输卵管腔脓肿的外科、超声引导引流及内科治疗。

ISRN infectious diseases

Pub Date : 2014-01-01 Epub Date: 2014-03-04 DOI: 10.1155/2014/501729

Frank A Crespo, Dervi Ganesh, Kaming Lo, Kevin Chin, Paul Norris, Nahida Chakhtoura

Objective: To compare surgical, ultrasound guided drainage, and medical management of tuboovarian abscesses (TOA) and determine if different characteristics in patient presentation influence treatment and outcome.

Methods: Retrospective cohort study of 158 patients admitted to Jackson Memorial Hospital between 2007 and 2012 with a TOA.

Results: Patients treated with IV antibiotics (IV) alone were hospitalized for 5.59 days (SD 2.52), IV antibiotics and US guided drainage (IV/US) were hospitalized for 9.63 days (SD 7.58), and IV antibiotics and surgery (IV/surgery) were hospitalized for 8.14 days ((SD3.9), (P < 0.001)). A total of 52 patients were readmitted with TOA; 41.8% were treated with IV; 26.9% were readmitted with IV/US; 7.1% were readmitted with IV/surgery (P < 0.022). Patients with a TOA measuring 0-8 cm were hospitalized for 5.97 days (SD 4.24), while those greater than 8 cm were hospitalized for 7.71 days ((SD 4.69), (P < 0.029)). Patients treated with a triple antibiotic regimen were hospitalized for 8.42 days (SD 5.70) versus 5.8 days (SD 3.24) when receiving an alternative regimen (P < 0.002).

Conclusions: Longer hospitalization in patients treated uniformly with either triple antibiotics, ultrasound guided drainage, or surgery represents a delay in optimal treatment. Tailoring treatment plans based on patient presentation may allow for shorter hospital stays and improved morbidity.

目的:比较手术、超声引导引流和药物治疗对输卵管卵巢脓肿(TOA)的影响，并确定患者表现的不同特征是否会影响治疗和结果。方法:回顾性队列研究2007年至2012年在杰克逊纪念医院收治的158例TOA患者。结果:单纯静脉注射抗生素(IV)患者住院时间5.59天(SD 2.52)，静脉注射抗生素联合US引导引流(IV/US)患者住院时间9.63天(SD 7.58)，静脉注射抗生素联合手术(IV/手术)患者住院时间8.14天(SD3.9)， (P < 0.001)。共有52例患者因TOA再次入院;静脉注射占41.8%;26.9%的患者因静脉注射/US再次入院;7.1%再次接受静脉注射/手术(P < 0.022)。TOA为0 ~ 8 cm的患者住院时间为5.97 d (SD 4.24)， TOA大于8 cm的患者住院时间为7.71 d (SD 4.69)， (P < 0.029)。接受三联抗生素方案治疗的患者住院时间为8.42天(SD 5.70)，而接受替代方案治疗的患者住院时间为5.8天(SD 3.24) (P < 0.002)。结论:采用三联抗生素、超声引导引流或手术统一治疗的患者住院时间较长，代表了最佳治疗的延迟。根据病人的表现制定治疗计划可以缩短住院时间并改善发病率。

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引用次数: 5

Fertility Desires and Intentions and the Relationship to Consistent Condom Use and Provider Communication Regarding Childbearing Among HIV Clients in Uganda. 在乌干达的艾滋病毒客户中，生育欲望和意图以及与一致使用避孕套和提供者沟通有关生育的关系。

ISRN infectious diseases

Pub Date : 2013-01-01 DOI: 10.5402/2013/478192

Glenn J Wagner, Rhoda Wanyenze

Objectives: HIV prevention and reproductive health programs emphasize consistent condom use and preventing unplanned pregnancies, but do not account for the childbearing desires of many HIV clients. We examined the correlates of fertility desires and intentions, including condom use, among HIV clients in Uganda.

Methods: Baseline data from a prospective cohort study of clients starting antiretroviral therapy were analyzed. All measures were self-report, except abstracted CD4 count.

Results: The sample included 767 clients; 34% were men and 50% had a primary sex partner. Among those with a desire (31%) or intention (24%) for having a child in the near future, 60% had not discussed this with providers. A majority (61%) had received advise about family planning, and 27% were told by their provider that they should not bear a child because of their HIV status. In regression analysis, male gender, younger age, higher CD4, having fewer children, and having a primary partner were significantly associated with fertility desires and intentions; having been told by one's provider not to have a child was associated with intentions but not desires. Among participants with a primary partner, consistent condom use was greater among those with no fertility intentions, as was receipt of advise about family planning, while HIV disclosure to partner was greater among those with intentions. Partner HIV status was not associated with fertility desires or intentions.

Conclusions: These findings highlight the need for HIV care and reproductive health programs to incorporate safer conception counseling and improve provider/patient communication regarding childbearing.

目的:艾滋病毒预防和生殖健康方案强调一贯使用避孕套和防止意外怀孕，但没有考虑到许多艾滋病毒客户的生育愿望。我们检查了乌干达艾滋病毒客户中生育欲望和意图的相关性，包括避孕套的使用。方法:对开始抗逆转录病毒治疗的客户进行前瞻性队列研究的基线数据进行分析。除抽象CD4计数外，所有测量均为自我报告。结果:样本包括767名客户;34%是男性，50%有主要性伴侣。在有意愿(31%)或有意向(24%)近期要孩子的受访者中，60%的人没有与医生讨论过这个问题。大多数(61%)接受过有关计划生育的建议，27%的人被其提供者告知，由于其艾滋病毒状况，他们不应该生育孩子。在回归分析中，男性、年龄较小、CD4较高、生育较少和有第一伴侣与生育意愿和意图显著相关;被供养者告知不要生孩子与意图有关，而与欲望无关。在有第一伴侣的参与者中，没有生育意图的人使用避孕套的比例更高，接受计划生育建议的比例也更高，而有生育意图的人向伴侣透露艾滋病毒的比例更高。伴侣的艾滋病毒状况与生育意愿或意图无关。结论:这些发现强调了艾滋病毒护理和生殖健康项目需要纳入更安全的受孕咨询，并改善关于生育的提供者/患者沟通。

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引用次数: 39

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