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7岁日本男孩原发性硬化性纵隔炎病例报道1例

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 49-50页

作者： Shinkawa T. Nakajima M. Kishimoto T. 虎小毅 department of paedia trics Nara Medical University 840 Shijo-cho 634-8522 Kashihara City Nara Japan

Sclerosing mediastinitis is a very rare benign disorder characterised by the d evelopment of dense fibrous tissue within the mediastinum. Affected patients are typically young adults with infant cases being uncommon especially in areas wit hout endemic histoplasmosis. We report a Japanese boy with markedly elevated ser um inflammatory markers for more than 1 year in the absence of any clinical mani festations. 67Gascintigraphy demonstrated an accumulation in the mediastinal reg ion and an open biopsy revealed a hard fibrous mass in the anteriosuperior media stinum. Thus, a diagnosis of idiopathic sclerosing mediastinitis was made. Concl usion:To the best of our knowledge, this case is the youngest patient reported w ith this disorder. In patients with mediastinal mass lesions the diagnosis of sc lerosing mediastinitis should be considered as well as infectious, autoimmune or neoplastic disease even in children.

关键词：硬化性纵隔炎闪烁照相术组织胞浆菌病肿瘤性疾病纤维性前上方组织增生组织损伤感染性

The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 158-169页

作者： Traoré Youssouf Téguété Ibrahima Dicko Fatoumata Traoré Bocoum Amadou Fané Seydou Traoré Tidiani Traoré Mamadou Salia Dao Seydou Touré Moustapha Varol Nesrin Dolo Amadou department of Gynaecology and Obstétrics Gabriel TOURE Teaching Hospital Bamako Mali department of Pediatics Gabriel TOURE Teaching Hospital Bamako Mali department of Gynaecology and Obstétrics Regional Hospital of Segou Bamako Mali department of Gynaecology and Obstétrics Point G Teaching Hospital Bamako Mali Motherhood Unit of “Csref Commune II” Bamako Mali department of Gynaecology and Obstétrics “Hopital du Mali” Teaching Hospital Bamako Mali Sydney Gynaecology & Endometriosis Centre Sydney Medical School The University of Sydney Sydney Australia

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0

关键词： Low Birth Weight Human Immunodeficiency Virus Infection Mother to Child Transmission Newborn Death Mali

HIV感染妇女宫颈上皮内瘤样I级病变的自然病程

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世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 53-54页

作者： Massad L.S. Evans C.T. Minkoff H. 张巧利 department of Obste trics Southern Illinois University PO Box 19640 Springfield IL 62794-9640 United States Dr.

OBJECTIVE: We sought to estimate rates of progression and regression of grad e 1 cervical intraepithelial neoplasia (CIN 1) among women with human immunodefici ency virus (HIV). METHODS: In a multicenter prospective cohort study, HIV-serop ositive and HIV-seronegative women were evaluated colposcopically after receivi ng an abnormal cytology test result between November 1994 and September 2002. Wo men with CIN 1 were included, except those who had undergone hysterectomy, cervi cal therapy, or had CIN 2-3 or cervical cancer. Those women who were included w ere followed cytologically twice yearly, with colposcopy repeated for atypia or worse. RESULTS: We followed 223 women with CIN 1 (202 HIV seropositive and 21 HI V seronegative) for a mean of 3.3 person-years. Progression occurred in 8 HIV- seropositive women (incidence density, 1.2/100 person-years; 95%confidence int erval [CI] 0.5-2.4/100 person-years) and in no HIV seronegative women. Regress ion occurred in 66 (33%) HIV-seropositive women (13/100 person-years, 95%CI 10-16/100 person-years) versus 14 (67%) seronegative women (32/100 person-ye ars, relative risk 0.40, 95%CI 0.25-0.66; P < .001). In multivariate analysis, regression was associated with human papillomavirus ( HPV) detection (hazard ratio [HR] for low risk 0.28, 95%CI 0.13-0.61, P=.001; and for high-risk 0.34,95%CI 0.20-0.55, P < .001 versus no HPV detected) and Hispanic ethnicity (HR 0.48, 95%CI 0.23-0.98; P = .04); HIV serostatus was onl y marginally linked to regression (HR 0.52, 95%CI 0.27-1.03; P=.06), but serop ositive women were less likely to regress when analysis was limited to 146 women with HPV detected at CIN 1 diagnosis (HR 0.18, 95%CI 0.05-0.62; P = .006). CO NCLUSION: Grade 1 cervical intraepithelial neoplasia infrequently progresses in women with HIV. Thus, observation appears safe absent oilier indications for tre atment.

关键词：上皮内瘤 HIV感染不典型增生阴道镜检查血清阳性子宫切除转归情况前瞻性队列研究多元分析

Maternal Hospital Mortality in Cotonou: Incidence, Care-Associated Adverse Events and Causes

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1688-1698页

作者： Djima Patrice Dangbemey Cedric Bigot Ogourindé Mathieu Ogoudjobi Moufalilou Aboubakar Raoul Atade Paterne Kpoviessi Hounkpatin Benjamin Christiane Tshabu-Aguemon Josiane Angeline Tonato-Bagnan Justin Lewis Denakpo Facultty of Health Sciences Abomey-Calavi University Abomey-Calavi Benin Gynecology-Obstétrics department Hospital and University Center for Mother and Child Lagune Cotonou Benin University Clinic of Gynecology and Obstetrics of the CNHU-HLM Cotonou Benin Nursing and Midwifery Training Institute University of Parakou Parakou Benin

Introduction: Despite the many efforts made to combat preventable maternal deaths, these still remain high in Benin. It was therefore important to revisit the causes but especially the adverse events associated with care (EIS) in maternity. Objective: Determine the incidence, adverse events associated with care and causes of intra hospital maternal mortality in cotonou. Methods: This was a cross-sectional maternal mortality review study with retrospective data collection. It covered all cases of maternal death recorded between 2017 and 2021 in two (2) reference university maternities in Cotonou. Adverse events associated with care and the patient were analyzed using the maternal death audit grid validated for Benin. SPSS.26 software was used for data analysis. Results: The in-hospital maternal mortality ratio in Cotonou was 2028 maternal deaths per 100,000 live births in 2021. Only 7.2% (n = 36) of deaths were audited. The deceased mothers were 29.8 ± 7.4 years old, with no fixed monthly income in 82.7% (n = 420). Serious adverse events associated with care were: delay in decision to refer in 37% (n = 188), non-medical referral in 85.8% (n = 436) of cases, inadequate pre-referral treatment in 25.7% of cases. In receiving maternities, delay in diagnosis and inappropriate treatment at the receiving maternity were noted respectively in 22.9% and 28.6% of cases of maternal death. The direct causes of maternal death were dominated by serious obstetric hemorrhage in 43.9% (n = 223). As for the indirect causes, they were dominated by anemia excluding obstetric hemorrhages in 21.5% (n = 109). Conclusion: The in-hospital maternal mortality ratio was very high in Cotonou. The main cause was severe obstetric hemorrhage. There were several serious healthcare-associated adverse events whose correct management would significantly reduce the incidence of maternal deaths.

关键词： Maternal Mortality Adverse Events Care Cotonou

Bacteriology of Healthcare-Associated Infections in the Gynecology and Obstetrics department of CHU Gabriel Touré

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Open Journal of Obstetrics and Gynecology 2019年第10期9卷 1336-1346页

作者： Amadou Bocoum Seydou Fané Youssouf Traoré Siaka Amara Sanogo Ibrahim Kanté Aminata Kouma Mamadou Sima Abdoulaye Sissoko Ibrahima Ongoiba Soumana Oumar Traore Ibrahima Tegueté Maténé Sacko Daouda Camara Alassane Traoré Assitan Wane Niani Mounkoro Amadou Dolo Gynecology-Obstetrics department of CHU G. Touré Bamako Mali Gynecology-Obstetrics Service of CHU of Point G Bamako Mali Gynecology-Obstetrics department of CHU of Kati Bamako Mali Gynecology-Obstetrics Service of Referral Health Center of Kati Kati Mali Gynecology-Obstetrics Service of Referral Health Center of Commune V Bamako Mali Gynécology-Obstétrics department of CHU of Mali Bamako Mali

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infe

关键词： Bacterial Infection Resistances Gabriel Touré University Hospital Antibiotics Obstetrics

Z-Score in Fetal Echocardiography–Is there Still Room for New Studies?

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Congenital Heart Disease 2024年第3期19卷 305-314页

作者： Marcio Fragoso Vieira Nathalie Jeanne Bravo-Valenzuela Edward Araujo Júnior department of Obstetrics Paulista School of MedicineFederal University of São Paulo(EPM-UNIFESP)São Paulo-SP04023-062Brazil department of Obstetrics Federal University of Ceará(UFC)Sobral-CE60020-181Brazil department of Pediatrics Pediatric CardiologySchool of MedicineFederal University of Rio de Janeiro(UFRJ)Rio de Janeiro-RJ21941-853Brazil

Congenital heart disease(CHD)is the most common type of birth defect,representing a significant cause of peri-natal morbidity and *** diagnosis of such anomalies is crucial for improving *** pro-tocols recommend a qualitative assessment of cardiac structures using two-dimensional ultrasound(2DUS)and color Doppler *** cases of suspected abnormalities,quantitative assessments through cardiac structure measurements and reference curves can aid in accurate *** to centiles widely employed in obste-trics,Z-scores provide more precise quantification of various cardiac structures,particularly at the extremes of the *** the development of reference curves and Z-scores has progressed over the past two decades,a lack of standardization in measurements and statistical methodology for their determination is *** reference curves requires adherence to specific recommendations to improve their *** purpose of this study is to provide a narrative review of the major studies that have generated reference values for cardiac struc-tures using 2DUS and Z-scores,to evaluate their methodology,and to provide a summary of the results.

关键词： Z-scores reference ranges fetal echocardiography