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Pregnancy and Obstetrical Outcomes Following Treatment for Cervical Intra-Epithelial Neoplasia (CIN) in Two Hospitals of a Low-Resource Country

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Advances in Reproductive Sciences 2024年第1期12卷 51-59页

作者： Bruno Kenfack Clovis-Achille Tanekeu Atem Bethel Ajong Zabdielle Blonde Goufack Kenfack Patrick Petignat Pierre Marie Tebeu Department of gynecology and obstetrics Faculty of Medicine and Pharmaceutical Science University of Dschang Dschang Camer-on Institur Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon Kekem MD District Hospital West Region Cameroon Department of Epidemiology and Public Health Faculty of Medicine and Pharmaceutical Science University of Dschang Dschang Cameron geneva University Hospitals Genevas Switzerland Faculty of Medicine and Biomedical Science University of Yaounde I Yaounde Cameroon

Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatment in Cameroon. Methods: This was a cohort study with two years retrospective data collection involving 82 women who underwent cervical treatment for CIN in two Cameroonian hospitals from January 2015 to December 2017. Data were collected from CIN treatment to end of pregnancy where applicable. Data analysis was done using Epi Info software version 3.5.4. Results: We collected data from 82 patients aged 27 to 48 years, with a mean age of 36.5 (SD: 5.3) years. During the study period, 33 out of 82 participants became pregnant 40.2 [29.56 - 51.66]%. The factor associated with pregnancy occurrence after treatment was age less than 35 years (Odds ratio = 4.37 [1.7 - 11.2]. From the 33 pregnancies recorded, 17 (51.5%) ended in a delivery, amongst which 15 (88.2%) were vaginal. Conclusion: Pregnancy frequency over two years following cervical treatment for CIN was relatively good, and younger women (age 35 years) were significantly more like to have conceived compared to their older counterparts. Post-treatment delivery outcomes seem to be similar to those in the general population.

关键词： Cervical Intraepithelial Neoplasia Cervical Treatment Pregnancy Outcome

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A Real-world Prospective Study of Mother-to-child Transmission of HBV in China Using a Mobile Health Application (Shield 01)

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Journal of Clinical and Translational Hepatology 2020年第1期8卷 1-8页

作者： Xueru Yin Guorong Han Hua Zhang MeiWang Wenjun Zhang Yunfei Gao Mei Zhong Xiaolan Wang Xiaozhu Zhong Guojun Shen Chuangguo Yang Huiyuan Liu Zhihong Liu Po-Lin Chan Marc Bulterys Fuqiang Cui Hui Zhuang Zhihua Liu Jinlin Hou Department of Infectious Diseases Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina Department of gynecology and obstetrics The Second Affiliated Hospital of the Southeast UniversityNanjingJiangsuChina Department of obstetrics and gynecology Beijing Youan HospitalCapital Medical UniversityBeijingChina Department of obstetrics and gynecology The Fifth Medical CentreChinese People’s Liberation Army General HospitalBeijingChina Department of obstetrics and gynecology The Fifth Affiliated Hospital of Southern Medical UniversityGuangzhouGuangdongChina Department of obstetrics and gynecology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina Department of obstetrics Jiujiang Maternal and Child Care CenterJiujiangJiangxiChina Department of Infectious Diseases Zhujiang HospitalSouthern Medical UniversityGuangzhouGuangdongChina Department of Infectious Diseases Third People’s Hospital of JiujiangJiujiangJiangxiChina Department of Infectious Diseases The Third Affiliated Hospital of Southern Medical universityGuangzhouGuangdongChina Department of Severe Liver Diseases Guangzhou Eighth People’s HospitalGuangzhouGuangdongChina World Health Organization/Western Pacific Regional Office(WPRO) ManilaPhilippines Global Hepatitis Programme World Health OrganizationGenevaSwitzerland School of Public Health Peking UniversityBeijingChina Department of Microbiology and Center of Infectious Diseases School of Basic Medical SciencesPeking University Health Science CenterBeijingChina

Background and Aims:The World Health Organization(WHO)Western Pacific Region set a target of eliminating mother-to-child transmission(MTCT)of hepatitis B virus(HBV)by *** assess the feasibility of this target in China,we carried out an epidemiological study to investigate the status quo of MTCT in the real-world ***:One thousand and eight hepatitis B surface antigen-positive preg-nant women were enrolled at 10 ***-laxis was administered to *** addition,mothers with HBV DNA level>2,000,000 IU/mL were advised to initiate antiviral therapy during late pregnancy.A health application called SHIELD was used to manage the ***:Nine hundred and five of the enrolled mothers,with 924 infants,completed the ***-dose hepatitis B vaccine and hepatitis B immunoglobulin were received by 99.7%and 99.7%of infants,respectively,within 24 h after *** ;were 446 mothers who received antiviral therapy,including 72.3%of the mothers with HBV DNA level>2,000,000 IU/mL and 21.0%of the mothers with HBV DNA level<2,000,000 IU/*** infants were infected with *** overall rate of MTCT was 0.9%.Birth defects were rare(0.5%among in-fants with maternal antiviral exposure versus 0.7%among infants without exposure;p=1.00).Conclusions:The MTCT rate was lower than the WHO Western Pacific Region elimina-tion MTCT target in this real-world study,indicating that a comprehensive management composed of immunoprophy-laxis to infants and antiviral prophylaxis to mothers may be a feasible strategy to achieve the 2030 WHO elimination goal.

关键词： Mother-to-child transmission Hepatitis B virus Antiviral therapy Immunoprophylaxis Shield Project

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Development of Misoprostol Suppositories for Postpartum Hemorrhage

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Pharmacology & Pharmacy 2013年第1期4卷 71-76页

作者： Isabelle O. Constantin Georges L. Zelger Anne-Lise Paroz Pascal Furrer Serge Rudaz Corinne Planchamp Messeiller Department of gynecology and obstetrics Hospitals of Nord Vaudois and Broye Yverdon-les-Bains Switzerland Department of Hospital Pharmacy Hospitals of Nord Vaudois and Broye Yverdon-les-Bains Switzerland School of Pharmaceutical Sciences University of Geneva University of Lausanne Geneva Switzerland

Misoprostol is a prostaglandin E1 analogue used to prevent and treat gastric ulcers. It has been commonly used in gynecology and obstetrics, especially for the management of postpartum hemorrhage (PPH). For this purpose, 1000 μg intrarectal (insertion of five 200 μg tablets) has been recommended as the third line after injectable oxytocin and methylergometrine. We proposed to manufacture a 1000 μg misoprostol suppository by determining formulation, release and stability. The administration facility was also evaluated. Several formulations of misoprostol suppositories were set up and evaluated. Misoprostol tablets and lipophilic bases (Hard fat—Adeps solidus Ph. Eur., Witepsol? H15 and Suppocire? AM and AS2X) were used to obtain suppositories. Surfactants were also tested (polysorbates Tween? 20, Tween? 80 and sodium lauryl sulfate (SLS)). The formula was monitored by the misoprostol release curve with an in vitro test and dosed by a HPLC method. Stability was determined by evaluating the percentage of misoprostol content remaining over the time in suppositories stored at 4℃ and 25℃. Facility of use versus tablets was evaluated by obstetricians of a Swiss regional hospital using a questionnaire. Misoprostol release was facilitated by adding surfactant to the lipophilic base. After 30 minutes, 59% ± 1.4% and 57% ± 8.2% of misoprostol was released with Adeps solidus + 1% SLS and Adeps solidus + 5% Tween 20 respectively. SLS was discarded to the final formula because of its irritating effect. After 7 months, suppositories still contained 94% ± 3.7% misoprostol with storage at 4℃. The administration was considered easier and faster compared with intra rectal use of tablets. The formula, consisting of 5 crushed misoprostol tablets dispersed in a suppository base made of Adeps solidus + 5% Tween? 20, is stable for at least 7 months at 4?C and facilitates the rectal administration of misoprostol in the treatment of PPH.

关键词： Postpartum Hemorrhage Misoprostol Rectal

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分娩时肛门括约肌裂伤者18年后的健康状况研究Ⅱ:尿失禁、性功能及身心健康

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世界核心医学期刊文摘（妇产科学分册） 2006年第9期2卷 33-34页

作者： Otero M. Boulvain M. Bianchi-Demicheli F. D.L. Faltin 吕涛 Department of obstetrics and gynecology Faculty of Medicine University of GenevaDr

Objective: We studied maternal health 18 years postpartum in women having sustained an anal sphincter tear and controls. Study design: We assessed symptoms with the short form of the urogenital distress inventory, the female sexual function index, and physical and mental health with the Short Form-12 summary scales. Results: Women with a sphincter tear had no increased risk of urinary symptoms (54 of 251, 22% , versus 51 of 273, 19% , risk ratio 1.2, 95% confidence interval 0.8 to 1.6) or sexual symptoms (84 of 223, 38% , versus 90 of 230, 39% , risk ratio 1.0, 95% confidence interval 0.8 to 1.2). Their physical health was also similar to controls (mean score ± SD, 47 ± 7 versus 47 ± 6), whereas their mental health was slightly lower (score 45 ± 6 versus 46 ± 6, difference 1, 95% confidence interval 0 to 2, P = .05). Conclusion: Women who sustained an anal sphincter tear have no more urinary or sexual symptoms 18 years after delivery.

关键词：肛门括约肌裂伤身心健康状况分娩后状况研究尿失禁症状发生率持续存在临床症状

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Clitoral Pain and Dyspareunia after Female Genital Mutilation/Cutting: A Case Report

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International Journal of Clinical Medicine 2019年第7期10卷 379-385页

作者： Jasmine Abdulcadir Emily Manin Daniela Huber Department of the Woman The Child and the Adolescent Division of Gynecology Geneva University Hospitals Geneva Switzerland Washington University St. Louis MO United States Division of gynecology Sion Hospital Sion Switzerland

Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.

关键词： Female Genital Mutilation/Cutting (FGM/C) Dyspareunia Clitorodynia

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Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

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Asian Journal of Urology 2024年第2期11卷 271-279页

作者： Andrea Cocci Marta Pezzoli Fernando Bianco Franco Blefari Pierluigi Bove Francois Cornud Gaetano De Rienzo Paolo Destefanis Danilo Di Trapani Alessandro Giacobbe Luca Giovanessi Antonino Laganà Giovanni Lughezzani Guglielmo Manenti Gianluca Muto Gianluigi Patelli Novello Pinzi Stefano Regusci Giorgio I.Russo Juan I.M.Salamanca Matteo Salvi Luigi Silvestri Fabrizio Verweij Eric Walser Riccardo GBertolo Valerio Iacovelli Alessandro Bertaccini Debora Marchiori Hugo Davila Pasquale Ditonno Paolo Gontero Gennaro Iapicca Theo M De Reijke Vito Ricapito Pierluca Pellegrini Andrea Minervini Sergio Serni Francesco Sessa Department of Urology Careggi HospitalUniversity of FlorenceFlorenceItaly Urology Section University of FlorenceFlorenceItaly Urological Research Network MiamiFLUSA Urology Section Prato HospitalPratoItaly Torvergata Oncoscience Research Centre of Excellence TORDepartment of Experimental MedicineUniversity of Rome Tor VergataRomeItaly Department of Urology San Carlo di Nancy HospitalRomeItaly Department of Radiology Hôpital CochinParis Descartes UniversityParisFrance Urology and Andrology Unit II Department of Emergency and Organ TransplantationUniversity of BariBariItaly Unit of Urology Cittàdella Salute e della Scienza HospitalUniversity of TurinTurinItaly Urology Unit Buccheri La Ferla Fatebenefratelli HospitalPalermoItaly Department of Urology Humanitas Gradenigo HospitalTurinItaly Urology Unit Surgical DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly Departement of Urology “S.Giovanni Evangelista”HospitalTivoliItaly Humanitas Clinical and Research CentereIRCCS Department of UrologyRozzanoItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly Department of Biomedicine and Prevention University of Rome“Tor Vergata”RomeItaly Department of Diagnostic Imaging and Interventional Radiology University of Rome“Tor Vergata”RomeItaly Department of Interventional Radiology Pesenti-Fenaroli Hospital-ASST Bergamo EstAlzano LombardoItaly Department of Urology University of SienaSienaItaly Swiss International Prostate Center GenevaSwitzerland Clinique Générale Beaulieu GenevaSwitzerland Department of Urology University of CataniaItaly Department of Urology Puerta de Hierro-Majadahonda University HospitalMadridSpain Lyx Institute of Urology Universidad Francisco de VitoriaMadridSpain Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of RomeFaculty of Pharmacy and MedicineUrology Unit ICOTLatinaItaly Department of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Department of Radiology D

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus ***: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and ***: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading t

关键词： Transperineal laser ablation Prostatecancer Benignprostatic hyperplasia Delphi consensus

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Antibiotic-Loaded Resorbable Bone-Graft Substitute： A New Treatment for Osteomyelitis/Osteitis

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Journal of Pharmacy and Pharmacology 2016年第8期4卷 405-412页

作者： Bemd Gachter Jennifer Frieda Angehrn Stephane Schlunke Sebastian Probst Paul Biegger Department of Surgery Ospedale Regionale di Locarno Locarno 6600 Switzerland Department of obstetrics and gynecology Ospedale Regionale di Locarno Locarno 6600 Switzerland Department of Surgery Clinica Luganese Moncucco Lugano 6900 Switzerland University of Applied Sciences Western Switzerland Geneva 1206 Switzerland

Patients with osteomyelitis require lengthy antibiotic treatment, often only to see the inflammation flare up once antibiotics are suspended. Unfortunately, patients often discontinue the antibiotic treatment due to collateral effects. Patients with osteitis are often polymorbid patients with other severe diseases such as diabetes mellitus and polyneuropathy, arteriopathy or polyarthfitis with immunosuppression. The eight patients included in the study presented nine bones with osteomyelitis （macroscopically, bacteriologically, histologically or radiologically）. The diseased part of the bone was resected, a locally radical debridement was done and a biopsy for bacteriology and histology were taken. The residual bone was then drilled out and filled with antibiotic-loaded （gentamicin） resorbable bone-graft substitute under radiologic imaging control. In total, seven patients are currently without recurrent osteomyelitis with a mean follow-up of 5.77 months （2-11 months）. The Kaplan Meier curve shows 80% survival rate without recurrent osteomyelitis at 11 months. Only one patient suffering from Morbus Buerger had a relapse osteomyelitis after cutting off severing his foot while swimming in the sea. Antibiotic-loaded resorbable bone-graft substitute is easy to use, has in our hands few complications and low recurrence rate.

关键词： Osteomyelitis bioabsorbable antibiotic carrier bone-graft substitute.

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Survival of a Patient with Amniotic Fluid Embolism Based on Multidisciplinary Team Training: A Case Report of a Swiss University Hospital

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Open Journal of obstetrics and gynecology 2019年第2期9卷 216-222页

作者： F. Theintz G. Haller R. E. Pfister B. Martinez de Tejada I. Eperon Department of Women-Children-Teenagers University Hospitals of Geneva Geneva Switzerland Department of Anesthesia University Hospitals of Geneva Geneva Switzerland

Amniotic fluid embolism (AFE) is a rare, unpredictable and unpreventable event with high maternal and fetal morbidity and mortality. Its clinical presentation is nonspecific ranging from moderate organ dysfunction to cardiovascular collapse with disseminated intravascular coagulation (DIC), which can lead to death. In a situation of severe systemic disease, maternal survival is largely dependent on the combined efficacy of gynecological and anesthetic teams. We report a case of AFE in a healthy woman admitted to the delivery room for labor induction. Due to a loss of consciousness soon after epidural anesthesia associated to fetal bradycardia, an emergency caesarean section was performed which was complicated by uterine atony and DIC requiring hysterectomy. The outcome was favorable due to fast and efficient multidisciplinary care, emphasizing the benefit of having been trained for such situations through simulation and team training programs for obstetrical emergency management.

关键词： Amniotic Fluid Embolism obstetrics Simulation Team Training

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超声诊断产后肛门括约肌撕裂预防大便失禁的随机对照试验

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世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 48-49页

作者： Faltin D.L. Boulvain M. Floris L.A. Irion O. 程金湘 Department of obstetrics University Hospitals of Geneva 1211 Geneva 14 Switzerland Dr.

Objective: Maternal anal sphincter tears after vaginal delivery are frequently not diagnosed clinically and are associated with subsequent fecal incontinence. This study examined whether diagnosis of these tears by ultrasonography, followed by immediate surgical repair, reduces the occurrence of incontinence. Methods: We conducted a randomized trial involving 752 primiparous women without a clinically evident anal sphincter tear to evaluate the benefit of adding endoanal ultrasonography immediately after vaginal delivery to the standard clinical examination of the perineum. When a sphincter tear was diagnosed, the perineum was surgically explored and the sphincter sutured. The main outcome evaluated was fecal incontinence 3 months postpartum graded by the Wexner incontinence scale, which measures incontinence to flatus and liquid or solid stools, need to wear a pad, and lifestyle alterations. Results: Among women assessed by ultrasonography, 5.6% had a sphincter tear. Severe incontinence was reported 3 months after childbirth by 3.3% of women in the intervention group compared with 8.7% in the control group (risk difference-5.4% ; 95% confidence interval -8.9 to -2.0; P = .002). The benefit of the intervention persisted 1 year after delivery, with 3.2% severe incontinence in the intervention group compared with 6.7% in the control group (risk difference -3.5% ; 95% confidence interval -6.8% to -0.3% ; P =.03). Ultrasonography needs to be performed in 29 women to prevent 1 case of severe fecal incontinence. Conclusion: Ultrasound examination of the perineum after childbirth improves the diagnosis of anal sphincter tears, and their immediate repair decreases the risk of severe fecal incontinence.

关键词：肛门括约肌撕裂大便失禁随机对照试验超声诊断阴道分娩肛管内超声临床诊断临床标准初产妇超声检查

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Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pregnant Patient: A Case Series

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Open Journal of obstetrics and gynecology 2020年第11期10卷 1563-1572页

作者： Carlos Montufar-Rueda Agnès Ditisheim Alfredo F. Gei Rolando Pinilla Eddie Dinh Jair Vélez Brenda Castillo Luis Farias Critical Care obstetrics Unit Complejo Hospitalario Metropolitano de la Caja de Seguro Social Ciudad de Panamá Panamá Center for Maternal-Fetal Medicine La Tour Hospital Geneva Switzerland Research Division Houston Center for Maternal Fetal Medicine Houston Texas USA

Rationale: Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. Currently, there are no guidelines for the management of respiratory failure in pregnancy. Objectives: To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. Methods: We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the paO2/FiO2 ratio or clinical deterioration 6 hours aft

关键词： Respiratory Support during Pregnancy ARDS in Pregnancy ALI in Pregnancy Ventilatory Support Non-Invasive Positive Pressure Ventilation

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