Improving adherence to guidelines for the diagnosis and management of pelvic inflammatory disease: a systematic review

Examining Chlamydia trachomatis and Neisseria gonorrhoeae rates between 2010 and 2015: a population-based observational study

Bacterial sexually transmitted infections including Chlamydia trachomatis and Neisseria gonorrhoeae remain an important public health concern. We aimed to assess the population-based incidence of C. trachomatis and N. gonorrhoeae in an age-standardized cohort over time. A retrospective study of a large Canadian health region was undertaken between 2010 and 2015 using linked census and digital laboratory data. C. trachomatis and N. gonorrhoeae tests were linked to patient data. Sex and age-standardized incidence rates (IR) and ratios (IRR) were calculated for cases and testing rates. The annual mean population was 1,150,556 individuals (50.1% female). A total of 15,109 cases of chlamydia and 981 cases of gonorrhoea occurred. The overall IR for chlamydia ranged from 18.81 to 25.63 cases per 10,000 person-years. The IRR was 1.27 (95% CI 1.20-1.34, p < 0.001) for the comparison of 2015 and 2010 rates. For gonorrhoea, overall rates ranged from 0.92 to 1.86 cases per 10,000 person-years. The IRR for gonorrhoea was 2.02 (95% CI 1.56-2.59, p < 0.001) for 2015 and 2010 rates. In our large population-based study spanning six years, we observed increasing rates of C. trachomatis and N. gonorrhoeae with low testing rates.

rs9263726 is a specific genetic marker for allopurinol-induced severe cutaneous adverse reactions in Chinese patients

Aim: Screening of an easily detectable biomarker to replace the HLA allele B variant (HLA-B*58:01) testing for predicting allopurinol-induced severe cutaneous adverse reactions (SCARs) in eastern Chinese patients. Methods: Six SNPs and the HLA-B*58:01 were analyzed in 17 patients with allopurinol-induced SCARs and in 151 control patients. SNPs were analyzed by pyrosequencing, and HLA-B*58:01 was evaluated by sequencing-based techniques. Consistency between sequencing-based HLA-B*58:01 testing and pyrosequencing-based rs9263726 testing was investigated in 262 individuals. Results: A significant association with allopurinol-induced SCARs was found at rs9263726 (odds ratio: 108.8) and HLA-B*58:01 (odds ratio: 108.8). The kappa values between sequencing-based HLA-B*58:01 testing and pyrosequencing-based rs9263726 testing were 0.96 (>0.75), demonstrating they were well coincident with each other. Conclusion: rs9263726 was a useful surrogate of HLA-B*58:01 testing for prescreening allopurinol-induced SCARs in eastern Chinese patients.

May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease?

BACKGROUND

Our aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID).

METHODS

Overall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted.

RESULTS

MPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = - 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively).

CONCLUSION

Since the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.