Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who...Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003) had two-, six- and ten-times higher odds of adverse pregnancy outcomes respectively, relative to women who required no treatment. Conclusion: Adverse pregnancy outcomes are prevalent among women who have received treatment in Zambia. The findings indicate that treating Cervical Intraepithelial Neoplasia has been linked to higher chances of experiencing abortion, delivering low birth weight babies and enduring prolonged labor that may result in a caesarean section delivery. Cervical neoplasia treatments, particularly Loop Electrosurgical Excision Procedure, are associated with significantly increased odds of adverse pregnancy outcomes. It is essential to include information about prior Cervical Intraepithelial neoplasia treatment outcomes in obstetric care.展开更多
目的比较皮质骨螺钉(cortical bone trajectory,CBT)固定与带袢钢板弹性固定在老年踝关节骨折(fracture of ankle joint,FAJ)下胫腓损伤患者中的应用效果。方法选取2022年8月—2023年7月菏泽骨伤医院收治的92例老年FAJ下胫腓损伤患者为...目的比较皮质骨螺钉(cortical bone trajectory,CBT)固定与带袢钢板弹性固定在老年踝关节骨折(fracture of ankle joint,FAJ)下胫腓损伤患者中的应用效果。方法选取2022年8月—2023年7月菏泽骨伤医院收治的92例老年FAJ下胫腓损伤患者为研究对象,根据不同治疗方法分为两组,各46例。对照组采用CBT固定治疗,研究组采用带袢钢板弹性固定治疗。比较两组术中与术后情况、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分(Ankle Hindfoot Scale,AHS)、并发症发生情况。结果两组术中操作时间、术中失血量比较,差异无统计学意义(P均>0.05)。研究组部分与完全负重活动时间均短于对照组,差异有统计学意义(P均<0.05)。术后6个月时,研究组AOFAS-AHS评分为(90.02±2.65)分,高于对照组的(85.02±2.75)分,差异有统计学意义(t=8.880,P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与CBT相比,带袢钢板弹性固定可以有效缩短老年FAJ下胫腓损伤患者的部分与完全负重活动时间,促进踝关节功能恢复。展开更多
文摘Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003) had two-, six- and ten-times higher odds of adverse pregnancy outcomes respectively, relative to women who required no treatment. Conclusion: Adverse pregnancy outcomes are prevalent among women who have received treatment in Zambia. The findings indicate that treating Cervical Intraepithelial Neoplasia has been linked to higher chances of experiencing abortion, delivering low birth weight babies and enduring prolonged labor that may result in a caesarean section delivery. Cervical neoplasia treatments, particularly Loop Electrosurgical Excision Procedure, are associated with significantly increased odds of adverse pregnancy outcomes. It is essential to include information about prior Cervical Intraepithelial neoplasia treatment outcomes in obstetric care.
文摘目的比较皮质骨螺钉(cortical bone trajectory,CBT)固定与带袢钢板弹性固定在老年踝关节骨折(fracture of ankle joint,FAJ)下胫腓损伤患者中的应用效果。方法选取2022年8月—2023年7月菏泽骨伤医院收治的92例老年FAJ下胫腓损伤患者为研究对象,根据不同治疗方法分为两组,各46例。对照组采用CBT固定治疗,研究组采用带袢钢板弹性固定治疗。比较两组术中与术后情况、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分(Ankle Hindfoot Scale,AHS)、并发症发生情况。结果两组术中操作时间、术中失血量比较,差异无统计学意义(P均>0.05)。研究组部分与完全负重活动时间均短于对照组,差异有统计学意义(P均<0.05)。术后6个月时,研究组AOFAS-AHS评分为(90.02±2.65)分,高于对照组的(85.02±2.75)分,差异有统计学意义(t=8.880,P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与CBT相比,带袢钢板弹性固定可以有效缩短老年FAJ下胫腓损伤患者的部分与完全负重活动时间,促进踝关节功能恢复。
