Homero Gustavo de Campos Guidi

Urinary Tract Infections in Pregnant Women

Abstract: Urinary tract infections are of great importance during pregnancy owing to undesirable complications such as fetal and maternal morbidity. This paper describes the functional alterations that occur in this condition and predispose to infection. Clinical presentation and subsidiary diagnosis are discussed, including asymptomatic bacteriuria, cystitis and pyelonephritis. In addition, the authors report drug options, and their safety and duration of treatment during pregnancy.

Urinary Tract Infections In Women

Abstract: Urinary tract infection (UTI) is one of the most frequent diseases in medical practice. Some definitions and epidemiology of UTI and bacteriuria are discussed, as well as host susceptibility and defense mechanisms. Aspects of infection in young women and in the elderly are reported, emphasizing microbiological, clinical and therapeutic aspects. Finally, epidemiologic and clinical aspects of fungal UTI are discussed.

Human Papillomavirus History and Epidemiology

Human papillomavirus (HPV) infection is a significant source of morbidity and mortality among the young population and, together with HIV, is considered the most costly sexually transmitted disease (STD) in terms of estimated direct medical expenses (Chesson et al., 2004). According to a recent Centers for Disease Control and Prevention (CDC) analysis (Forhan et al., 2008), one in four American women between the ages of 14 and 19 (approximately 3.2 million young girls) is infected with at least one of the most common STDs (i.e., HPV, Chlamydia trachomatis, trichomoniasis, and herpes simplex virus type 2). While genital chlamydia is the most commonly reported condition in the United States (Satterwhite, 2008), HPV is by far the most prevalent (18.3% in the CDC study compared to 3.9% for chlamydia).

Predictive value of clinical history compared with urodynamic study in 1,179 women.

OBJECTIVE to determine the positive predictive value of clinical history in comparison with urodynamic study for the diagnosis of urinary incontinence. METHODS retrospective analysis comparing clinical history and urodynamic evaluation of 1,179 women with urinary incontinence. The urodynamic study was considered the gold standard, whereas the clinical history was the new test to be assessed. This was established after analyzing each method as the gold standard through the difference between their positive predictive values. RESULTS the positive predictive values of clinical history compared with urodynamic study for diagnosis of stress urinary incontinence, overactive bladder and mixed urinary incontinence were, respectively, 37% (95% CI 31-44), 40% (95% CI 33-47) and 16% (95% CI 14-19). CONCLUSION we concluded that the positive predictive value of clinical history was low compared with urodynamic study for urinary incontinence diagnosis. The positive predictive value was low even among women with pure stress urinary incontinence.

Sexually Transmitted Infections

Sexually transmitted infections (STIs) mainly manifest as genital ulcers, urethritis, or genital warts. STIs must always be correctly diagnosed and treated so as to prevent further transmission and reduce the risk of human immunodeficiency virus (HIV) acquisition. This Chapter discusses the genital manifestations and current management of STIs caused by the organisms involved in the conditions related above.

Systemic Disorders Affecting the Genital Skin

Several systemic diseases may become manifest in the genital region. A systematic approach to diagnosis, including careful review of the clinical history associated with a comprehensive knowledge of local and systemic signs and symptoms is paramount in order to properly manage these conditions. Furthermore, selecting the most adequate laboratory investigation to aid in the diagnosis, particularly in diseases with unusual etiology or presentation, is an important skill. In this Chapter, the systemic disorders that may affect the male genitalia are reviewed.

Premalignant Lesions of the Penis

Premalignant penile lesions are a known risk factor for the development of penile neoplasias, and they have been reported in nearly half of invasive tumors. Prompt recognition and treatment prior to malignant transformation may avoid the need for traumatic procedures, which is often required when invasive penile cancer is diagnosed. The current terminology and categorization of penile precursor lesions, including risk factors, management, and prevention is reviewed in this chapter.

Pigmentary Lesions/Pigmentary Skin Changes

Melanocytic lesions of the male genital area are rare, and they share similar histological features to those pigmented lesions from other body sites. However, benign pigmented mucocutaneous macules have been described under various terms, which may cause a certain degree of confusion for non-dermatologist practitioners interested in the subject. This Chapter reviews the pigmentary lesions and pigmentary skin changes that may affect the male external genitalia

Nonsquamous Malignant Neoplasms of the Penis and Scrotum

Malignant lesions other than SCC infrequently involve the male external genitalia and usually affect older individuals. In this Chapter, basal cell carcinoma, lymphoma, malignant melanoma and sarcomas are discussed.

Embryology and Functional Anatomy of the Male External Genitalia

Dermatoses of the male external genitalia may comprise either specific disorders of the genital region or local manifestations of systemic diseases. In addition, normal anatomical variations of the penis and scrotum are commonly observed, which may further confound the correct diagnosis of the innumerous conditions affecting the region. Therefore, understanding the basic notions of the male genital embryology and functional anatomy, as well as the correct sequence of history taking and physical examination are of utmost importance in order to better characterize the conditions involving this particular site. The embryology of the male external genitalia and its functional anatomy are discussed in this Chapter.