Anti-diabetic drugs for effectively lowering glucose with limited side effects are necessary in providing patient-centered diabetic management. Sodium glucose cotransporter 2 (SGLT 2) inhibitors provide a novel therapeutic approach for managing type 2 diabetic patients by lowering glucose levels by increasing urinary excretion of glucose independently of insulin secretion or action. Several SGLT 2 inhibitors were recently approved and available in the US, European and Korean markets. SGLT 2 improved glycemic control with low propensity of hypoglycemia. Through the clinical trials, most SLGT2 inhibitors were generally well tolerated. Genital tract infections were more frequent in most clinical studies of SGLT2 inhibitors and urinary tract infections were slightly increased in some studies. This review will describe the main safety issues that have been uncovered in clinical trials of SGLT 2 inhibitors.
Diabetes Mellitus, Type 2 ; Glucose* ; Humans ; Hypoglycemia ; Insulin ; Reproductive Tract Infections ; Sodium* ; Urinary Tract Infections

OBJECTIVETo investigate the natural outcome of genital tract high risk human papillomavirus (HR-HPV) infection and associated factors among women in Xi'an region.

METHODSTotally 760 women with primary genital tract HR-HPV infection were enrolled and followed up by HPV-DNA genotyping technology. The cervical cytological techniques and/or colposcopy were used when necessary.

RESULTSAmong these subjects,the natural clearance rate of HR-HPV infection was 71.58%,with the median time of 8.10 months. The rate of HPV persistent infection was 22.63%, with the median time of 17.23 months. The rate of progression to cervical intraepithelial neoplasia (CIN)/cervical cancer (CC) was 5.79%, with the median time of 29.34 months. The natural clearance rate (P=0.000), persistent infection rate (P=0.000) and progression rate (P=0.040) in women older than 50 years were statistically difference from other age groups. The persistent infection rate in multiple infections group was significantly lower than that in single infection group (P=0.010), with the median time statistically longer than that in single infection group (P=0.018). The most easily progressive genotypes were HPV-16,HPV-33, HPV-58,HPV-18,HPV-52, and HPV-68, among which HPV-16 was the most common genotype in CIN 3/CC cases, accounting for 85.00%.

CONCLUSIONSMost of HR-HPV infections are naturally cleared within 2 years, and only a few cases progresses to CIN/CC. Women older than 50 years have a lower natural clearance rate and higher persistent and progressive rates. Multiple infections can affect the persistent infection. HPV-16 is the most common carcinogenic genotype in Xi'an region.

Cervical Intraepithelial Neoplasia ; Colposcopy ; Female ; Genotype ; Humans ; Papillomaviridae ; Papillomavirus Infections ; Reproductive Tract Infections ; Risk Factors

OBJECTIVE: To evaluate the infection rate of cervicovaginal U. urealyticum and M. hominis in normal full-term and preterm labor women, to know whether these infections are related to the increase of preterm labor incidence. METHODS: We took the test for U. urealyticum and M. hominis in cervicovaginal fluid in 35 cases of premature labor women and 74 cases of normal full-term women. Culture of U. urealyticum and M. hominis with Mycoscreen kitR and other bacterial culture were performed, simultaneously. Clinical outcomes were reviewed and the test results between preterm labor and full-term pregnancy group were compared. Student t-tests and Chi-square, Fisher's exact test were used to determine the statistical significance. RESULTS: The infection rates of U. urealyticum in preterm labor group and normal full-term group were 71.4% (25/35 cases) and 58.1% (43/74 cases), respectively (p>0.05). The M. hominis infection rates in premature labor group and normal full-term group were 20% (7/35 cases) and 2.7% (2/74 cases), respectively (p<0.01). Other bacterial infection rates in premature labor and normal full-term group were 31.4% (11/35 cases) and 10.8% (8/74 cases), respectively (p<0.01). Among the premature labor women, the duration of pregnancy prolongation after onset of premature labor was significantly longer in M. hominis positive group than that in M. hominis negative group (21.7 days vs 3.5 days). CONCLUSION: The lower genital tract infection may be an important causative factor of premature labor, especially with colonization of M. hominis. It was suggested that the efforts of obstetricians to detect and control genital M. hominis and bacterial infection may, in some degree, prevent the preterm labor and birth.
Bacterial Infections ; Colon ; Female ; Humans ; Incidence ; Mycoplasma Infections* ; Mycoplasma* ; Obstetric Labor, Premature* ; Parturition ; Pregnancy ; Reproductive Tract Infections

Infertility can be attributed to reproductive tract infections (RTI), most commonly nongonococcal urethritis, mainly including Mycoplasma and Chlamydia infections, which may directly or indirectly damage spermatozoa and spermatogenic cells. In addition, a series of immune responses caused by such infections are also associated with male infertility. Methods for the clinical detection of these microbial infections are being constantly improved for more specific and precise control over the impact of Mycoplasma and Chlamydia infections on male fertility.
Chlamydia Infections ; complications ; Humans ; Infertility, Male ; microbiology ; Male ; Mycoplasma ; Mycoplasma Infections ; complications ; Reproductive Tract Infections ; Spermatozoa ; microbiology ; Urethritis ; complications ; microbiology

Labial adhesions are extremely rare in adolescent and adult populations, because the etiology of this entity commonly relates to chronic vulvar inflammation or irritation, and is basically associated with low estrogen status. Although a few cases reported urinary retention resulting from severe labial adhesions, there is no report of labial adhesion that precipitates upper genital tract infection in prepubertal and postpubertal females. We present a rare case of severe labial adhesion and consequential lower genital tract obstruction that allegedly causing bilateral pyosalpinx in a 14-year-old adolescent girl who decisively denied sexual experience. The patient was successfully treated with surgical lysis of adhesion and administration of antibiotics.
Adolescent ; Adult ; Anti-Bacterial Agents ; Estrogens ; Female ; Humans ; Inflammation ; Reproductive Tract Infections ; Urinary Retention

OBJECTIVETo investigate the association of male reproductive tract infection (RTI) with semen parameters and sperm DNA damage.

METHODSWe classified 1 084 males attending the infertility clinic into an RTI group (n = 300) and a non-RTI control group (n = 784). According to the WHO standards, we obtained routine semen parameters, detected sperm morphology, and determined the sperm DNA fragmentation index (DFI) by sperm chromatin structure assay.

RESULTSThere were statistically significant differences between the RTI and control groups in the semen volume ( [2.58 ± 1.20] vs [3.00 ± 2.10] ml), grade a + b sperm ([50.6 ± 17.2] vs [53.2 ± 15.8]%), grade d sperm ( [39. 8 ± 17.8] vs [36.5 ± 16.2]%), and total sperm count ([218.5 ± 185.0 ] vs [278.5 ± 375.5 ] x 10(6)/ejaculate) (all P < 0.05), but not in the males' age, sperm concentration or pH value (P > 0.05). The percentage of morphologically normal sperm was significantly lower ([3.46 ± 2.90] vs [4.61 ± 3.60%, P < 0.05) but the DFI was markedly higher in the RTI group than in the control ([19.4 ± 11.4] vs [15.2 ± 8.8]% , P < 0.01). The percentage of the cases with DFI > 30% was remarkably higher (13.0 vs 5.74% ) while that of the cases with DFI < 10% dramatically lower in the former than in the latter (16.0 vs 28.0%). The level of seminal plasma elastase was correlated negatively to sperm concentration, sperm count, and the percentage of morphologically normal sperm (P < 0.05) but positively to DFI and grade d sperm (P < 0.05 or P < 0.01).

CONCLUSIONMale reproductive tract infection not only affects semen parameters and sperm morphology but also causes serious sperm DNA damage.

DNA Fragmentation ; Humans ; Infertility, Male ; physiopathology ; Male ; Reproductive Tract Infections ; physiopathology ; Semen ; chemistry ; Semen Analysis ; Sperm Count ; Spermatozoa ; pathology

OBJECTIVE: To determine the vaginal flora distribution in cervical cancer patients and the common pathogenic bacteria as well as drug resistance, and to explore the correlation of vaginal bacterial infection and high-risk human papillomavirus (HR-HPV) infection with cervical cancer.
 METHODS: A total of 216 patients with cervical cancer served as an experimental group, and 53 patients with chronic cervicitis served as a control group. The patients' vaginal fluid in two groups was collected before the treatment for regular bacterial culture and HPV testing. The distribution and drug resistance of bacteria in two groups of vaginal secretion were observed, and the correlation of the bacterial infection and HPV infection with the cervical cancer was analyzed.
 RESULTS: The gram-negative and gram-positive bacteria accounted for 74.38% and 21.49% in the experimental group, respectively. They were mainly resistant to ampicillin and piperacillin or penicillin and erythromycin. The gram-negative and gram-positive bacteria accounted for 42.31% and 23.08% in the control group, respectively. They were mainly resistant to ampicillin and piperacillin or penicillin. HPV-positive rates in the experiment group and the control group were 60.65% and 41.51%, respectively. There were 70 patients (32.41%) and 12 patients (22.64%) with both bacterial infection and HPV-positive infection in the experiment group and the control group, respectively. However, there was no statistical difference between the 2 groups (P>0.05). 
 CONCLUSION Escherichia coli are the main pathogen in cervical cancer and they are highly resistant to antibiotics. Bacterial infection in genital tract is not an efficient cofactor for HPV to cause the cervical cancer.
Drug Resistance, Bacterial ; Female ; Gram-Negative Bacterial Infections ; Gram-Positive Bacteria ; Gram-Positive Bacterial Infections ; Humans ; Reproductive Tract Infections ; Uterine Cervical Neoplasms

BACKGROUND: Pelvic inflammatory disease (PID) is a common genital tract infection in reproductive women. This study aimed to determine the frequency of Neisseria gonorrheae, Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in Pelvic inflammatory disease (PID), and to further sub-analyze the clinical characteristics in patients diagnosed with Fitz-Hugh-Curtis syndrome (FHCS). MATERIAL AND METHODS: Sixty-six patients diagnosed clinically as PID were recruited from April, 2007 to February, 2011. Retrospective chart review was performed for investigating the characteristics of the clinical manifestation, laboratory findings, and image findings. And then all subjects were classified into two groups, the PID-only group and the FHCS group, depending on whether or not computed tomography showed increased perihepatic enhancement. Samples obtained in endocervical swabs were tested using Roche COBAS Amplicor Polymerase-chain reaction (PCR) for N. gonorrheae, C. trachomatis, U. urealyticum, and M. hominis. RESULTS: The 66 PID patients ranged in age from 19 to 49 years. Thirty nine patients were diagnosed as having an inflammation localized only in the lower abdomen (PID only), and 27 patients were diagnosed as FHCS. According to results of PCR, U. urealyticum was found most commonly in both the PID-only group and the FHCS group (66.7% and 59.3%, respectively). CONCLUSIONS: Organisms other than C. trachomatis and N. gonorrheae, particularly U. urealyticum, may be detected more frequently in PID patients in Korea. In addition, identification of M. hominis may be of importance in female health problems such as FHCS.
Abdomen ; Chlamydia Infections ; Chlamydia trachomatis ; Female ; Gonorrhea ; Hepatitis ; Humans ; Inflammation ; Korea ; Mycoplasma hominis ; Neisseria ; Pelvic Inflammatory Disease ; Peritonitis ; Polymerase Chain Reaction ; Reproductive Tract Infections ; Retrospective Studies ; Ureaplasma urealyticum

PURPOSE: Circumcision in childhood is widely practiced in Korea, but the Korean attitude to circumcision has not been well studied. Our aim was to evaluatethe knowledge and general opinion of Korean adult males toward circumcision. MATERIALS AND METHODS: One thousand five hundred self-completed questionnaires were distributed to adult males of five major age groups from 10s' to 50s' divided into decades. Questions asked about the responders' opinions regarding the necessity, reasons, potential benefits, and disadvantages for circumcision, and also asked if there was any peer pressure when deciding upon circumcision. The responses were collected and analyzed statistically. RESULTS: The response rate was 62.7% (936). Of 836 responders, 611 (73.1%) believed that circumcision is necessary, while 59 (7.1%) believed it to be unnecessary. The principal reason for circumcision was improvement of penile hygiene (77.9%). Of 921 responders, 768 (83.4%) believed that the smegma is a dirty material infected by microorganisms. Of 901 responders, 619 (68.7%) didn't prefer the neonatal period regardless of age. The major reason was pain (36.9%). Peer pressure was one of the most influencing factors when deciding upon circumcision: 540 (60.8%) of 888 responders believed that they might be ridiculed by their peer group unless they were circumcised and the younger, the more frequent (p<0.05). Of 917 responders, 616 (62.7%) thought that circumcision would prevent genital tract infection of the sexual partner. Responders with lower education or older responders were prone to emphasize the improvement in sexual potency (p<0.05). CONCLUSIONS: Our study indicates that common beliefs held by adult males about the prepuce or circumcision are homogeneous according to age. It is critical to tailor education about the potential benefits and disadvantages of circumcision.
Adult* ; Circumcision, Male* ; Education ; Female ; Humans ; Hygiene ; Korea ; Male ; Male* ; Peer Group ; Phimosis ; Surveys and Questionnaires* ; Reproductive Tract Infections ; Sexual Partners ; Smegma

PURPOSE: The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. METHODS: The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. RESULTS: About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. CONCLUSIONS: The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population.
Asian Continental Ancestry Group ; China ; Delivery of Health Care ; Female ; Health Education ; Humans ; Pregnancy ; Prevalence ; Reproductive Tract Infections ; Research Design ; Rural Population