ỏc trang th loi Bnh lõy truyn qua ng tỡnh dc Mc lc sng 1.1 Nguyờn nhõn 1.2 Triu chng 1.3 iu tr 1.4 am kho B tng 2.1 Bch tng ngi 2.1.1 Du hiu v triu chng 2.2 Chỳ thớch 2.3 Liờn kt ngoi Bnh Behỗet 3.1 Du hiu v triu chng 3.1.1 Da v niờm mc 3.1.2 H thng mt 3.1.3 ng rut 3.1.4 Phi 3.1.5 H thng c xng 3.1.6 H thn kinh 3.2 Chn oỏn 3.3 Bnh sinh 3.4 iu tr 3.5 Sinh lý bnh 3.6 Dch t hc 3.7 Lch s 3.8 Chỳ thớch 3.9 Liờn kt ngoi Bnh da liu 4.1 Hỡnh thỏi hc 4.1.1 Tn thng s cp 4.1.2 Tn thng th cp i ii MC LC 4.2 Chỳ thớch Bnh gh 11 5.1 11 Chỳ thớch Bnh lõy truyn qua ng tỡnh dc 12 6.1 T nguyờn hc 12 6.2 Phõn loi 12 6.3 Nguyờn nhõn 12 6.3.1 Bnh vi khun 12 6.3.2 Bnh nm 12 6.3.3 Bnh virus 12 6.3.4 Bnh ký sinh trựng 13 6.3.5 Xỏc sut lõy truyn 13 6.4 Sinh lý bnh 13 6.5 Dch t hc 13 6.6 Phũng nga 14 6.6.1 Vc xin 14 6.6.2 Bao cao su 14 6.7 Chn oỏn 14 6.8 Lch s 14 6.9 Xem thờm 15 6.10 Chỳ thớch 15 6.11 Liờn kt ngoi 16 Bnh vy da 17 7.1 Triu Chng 17 7.2 C Ch Gõy Bnh 17 7.3 Din Bin 17 7.4 Phõn loi 18 7.5 iu Tr 18 7.6 Chỳ thớch 18 Bnh vy nn 19 8.1 Nguyờn nhõn 19 8.2 Nhn din 19 8.3 Nhng iu cn trỏnh ca ngi b vy nn 20 8.4 iu tr 20 8.4.1 iu tr ti ch 20 8.4.2 iu tr ton thõn 20 8.5 c thờm 21 8.6 Liờn kt ngoi 21 MC LC iii 22 Chm (bnh) 9.1 Triu chng v din bin ca bnh 22 9.2 Cỏc th lõm sng 22 9.2.1 Eczema tip xỳc (Contact eczema, contact dermatitis) 22 9.2.2 Eczema th a (Atopic dermatitis) 22 9.2.3 Eczema th ng tin (Nummular Eczema) 23 9.2.4 Eczema da du (Seborrheic dermatitis) 23 Nguyờn nhõn v c ch bnh sinh 23 9.3.1 Nguyờn nhõn ngoi gii 23 9.3.2 Nguyờn nhõn ni gii 23 9.3.3 Phn ng d ng 23 23 9.4.1 Dõn gian cha Eczema 23 9.4.2 ụng y cha Eczema 23 9.4.3 Tõy y cha Eczema 24 24 9.3 9.4 9.5 iu tr Chỳ thớch 10 Cornu cutaneum 25 10.1 am kho 11 Da v ni 25 26 11.1 Triu chng 26 11.2 Nguyờn nhõn 26 11.3 iu tr 26 11.4 Dch t hc 26 11.5 Xem thờm 27 11.6 Chỳ thớch 27 11.7 Liờn kt ngoi 27 12 D ng 28 12.1 Triu chng 28 12.2 Nguyờn nhõn 28 12.2.1 D ng thc phm 28 12.2.2 D ng vi cỏc tỏc nhõn khụng phi l thc phm 29 12.2.3 C s di truyn 29 12.2.4 Gi thuyt v v sinh 29 12.2.5 Cỏc yu t mụi trng 29 12.2.6 Phn ng cp tớnh 29 12.2.7 Phn ng giai on cui 30 12.3 Chn oỏn 30 12.3.1 Kim tra phn ng trờn da (Skin testing) 30 12.3.2 Xột nghim mỏu 31 iv MC LC 12.4 iu tr 31 12.4.1 Liu phỏp dựng thuc 31 12.4.2 Liu phỏp dch 31 12.5 Dch t hc 31 32 12.7 Liờn kt ngoi 33 12.6 Chỳ thớch 13 D ng xi mng 34 13.1 Lch s bnh 34 13.2 Triu chng 34 13.3 C ch d ng xi mng 34 13.4 iu tr 35 13.4.1 V sinh v sau tip xỳc vi xi mng 35 13.4.2 ụng tõy y kt hp 35 13.4.3 Tiờm K - cort, tờn khỏc: Triamcinolon, Sivkort, Kafencort 35 13.4.4 Ung thuc v bụi thuc tõy kt hp 35 13.5 Phũng nga 35 13.6 am kho 35 13.7 c thờm 36 13.8 Liờn kt ngoi 36 14 Herpes n dng 37 14.1 Phõn loi 37 14.2 Du hiu v triu chng 37 14.2.1 Bnh lit Bell 37 14.2.2 Bnh Alzheimer 37 14.3 Sinh lý bnh 37 14.4 Phũng chng 37 14.4.1 Phng phỏp hng ro bo v 37 14.4.2 Vc-xin 38 14.4.3 uc khỏng siờu vi 38 14.4.4 i k mang thai 38 14.5 iu tr 14.6 Dch t hc 38 38 14.7 Lch s 38 14.8 Xó hi v húa 38 14.9 Chỳ thớch 39 14.10 Liờn kt ngoi 40 15 Herpes sinh dc 41 15.1 Triu chng 41 15.1.1 Bin chng 41 MC LC 15.2 iu tr v 41 15.3 Xem thờm 42 15.4 Liờn kt ngoi 42 15.5 Chỳ thớch 42 16 Lupus ban h thng 43 16.1 Triu chng 16.1.1 Biu hin v da liu 43 43 16.1.2 Biu hin v c xng 43 16.1.3 Biu hin v huyt hc 44 16.1.4 Biu hin v tim 44 16.1.5 Biu hin v phi 44 16.1.6 Biu hin v thn 44 16.1.7 Biu hin v thn kinh-tõm thn 44 16.1.8 Biu hin h thng 45 16.2 Nguyờn nhõn 45 16.2.1 Yu t gen 45 16.2.2 Yu t kớch hot t mụi trng 45 16.2.3 Tng tỏc thuc 45 16.2.4 Cỏc dng lupus khụng phi l lupus ban h thng 45 16.3 Sinh lý bnh hc 45 16.3.1 S lan ta bnh 45 16.3.2 Ri lon quỏ trỡnh t hy t bo 46 16.3.3 Gim kh nng thi loi t bo cht 46 16.3.4 S tớch t ti trung tõm mm 47 16.3.5 S t chng li cỏc ribonucleoprotein nhõn (nRNP) 47 16.3.6 Cỏc c ch khỏc 47 16.4 Chn oỏn 47 16.4.1 Xột nghim 47 16.4.2 Tiờu chun chn oỏn 48 16.5 iu tr 49 16.5.1 Cỏc loi thuc 49 16.5.2 ay i li sng 50 16.5.3 Ghộp thn 50 16.6 Phũng bnh 50 16.6.1 Bin chng thai sn 50 16.7 Tiờn lng 50 16.8 Dch t hc 51 16.9 Lch s v húa 51 16.9.1 T gc 51 16.9.2 Lch s 51 16.10 Chỳ thớch 51 vi MC LC 16.11 Liờn kt ngoi 17 Mn cúc 54 55 17.1 Nguyờn nhõn gõy bnh 55 17.2 Phõn loi 55 17.3 iu tr chung 55 17.3.1 Dc phm 55 17.3.2 thut 56 17.4 iu tr cho mn cúc sinh dc 56 17.4.1 Hiu qu cỏc liu phỏp iu tr mn cúc sinh dc 57 17.5 Chỳ thớch 57 17.6 Liờn kt ngoi 57 18 Trn Hu Ngon 58 18.1 Cuc i 58 18.2 Cuc sng bch 58 18.3 Gia ỡnh 59 18.4 Tiờm vi khun bnh phong vo ngi 59 18.5 Trong ngh thut 59 18.6 Cụng trỡnh nghiờn cu 59 18.7 Ghi chỳ 59 18.8 Liờn kt ngoi 60 19 Viờm da thn kinh 19.1 Bnh nguyờn 61 61 19.2 Biu hin lõm sng 61 19.3 Chn oỏn v iu tr 61 19.4 Chỳ thớch 61 19.5 am kho 61 20 Viờm da tip xỳc 62 20.1 Cỏc triu chng 62 20.2 Nguyờn nhõn 62 20.3 Phõn loi 62 20.3.1 Viờm da tip xỳc kớch ng 62 20.3.2 Viờm da tip xỳc d ng 62 20.3.3 Viờm da Photocontact 64 20.4 Cỏc triu chng 64 20.5 iu tr 64 20.5.1 T chm súc 64 65 20.6 Chn oỏn 65 20.7 Phũng nga 65 20.5.2 Chm súc y t MC LC 20.8 Túm tt vii 65 20.9 Xem thờm 65 20.10 Chỳ thớch 65 20.11 Liờn kt ngoi 66 21 Viờm da tit bó nhn 67 21.1 T l hin mc v bnh nguyờn 67 21.2 Biu hin lõm sng 67 21.3 Chn oỏn 67 21.4 iu tr 67 21.5 am kho 68 22 Viờm da ng 69 22.1 T l mi mc v bnh nguyờn 69 22.2 Triu chng 69 22.3 Biu hin lõm sng 69 22.4 iu tr 69 22.5 Chỳ thớch 69 23 Bnh Chlamydia 70 23.1 Cỏc du hiu v triu chng 70 23.1.1 Bnh qua ng sinh dc 70 23.2 Chỳ thớch 71 24 Bnh virus Ebola 72 24.1 Nguyờn nhõn v Chn oỏn 72 24.2 Nguyờn nhõn 72 24.3 Du hiu v triu chng 73 24.4 Vcxin 73 24.5 Dch bnh Virus Ebola 1976 74 24.6 Dch bnh Virus Ebola 2014 chõu Phi 74 24.7 Khụng th cha 74 24.7.1 Cỏc di chng 74 24.7.2 S ngi bỡnh phc rt ớt 75 24.8 Phũng trỏnh 75 24.9 am kho 75 24.10 Liờn kt ngoi 77 25 Bnh rn mu 78 25.1 Nguyờn nhõn 78 25.2 Triu chng 78 25.3 Chn oỏn 78 25.4 Phũng tr 79 viii MC LC 25.5 Chỳ thớch 79 25.6 Xem thờm 79 25.7 Liờn kt ngoi 79 26 Chlamydia traomatis 80 26.1 Bnh gõy bi Chlamydia trachomatis 80 26.1.1 Bnh ng sinh dc 80 26.2 Hỡnh nh 81 26.3 am kho 81 26.4 Chỳ thớch 81 27 Giang mai 82 27.1 Chn oỏn 82 27.1.1 Giai on 82 27.1.2 Giai on 82 27.1.3 Giai on tim n 83 27.1.4 Giai on 83 27.2 iu tr 84 27.2.1 Giai on u 84 27.2.2 Giai on bin chng 84 27.2.3 Phn ng Jarisch-Herxheimer 84 27.3 Phũng nga 85 27.4 Dch t hc 85 27.5 Lch s 85 27.5.1 Cỏc tờn gi khỏc 85 27.5.2 Ngun gc 86 27.6 Hỡnh nh 86 27.7 Chỳ thớch 87 27.8 Liờn kt ngoi 88 28 HIV 89 28.1 Phõn loi 89 28.2 Cu trỳc v b gen 89 28.3 Xem thờm 90 28.4 Chỳ thớch 90 28.5 Liờn kt ngoi 90 29 HIV/AIDS 91 29.1 Hi chng, suy gim dch, mc phi 91 29.2 Du hiu v triu chng 92 29.2.1 Giai on cp tớnh 92 29.2.2 Giai on tớnh 93 29.2.3 Giai on AIDS 93 MC LC ix 29.3 Phng thc lõy truyn 93 93 29.3.2 ng mỏu 94 29.3.3 M truyn sang 94 29.4 HIV/AIDS v ng tớnh luyn ỏi 95 29.5 Nghiờn cu cỏch iu tr v vaccine 96 29.6 Xem thờm 96 29.7 Chỳ thớch 96 29.8 Liờn kt ngoi 99 29.3.1 Tỡnh dc 30 Lu m 100 30.1 Triu chng 100 30.2 Chn oỏn 100 30.3 iu tr 100 30.4 Dch t hc 101 30.5 Tỏc hi ca bnh lu vi nam gii 101 30.6 Phũng nga 101 30.7 Chỳ thớch 101 30.8 Liờn kt ngoi 102 31 Nhim khun õm o 103 31.1 am kho 103 32 Nhim virus papilloma ngi 32.1 Phõn loi HPV 104 104 32.2 HPV v ung th c t cung 104 32.3 Chng nga chng HPV 104 32.4 Hỡnh nh 104 32.5 Chỳ thớch 105 32.6 Liờn kt ngoi 105 33 Rn mu 106 33.1 c im 106 33.2 Bnh rn mu 106 33.3 Nguy c tuyt chng 107 33.4 i vi cỏc ng vt khỏc 107 33.5 Chỳ thớch 107 33.6 Liờn kt ngoi 107 34 Sựi mo g 108 34.1 Nguyờn nhõn gõy bnh sựi mo g 108 34.2 iu tr mn cúc sinh dc 108 34.2.1 Hiu qu cỏc liu phỏp iu tr mn cúc sinh dc 109 38.13 LIấN KT NGOI 38.9 Tm soỏt ung th c t cung Ti tm soỏt ung th c t cung: Ung th c t cung cú t l mc bnh cao, ng thi t l t vong cng cao phỏt hin giai on mun Cú th phỏt hin giai on tin lõm sng, v thi gian t giai on ny n giai on biu hin lõm sng khỏ lõu, trung bỡnh l 10-15 nm t cú nghch sn c t cung n ung th c t cung Giai on nghch sn c t cung, kh nng iu tr thnh cụng cao v iu tr n gin, ớt tn kộm hn nhiu so vi ung th giai on tin trin Pht t bo c t cung l mt test dựng tm soỏt khỏ n gin, nhy v c hiu cng tng i, giỏ thnh r, ớt gõy khú chu hay bt tin cho bnh nhõn, ớt xõm ln Soi c t cung v sinh thit c t cung l nhng xột nghim tip theo dựng chn oỏn sm kt qu pht t bo bt thng 38.10 Tiờn lng Giai on 1: t l sng cũn sau nm khong 90% Giai on 2: khong 75% Giai on 3: khong 40% Giai on 4: khong 10% 38.11 Tham kho Chỳ gii 1: Chỳ gii 2: Ung th hc ni khoa PGS Nguyn Chn Hựng Nh xut bn Y Hc nh ph H Chớ Minh Nm 2004 trang 1819 Chỳ gii 3: Manual of Clinical Oncology 6th 1994 UICC Chỳ gii 4: NEJM - Cancer of the Unterine Cervix Stephen A.Cannistra M.D., Jonathan M Nilo M.D Chỳ gii 5: Cervical Cancer by Agustin A Garcia, MD - Emedicine 38.12 Xem thờm Tõn sinh biu mụ c t cung Pht t bo c t cung Soi c t cung 117 38.13 Liờn kt ngoi Vin ung th quc gia Hoa K Hi ung th Hoa K Chng 39 Viờm c t cung Do chlamydia trachomatic: a nghiờn cu, khong 20 - 25% ngi bnh khụng cú triu chng; 30 - 60% trng hp khớ h ging nh m Ngoi ra, mt s trng hp mỏu, tiu khú Viờm c t cung l hin tng c t cung ca n gii b viờm nhim, l loột hoc mng m s tn cụng t cỏc loi vi khun, nm v ký sinh trựng gõy Viờm c t cung l mt nhng bnh lý thng gp ph n Cp tớnh: ng gp thi k sau sinh, sy thai, rỏch c t cung lm niờm mc c b ln vo õm o v b nhim khun Hỡnh thỏi nhim khun ny ca c t cung gõy viờm bch mch nn dõy chng rng; biu hin khớ h nh cht nhy, cú m, c t cung sung huyt phự n 39.1 Triu chng v hu qu Dch õm o mu xỏm, khớ h mu vng cú m kem theo mựi khú chu, au sau i v sinh, au sau giao hp, chy mỏu õm o sau giao hp, mỏu bt thng gia cỏc k kinh nguyt Cỏc triu chng viờm c t cung thng xut hin khụng in hỡnh Chỳng cng cú th d b nhm ln vi triu chng ca cỏc bnh ph khoa khỏc nờn nu ch da trờn cỏc du hiu ú chn oỏn bnh thỡ cha Mn tớnh: Tỡnh trng viờm c t cung b kộo di Khớ h c sỏnh cú m, khụng nga, giao hp khụng au, nhng ụi b mỏu giao hp 39.3 iu tr v phũng chng 39.4 Chỳ thớch 39.1.1 Hu qu Bnh thng gõy au n cho ngi bnh vựng h v, kinh nguyt ri lon v lm xỏo trn cỏc chc nng ca c t cung Nhng ngi mc bnh ny thng khú cú v suy gim i sng quan h v chng Viờm c t cung cng l yu t bt li cú thai Tỡnh trng viờm nhim lm thay i mụi trng sinh lý ti õm o, c t cung, gõy bt li cho s tn ti v hot ng ca tinh trựng ng sinh dc n Viờm nhim c t cung lõu ngy cũn cú th dn n viờm nhim ngc dũng, gõy dớnh bung t cung, viờm tc vũi trng, e da trm trng sc khe sinh sn ca bn 39.2 Nguyờn nhõn Cú mt s loi viờm c t cung: Do lu cu: Lu n cú 97% khụng cú triu chng; 3% bnh nhõn tiu but, tiu gt, khớ h vng Bnh thng c chn oỏn qua xột nghim vi khun[1] 118 [1] Bt bnh ph khoa qua khớ h - VnExpress VnExpress - Tin nhanh Vit Nam Truy cp 25 thỏng 10 nm 2015 Chng 40 Viờm gan siờu vi B Viờm gan sinh Viờm gan siờu vi B l mt s dng bnh viờm gan viờm gan siờu vi B gõy ra, truyn nhim theo ng mỏu v sinh dc lõy n gn mt phn dõn s trờn ton th gii , nhiu nht ti cỏc nc ang phỏt trin 10% 90% Hi phc hon ton 40.1 Virus Viờm gan trng thnh 10% Viờm gan mn tớnh 80% 90% Hi phc hon ton 20% 40.2 Dch t hc Ti Hoa K: Hng nm khong 200.000 ngi mi mc bnh HBV, khong 1-1,25 triu ngi cú siờu vi trựng viờm gan B mỏu Bnh cú nhiu hn dõn M gc Phi, dõn Hispanic v ngi gc chõu , mt s khỏc hay b HBV l dõn Eskimo, dõn gc o ỏi Bỡnh Dng v th dõn c HBV l nguyờn nhõn ca 5-10% bnh hoi gan mn tớnh v 10-15% ung th gan HBV lm khong 5.000 ngi cht mi nm, nhiu hn tui trờn 12 (lý cú l l vỡ sinh hot tỡnh dc bt u nhiu hn sau tui ny) cỏc yu t nguy c khỏc gm s dng thuc cocaine v cỏc loi thuc cm chớch mch, nhiu bn tỡnh, li d, trỡnh giỏo dc thp Khụng cú bin chng nng Cú bin chng nng nh x gan ung th gan Tiờn lng Viờm gan siờu vi B lỏch to Him thy bn tay ng hoc spider nevi (mch mỏu li ti kt to thnh hỡnh nhn nh hoa th trờn da) 40.3 Phõn loi giai on 40.3.1 40.3.2 Viờm gan mn tớnh Viờm gan cp tớnh i gian bnh t - thỏng Mt s bnh nhõn cú cm giỏc nh b cm nh, ụi khụng bit mỡnh b HBV Mt s khỏc b vng da, mt mi, au nhc, bun úi, chỏn n, st nh, bin i cm giỏc (hin tng c bit l ngi ghin thuúc lỏ t nhiờn khụng thớch mựi thuc lỏ), au bng (di sn bờn phi) Nhng trng hp b viờm nng s a n gan to, ngy ngt, khú ng, mờ mui, lóng trớ hoc bt tnh Phn ln b viờm mn tớnh cm thy bnh nhõn hon ton bỡnh thng Mt s b viờm mn tớnh nng thỡ tip tc b cỏc triu chng viờm cp nh mt mi, chỏn n, au bng, v suy gan Biu hin lõm sng: Gan to, bn tay ng , spider nevi Khi b bin chng x gan cú th b nc bng, vng da, loóng mỏu, chy mỏu d dy, tnh mch to ln t rn (do tng ỏp lm gión tnh mch ca gan), Biu hin lõm sng: Tng nhit , vng da (1 tun sau nam vỳ ln nh vỳ n, tinh hon teo nh (vỡ gan yu b nhim v cú th kộo di n 1-3 thỏng), gan to, lm thay i cõn bng ca cỏc hormone gii tớnh) 119 120 CHNG 40 VIấM GAN SIấU VI B 40.4 Bin chng Suy gan X gan Ung th gan 40.5 iu tr Vic iu tr ch yu l ngn chn s sinh sụi, nhõn lờn ca virus hoc cỏc cht lm ri lon quỏ trỡnh tng hp, t nhõn lờn ca virus Lu ý: Khi nhim bnh, cn tng cng sc khe v tớnh khỏng ca c th bng ch n ung, chỳ ý n cỏc loi thc phm cú li cho gan Hn ch ung ru vỡ ru khụng nhng gõy x gan m cũn h tr quỏ trỡnh chộp, sinh sn ca virus viờm gan nờn lm tng nhanh s lng virus cú mỏu v lm gim kh nng chu ng ca t bo gan trc s tn cụng ca virus 40.5.1 Xột nghim mỏu nh dng eo dừi tỡnh trng ca gan Bng sau õy l thớ d th nghim gan ca mt bnh nhõn viờm gan mn tớnh 40.5.2 Sinh thit Gan 40.5.3 Thuc Thuc Tõy Cỏc thuc sau ó c FDA (Cc qun lý dc phm Hoa K) chng nhn iu tr viờm gan virus B thuc ung: lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka), entecavir (Baraclude), tenofovir (Viread,topovir) thuc tiờm: alpha-2a, pegylated interferon alfa-2a (Pegasys) Mt s thuc h tr iu tr khỏc: cú tỏc dng tng cng chc nng gan (nh Artichaux, Methionin, Arginin, Ornithine Silymarin, Nissen, Omitan, cỏc vitamin B, C, E) Thuc tho dc Cõy k sa: virus viờm gan B (HBV) l mt nhng yu t nghiờm trng nht dn n ung th biu mụ t bo gan (Hepatocellular carcinoma HCC) Cỏc nghiờn cu trc õy cho thy vic nhim HBV s dn n s lng ROS (gc oxy húa t ph bin) gan tng lờn v gõy kớch hot cỏc gen liờn quan n mt cõn bng cỏc tỏc nhõn oxy húa eo nghiờn cu ca Wu v cỏc cng s[1] cho thy rng c ch phõn t cú tỏc dng chng oxy húa thụng qua silymarin, bao gm cỏc gen liờn quan trc tip hoc giỏn tip n glutathione (GSH) quỏ trỡnh trao i cht S nhõn lờn ca Idh2 to iu kin cho vic hỡnh thnh NADPH v chuyn i GSH t dng b oxy thnh dng rỳt gn ỏ trỡnh gia tng GSH rỳt gn tip tc to iu kin cho vic loi b cỏc H2O2 t bo Ngoi ra, s lng enzyme glutathione S-transferases gia tng (Gs2, Gsto1, Gstk1, v Mgst3) cú chc nng tham gia vo cỏc phn ng liờn hp ca GSH ti nhng cht eletrophin khỏc nhau, giỳp GSH t n nng cao hn Hn na, tng cng iu chnh gen bi silymarin v tham gia vo s trao i cht glutamate, chu k urờ, v chu k citrate cú th tt c giỏn tip gúp phn vo s gia tng ca mc GSH v s o sinh lý bnh gan Cõy Dip H Chõu ng, tho dc ó c chng minh cú tỏc dng thi tr virus viờm gan B, lm sch khỏng nguyờn HBsAg, c ch s phỏt trin ca virus viờm gan B Cõy C Gai leo ó c PGS.TS Phm Kim Món, TS Nguyn Minh Khai nghiờn cu t u nhng nm 90, cú tỏc dng gim nhanh cỏc triu trng lõm sng (mt mi, au tc h sn phi, nc tiu vng, da niờm mc vng,); men gan (transaminase) v bilirubin v bỡnh thng nhanh hn nhúm chng; sau iu tr, nhng bin i v cỏc marker ca virut viờm gan B l rừ rt ti ba bnh vin 103, 108, 354: mt HBsAg 23,3%; chuyn o huyt 37,8%; 62,9% cú HBV-DNA < copies/ml 40.6 Tiờn lng Trng hp b HBV t ngi m cú mm bnh lõy qua sanh: Nu m cú HBsAg thỡ t l truyn cho khong 20% Nu m cú HBcAg thỡ t l truyn cho l khong 90%, nu m cú HBeAg thỡ d b viờm gan tớnh Tuy nhiờn iu ny hon ton cú th c ngn chn, nu tiờm vaxcin cho tr vũng 12h sau sinh 40.10 CH THCH Trng hp b HBV lõy ó trng thnh: Mt s ớt cú th b viờm mn tớnh nhng kh nng b bin chng khụng nhiu.[2] 40.7 Phng thc lõy bnh - Virus HBV lõy lan qua nhng ng sau: + T m sang +a ng tỡnh dc + a ng mỏu T õy chỳng ta cú th liờn h vi nhng cỏch phũng nga sau: +Cỏc trng hp m ó nhim HBV, sinh em cn c tiờm huyt c hiu chng virus HBV +Cỏc cp v chng trc kt hụn nờn n khỏm ti cỏc c s ý t kim tra sc khe v nhn t t nhõn viờn y t +an h tỡnh dc an ton, mt v mt chng, s dng bao cao su quan h +Trỏnh tip xỳc trc tip vi mỏu, nht l cỏc nhõn viờn y t cn s dng cỏc bin phỏp an ton lm vic vi cỏc bnh phm dớnh mỏu, khụng dựng chung kim tiờm, - Tiờm nga vaccin: Vaccinum hepatitis B explasma humanum; Vaccinum hepatitis B recombinatum 40.8 Xem thờm Chú rng ca 40.9 Liờn kt ngoi Viờm gan siờu vi B khụng di truyn Viờn gan loi B l mt nhng mi e da ln nht i vi ngi Vit Viờm gan 40.10 Chỳ thớch [1] Wu, Y.F.; Fu, S.L.; Kao, C.H.; Yang, C.W.; Lin, C.H.; Hsu, M.T.; Tsai, T.F Chemopreventive eect of silymarin on liver pathology in HBV X protein transgenic mice Cancer Res., 2008, 68 [2] VietNamNet VietNamNet Truy cp 14 thỏng nm 2014 121 Chng 41 Viờm vựng chu Viờm vựng u l chng nhim trựng phn trờn ca b phn sinh dc ph n gm t cung, ng Fallop, bung trng, v bờn khung chu.[1][2] ụng thng bnh ny khụng cú triu chng no.[3] Cỏc du hiu v triu chng nu tn ti cú th bao gm au bng di, khớ h, st, cm giỏc bng i tiu tin, au giao hp, hoc kinh nguyt bt thng Bnh viờm vựng chu nu khụng c iu tr cú th gõy cỏc bin chng lõu di nh vụ sinh, thai ngoi t cung, au vựng chu tớnh v ung th.[4][5] Cn bnh ny vi khun lõy lan t õm o v c t cung gõy ra.[6] Cỏc viờm nhim ca vi khun Neisseria gonorrhoeae hoc Chlamydia trachomatis cú mt 75-90 phn trm trng hp ng thỡ bnh cú liờn quan n nhiu loi vi khun khỏc nhau.[2] Nu khụng iu tr khong 10 phn trm ca nhng ngi mc bnh chlamydia v 40 phn trm ca nhng ngi nhim lu m s dn n bnh viờm vựng chu.[2][7] Yu t nguy c tng t nh ca cỏc bnh lõy truyn qua ng tỡnh dc núi chung v bao gm nhng ngi cú nhiu bn tỡnh v nhng ngi s dng ma tỳy t õm o cng cú th lm tng nguy c Vic chn oỏn thng da trờn cỏc du hiu v triu chng thy c Cú khuyn cỏo rng bnh ny cn c xem xột tt c ph n tui sinh m cú au bng di Mt chn oỏn chc chn bnh ny c thc hin bng cỏch tỡm m liờn quan n ng dn trng phu thut Siờu õm cú th giỳp h tr chn oỏn.[2] nm 2008.[7] Tuy nhiờn s lng ca bnh viờm vựng chu li khụng rừ rng.[11] Ngi ta c tớnh bnh ny nh hng n khong 1,5 phn trm ph n tr hng nm.[11] Hoa K bnh ny c c tớnh nh hng n khong mt triu ngi mi nm.[12] Mt loi dng c t cung (IUD) c gi l lỏ chn Dalkon dn n vic tng t l viờm vựng chu nhng nm 1970 Dng c t cung hin ti khụng lm tng bnh ny sau thỏng u tiờn.[2] 41.1 Tham kho Nhng n lc ngn chn cn bnh ny bao gm vic khụng cú quan h tỡnh dc hoc gim s bn tỡnh v s dng bao cao su.[8] Vic tm soỏt nhng ph n cú nguy c nhim chlamydia sau ú thc hin iu tr giỳp gim nguy c nhim bnh viờm vựng chu Nu chn oỏn cú nghi ng thỡ vic cha tr l nờn lm Cn cha tr c bn tỡnh ca ngi bnh.[9] Trong nhng ngi cú triu chng nh hoc va phi, cn mt liu tiờm khỏng sinh ceriaxone nht, kốm vi iu tr dựng doxycycline hai tun v cú th metronidazole mt thỏng i vi nhng ngi khụng cú ci thin sau ba ngy hoc nhng ngi cú bnh nng thỡ nờn s dng vic tiờm tnh mch.[10] Trờn ton cu khong 106 triu trng hp nhim chlamydia v 106 triu trng hp bnh lu m xy 122 [1] Campion, Edward W.; Brunham, Robert C.; Golieb, Sami L.; Paavonen, Jorma (ngy 21 thỏng nm 2015) Pelvic Inammatory Disease New England Journal of Medicine 372 (21): 20392048 PMID 25992748 doi:10.1056/NEJMra1411426 [2] Mitchell, C; Prabhu, M (thỏng 12 nm 2013) Pelvic inammatory disease: current concepts in pathogenesis, diagnosis and treatment. Infectious disease clinics of North America 27 (4): 793809 PMID 24275271 doi:10.1016/j.idc.2013.08.004 [3] Pelvic Inammatory Disease (PID) Clinical Manifestations and Sequelae cdc.gov ỏng 10 nm 2014 Truy cp ngy 21 thỏng nm 2015 [4] Chang, A H.; Parsonnet, J (2010) Role of Bacteria in Oncogenesis Clinical Microbiology Reviews 23 (4): 837 857 ISSN 0893-8512 PMC 2952975 PMID 20930075 doi:10.1128/CMR.00012-10 [5] Chan, Philip J.; Seraj, Ibrahim M.; Kalugdan, eresa H.; King, Alan (1996) Prevalence of Mycoplasma Conserved DNA in Malignant Ovarian Cancer Detected Using Sensitive PCRELISA Gynecologic Oncology 63 (2): 258260 ISSN 0090-8258 PMID 8910637 doi:10.1006/gyno.1996.0316 [6] Brunham RC, Golieb SL, Paavonen J (2015) Pelvic inammatory disease e New England Journal of Medicine 372 (21): 203948 PMID 25992748 doi:10.1056/NEJMra1411426 [7] World Health Organization (2012) Global incidence and prevalence of selected curable sexually transmied infections - 2008 (PDF) who.int tr 2, 19 Truy cp ngy 22 thỏng nm 2015 41.1 THAM KHO [8] Pelvic Inammatory Disease (PID) Patient Counseling and Education Centers for Disease Control ỏng 10 nm 2014 Truy cp ngy 21 thỏng nm 2015 [9] Pelvic Inammatory Disease (PID) Partner Management and Public Health Measures Centers for Disease Control ỏng 10 nm 2014 Truy cp ngy 21 thỏng nm 2015 [10] 2010 STD Treatment Guidelines Pelvic Inammatory Disease Centers for Disease Control Ngy 15 thỏng nm 2014 Truy cp ngy 22 thỏng nm 2015 [11] Eschenbach, D (2008) Acute Pelvic Inammatory Disease Glob libr womens med ISSN 1756-2228 doi:10.3843/GLOWM.10029 [12] Self-Study STD Modules for Clinicians Pelvic Inammatory Disease (PID) Next Centers for Disease Control and Prevention Your Online Source for Credible Health Information CDC Home Footer Separator Rectangle Epidemiology Centers for Disease Control ỏng 10 nm 2014 Truy cp ngy 21 thỏng nm 2015 123 124 CHNG 41 VIấM VNG CHU 41.2 Ngun, ngi úng gúp, v giy phộp cho bn v hỡnh nh 41.2.1 Vn bn sng Ngun: https://vi.wikipedia.org/wiki/%C3%81_s%E1%BB%ABng?oldid=25950469 Ngi úng gúp: ỏi Nhi, AlleinStein, Tnt1984, Cheers!-bot, Violetbonmua, D1101l nthai, AlphamaBot, ach1990, itxongkhoiAWB, Tuanminh01, TuanminhBot, ẫn bc v ngi vụ danh B tng Ngun: https://vi.wikipedia.org/wiki/B%E1%BA%A1ch_t%E1%BA%A1ng?oldid=26618125 Ngi úng gúp: AlleinStein, NgocChinh, Tnt1984, TuHan-Bot, EmausBot, Cheers!-bot, MerlIwBot, Vagobot, Justincheng12345-bot, Addbot, OctraBot, TuanminhBot v ngi vụ danh Bnh Behỗet Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_Beh%C3%A7et?oldid=22383035 Ngi úng gúp: ỏi Nhi, Trungda, Qbot, AlleinStein, Rubinbot, TuHan-Bot, EmausBot, Cheers!-bot, AvocatoBot, AlphamaBot, Addbot, Tuanminh01, TuanminhBot v ẫn bc AWB Bnh da liu Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_da_li%E1%BB%85u?oldid=24114434 Ngi úng gúp: Lờ y, Escarbot, AlleinStein, KamikazeBot, Tnt1984, TuHan-Bot, ZộroBot, CNBH, Cheers!-bot, MerlIwBot, Daiannamthang, HiW-Bot, Beckerbao, Donyesin, Alphama, AlphamaBot, Addbot, Gaconnhanhnhen, itxongkhoiAWB, TuanminhBot v ngi vụ danh Bnh gh Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_gh%E1%BA%BB?oldid=30737669 Ngi úng gúp: DHN, Mekong Bluesman, Phan Ba, aisk, Newone, DHN-bot, Lờ y, Trungda, Cao Xuan Kien, JAnDbot, Dany, VolkovBot, Bd, Idioma-bot, Qbot, Sholokhov, StigBot, Luckas-bot, Xqbot, KamikazeBot, Dr.cool, Dinhtuydzao, EmausBot, ZộroBot, Donghienhp, Cheers!-bot, MerlIwBot, Daiannamthang, TuanUt, AlphamaBot, Addbot, , Gaconnhanhnhen, Vuivuiti28, itxongkhoiAWB, Tuanminh01, TuanminhBot, Kenwiseman v 13 ngi vụ danh Bnh lõy truyn qua ng tỡnh dc Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_l%C3%A2y_truy%E1%BB%81n_qua_%C4% 91%C6%B0%E1%BB%9Dng_t%C3%ACnh_d%E1%BB%A5c?oldid=26437316 Ngi úng gúp: DHN, Robbot, Mekong Bluesman, Nguyn anh ang, Chobot, YurikBot, Apple, Newone, DHN-bot, Lờ y, Gsh, Cao Xuan Kien, Pham ngu lao, JAnDbot, ijs!bot, VolkovBot, TXiKiBoT, SieBot, Loveless, DragonBot, Idioma-bot, Qbot, OKBot, Alexbot, S3056007, BodhisavaBot, MelancholieBot, AlleinStein, Nallimbot, Luckas-bot, VNO, Mt tri , ArthurBot, Porcupine, Darkicebot, Xqbot, GhalyBot, 2dep, Trn Nguyn Minh Huy, Bongdentoiac, Phng Huy, Dinhtuydzao, MastiBot, Tnt1984, TuHan-Bot, EmausBot, ZộroBot, Yduocizm, Trongkhanhknv, AVS, FoxBot, Cheers!, ChuispastonBot, WikitanvirBot, Sachlachong, Cheers!-bot, Ldwiki2011, Akate, Donyesin, TuanUt, JYBot, Hoang Dat, AlphamaBot, Phamnhatkhanh, AlphamaBot2, Addbot, itxongkhoiAWB, GcnnAWB, GHA-WDAS, Tuanminh01, TuanminhBot, ẫn bc AWB, Cafess v 17 ngi vụ danh Bnh vy da Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_v%E1%BA%A9y_da?oldid=26394604 Ngi úng gúp: ỏi Nhi, Qbot, AlleinStein, Cheers!-bot, F~viwiki, AlphamaBot, ach1990, Arc Warden, itxongkhoiAWB, Tuanminh01, TuanminhBot v Mt ngi vụ danh Bnh vy nn Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_v%E1%BA%A9y_n%E1%BA%BFn?oldid=26445950 Ngi úng gúp: Mekong Bluesman, Vng Ngõn H, Chobot, Vnbomber9~viwiki, JAnDbot, ijs!bot, VolkovBot, TXiKiBoT, Langtucodoc, BotMultichill, AlleborgoBot, SieBot, Loveless, PixelBot, BodhisavaBot, Luckas-bot, ArthurBot, Rubinbot, Xqbot, Prenn, Bongdentoiac, Tnt1984, TuHan-Bot, EmausBot, Yanajin33, ZộroBot, Huuanhuynh, JackieBot, Donghienhp, WikitanvirBot, Cheers!-bot, F~viwiki, Kasirbot, MerlIwBot, DS BuiNgocanh01, Tahang01, Daiannamthang, Dexbot, Hoang Dat, AlphamaBot, Hugopako, Mvquang, Earthshaker, Addbot, , OctraBot, ach1990, itxongkhoiAWB, Hoangdat bot, Khanhminhjsc, Tien truong ke, Tuanminh01, Benhvaynen, ẫn bc, Shipcaptainno1, Mr.TanNhan, Mr.TanNhan2, Phusa12 v 21 ngi vụ danh Chm (bnh) Ngun: https://vi.wikipedia.org/wiki/Ch%C3%A0m_(b%E1%BB%87nh)?oldid=26618212 Ngi úng gúp: Mxn, Arisa, ỏi Nhi, YurikBot, DHN-bot, JAnDbot, TXiKiBoT, SieBot, DragonBot, Idioma-bot, Qbot, MelancholieBot, AlleinStein, Luckas-bot, Smokestack Basilisk, Vit Nam, Tnt1984, EmausBot, Jspeed1310, Trongkhanhknv, Anhtucxac, Cheers!-bot, MerlIwBot, Vagobot, Daiannamthang, D1101l nthai, GrouchoBot, Alphama, AlphamaBot, Earthshaker, Addbot, , itxongkhoiAWB, TuanminhBot, ẫn bc AWB v ngi vụ danh Cornu cutaneum Ngun: https://vi.wikipedia.org/wiki/Cornu_cutaneum?oldid=26238423 Ngi úng gúp: itxongkhoiAWB, GHAWDAS, Tuanminh01 v Mt ngi vụ danh Da v ni Ngun: https://vi.wikipedia.org/wiki/Da_v%E1%BA%BD_n%E1%BB%95i?oldid=27354168 Ngi úng gúp: AlleinStein, Dinhtuydzao, TuHan-Bot, DSisyphBot, ChuispastonBot, K3nzai, Cheers!-bot, AlphamaBot, Addbot, Gaconnhanhnhen, itxongkhoiAWB, Tuanminh01 v Bacsidalieu99 D ng Ngun: https://vi.wikipedia.org/wiki/D%E1%BB%8B_%E1%BB%A9ng?oldid=24034947 Ngi úng gúp: NguyenNghia, AlleinStein, Luckas-bot, Xqbot, angbao, Dinhtuydzao, Tnt1984, TuHan-Bot, EmausBot, Donghienhp, Anhtucxac, Ripchip Bot, Cheers!-bot, Violetbonmua, angdung618, Alphama, AlphamaBot, Addbot, OctraBot, itxongkhoiAWB, Nhanpham, Tuanminh01, TuanminhBot, Daianmytan, ẫn bc AWB v ngi vụ danh D ng xi mng Ngun: https://vi.wikipedia.org/wiki/D%E1%BB%8B_%E1%BB%A9ng_xi_m%C4%83ng?oldid=26171608 Ngi úng gúp: Trungda, Jspeed1310, DanGong, Daiannamthang, Alphama, AlphamaBot, Arc Warden, itxongkhoiAWB, Tuanminh01, TuanminhBot, Rotave, Daianmytan, ẫn bc AWB, Trantrongnhan100YHbot v ngi vụ danh Herpes n dng Ngun: https://vi.wikipedia.org/wiki/Herpes_%C4%91%C6%A1n_d%E1%BA%A1ng?oldid=24192822 Ngi úng gúp: ỏi Nhi, Trungda, Adia, MystBot, AlleinStein, Luckas-bot, DragonySixtyseven, Xqbot, TuHan-Bot, EmausBot, Cheers!-bot, Daiannamthang, AlphamaBot, Addbot, OctraBot, Gaconnhanhnhen, itxongkhoiAWB, Tuanminh01 v TuanminhBot Herpes sinh dc Ngun: https://vi.wikipedia.org/wiki/Herpes_sinh_d%E1%BB%A5c?oldid=26649932 Ngi úng gúp: AlleinStein, Phỏ phỏch, TuHan-Bot, Sachlachong, Cheers!-bot, MerlIwBot, Alphama, Addbot, itxongkhoiAWB, Truowngfan, Tuanminh01, TuanminhBot, Lauracgodfrey, Eqrwqereqwreqwerqw, Eqrwqereqwreqwerqwss, Tuanchaly, Tonytruong667 v ngi vụ danh Lupus ban h thng Ngun: https://vi.wikipedia.org/wiki/Lupus_ban_%C4%91%E1%BB%8F_h%E1%BB%87_th%E1%BB%91ng? oldid=26818869 Ngi úng gúp: Newone, Trungda, JAnDbot, VolkovBot, TXiKiBoT, SieBot, Qbot, Meotrangden, AlleinStein, SilvonenBot, Doanmanhtung.sc, Banhtrung1, Tnt1984, TuHan-Bot, Tranphuongthuy, EmausBot, ZộroBot, Ritavn, Trongkhanhknv, Mjbmrbot, Cheers!-bot, MerlIwBot, Daiannamthang, Demons9909, Alphama, AlphamaBot, Earthshaker, Addbot, itxongkhoiAWB, Tuanminh01, TuanminhBot, P.T., Hi Lờ ỡnh v 12 ngi vụ danh 41.2 NGUN, NGI ểNG GểP, V GIY PHẫP CHO VN BN V HèNH NH 125 Mn cúc Ngun: https://vi.wikipedia.org/wiki/M%E1%BB%A5n_c%C3%B3c?oldid=26537230 Ngi úng gúp: Mekong Bluesman, Sziwbot, ỏi Nhi, Cao Xuan Kien, Escarbot, JAnDbot, VolkovBot, TXiKiBoT, SieBot, DragonBot, Qbot, CarsracBot, Luckas-bot, Amirobot, Ptbotgourou, ArthurBot, Xqbot, Obersachsebot, D'ohBot, TuHan-Bot, EmausBot, ZộroBot, RedBot, Tran Xuan Hoa, ChuispastonBot, WikitanvirBot, Baoanduong, Cheers!-bot, Dokushin, MerlIwBot, Dexbot, AlphamaBot, Hugopako, Addbot, GHAWDAS, Tuanminh01, TuanminhBot, ẫn bc, JacobDavis19912000, Trantrongnhan100YHbot, Hng94 v ngi vụ danh Trn Hu Ngon Ngun: https://vi.wikipedia.org/wiki/Tr%E1%BA%A7n_H%E1%BB%AFu_Ngo%E1%BA%A1n?oldid=26712192 Ngi úng gúp: Newone, Hoang Dat, Tuanminh01, TuanminhBot v Hunh Nhõn-thp Viờm da thn kinh Ngun: https://vi.wikipedia.org/wiki/Vi%C3%AAm_da_th%E1%BA%A7n_kinh?oldid=26395809 Ngi úng gúp: ỏi Nhi, AlleinStein, Cheers!-bot, TuanUt, Dc s Lan Anh, itxongkhoiAWB, TuanminhBot, Mytan123 v ẫn bc Viờm da tip xỳc Ngun: https://vi.wikipedia.org/wiki/Vi%C3%AAm_da_ti%E1%BA%BFp_x%C3%BAc?oldid=22177169 Ngi úng gúp: Jspeed1310, Cheers!-bot, AlphamaBot, GHA-WDAS, TuanminhBot, Mytan123 v ngi vụ danh Viờm da tit bó nhn Ngun: https://vi.wikipedia.org/wiki/Vi%C3%AAm_da_ti%E1%BA%BFt_b%C3%A3_nh%E1%BB%9Dn?oldid= 22386337 Ngi úng gúp: Tnt1984, Cheers!-bot, TuanUt, Alphama, Dc s Lan Anh, TuanminhBot v ngi vụ danh Viờm da ng Ngun: https://vi.wikipedia.org/wiki/Vi%C3%AAm_da_%E1%BB%A9_%C4%91%E1%BB%8Dng?oldid=26238620 Ngi úng gúp: ỏi Nhi, AlleinStein, Cheers!-bot, AlphamaBot, Dc s Lan Anh, itxongkhoiAWB v Mt ngi vụ danh Bnh Chlamydia Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_Chlamydia?oldid=25386412 Ngi úng gúp: Viethavvh, AlleinStein, AlphamaBot, TuanminhBot, Vdongold, Cafess v Mt ngi vụ danh Bnh virus Ebola Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_do_virus_Ebola?oldid=26765450 Ngi úng gúp: Newone, Dinhxuanduyet, Linhhp, Tuankiet65, TuHan-Bot, Cheers!-bot, DanGong, Trongducvtc, Alphama, AlphamaBot, Damian Vo, Addbot, TuanUt-Bot!, itxongkhoiAWB, Tanloc1506, Titụ, Tuanminh01, AlphamaBot4, TuanminhBot, CFCF, Chdhau, Muinguyen82, Linhphanduy, Powerover, Haiduongzzzz123, Sinhvu99 v 16 ngi vụ danh Bnh rn mu Ngun: https://vi.wikipedia.org/wiki/B%E1%BB%87nh_r%E1%BA%ADn_mu?oldid=27251275 Ngi úng gúp: ỏi Nhi, Newone, AlleinStein, Phng Huy, TuHan-Bot, Cheers!-bot, Alphama, AlphamaBot, Tuankiet65-Bot, Addbot, itxongkhoiAWB v TuanminhBot Chlamydia traomatis Ngun: https://vi.wikipedia.org/wiki/Chlamydia_trachomatis?oldid=26402068 Ngi úng gúp: Nguyn anh ang, Casablanca1911, Newone, DHN-bot, Cao Xuan Kien, ijs!bot, 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Tp_tin:STDs_excluding_HIV_world_map_-_DALY_-_WHO2004.svg Ngun: https://upload.wikimedia.org/wikipedia/commons/6/ 6f/STDs_excluding_HIV_world_map_-_DALY_-_WHO2004.svg Giy phộp: CC BY-SA 2.5 Ngi úng gúp: Vector map from BlankMap-World6, compact.svg by Canuckguy et al Ngh s u tiờn: Lokal_Prol Tp_tin:Scabies_life_cycle.png Ngun: https://upload.wikimedia.org/wikipedia/commons/6/64/Scabies_life_cycle.png Giy phộp: Public domain Ngi úng gúp: CDC web site > DPDx - Laboratory Identication of Parasites of Public Health Concern > Scabies [1] Ngh s u tiờn: Mikael Họggstrửm Tp_tin:Secondary_Syphilis_on_palms_CDC_6809_lores.rsh.jpg Ngun: https://upload.wikimedia.org/wikipedia/commons/b/bd/ Secondary_Syphilis_on_palms_CDC_6809_lores.rsh.jpg Giy phộp: Public domain Ngi úng gúp: This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identication number #6809 Ngh s u tiờn: CDC/ Robert Sumpter Tp_tin:Sehsystem.png Ngun: https://upload.wikimedia.org/wikipedia/vi/0/0d/Sehsystem.png Giy phộp: Phm vi cụng cng Ngi úng gúp: de:Datei:Sehsystem.png Ngh s u tiờn: de:Benutzer:Hati Tp_tin:Skintest2.jpg Ngun: https://upload.wikimedia.org/wikipedia/commons/8/89/Skintest2.jpg Giy phộp: CC BY-SA 3.0 Ngi úng gúp: Tỏc phm chớnh ngi ti lờn to Ngh s u tiờn: Skoch3 Tp_tin:Squamous_cell_carcinoma_in_the_cervix,_pap_stain.jpg Ngun: https://upload.wikimedia.org/wikipedia/commons/3/32/ Squamous_cell_carcinoma_in_the_cervix%2C_pap_stain.jpg Giy phộp: Public domain Ngi úng gúp: http://visualsonline.cancer gov/details.cfm?imageid=2578 Ngh s u tiờn: ? 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