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Sample records for anillo anticonceptivo vaginal

  1. Anillos de Jacobson

    OpenAIRE

    Vélez Caicedo, Juan Diego

    1985-01-01

    En este trabajo se demostrará la conmutatividad de ciertos Jn-anillos con una técnica propia y completamente diferente. Se desarrollará un método que involucro el uso de anillos de polinomios y que permite reducir el problema de demostrar la conmutatividad de un Jn-anillo, al problema de probar que cierto subanillo, de un anillo cociente, en un anillo de polinomios, es igual a todo el anillo. Como puede verse en el apéndice 2, es posible demostrar de manera elemental la conmutatividad de u...

  2. Dispensacion de anticonceptivos hormonales orales

    OpenAIRE

    Molinero Crespo, Ana María; Diego Martinez , Cristina de; Méndez Mora-Figueroa, Pilar; Esteso, Pilar; García Valiente, Paloma; González, Ana; Peiró Martínez, Alicia; Pérez Martín, Vanessa

    2010-01-01

    El 80% de las mujeres españolas en edad fértil utilizan métodos anticonceptivos. Los anticonceptivos orales hormonales son los que obtienen mayor grado de satisfacción entre las usuarias siendo el segundo método utilizado. Método Estudio observacional descriptivo en 7 farmacias de la Comunidad de Madrid. Durante seis meses (enero-junio de 2009) se realizó una entrevista en el mostrador a las usuarias de métodos anticonceptivos hormonales orales para conocer qué tipo de paciente los dema...

  3. Conocimientos previos acerca de métodos anticonceptivos y su relación con conocimientos adquiridos después de una intervención educativa con simulador

    Directory of Open Access Journals (Sweden)

    María Neyfeth Posada Morales

    2015-01-01

    Full Text Available Introducción. El objetivo de este trabajo es relacionar conocimientos previos (pre-saberes acerca de métodos anticonceptivos con los conocimientos adquiridos (saberes, después una intervención educativa con simulador.Método. Es un estudio realizado con 295 adolescentes escolarizados que cursan noveno, décimo y undécimo en una institución educativa pública. Es de tipo descriptivo. El proceso estuvo compuesto por tres fases; en la primera se midió conocimientos o saberes previos acerca de métodos anticonceptivos, mediante un cuestionario auto-informado; en la segunda se definió los contenidos y actividades de intervención para mejorar los conocimientos previos, y en la tercera fase de post-intervención educativa, se reevaluó los saberes adquiridos con el simulador. Resultados. Se detectó que los pre-saberes en métodos anticonceptivos son deficientes independientemente de la edad y la escolaridad, lo cual requiere planeación, desarrollo y evaluación de la estrategia de aprendizaje colectivo y cooperativo mediante talleres. En cuanto a los post-saberes, se obtuvo una calificación de deficientes a regulares, en el caso del condón masculino, mientras que el reconocimiento de métodos modernos como parche, anillo vaginal, dispositivo intrauterino, entre otros, se dio gracias al contacto directo con el simulador.Conclusiones. Se recalca que a pesar de las  diferencias de edad y escolaridad, no hubo hallazgos relevantes que demostraran diferencias de conocimiento. En los pre-saberes, se encontró niveles de conocimiento deficientes sobre métodos anticonceptivos. El uso de simuladores como herramienta de aprendizaje demostró eficacia en los talleres; en cuanto a los simuladores posibilitan la ruptura de la barrera cognitiva, dado que el adolescente, en este caso, puede explorar y adquirir conocimiento al interaccionar con el objeto de aprendizaje.

  4. Vaginitis

    Science.gov (United States)

    ... vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse. Glossary Antibiotics: ... Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info ...

  5. Un paseo por los anillos de bucles

    OpenAIRE

    2012-01-01

    La teoría de anillos de bucles no es solamente una generalización de los anillos de grupos: es una teoría en sí misma, con origen y aún en movimiento. El concepto de anillo de bucles surge en 1944 en los trabajos de R.H. Bruck con la construcción de anillos no asociativos. En los últimos años esta teoría se desarrolló ampliamente. Como ejemplo de esto tenemos la descripción completa del bucle de los elementos invertibles del Álgebra de Zorn. En este trabajo se hace un recorr...

  6. Un paseo por los anillos de bucles

    Directory of Open Access Journals (Sweden)

    Carmen Rosa Giraldo Vergara

    2012-01-01

    Full Text Available La teoría de anillos de bucles no es solamente una generalización de los anillos de grupos: es una teoría en sí misma, con origen y aún en movimiento. El concepto de anillo de bucles surge en 1944 en los trabajos de R.H. Bruck con la construcción de anillos no asociativos. En los últimos años esta teoría se desarrolló ampliamente. Como ejemplo de esto tenemos la descripción completa del bucle de los elementos invertibles del Álgebra de Zorn. En este trabajo se hace un recorrido a lo largo del desarrollo de esta teoría que ha intrigado a matemáticos de diversas áreas.

  7. administra como anticonceptivo de emergencia

    Directory of Open Access Journals (Sweden)

    Horacio Croxatto

    2007-01-01

    Full Text Available La anticoncepción hormonal de emergencia (AHE es uno de los pocos recursos que la mujer puede usar para prevenir un embarazo no deseado después de haber tenido una relación sexual en la que no usó método anticonceptivo o el que usó presentó una falla. Actualmente, el método preferido para la AHE es la píldora que contiene solamente levonorgestrel (LNG. Según la OMS, puede prevenir embarazos si se usa hasta 120 horas después del acto sexual, pero su eficacia disminuye drásticamente desde 85% a 31% mientras más se posterga su administración. La introducción de la AHE ha generado controversia en muchos países latinoamericanos por la percepción errónea de que induce aborto y la oposición de los sectores más conservadores de la sociedad que temen que favorezca la promiscuidad. Con el propósito de dar a conocer la evidencia científica producida por las investigaciones diseñadas para dilucidar como el LNG previene el embarazo cuando se administra como AHE, y su correcta interpretación, este artículo analiza críticamente dichos estudios y explica además en que circunstancias este método no logra prevenir el embarazo. El conjunto de la evidencia indica que LNG previene el embarazo solamente cuando impide la fecundación y descarta que el prevenga el embarazo interfiriendo con la implantación del embrión, por lo que la creencia de que es abortivo no tiene sustento científico.

  8. Anillos de fracciones caso no conmutativo

    OpenAIRE

    2012-01-01

    La construcción del campo de cocientes de un dominio de integridad se generaliza no solamente a anillos conmutativos (Ver [1]), sino a anillos en general no conmutativos. En este trabajo mostramos dicha generalización siguiendo las ideas de [2], pero incluyendo las pruebas allí omitidas. Ilustramos además la teoría expuesta con suficiente cantidad de ejemplos, no tratados por lo general en la literatura clásica de esta temática

  9. Estudio PIENSA: efecto de la asesoría sobre la elección de anticonceptivos hormonales combinados en mujeres chilenas

    OpenAIRE

    Pizarro,Ernesto; Galán,Guillermo; Lavín,Pablo; Benavides,Claudio; Rivera,Francisca

    2014-01-01

    Objetivos: Evaluar la asesoría acerca de los anticonceptivos hormonales combinados de auto administración por parte de profesionales de la salud y cómo influye en el cambio o elección del método a utilizar. Método: Durante la consulta ginecológica habitual, se registra la elección del método anticonceptivo (MAC) combinado de auto administración (píldora, anillo o parche transdérmico) previa a la asesoría del médico y posterior a esta. El registro se realiza por medio de una encuesta que debe ...

  10. Un paseo por los anillos de bucles

    Directory of Open Access Journals (Sweden)

    Carmen Rosa Giraldo Vergara

    2012-06-01

    Full Text Available La teoría de anillos de bucles no es solamente una generalización de los anillos de grupos: es una teoría en sí misma, con origen y aún en movimiento. El concepto de anillo de bucles surge en 1944 en los trabajos de R.H. Bruck con la construcción de anillos no asociativos. En los últimos años esta teoría se desarrolló ampliamente. Como ejemplo de esto tenemos la descripción completa del bucle de los elementos invertibles del Álgebra de Zorn. En este trabajo se hace un recorrido a lo largo del desarrollo de esta teoría que ha intrigado a matemáticos de diversas áreas. Abstract. The loop ring theory is more that a generalization of group rings; in fact, it is a theory with its own spirit, with origin and still in development. The loop rings borns in 1944 with the works of R. H. Bruck about construction of non-associative rings. In recent years, this theory was developed largely, and as an example of this we know now the complete description of the loop of invertible elements of the Zorn algebra. In this paper we travel through the development of this theory that has intrigued mathematicians from different areas.

  11. Fecundidad y uso de anticonceptivo en Costa Rica, 1987

    OpenAIRE

    Oberle, Mark W.; Sosa, Doris; Madrigal Pana, Johnny; Becker, Stan; Morris, Leo; ROSERO-BIXBY, LUIS

    1989-01-01

    Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1989 La prevalencia de anticonceptivos en Costa Rica es una de las más altas de América Latina: el 70 por ciento de las mujeres actualmente casadas utilizan algún método anticonceptivo. Los diferenciales en el uso de anticonceptivos en función del nivel educativo y entre las zonas rurales y urbanas resultan en efecto muy reducidos en comparación con otros países latinoamericanos. Si bien los niveles de...

  12. Vaginal dryness

    Science.gov (United States)

    ... Vaginitis due to reduced estrogen; Atrophic vaginitis; Menopause vaginal dryness ... sexual intercourse more comfortable. It also helps decrease vaginal dryness. If estrogen levels drop off, the vaginal tissue ...

  13. El anillo verde de Vitoria-Gasteiz

    Directory of Open Access Journals (Sweden)

    Marañón, Blanca

    2001-10-01

    de la periferia de la ciudad, donde coexistían zonas de alto valor ecológico sometidas a agresiones de todo tipo, con otros espacios degradados y marginales, fruto de la expansión urbana e industrial. La restauración ecológico-paisajística de estos espacios y su acondicionamiento para el uso público han permitido configurar un "anillo verde multifunción" en torno a la ciudad que está proporcionando importantes beneficios ambientales, sociales y económicos. El anillo verde ha jugado un papel importante en la integración naturaleza-ciudad, equilibrando la oferta de zonas verdes entre todos los barrios y favoreciendo la conexión entre los espacios verdes urbanos y los espacios naturales del entorno agrícola. Ha propiciado, asimismo, el desarrollo de nuevas actividades relacionadas con el ocio y el esparcimiento y con la formación, educación y sensibilización ambiental; actividades que, por un lado, están suponiendo un revulsivo para el sector empresarial ambiental y la integración socio-laboral de determinados colectivos sociales y, por otro, contribuyen a la conservación de estos espacios, al convertirse los usuarios en sus mayores defensores y guardianes. La utilización de algunos de estos espacios como superficies de laminación de agua en épocas de avenidas para solventar problemas de inundación en las zonas industriales es otro ejemplo del valor añadido obtenido al plantear soluciones integrales. Los excelentes resultados obtenidos tras nueve años de trabajo demuestran la viabilidad técnica y económica y la rentabilidad social de este proyecto, que representa una prueba evidente de la decidida voluntad municipal de avanzar hacia un modelo de ciudad sostenible en armonía con el medio natural que la rodea.

  14. Vaginal Atrophy

    Science.gov (United States)

    ... Body in Balance › Vaginal Atrophy Fact Sheet Vaginal Atrophy November, 2011 Download PDFs English Espanol Editors JoAnn ... MD Richard J. Santen, MD What is vaginal atrophy? Vaginal atrophy is a condition in which the ...

  15. Algunos aspectos de la teoría de casi-anillos de polinomios

    OpenAIRE

    2011-01-01

    RESUMEN. La memoria trata algunos aspectos de la teoría de casi-anillos de polinomios r(x) con coeficientes en un anillo r conmutativo y con unidad. En el capítulo I damos una descripción explicita de los elementos distributivos de r(x) y de la parte cero-simétrica r sub 0 (x). En los párrafos damos algunas caracterizaciones y propiedades del anillo formado por estos elementos distributivos. Obtenemos resultados similares en el casi-anillo de series de potencias formales. En el capítulo II es...

  16. El anillo de los números duales

    OpenAIRE

    Jiménez, Haydee; Luque, Carlos Julio

    2007-01-01

    Se inicia con una presentación de la estructura de * - Álgebra de los números duales; se muestran diferentes representaciones que permiten la definición de potencias racionales de números duales, lo que exige una extensión de su estructura a un anillo de números duales con coeficientes complejos. Seguidamente se estudian la función exponencial dual y la función logaritmo dual que permiten la definición de potencias duales de un número dual; luego se estudian ecuaciones en los números duales h...

  17. Vaginal Diseases

    Science.gov (United States)

    Vaginal problems are some of the most common reasons women go to the doctor. They may have ... that affect the vagina include sexually transmitted diseases, vaginal cancer, and vulvar cancer. Treatment of vaginal problems ...

  18. EFECTO ABORTIVO DE LOS ANTICONCEPTIVOS HORMONALES: UNA REVISIÓN

    Directory of Open Access Journals (Sweden)

    PAU AGULLES SIMÓ

    2015-01-01

    Full Text Available En gran parte de la comunidad científica, así como del ámbito jurídico, al tratar del embrión no nacido, está vigente el criterio según el cual hay que definir el embarazo como el período que comprende sólo desde la implantación hasta el nacimiento natural. Esto lleva consigo otras novedades; por ejemplo, la redefinición de aborto como la eliminación del embrión sólo en ese período, o la extensión de la anticoncepción a cualquier medio que impida la unión entre los gametos como consecuencia de una relación íntima, o también que elimine el producto de la concepción antes de su implantación. De modo que la industria farmacéutica está lanzando al mercado, bajo el nombre de anticonceptivos, productos que actúan también mediante un mecanismo antiimplantatorio. Este hecho tiene grandes repercusiones éticas con relación al respeto del embrión, que obligan a reflexionar acerca de la valoración moral de la prescripción, dispensación y uso de estos medios. Ahora bien, ¿cuáles de los medios contraceptivos actualmente presentes en el mercado incluyen un efecto antiimplantatorio?, ¿qué mecanismos contribuyen a su acción farmacológica y en qué medida lo hacen? Esto es lo que hemos estudiado en este artículo, basándonos en la bibliografía científica disponible. Aunque no ha sido una tarea sencilla, puesto que los resultados aportados por la literatura varían mucho, se ha tratado de ofrecer una conclusión bastante precisa. Básicamente hemos cumplido un doble objetivo: actualizar y completar los estudios —pocos, parciales o lejanos en el tiempo— que tenían este mismo objeto; y ofrecer una valoración ética respecto al respeto de la vida naciente del uso de los anticonceptivos hormonales que pueden tener efecto antiimplantatorio.

  19. Vaginal Cancer

    Science.gov (United States)

    Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human ... test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its ...

  20. Vaginal cysts

    Science.gov (United States)

    ... cysts URL of this page: //medlineplus.gov/ency/article/001509.htm Vaginal cysts To use the sharing ... may need a biopsy to rule out vaginal cancer, especially if the mass appears to be solid. If the cyst is located under the bladder or urethra, x-rays may be needed to see if ...

  1. SATISFACCIÓN SEXUAL ENTRE MUJERES USUARIAS Y NO USUARIAS DE MÉTODOS ANTICONCEPTIVOS

    OpenAIRE

    2010-01-01

    Objetivo: Comparar la satisfacción sexual entre mujeres usuarias y no usuarias de métodos anticonceptivos. Material y métodos, Estudio observacional, comparativo y transversal. Muestra no probablilística de 150 mujeres en edad fértil y con vida sexual activa, usuarias y no usuarias de métodos anticonceptivos. Se identificó satisfacción sexual a través de la Escala de Intimidad Sexual de la Pareja. Para el análisis estadístico se utilizó prueba de x2 y prueba exacta de Fisher. Resultados, El 8...

  2. Terconazole Vaginal Cream, Vaginal Suppositories

    Science.gov (United States)

    Terconazole comes as a cream and suppository to insert into the vagina. It is usually used daily at bedtime for either 3 or 7 days. ... prescribed by your doctor.To use the vaginal cream or vaginal suppositories, read the instructions provided with ...

  3. Birth Control Ring

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Ring KidsHealth > For Teens > Birth Control Ring A A A What's in this article? ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ring ...

  4. Vaginal cancer

    Science.gov (United States)

    Hacker NF. Vulvar and vaginal cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 40. Jhingran ...

  5. Clindamycin Vaginal

    Science.gov (United States)

    ... be used to treat vaginal irritation caused by yeast infections or by sexually transmitted diseases such as ... the lining of all or part of the intestine is swollen, irritated, or has sores) or severe ...

  6. Conocimiento y uso de metodos anticonceptivos por la poblacion femenina de una zona de salud

    Directory of Open Access Journals (Sweden)

    Maroto de Agustín Alicia

    1998-01-01

    Full Text Available FUNDAMENTO: El uso de métodos anticonceptivos está en relación, entre otros, con factores demográficos, sociales, económicos, educativos e ideológicos. El objetivo de este trabajo es conocer qué métodos anticonceptivos conocen las mujeres en edad fértil, así como la prevalencia de su uso. MÉTODOS: A partir del listado de tarjeta sanitaria se seleccionaron mediante muestreo sistemático 389 de las 5800 mujeres en edad fértil (15-45 años asignadas a un centro de salud. Previo envío de una carta, comunicando el motivo del estudio, se contactó telefónicamente con ellas para la realización de una encuesta, la cual incluía preguntas acerca del conocimiento y uso de métodos anticonceptivos, características socioculturales y actividad sexual. Las mujeres que no tenían teléfono fueron citadas en el centro de salud. RESULTADOS: Se contactó con 178 mujeres, de las que participaron 166 (tasa de respuesta de 42,7%. De ellas utilizaban algún método anticonceptivo 86 (51,8%; IC:44,2-59,4%. Sin embargo, entre mujeres con riesgo de embarazo no deseado, la prevalencia de uso era del 70,5% (IC: 62,4-78,6%, destacando el hecho de que en el grupo de mujeres de 40 a 45 años sólo utilizaran anticonceptivos el 45,4%, con una frecuencia significativamente inferior a los otros grupos de edad. Los métodos más conocidos eran el preservativo (90,4%, los contraceptivos orales (89,2% y el dispositivo intrauterino (78,3%, siendo escaso el conocimiento de otros métodos. CONCLUSIONES: La tasa de utilización de métodos anticonceptivos en mujeres con riesgo de embarazo no deseado es aceptable, si bien entre 40 y 45 años es llamativamente baja. Los métodos más conocidos son el preservativo, los contraceptivos orales y el dispositivo intrauterino.

  7. Algoritmo para la Inspección de Anillos de Compresión

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    J. Mauricio de Anda

    2006-01-01

    Full Text Available En el presente trabajo se describe el procedimiento utilizado en el análisis de anillos de compresión para el motor de un auto. Dicho análisis se lleva a cabo usando técnicas de procesamiento de imágenes con la finalidad de determinar si el anillo cumple con los requerimientos suficientes de calidad. El sistema de inspección está integrado por una cámara de video, un sistema de iluminación por leds blancos de alta luminosidad, una tarjeta que recibe la señal de video convirtiéndola a una señal digital y una serie de algoritmos de procesamiento de imágenes.

  8. Vaginal dryness alternative treatments

    Science.gov (United States)

    Alternative treatments for vaginal dryness ... Question: Is there a drug-free treatment for vaginal dryness? Answer: There are many causes of vaginal dryness . It may be caused by reduced estrogen level, infection, medicines, and ...

  9. Una introducción al estudio de las estructuras algebraicas de grupo y de anillo

    OpenAIRE

    Asmar Charris, Iván Francisco

    1984-01-01

    Con este trabajo he querido hacer un estudio elemental de las estructuras algebraicas de grupos y anillos, intentando lograr que quien las estudien adquieren los conocimientos básicos indispensables para un mayor comprensión de los cursos de algebra moderna (algebra abstracta) dictados en la carrera de matemáticas, por esto propongo este material para ser desarrollando en el curso fundamento II de esta carrera en el primer capítulo, desarrolle el tema de las permutaciones ya que históricame...

  10. Utilización de Métodos Anticonceptivos en estudiantes de Enfermería

    OpenAIRE

    Covarrubias, Esmeralda; Universidad Autónoma Metropolitana; Ramírez Villegas, Raquel; Universidad Autónoma Metropolitana; Verde Flota, Elsy Elizabeth de Jesús; Universidad Autónoma Metropolitana; Rivas Espinosa, Juan Gabriel; Universidad Autónoma Metropolitana; Rivero Rodríguez, luis Fernando; Universidad Autónoma Metropolitana

    2015-01-01

    Objetivo: Identificar el uso de métodos anticonceptivos como medida de prevención de infecciones de transmisión sexual (ITS) y embarazos no planeados, en estudiantes de la Licenciatura en Enfermería de una universidad pública de la Ciudad de México. Método: Estudio cuantitativo, descriptivo y transversal. Se realizó en una población total de 364 estudiantes, con una muestra de 71 universitarios, mayores de 18 años, de ambos sexos e inscritos en alguno de los últimos nueve módulos de la Licenc...

  11. Conocimiento y uso de anticonceptivos entre los jóvenes mexicanos. El papel del género

    OpenAIRE

    Irene Casique

    2011-01-01

    Con base en datos provenientes de la Encuesta Nacional sobre Violencia en el Noviazgo, levantada en 2007 entre jóvenes mexicanos de 15 a 24 años de edad, se exPlora el.nivel de conocimiento y uso de anticonceptivos en el contexto de las relaciones de noviazgo. Con este análisis se pretende evidenciar el rol que desempeñan las diversas características sociodemográficas de los jóvenes en el conocimiento y uso de anticonceptivos, con partic cular atención en el papel que juega el género. En gene...

  12. Relación entre el consumo de anticonceptivos orales y la endometriosis en pacientes sometidas a laparoscopia. Profamilia, Medellín, 1998-1999

    OpenAIRE

    Luis Serna; Beatriz Preciado; Juan Ochoa; José De Los Ríos

    2001-01-01

    Determinar la relación entre el consumo de anticonceptivos orales y la prevalencia y severidad de la endometriosis en pacientes sometidas a laparoscopia por cualquier causa en Profamilia Medellín, entre julio de 1998 y abril de 1999. El 24.8% del grupo que recibió anticonceptivos tenía endometriosis comparado con el 44.5% del grupo que no los recibió. No hubo asociación entre el consumo de
    anticonceptivos y el grado, tipo o localización de las lesiones. Tampoco se encontró asociaci...

  13. Hepatocarcinoma gigante unifocal en mujer con ingesta prolongada de anticonceptivos hormonales: ¿casualidad o causalidad?

    Directory of Open Access Journals (Sweden)

    VICTOR MANUEL LOPEZ MOURIÑO

    2016-12-01

    Full Text Available Presentamos un caso de una paciente de mediana edad con ingesta mantenida de anticonceptivos hormonales (AH que desarrolla múltiples adenomas hepáticos (asociación bien documentada y un carcinoma hepatocelular (CHC unifocal gigante sin encontrar otros factores de riesgo para el mismo (enolismo, tabaquismo, cirrosis, hemocromatosis,..... Si bien en la literatura no hay unanimidad respecto a la asociación del consumo de AH con el CHC, algunos autores ya contemplaron esa posibilidad, excluyendo también otras etiologías reconocidas de CHC, por lo que debería reevaluarse si su asociación es aleatoria o por el contrario existe nexo causal.

  14. Neglected vaginal pessary

    Directory of Open Access Journals (Sweden)

    Meenu Jain

    2014-02-01

    Full Text Available Vaginal pessary may be opted for management of uterine prolapse as a safe option, but to avoid complications regular follow-up is a must. We are reporting a case of neglected vaginal pessary in a 72 year old female which got embedded in vaginal mucosa and required excision of vaginal band for its removal. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 291-292

  15. Relación entre el consumo de anticonceptivos orales y la endometriosis en pacientes sometidas a laparoscopia. Profamilia, Medellín, 1998-1999

    Directory of Open Access Journals (Sweden)

    Luis Serna

    2001-04-01

    Full Text Available Determinar la relación entre el consumo de anticonceptivos orales y la prevalencia y severidad de la endometriosis en pacientes sometidas a laparoscopia por cualquier causa en Profamilia Medellín, entre julio de 1998 y abril de 1999. El 24.8% del grupo que recibió anticonceptivos tenía endometriosis comparado con el 44.5% del grupo que no los recibió. No hubo asociación entre el consumo de
    anticonceptivos y el grado, tipo o localización de las lesiones. Tampoco se encontró asociación entre tiempo de uso, dosis y tiempo de suspensión de los anticonceptivos con la prevalencia de endometriosis.

  16. Conocimiento y uso de anticonceptivos entre los jóvenes mexicanos. El papel del género

    Directory of Open Access Journals (Sweden)

    Irene Casique

    2011-01-01

    Full Text Available Con base en datos provenientes de la Encuesta Nacional sobre Violencia en el Noviazgo, levantada en 2007 entre jóvenes mexicanos de 15 a 24 años de edad, se exPlora el.nivel de conocimiento y uso de anticonceptivos en el contexto de las relaciones de noviazgo. Con este análisis se pretende evidenciar el rol que desempeñan las diversas características sociodemográficas de los jóvenes en el conocimiento y uso de anticonceptivos, con partic cular atención en el papel que juega el género. En general se observan diferencias importantes entre los factores relacionados con el uso de anticonceptivos alguna vez y los factores asociados al uso del condón en las relaciones con la pareja actual. El uso de anticonceptivos aparece asociado positivamente tanto entre los hombres como entre las mujeres con las condiciones socioeconómicas más favorables, con más conocimientos sobre los anticonceptivos, y con un mayor número de compañeros sexuales (sólo para los varones. Entre las mujeres también el hecho de ser estudiante favorece el uso de anticonceptivos. No obstante, cuando se incorporan al análisis elementos proPios de la relación de noviazgo y secircunscribe el análisis a la frecuencia de uso del condón en las relaciones sexuales con la pareja actual, pierden relevancia los factores objetivos y cobran significancia ciertos elementos más subjetivos propios de la relación: la diferencia de edad con la pareja (Para hombres y mujeres, la duración del noviazgo (Para las mujeres, quién decide cuándo y cómo tener sexo (Para los hombres, el apoyo que ofrece la pareja (sólo los hombres, la actitud hacia los roles de género (en el caso de los hombres, y la presen¬cia de violencia emocional (Para los hombres y de violencia física.

  17. EXPERIENCIA CHILENA CON EL USO DE UN ANTICONCEPTIVO ORAL COMBINADO DE ACETATO DE CLORMADINONA/ETINILESTRADIOL: ESTUDIO NO INTERVENCIONAL

    OpenAIRE

    2008-01-01

    Objetivos: Evaluar en mujeres chilenas, la eficacia, tolerabilidad y seguridad del anticonceptivo Belara® (Acetato de Clormadinona 2 mg y Etinilestradiol 0,03 mg) (ACM/EE). Métodos: Estudio no intervencional, multicéntrico, prospectivo, de 6 ciclos de seguimiento, evaluando efectividad anticonceptiva, estabilidad de ciclo, tolerabilidad, seguridad y acción sobre peso, piel y cabello. Resultados: ACM/EE fue tomado por 593 mujeres durante 3426 ciclos. Hubo 2 embarazos durante el seguimiento, un...

  18. Longevidad y anillos de crecimiento en el Pino de la Virgen (El Paso, La Palma

    Directory of Open Access Journals (Sweden)

    María del Mar Génova Fuester

    2013-11-01

    Full Text Available En el seno del proyecto de investigación que se está desarrollando en Canarias orientado a la reconstrucción de la variabilidad climática del Archipiélago a lo largo del último milenio a partir de la información climática contenida en los anillos de crecimiento de ejemplares de pino canario, uno de los árboles estudiados ha sido el célebre Pino de la Virgen de El Paso, La Palma. Su alto valor simbólico y cultural ha llevado a un análisis más detenido, centrado en la aplicación de técnicas específicas para la estimación de su edad.Within the framework of the investigation wich is being developed in the Canary Islans for the reconstruction of the last millennium climatic variability in the Archipelago from the climatic information recorded in canary pine tree-rings, one of the analized trees has been the renowed Pino de La VIrgen de El Paso, La Palma. Its high simbolic and cultural value deserved the application of specific techniques for the estimation of its age. 

  19. Vaginal infections update.

    Science.gov (United States)

    Mashburn, Jane

    2012-01-01

    Vaginal symptoms are one of the leading reasons that women visit their health care providers. Women often self-diagnose and may treat themselves inappropriately. This article describes the etiology, risk factors, symptoms, diagnosis, and treatment of the 3 most common vaginal infections: bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis.

  20. The contraceptive vaginal ring.

    Science.gov (United States)

    Edwardson, Jill; Jamshidi, Roxanne

    2010-03-01

    The contraceptive vaginal ring offers effective contraception that is self-administered, requires less frequent dosing than many other forms of contraception, and provides low doses of hormones. NuvaRing (Organon, Oss, The Netherlands), the only contraceptive vaginal ring approved for use in the United States, contains etonogestrel and ethinyl estradiol. It is inserted into the vagina for 3 weeks, followed by a 1-week ring-free period, and works by inhibiting ovulation. Most women note a beneficial effect on bleeding profiles and are satisfied with NuvaRing. Commonly reported adverse events include vaginitis, leukorrhea, headaches, and device-related events such as discomfort. Serious adverse events are rare. In Chile and Peru, progesterone-only vaginal contraceptive rings are available for nursing women. Studies are ongoing examining new formulations of vaginal contraceptive rings.

  1. Cómo y cuando el levonorgestrel previene el embarazo cuando se administra como anticonceptivo de emergencia

    OpenAIRE

    Ortiz, Maria Elena; Croxatto, Horacio

    2007-01-01

    La anticoncepción hormonal de emergencia (AHE) es uno de los pocos recursos que la mujer puede usar para prevenir un embarazo no deseado después de haber tenido una relación sexual en la que no usó método anticonceptivo o el que usó presentó una falla. Actualmente, el método preferido para la AHE es la píldora que contiene solamente levonorgestrel (LNG). Según la OMS, puede prevenir embarazos si se usa hasta 120 horas después del acto sexual, pero su eficacia disminuye drást...

  2. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto

    OpenAIRE

    Núñez-Urquiza Rosa María; Hernández-Prado Bernardo; García-Barrios Cecilia; González Dolores; Walker Dylis

    2003-01-01

    Objetivo. Describir la proporción de embarazo no deseado en adolescentes, su asociación con características sociodemográficas y la utilización de anticonceptivos posparto. Material y métodos. Se trata de un estudio transversal con una muestra de 220 mujeres adolescentes entre 13 y 19 años de edad, de dos municipios semiurbanos del estado de Morelos, México, entrevistadas entre 1992 y 1994. Las mujeres fueron entrevistadas en su casa entre seis y 12 semanas después del parto. Se les preguntó s...

  3. LA INFLUENCIA DE SCHOPENHAUER EN LA ESTÉTICA WAGNERIANA: UN ESTUDIO FILOSÓFICO DEL ANILLO DEL NIBELUNGO

    Directory of Open Access Journals (Sweden)

    Carolina Rodríguez Rodríguez

    2005-01-01

    Full Text Available El texto constituye una síntesis de los resultados obtenidos con la investigación «Richard Wagner y las relaciones entre filosofía y música». Como objetivo fundamental se pretendió describir el impacto que ejerció el pensamiento de Schopenhauer en la estética wagneriana, teniendo como marco de referencia «El anillo del nibelungo» y, en particular, el arquetipo mitológico de Wottan.

  4. Validación del ritmo de formación de los anillos de crecimiento en otolitos del jurel Trachurus murphyiNichols 1920

    Directory of Open Access Journals (Sweden)

    Carlos Goicochea

    2013-10-01

    Full Text Available Se presentan resultados de la validación del crecimiento del jurel Trachurus murphyipor tres técnicas: 1 validación del primer anillo anual mediante lectura de microincrementos diarios; 2 análisis del crecimiento del radio del otolito entre el segundo y tercer anillo, siguiendo una cohorte; y, 3 lectura convencional de anillos anuales. Los resultados demostraron que la edad promedio de jureles T. murphyicon el primer anillo completamente formado fue de 364.8 días, con una talla media de 19.5 cm, y que el incremento promedio del segundo al tercer anillo fue de 0.62 mm. Se estimaron los parámetros de crecimiento L oo= 75.17 cm, k= 0.165/año, t o = -0.817año y se discuten estos resultados destacándose que estos parámetros indican que el jurelT. murphyiperuano crece más rápido que el jurel T. murphyichileno. Las mediciones del radio del primer anillo anual alcanzaron valores hasta 18% más altos que los reportados por otros autores para el jurel chileno, y las medidas del radio de otolitos de individuos de dos y tres años fueron hasta 20% más altas. La longitud promedio de ejemplares de jurel peruano de un año de edad es aproximadamente 35% mayor que la del jurel chileno obtenida por otros autores. El índice de crecimiento phi prima (Ø’de jurel peruano obtenido en este estudio y en otros, evidencia patrones de crecimiento similares, por el bajo valor del coeficiente de variación (1%, y que es menor al 7% obtenido por otros autores para el jurel T. murphyide más al sur.

  5. How Is Vaginitis Treated?

    Science.gov (United States)

    ... to learn the specific type of vaginitis. 1 Bacterial Vaginosis Bacterial vaginosis (BV) is treated with an antibiotic that gets ... diagnosed? Are there complications? » Related A-Z Topics Bacterial Vaginosis Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...

  6. Anterior vaginal wall repair

    Science.gov (United States)

    ... may have you: Learn pelvic floor muscle exercises ( Kegel exercises ) Use estrogen cream in your vagina Try ... Urinary incontinence - vaginal sling procedures Vagina Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  7. Can Vaginitis Be Prevented?

    Science.gov (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications Can vaginitis be prevented? Skip sharing on social media links Share this: Page Content These steps can ...

  8. What Is Vaginal Cancer?

    Science.gov (United States)

    ... or epithelial lining ) because it is formed by epithelial cells. The vaginal wall underneath the epithelium is made up of connective tissue, muscle tissue, lymph vessels, and nerves. The vagina ...

  9. Las Armas con Pomo en Forma de Anillo. Aportación al Estudio de su Evolución

    Directory of Open Access Journals (Sweden)

    Cirlot, Juan Eduardo

    1970-12-01

    Full Text Available Consultadas diversas obras sobre las armas con anillo (no colocado sobre el pomo, como en ciertas espadas y dagas de la baja Edad Media, sino sustituyéndolo, he podido advertir que su área de difusión es mucho más amplia de lo que supuse en principio, tanto en el espacio como en el tiempo. Hay armas de este tipo desde el Japón a Francia, y su cronología se extiende unos dieciocho siglos, con un vacío intermedio de tres a cinco. Dicho de otro modo: empiezan a aparecer armas de pomo de anillo hacia el 1600-1500 a. C. en bronce, y siguen existiendo con discontinuidades (que no he podido llenar, sin duda por lagunas de investigación más que de existencia de tales armas hasta La Tène III, o sea, el siglo I a. C. Luego reaparecen en el siglo IV-V d. C., y se las encuentra hasta el VIII.

  10. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto

    Directory of Open Access Journals (Sweden)

    Núñez-Urquiza Rosa María

    2003-01-01

    Full Text Available OBJETIVO: Describir la proporción de embarazo no deseado en adolescentes, su asociación con características sociodemográficas y la utilización de anticonceptivos posparto. MATERIAL Y MÉTODOS: Se trata de un estudio transversal con una muestra de 220 mujeres adolescentes entre 13 y 19 años de edad, de dos municipios semiurbanos del estado de Morelos, México, entrevistadas entre 1992 y 1994. Las mujeres fueron entrevistadas en su casa entre seis y 12 semanas después del parto. Se les preguntó si antes de embarazarse desearon el último embarazo. Además, se indagó sobre conocimientos y uso de métodos anticonceptivos posparto. RESULTADOS: Un 17% de todos los nacimientos registrados en la población total en ese periodo fueron producto de madres adolescentes. De éstas, 22.73% declararon que su embarazo no fue deseado. Se encontró una asociación positiva entre no tener derecho de acceso a los servicios de salud de las instituciones del sistema de seguridad social -Instituto Mexicano del Seguro Social (IMSS, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE- y embarazo no deseado (RM ajustada=3.03, IC 95% 1.31, 7. Asimismo, las adolescentes de comunidades urbanas manifestaron no deseo del embarazo con mayor frecuencia que las mujeres de comunidades rurales (RM ajustada=2.16, IC 95% 1.08, 4.33. Un 91.3% de las madres adolescentes enunció la píldora anticonceptiva entre los métodos que conocía. Un 84.72% conocía el DIU y 63.68% el condón. Sin embargo, sólo 35% estaba utilizando algún método anticonceptivo efectivo después de las seis semanas posparto. No se encontró diferencia en la frecuencia de uso de anticonceptivos según deseo del último embarazo. Entre quienes se atendieron el parto en centros de salud u hospital sólo 43.39% estaba utilizando algún método efectivo de planificación familiar. CONCLUSIONES: Estos hallazgos sugieren que los programas de planificación familiar tienen un

  11. Menopause and the vaginal microbiome.

    Science.gov (United States)

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

    2016-09-01

    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis.

  12. Factores incidentes en el uso de métodos anticonceptivos en la población adolescente y adulta joven en Costa Rica

    Directory of Open Access Journals (Sweden)

    Carmen Sánchez-Retana

    2016-01-01

    Full Text Available Objetivo: analizar los factores que inciden en el uso de métodos anticonceptivos de la población adolescente y adulta joven de Costa Rica (entre 15 y 35 años de edad. Métodos: Por medio de los datos de la Encuesta Nacional de Juventud 2007 y la metodología basada en el Modelo Probit binario con corrección de sesgos de selección mediante Heckman, se modela la decisión de uso de anticonceptivos con base en diferentes características personales y socioeconómicas. Resultados: se muestra que la edad de la persona y la de la pareja, la estabilidad de la relación y pertenecer a la zona urbana son factores que disminuyen la probabilidad de uso de anticonceptivos. Por otro lado, ser mujer, tener educación universitaria, haber recibido información sobre anticonceptivos e infecciones de transmisión sexual (ITS, la frecuencia de las relaciones y contar con una relación familiar de apoyo son factores que incrementan la posibilidad de protección mediante el uso de métodos anticonceptivos. Conclusiones: Estos resultados pueden ayudar en el diseño de políticas para prevenir el embarazo adolescente y la transmisión de ITS. Además, se resalta la importancia de brindar educación sexual tanto a los jóvenes como a sus familias más allá de incentivar la abstinencia, de manera que se motive a tener una vida sexual responsable.

  13. Factores incidentes en el uso de métodos anticonceptivos en la población adolescente y adulta joven en Costa Rica

    Directory of Open Access Journals (Sweden)

    Carmen Sánchez-Retana

    2016-07-01

    Full Text Available Objetivo: analizar los factores que inciden en el uso de métodos anticonceptivos de la población adolescente y adulta joven de Costa Rica (entre 15 y 35 años de edad. Métodos: Por medio de los datos de la Encuesta Nacional de Juventud 2007 y la metodología basada en el Modelo Probit binario con corrección de sesgos de selección mediante Heckman, se modela la decisión de uso de anticonceptivos con base en diferentes características personales y socioeconómicas. Resultados: se muestra que la edad de la persona y la de la pareja, la estabilidad de la relación y pertenecer a la zona urbana son factores que disminuyen la probabilidad de uso de anticonceptivos. Por otro lado, ser mujer, tener educación universitaria, haber recibido información sobre anticonceptivos e infecciones de transmisión sexual (ITS, la frecuencia de las relaciones y contar con una relación familiar de apoyo son factores que incrementan la posibilidad de protección mediante el uso de métodos anticonceptivos. Conclusiones: Estos resultados pueden ayudar en el diseño de políticas para prevenir el embarazo adolescente y la transmisión de ITS. Además, se resalta la importancia de brindar educación sexual tanto a los jóvenes como a sus familias más allá de incentivar la abstinencia, de manera que se motive a tener una vida sexual responsable.

  14. Anillos vasculares como diagnóstico diferencial del asma Vascular rings in differential diagnosis of asthma

    Directory of Open Access Journals (Sweden)

    Patricio Rioseco S

    2012-03-01

    Full Text Available Las anomalías del arco aórtico y sus ramas son infrecuentes. La presencia de un anillo vascular determina la aparición de sintomatologia relacionada con compresión traqueal o esofágica. El diagnóstico en la edad adulta es extremadamente inusual. Se presenta el caso de una mujer de 64 años con diagnóstico de Asma inducida por ejercicio, refractaria a tratamiento, la cual presentó disnea sibilante en relación al ejercicio, que no cedió con tratamiento bien llevado. La curva flujo-volumen sugirió obstrucción variable de la vía aérea central intratorácica, la radiografía de tórax mostró botón aórtico situado a derecha, la tomografía computada del tórax demostró un anillo vascular formado por un arco aórtico derecho, con la arteria subclavia izquierda aberrante, divertículo de Kommerell comprimiendo el esófago y con la aorta descendente que en su trayecto comprime la pared posterior de la tráquea, lo que es corroborado por videobroncoscopía, describiéndose compresión pulsátil, que se exacerbaba con la taquicardia. Se concluye que la paciente tiene un anillo vascular causante de los síntomas descritos y nos orienta a establecer que en el esquema de estudio de pacientes con asma atípica o de difícil manejo, es necesario incluir las malformaciones del arco aórtico en el diagnóstico diferencial, realizando al menos radiografía de tórax y revisando atentamente la gráfica de la curva flujo-volumen.Aortic arch abnormalities and vascular rings are a rare cause of compression of trachea and esophagus causing respiratory and digestive symptoms in adults. We report a 64 years old woman with exercise induced asthma not resolving with adequate treatment. Flow/volume loop shape suggested an intrathoracic major airway obstruction. Chest X ray showed a right sided aortic notch and CT scan revealed a vascular ring composed by a right aortic arch with aberrant left subclavian artery and Kommerell's diverticulum compressing

  15. Vaginal itching and discharge - child

    Science.gov (United States)

    ... vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... To prevent and treat vaginal irritation, your child should: Avoid colored or perfumed toilet tissue and bubble bath. Use plain, unscented soap. Limit bath time to 15 minutes or less. Ask ...

  16. Vaginal and Vulvar Cancer

    Science.gov (United States)

    ... is passed from one person to another during sex. There is a vaccine that protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. It is recommended for preteens (both boys and girls) aged 11 to 12 ...

  17. Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief?

    Science.gov (United States)

    Stute, Petra

    2013-12-01

    In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0

  18. Perfil de la mujer usuaria y no usuaria de método anticonceptivo y causas de no utilización

    OpenAIRE

    I. Acevedo-Galindo; J, Najera-Soto; A. Bernal-Fernández

    2005-01-01

    Objetivo: Determinar el perfil de la usuaria y no usuaria de método anticonceptivo y causas de no utilización. Diseño: Estudio descriptivo, Observacional, transversal y prospectivo. Material y Métodos: En mujeres en edad fértil atendidas en una Unidad de Medicina Familiar de la Ciudad de México. Se realizó una muestra no probabilística de 150 mujeres. Se aplicó una cédula de recolección de datos específicos para identificar el perfil de la usuaria y no usuaria de método anticonceptivo y con p...

  19. Actividad sexual y métodos anticonceptivos utilizados por los estudiantes de la Universidad Nacional de Colombia, sede Bogotá

    Directory of Open Access Journals (Sweden)

    Bernal Roldán María del Carmen

    1990-12-01

    Full Text Available

    El presente estudio trata de una encuesta sobre actividad sexual y utilización de métodos anticonceptivos entre los estudiantes de pregrado de la Universidad Nacional. Dicha encuesta se aplicó a 701 estudiantes de todas las carreras de la Universidad, buscando conocer las necesidades reales de promoción y asistencia en sexualidad humana y anticoncepción de dicha población. Los resultados nos muestran que un alto porcentaje de la población estudiantil tienen vida sexual activa, no planifican, y el aborto está siendo utilizado como método anticonceptivo y que los métodos más utilizados son el ritmo y el condón.

  20. Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.

    Science.gov (United States)

    Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

    2012-12-01

    Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour.

  1. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  2. RECONSTRUCCIÓN DE PRECIPITACIÓN INVIERNO-PRIMAVERA CON ANILLOS ANUALES DE Pinus douglasiana EN LA RESERVA DE LA BIOSFERA SIERRA DE MANANTLÁN, JALISCO

    OpenAIRE

    Julián Cerano-Paredes; Jorge Méndez-González; Abihail Amaro-Sánchez; José Villanueva-Díaz; Rosalinda Cervantes-Martínez; Ernesto A. Rubio-Camacho

    2013-01-01

    Se reconstruyó la precipitación invierno-primavera de 219 años (1792-2010) de la Reserva de la Biosfera Sierra de Manantlán (RBSM), Jalisco, México, empleando los anillos anuales de Pinus douglasiana (Mtz.) como proxy. La sequía de mediados del siglo XX (1941-1963) fue la más severa del periodo estudiado. El índice multivariado de El Niño Oscilación del Sur (ENSO; 1959-2010) y el índice de ancho del anillo de P. douglasiana mostraron correlación significativa (r = 0.4542; P 0.05) de los mese...

  3. Steroidal contraceptive vaginal rings.

    Science.gov (United States)

    Sarkar, N N

    2003-06-01

    The development of steroid-releasing vaginal rings over the past three decades is reviewed to illustrate the role of this device as an effective hormonal contraceptive for women. Vaginal rings are made of polysiloxane rubber or ethylene-vinyl-acetate copolymer with an outer diameter of 54-60 mm and a cross-sectional diameter of 4-9.5 mm and contain progestogen only or a combination of progestogen and oestrogen. The soft flexible combined ring is inserted in the vagina for three weeks and removed for seven days to allow withdrawal bleeding. Progesterone/progestogen-only rings are kept in for varying periods and replaced without a ring-free period. Rings are in various stages of research and development but a few, such as NuvaRing, have reached the market in some countries. Women find this method easy to use, effective, well tolerated and acceptable with no serious side-effects. Though the contraceptive efficacy of these vaginal rings is high, acceptability is yet to be established.

  4. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    , pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC......The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest...

  5. Treatment Options by Stage (Vaginal Cancer)

    Science.gov (United States)

    ... Health Professional Vaginal Cancer Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  6. Vaginal contraceptives still evolving.

    Science.gov (United States)

    Pearson, R M

    1986-01-01

    The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future.

  7. Neoplasia vaginal intraepitelial

    OpenAIRE

    Baquedano M.,Laura; Lamarca B,Marta; José G,Yasmina; Rubio C,Patricia; Ruiz C,Miguel Ángel

    2013-01-01

    Objetivo: Actualizar los conocimientos disponibles sobre la neoplasia vaginal intraepitelial (VAIN) especialmente en el diagnóstico y tratamiento. Métodos: Revisión de la literatura en Pubmed de los últimos 20 años, especialmente de los publicados desde 2005 hasta la actualidad y considerando sobre todo los ensayos clínicos aleatorizados. Resultados: Su prevalencia real es desconocida, aunque es una patología rara generalmente en mujeres posmenopaúsicas. Su fisiopatología es similar a la neop...

  8. Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Azubuike Uzoma

    2009-01-01

    Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.

  9. Vaginal haemangioendothelioma: an unusual tumour.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.

  10. Cómo y cuando el levonorgestrel previene el embarazo cuando se administra como anticonceptivo de emergencia

    Directory of Open Access Journals (Sweden)

    Ortiz, Maria Elena

    2007-01-01

    Full Text Available La anticoncepción hormonal de emergencia (AHE es uno de los pocos recursos que la mujer puede usar para prevenir un embarazo no deseado después de haber tenido una relación sexual en la que no usó método anticonceptivo o el que usó presentó una falla. Actualmente, el método preferido para la AHE es la píldora que contiene solamente levonorgestrel (LNG. Según la OMS, puede prevenir embarazos si se usa hasta 120 horas después del acto sexual, pero su eficacia disminuye drásticamente desde 85% a 31% mientras más se posterga su administración. La introducción de la AHE ha generado controversia en muchos países latinoamericanos por la percepción errónea de que induce aborto y la oposición de los sectores más conservadores de la sociedad que temen que favorezca la promiscuidad. Con el propósito de dar a conocer la evidencia científica producida por las investigaciones diseñadas para dilucidar como el LNG previene el embarazo cuando se administra como AHE, y su correcta interpretación, este artículo analiza críticamente dichos estudios y explica además en que circunstancias este método no logra prevenir el embarazo. El conjunto de la evidencia indica que LNG previene el embarazo solamente cuando impide la fecundación y descarta que el prevenga el embarazo interfiriendo con la implantación del embrión, por lo que la creencia de que es abortivo no tiene sustento científico.

  11. Linfoma de células en anillo de sello que simula carcinoma mucosecretante Signet ing cell lymphoma mimicking mucin-producing carcinoma

    Directory of Open Access Journals (Sweden)

    Ana María Saenz de Chirife

    2004-12-01

    Full Text Available El linfoma de células en anillo de sello es una neoplasia poco frecuente, caracterizada por la presensencia de grandes células de citoplasma vacuolado, claro, similar a los encontrados en adeno-carcinomas mucosecretantes. Se ha descripto en ganglios linfáticos y tejidos extralinfáticos. Se presenta el caso de un paciente varón de 59 años con linfoma de células en anillo de sello localizado en pared lateral de orofaringe. Esta localización creemos que no ha sido descripta anteriormente. La histología mostró células en anillo de sello y el inmunofenotipo tumoral fue: vimentina, CD45, CD20, Ig M y cadenas kappa positivos, siendo la fracción de crecimiento tumoral alta (Ki 67:70%. El paciente evolucionó desfavorablemente y falleció a los dos meses del diagnóstico sin recibir tratamiento.Signet ring cell lymphoma is a rare neoplasm caracterized by large, vacuolated and clear cells mimicking mucin-producing adenocarcinoma. It is localized in nodal and extranodal sites. A case of a 59 years old male, with a diffuse lymphoma signet ring cell type localized on oropharingeal mucosa is reported. The histopathology study showed signet ring cells and the immunophenotype was: vimentine(+, CD45(+, CD20(+, Ig M(+, Kappa chain(+ and high index proliferative activity of neoplastic cells (Ki 67:70%. After a review of the literature and previous reports, we could not find a similar case in this anatomic site. The patient had a unfavourable clinical course and died two months after the diagnosis without receiving any treatment.

  12. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods

    OpenAIRE

    Rosa María Núñez-Urquiza; Bernardo Hernández-Prado; Cecilia García-Barrios; Dolores González; Dylis Walker

    2003-01-01

    OBJETIVO: Describir la proporción de embarazo no deseado en adolescentes, su asociación con características sociodemográficas y la utilización de anticonceptivos posparto. MATERIAL Y MÉTODOS: Se trata de un estudio transversal con una muestra de 220 mujeres adolescentes entre 13 y 19 años de edad, de dos municipios semiurbanos del estado de Morelos, México, entrevistadas entre 1992 y 1994. Las mujeres fueron entrevistadas en su casa entre seis y 12 semanas después del parto. Se les preguntó s...

  13. Uso de anticonceptivos en México: ¿qué diferencia hacen el poder de decisión y la autonomía femenina?

    OpenAIRE

    Irene Casique

    2003-01-01

    Este trabajo analiza las relaciones entre dos indicadores del empoderamiento femenino —el poder de decisión de las mujeres y su autonomía— y el uso de métodos anticonceptivos entre las mujeres mexicanas, usando información proveniente de la Encuesta Nacional de Planificación Familiar 1995. En general para las mujeres de esta muestra un mayor nivel de autonomía incrementa sus probabilidades de estar en necesidad de anticoncepción, y mayores niveles de poder de decisión y autonomía incrementan ...

  14. Indices de anillos de crecimiento en coníferas del eje neovolcánico transversal de México.

    OpenAIRE

    Martínez Molina, Gabriel

    2011-01-01

    Se determinaron índices de crecimiento a partir de los anillos anuales en Abies religiosa (Kunth Schltdl. et Cham) (oyamel) y Pinus hartwegii (Lindl.) (pino) en un transecto sobre el Eje Neo-volcánico Transversal, en México. El muestreo se repitió en sitios con condiciones ambientales similares en seis montañas del centro de México, donde se desarrollan ambas especies forestales. Las montañas seleccionadas fueron: Nevado de Colima, Pico de Tancítaro, Nevado de Toluca, Cerro Tláloc, La Malinc...

  15. Beneficios no anticonceptivos de 0,02 mg de etinilestradiol/2 mg de acetato de clormadinona administrados en un régimen de 24+4 días

    OpenAIRE

    2011-01-01

    Objetivo: Demostrar la influencia sobre las molestias emocionales y físicas (beneficios no anticonceptivos) experimentadas durante el primer año de uso de un anticonceptivo oral combinado (AOC) que contiene 0,02 mg de etinilestradiol (EE) y 2 mg de acetato de clormadinona (ACM) administrado en un régimen de 24 + 4 días de placebo. Diseño del estudio: Análisis adicional de las sensaciones subjetivas registradas en los diarios de 1665 participantes de un estudio de Fase III multicéntrico, no co...

  16. Drugs Approved for Vaginal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  17. Urinary incontinence - vaginal sling procedures

    Science.gov (United States)

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... Urinary incontinence - tension-free vaginal tape Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  18. How Is Vaginal Cancer Diagnosed?

    Science.gov (United States)

    ... light is inserted into the bladder through the urethra. If suspicious areas or growths are seen, a biopsy will be done. Cystoscopy may be recommended if a vaginal cancer is large and/or located in the front ...

  19. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    There are many causes of abnormal vaginal bleeding. HORMONES Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB) . DUB is more ...

  20. MICROBIOLOGICAL PROFILE OF VAGINAL SWABS.

    Directory of Open Access Journals (Sweden)

    Sevitha

    2012-10-01

    Full Text Available ABSTRACT: BACKGROUND/OBJECTIVES: Bacterial vaginosis (BV, an alteration of vaginal flora involving a decrease in Lactobacilli and predo minance of anaerobic bacteria, is the most common cause of vaginal complaints for women of chil dbearing age .Causative agents include Gardnerella vaginalis, facultative lactobacilli, My coplasma hominis, Viridans streptococci & anaerobic bacteria. The most frequent manifestation s of genitourinary candidiasis is vulvovaginal candidiasis & is diagnosed in 40 % of women with vaginal complaints. The present study was undertaken to study the occurrence of Bac terial vaginosis & Vulvovaginal candidiasis in women with vaginal complaints. MATERIALS AND METHODS: The study included 100 High vaginal swabs with H/O white discharge per vaginum f or a period of 6 months from June 2011.Swabs were stained by Grams method & were cult ured. RESULTS: Out of 100 samples, in 35(35%Gram smear findings were normal & no growth in culture. 26(26%samples had polymorphs with Gardnerella morphotype, gram negative c urved rods, fusiforms & Lactobacilli were absent/present in low numbers(1 to 2+, the sme ar was interpreted as consistent with BV. 15 samples (15% had the growth of Candida spp. In the remaining 24 samples, the Gram stain findings had only vaginal epithelial cells with Lactobacilli, but the culture had the growth o f Group B Streptococcus 10(10%, E. coli & coliforms 10(10%,Enterococcus spp 14(14%which could just be colonisers. CONCLUSION: Bacterial vaginosis is the predominant cause of leuc orrhoea (26% followed by vulvovaginal candidiasis accounting for 15 % of the cases. Detection of intrapartum vaginal colonisation of Group B Streptococci, E. coli & colif orms & Enterococcus spp. in pregnant women is of significance as it can get transmitted to the neonate & cause sepsis

  1. The vaginal contraceptive sponge.

    Science.gov (United States)

    Edelman, D A

    1984-06-01

    The vaginal contraceptive sponge, approved on April 1, 1983 by the US Food Administration (FDA) for sale in the US as a single use, disposable, over-the-counter contraceptive, is made of polyurethane and designed to be biocompatible with the vaginal environment. The sponge is available in a single size, is round, and about 5.5 cm in diameter and 2.5 cm thick. An indentation on 1 side helps to ensure the sponge's correct placement against the cervix. A polyester retrieval loop attached to the sponge facilitates removal. Postcoital tests of the sponge without the spermicide indicated that it was ineffective in preventing sperm from entering the cervical canal. Before insertion, the contraceptive sponge is moistened with tap water to activate the spermicide and is inserted into the vagina with the indentation placed against the cervis. The sponge has been designed to provide continuous protection against pregnancy for at least 24 hours after insertion. Following a successful phase ii clinical trail of the sponge, in 1979 comparative phase iii clinical trials were initiated by Family Health International. The following trials were conducted: sponge versus the diaphragm (arcing-spring) used with a spermicide (nonoxynol-9) at 13 clinics in the US (1439 subjects) and at 2 clinics in Canada and the UK (502 subjects); sponge versus a foaming spermicidal (menfegol) suppository at 5 clinics in Yugoslavia, Taiwan, and Bangladesh (1386) subjects); and sponge versus spermicidal (nonoxynol-9) foam at 2 clinics in Israel and Thailand (366 subjects). In all trials the contraceptive methods were raondomly assigned. Clinics were required to follow up subjects for 1 year. Only the US study has been completed. In the comparative trials of the sponge and diaphragm (both US based and overseas) the pregnancy rates were significantly higher for the sponge. In the comparative trials of the sponge and foaming suppositories or spermicidal foam there were no significant differences between the

  2. Contraceptive vaginal rings: a review.

    Science.gov (United States)

    Brache, Vivian; Faundes, Anibal

    2010-11-01

    Development efforts on contraceptive vaginal rings were initiated over 40 years ago based on two principles: the capacity of the vaginal epithelium to absorb steroids and the capacity of elastomers to release these hormones at a nearly constant rate. Numerous models of contraceptive vaginal rings (CVRs) have been studied, but only two have reached the market: NuvaRing, a combined ring that releases etonogestrel (ENG) and ethinylestradiol (EE), and Progering, a progesterone-releasing ring for use in lactating women. The main advantages of CVRs are their effectiveness (similar to or slightly better than the pill), ease of use without the need of remembering a daily routine, user's ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring. The main disadvantages are related to the mode of delivery; CVRs may cause vaginal discharge and complaints, ring expulsion is not uncommon, the ring may be felt during coitus and vaginal insertion may be unpleasant for some women. The studies reviewed in this article provide evidence that CVRs are safe, effective and highly acceptable to women. There is no doubt that CVRs offer a new, effective contraceptive option to women, expanding their available choices of hormonal contraception.

  3. Citología Vaginal

    OpenAIRE

    Arrunategui, Ana María; Fundación Valle de Lili

    2001-01-01

    ¿Qué es una neoplasia?/ ¿Qué grupo de mujeres tiene un mayor riesgo de desarrollar cáncer del cuello de la matriz?/ ¿Cuáles son los síntomas más frecuentes del cáncer del cuello de la matriz?/ Anatomía de los órganos genitales femeninos/¿Cómo se realiza la prueba de la citología vaginal?/¿Cómo se interpretan los resultados de la citología vaginal?/ ¿Toda citología anormal es cáncer?/ ¿Qué otras utilidades tiene la citología vaginal?/ ¿Desde qué edad, hasta que edad y con qué frecuencia debe t...

  4. Vaginal radical trachelectomy: an update.

    Science.gov (United States)

    Plante, Marie

    2008-11-01

    The vaginal radical trachelectomy has emerged as a valuable fertility-preserving treatment option for young women with early-stage disease. Cancer-related infertility is associated with feelings of depression, grief, stress, and sexual dysfunction. Data have shown that the overall oncological outcome is safe and that the obstetrical outcome is promising. In this article, we analyze the data on the vaginal radical trachelectomy published over the last 10 years in the context of what we have learned, what issues remain unclear, and what the future holds.

  5. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  6. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  7. Effects of vaginal prolapse surgery and ageing on vaginal vascularization

    NARCIS (Netherlands)

    Weber, M.A.

    2016-01-01

    Ageing affects pelvic floor anatomy and function, resulting in several disorders like pelvic organ prolapse (POP), lower urinary tract symptoms and vaginal atrophy (VA). In this thesis we searched for methods to link the function of pelvic organs to physiological changes. The effects of POP and vagi

  8. A New Method to Measure Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, M. M. E.; Laan, E.; Vaart, C. H.; Roovers, J. P.

    2010-01-01

    Introduction: Vaginal surgery may affect sexual function both positively and negatively. Possibly, negative consequences of surgical interventions on sexuality may be caused by reduced sensibility of the vaginal wall. Aims: To develop a new method to measure vaginal sensibility. Methods: We develope

  9. Uso de métodos anticonceptivos en relación con la información sexual en una muestra de adolescentes embarazadas

    OpenAIRE

    Della Mora, Marcelo; Universidad Argentina

    2014-01-01

    Se estudian las características psicológicas y sociodemográficas en una muestra de adolescentes embarazadas, escolarizadas, de 13 a 18 años de la ciudad de Buenos Aires, Argentina. Se com-paran con un grupo de jóvenes no embarazadas. Se recolectan datos primarios a través de la administración de una encuesta que permite analizar y comparar la relación entre la utilización de métodos anticonceptivos y la información y formación sexual recibidas en los distintos ámbitos relacionales. Se analiza...

  10. Inicio de vida sexual, uso de anticonceptivos y planificación familiar en mujeres adolescentes y adultas en México

    OpenAIRE

    Betania Allen-Leigh; Aremis Villalobos-Hernández; Leticia Suárez; Elvia de la Vara; Filipa de Castro; Raffaela Schiavon-Ermani; María I Hernández-Serrato

    2013-01-01

    Objetivo. Ofrecer evidencia actualizada sobre inicio de vida sexual y uso de anticonceptivos en mujeres adolescentes y adultas en México por grupos de edad, lugar de residencia y estado civil. Material y métodos. Se analizaron datos de las ENSANUT 2006 y 2012, sobre conocimientos y uso de anticoncepción. Resultados. En 2012, 31.2% de las adolescentes (15-19 años) había iniciado vida sexual; el uso del condón aumentó de 31.8 a 47.8% entre 2006 y 2012. El 47.9% de 30 a 34 años y 53.2% de 35 a 4...

  11. Vaginal leiomyoma: MRI features with pathologic correlation

    Directory of Open Access Journals (Sweden)

    Avantika Gupta

    2015-06-01

    Full Text Available We present a rare case of vaginal leiomyoma presenting as prolapsed vaginal mass in a 45 years old woman. The leiomyoma was found to arise from the right lateral vaginal fornix with a vascular stalk. MRI showed homogenous hypointense signals on T1W1 and iso to hyperintense signals on T2W1 images with moderate heterogenous enhancement on post contrast images. It was enucleated via vaginal route and the histopathological examination confirmed the diagnosis of vaginal leiomyoma.

  12. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S;

    2007-01-01

    , pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...... and lifting 2 and 5 kg. Lifting in the walking position created a slightly higher VP compared to other lifting techniques, which did not differ. The VP did not increase when lifting 5 kg compared to 2 kg. Mean VP during coughing and Valsalva were significantly lower 1-5 days after the operation. VP...... was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities....

  13. Antigonococcal effects of vaginal tampons.

    Science.gov (United States)

    Arko, R J; Wong, K H; Smith, S J; Finley-Price, K G

    1983-01-01

    Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae. Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections. Strains from patients with pelvic inflammatory disease were moderately sensitive. Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice. Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice. These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes. PMID:6403199

  14. Vaginal birth after cesarean section

    Directory of Open Access Journals (Sweden)

    Vidyadhar B Bangal

    2013-01-01

    Full Text Available Background: The rate of primary cesarean section (CS is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC in selected cases of one previous lower segment CS (LSCS. Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

  15. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods

    Directory of Open Access Journals (Sweden)

    Rosa María Núñez-Urquiza

    2003-01-01

    Full Text Available OBJETIVO: Describir la proporción de embarazo no deseado en adolescentes, su asociación con características sociodemográficas y la utilización de anticonceptivos posparto. MATERIAL Y MÉTODOS: Se trata de un estudio transversal con una muestra de 220 mujeres adolescentes entre 13 y 19 años de edad, de dos municipios semiurbanos del estado de Morelos, México, entrevistadas entre 1992 y 1994. Las mujeres fueron entrevistadas en su casa entre seis y 12 semanas después del parto. Se les preguntó si antes de embarazarse desearon el último embarazo. Además, se indagó sobre conocimientos y uso de métodos anticonceptivos posparto. RESULTADOS: Un 17% de todos los nacimientos registrados en la población total en ese periodo fueron producto de madres adolescentes. De éstas, 22.73% declararon que su embarazo no fue deseado. Se encontró una asociación positiva entre no tener derecho de acceso a los servicios de salud de las instituciones del sistema de seguridad social -Instituto Mexicano del Seguro Social (IMSS, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE- y embarazo no deseado (RM ajustada=3.03, IC 95% 1.31, 7. Asimismo, las adolescentes de comunidades urbanas manifestaron no deseo del embarazo con mayor frecuencia que las mujeres de comunidades rurales (RM ajustada=2.16, IC 95% 1.08, 4.33. Un 91.3% de las madres adolescentes enunció la píldora anticonceptiva entre los métodos que conocía. Un 84.72% conocía el DIU y 63.68% el condón. Sin embargo, sólo 35% estaba utilizando algún método anticonceptivo efectivo después de las seis semanas posparto. No se encontró diferencia en la frecuencia de uso de anticonceptivos según deseo del último embarazo. Entre quienes se atendieron el parto en centros de salud u hospital sólo 43.39% estaba utilizando algún método efectivo de planificación familiar. CONCLUSIONES: Estos hallazgos sugieren que los programas de planificación familiar tienen un

  16. Concurrent chemoradiation for vaginal cancer.

    Directory of Open Access Journals (Sweden)

    David T Miyamoto

    Full Text Available BACKGROUND: It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT or concurrent chemoradiation therapy (CRT. METHODS: Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS and disease-free survival (DFS rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. RESULTS: The median age at diagnosis was 61 years (range, 18-92 years and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011. Twenty-three patients (45% in the RT group had a relapse at any site compared to 3 (15% in the CRT group (p = 0.027. With regard to the sites of first relapse, 10 patients (14% had local only, 4 (6% had local and regional, 9 (13% had regional only, 1 (1% had regional and distant, and 2 (3% had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10-0.97; p = 0.04. CONCLUSIONS: Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.

  17. Uso de métodos anticoncepcionais entre adolescentes universitários El uso de metodos anticonceptivos en adolescentes universitarios Use of contraceptive methods among university adolescents

    Directory of Open Access Journals (Sweden)

    Aline Salheb Alves

    2008-04-01

    Full Text Available Objetivou-se identificar o uso de métodos anticoncepcionais entre adolescentes, ingressantes de uma universidade pública paulista e descrever o perfil desses universitários quanto a algumas características sócio-demográficas. Foi utilizado um questionário e a amostra foi composta por 295 adolescentes. Relataram ter iniciado atividade sexual 48,8%. A idade média para o início foi aos 17 anos, e a maioria relatou ter usado um método contraceptivo. O método mais utilizado foi o preservativo e este em combinação com a pílula, principalmente. Observou-se que os adolescentes buscam informações, seja através de profissionais da saúde, professores, ou através de livros, com destaque para a mídia. Conclui-se que os universitários iniciam atividade sexual mais tardiamente e buscam conhecimento sobre anticoncepção.El objetivo de este trabajo es identificar el uso de los métodos anticonceptivos entre adolescentes, alumnos de una universidad paulista, y describir su perfil basados en algunas características socio-demográficas. Se utilizó un cuestionario aplicado a 295 adolescentes. El 48,8% relataron haber iniciado actividad sexual. En media, la edad para el inicio son los 17 años y la mayoría afirma haber usado métodos anticonceptivos. El más utilizado fue, principalmente, el preservativo combinado con la píldora. Se observó que los adolescentes buscan información consultando a profesionales de la salud, profesores o a través de libros, y sobretodo por los medios de comunicación. Se concluye que los universitarios inician su actividad sexual más tarde y buscan conocimiento sobre métodos anticonceptivos.The objective of this study was to identify the use of contraceptive methods among teenagers at a public University in São Paulo, as well as to describe their profile concerning social and demographic characteristics. A questionnaire was used and the sample was composed by 295 teenagers. The initiation of sexual activity

  18. Vaginal rejuvenation using energy-based devices

    Directory of Open Access Journals (Sweden)

    Cheryl Karcher, MD

    2016-09-01

    Full Text Available Physiologic changes in a woman’s life, such as childbirth, weight fluctuations, and hormonal changes due to aging and menopause, may alter the laxity of the vaginal canal, damage the pelvic floor, and devitalize the mucosal tone of the vaginal wall. These events often lead to the development of genitourinary conditions such as stress urinary incontinence; vaginal atrophy; dryness; and physiologic distress affecting a woman’s quality of life, self-confidence, and sexuality. Various treatment modalities are currently available to manage these indications, varying from invasive vaginal surgery to more benign treatments like topical vaginal hormonal gels or hormone-replacement therapy. A new trend gaining momentum is the advent of energy-based devices for vaginal rejuvenation that apply thermal or nonthermal energy to the various layers of the vaginal tissue, stimulating collagen regeneration contracture of elastin fibers, neovascularization, and improved vaginal lubrication. This review aims to present the available technologies offering vaginal rejuvenation and the scientific evidence that underlines their safety and efficacy for this indication.

  19. Dynamic Clinical Measurements of Voluntary Vaginal Contractions and Autonomic Vaginal Reflexes

    NARCIS (Netherlands)

    Broens, Paul M. A.; Spoelstra, Symen K.; Weijmar Schultz, Willibrord C. M.

    2014-01-01

    IntroductionThe vaginal canal is an active and responsive canal. It has pressure variations along its length and shows reflex activity. At present, the prevailing idea is that the vaginal canal does not have a sphincter mechanism. It is hypothesized that an active vaginal muscular mechanism exists a

  20. Efficacy and Tolerability of Fitostimoline (Vaginal Cream, Ovules, and Vaginal Washing) and of Benzydamine Hydrochloride (Tantum Rosa Vaginal Cream and Vaginal Washing) in the Topical Treatment of Symptoms of Bacterial Vaginosis

    OpenAIRE

    Papa, R; Ascione, L.; Rullo, V.; Campedelli, A; Muzi, M.; Petrella, E.; Boselli, F.; Saponati, G.

    2012-01-01

    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0–3) were evaluated at baseline and at the end of treatment; the total symptoms sc...

  1. Long-retained vaginal foreign body causing chronic vaginitis in a bulldog.

    Science.gov (United States)

    Snead, Elisabeth C; Pharr, John W; Ringwood, Brendon P; Beckwith, Jennifer

    2010-01-01

    A vaginal foreign body consisting of a piece of retained calvarium from a macerated fetus was identified and removed using vaginoscopy in a 4-year-old, spayed female bulldog. The dog had a 12-month history of chronic mucopurulent vaginitis. Vaginal foreign bodies, although uncommon, are a differential diagnosis for recurrent mucopurulent or hemorrhagic chronic vaginal discharge. A case of chronic vaginitis caused by a long-retained intravaginal foreign body in a dog is described and compared to four other canine cases reported in the literature.

  2. Treatment of postmenopausal vaginal atrophy with 10-μg estradiol vaginal tablets.

    Science.gov (United States)

    Panay, Nick; Maamari, Ricardo

    2012-03-01

    Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-µg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-µg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg.

  3. Diagnóstico diferencial de lesiones cerebrales con realce en anillo en tomografía computarizada y resonancia magnética

    Directory of Open Access Journals (Sweden)

    Vicente de Jesús Aljure

    2016-07-01

    Full Text Available La tomografía computarizada y la resonancia magnética nuclear son técnicas imagenológicas de diagnóstico médico que ofrecen información excelente de diferentes procesos infecciosos, traumáticos o tumorales de cualquier parte del cuerpo humano. Con ellos se permitió la identificación de innumerables patologías y patrones característicos de las mismas, siendo una de ellas, el realce en anillo en el Sistema Nervioso Central. Numerosas patologías presentan este patrón imagenológico: Glioblastoma multiforme, síndromes desmielinizantes, metástasis, abscesos cerebrales, toxoplasmosis cerebral, neurocisticercosis, linfomas, entre otros. El objetivo del presente artículo es brindar una revisión general de las patologías más frecuentes en los servicios de imagenología, permitiendo su correlación con las características clínicas y brindando una ayuda al clínico que para establecer un diagnóstico adecuado.

  4. Treatment of Vaginal Atrophy with Vaginal Estrogen Cream in Menopausal Indian Women

    Science.gov (United States)

    Shah, Maitri; Karena, Zalak; Patel, Sangita V.; Parmar, Niyati; Singh, Pawan K.; Sharma, Atul

    2017-01-01

    Objectives To measure the effect of vaginal estrogen cream in the treatment of vaginal atrophy in menopausal Indian women. Methods A total of 50 menopausal women aged between 40 and 80 years old with symptoms of vaginal atrophy were selected and treated with 0.5 g vaginal estrogen cream, twice weekly for 12 weeks. The women were followed-up monthly where symptom score, Genital Health Clinical Evaluation (GHCE) score, vaginal pH, and vaginal maturation index (VMI) were assessed and compared to baseline data. Any adverse events were recorded. Results There was a significant improvement (p cream causes symptomatic relief in women of menopausal age in India suffering from vaginal atrophy. PMID:28042397

  5. 21 CFR 884.3900 - Vaginal stent.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or...

  6. Use of vaginal estrogen in Danish women

    DEFF Research Database (Denmark)

    Meaidi, Amani; Goukasian, Irina; Lidegaard, Oejvind

    2016-01-01

    INTRODUCTION: We know little about the use of vaginal estrogen in perimenopausal and postmenopausal women. We aimed to assess the prevalence of vaginal estrogen use in Denmark. MATERIAL AND METHODS: The study was designed as a nationwide cross-sectional study of all Danish women aged 40-79 years,...

  7. VULVO-VAGINAL CANDIDIASIS ASSOCIATED WITH ACITRETIN

    NARCIS (Netherlands)

    STURKENBOOM, MCJM; MIDDELBEEK, A; VANDENBERG, LTWD; VANDENBERG, PB; STRICKER, BHC; WESSELING, H

    1995-01-01

    The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years

  8. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Bergholt, Thomas; Nikolajsen, Sys

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  9. Estrogen receptors in human vaginal tissue

    NARCIS (Netherlands)

    Wiegerinck, M.A.H.M.; Poortman, J.; Agema, A.R.; Thijssen, J.H.H.

    1980-01-01

    The presence of specific estrogen receptors could be demonstrated in vaginal tissue, obtained during operation from 38 women, age 27–75 yr. In 23 premenopausal women the receptor concentration in the vaginal tissue varied between 12 and 91 fmol/mg protein, no significant difference in the receptor

  10. Value of bacterial culture of vaginal swabs in diagnosis of vaginal infections

    Directory of Open Access Journals (Sweden)

    Nenadić Dane

    2015-01-01

    Full Text Available Bacground/Aim. Vaginal and cervical swab culture is still very common procedure in our country’s everyday practice whereas simple and rapid diagnostic methods have been very rarely used. The aim of this study was to show that the employment of simple and rapid diagnostic tools [vaginal fluid wet mount microscopy (VFWMM, vaginal pH and potassium hydroxide (KOH test] offers better assessment of vaginal environment than standard microbiologic culture commonly used in Serbia. Methods. This prospective study included 505 asymptomatic pregnant women undergoing VFWMM, test with 10% KOH, determination of vaginal pH and standard culture of cervicovaginal swabs. Combining findings from the procedures was used to make diagnoses of bacterial vaginosis (BV and vaginitis. In addition, the number of polymorphonuclear leukocytes (PMN was determined in each sample and analyzed along with other findings. Infections with Candida albicans and Trichomonas vaginalis were confirmed or excluded by microscopic examination. Results. In 36 (6% patients cervicovaginal swab cultures retrieved several aerobes and facultative anaerobes, whereas in 52 (11% women Candida albicans was isolated. Based on VFWMM findings and clinical criteria 96 (19% women had BV, 19 (4% vaginitis, and 72 (14% candidiasis. Of 115 women with BV and vaginitis, pH 4.5 was found in 5, and of 390 with normal findings 83 (21% had vaginal pH 4.5. Elevated numbers of PMN were found in 154 (30% women - in 83 (54% of them VFWMM was normal. Specificity and sensitivity of KOH test and vaginal pH determination in defining pathological vaginal flora were 95% and 81%, and 79% and 91%, respectively. Conclusion. Cervicovaginal swab culture is expensive but almost non-informative test in clinical practice. The use of simpler and rapid methods as vaginal fluid wet mount microscopy, KOH test and vaginal pH offers better results in diagnosis, and probably in the treatment and prevention of sequels of vaginal

  11. [Bacterial vaginal fluor in intrauterine contraception].

    Science.gov (United States)

    Feichter, G E; Nohlen, M; Tauber, P F

    1979-11-01

    Vaginal swabs obtained from 100 IUD-users were examined bacteriologically. Fifty-one women had vaginal discharge and 49 women used as control group had no complaints originating either from the IUD or from the genital tract. In the group of IUD-users with vaginal discharge the number of bacterial isolates was higher and the cultures were more diversified. The nulliparous patients in this group exhibited more anaerobic cultures than the IUD-users without discharge. The significance of vaginal discharge in IUD-users is its function as a pool for pathogenic bacteria which may provoke and/or maintain inflammatory diseases of the female genital tract. IUD-users with vaginal discharge do therefore need not only bacteriologic diagnosis, but also consequent treatment of the discharge.

  12. A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012

    Directory of Open Access Journals (Sweden)

    Pardis Hosseinzadeh

    2015-01-01

    Full Text Available Background: Atrophic vaginitis is a disease, which affects up to 50% of postmenopausal women. This study compared the effectiveness and user-friendliness of Vagifem (an estradiol vaginal tablet and vaginal estrogen cream in the treatment of atrophic vaginitis. Materials and Methods: One hundred and sixty postmenopausal women with symptoms of atrophic vaginitis were randomly divided into two groups of treatment with Vagifem or with vaginal estrogen cream for 12 weeks. Patients used the medication daily for the first 2 weeks of the study, and twice weekly. Severity of vaginal atrophy and four main symptoms of atrophic vaginitis including dysuria, dyspareunia, vaginal itching, and dryness were evaluated and compared before and after treatment. In addition, patients were asked regarding user-friendliness and hygienic issues of medications. Results: Both vaginal estrogen cream and Vagifem significantly improved symptoms of atrophic vaginitis but in terms of effectiveness for the treatment symptoms of atrophic vaginitis, there was no significant difference between the two medications. Vagifem compared to estrogen cream resulted in significantly lower rate of hygienic problems (0% versus 23%, P < 0.001, and was reported by the patients as a significantly easier method of treatment (90% versus 55%, P < 0.0001. Conclusion: This investigation showed that Vagifem is an appropriate medication for the treatment of atrophic vaginitis, which is as effective as vaginal estrogen creams and is more user-friendly.

  13. Pyometra and complete vaginal adhesion in a miniature horse

    Science.gov (United States)

    Cozens, Elizabeth R.W.

    2009-01-01

    A 4-year-old miniature horse experienced intermittent episodes of pyrexia, lethargy, and purulent vaginal discharge following dsytocia. Vaginal endoscopy and transrectal ultrasonography revealed a blind-ending vaginal cavity and distended uterus. Surgical treatment was declined and the mare was euthanized. Post-mortem examination confirmed the diagnosis of pyometra and vaginal adhesions. PMID:19949560

  14. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  15. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  16. Pudendal nerve block for vaginal birth.

    Science.gov (United States)

    Anderson, Deborah

    2014-01-01

    Pudendal nerve block is a safe and effective pain relief method for vaginal birth. Providing analgesia to the vulva and anus, it is used for operative vaginal birth and subsequent repair, late second stage pain relief with spontaneous vaginal birth, repair of complex lacerations, or repair of lacerations in women who are unable to achieve adequate or satisfactory pain relief during perineal repair with local anesthesia. Key to its efficacy is the knowledge of pudendal nerve anatomy, the optimal point of infiltration of local anesthetic, and an understanding of the amount of time necessary to effect adequate analgesia.

  17. Cuatro siglos de variabilidad hidroclimática en el noroeste de Chihuahua, México, reconstruida con anillos de árboles

    Directory of Open Access Journals (Sweden)

    José Villanueva Díaz

    2015-01-01

    Full Text Available En el noroeste de Chihuahua, sitio Mesa de las Guacamayas, catalogada como “Área Natural Protegida” ( ANP para anidamiento de la cotorra serrana, se desarrolló una serie dendrocronológica con abeto Douglas ( Pseudotsuga menziesii con una extensión de 409 años (1600-2008. La cronología de anillo total mostró asociaciones signi - ficativas (r>0.40, p=0.000 con cronologías vecinas (no separadas más de 200 km, particularmente las ubicadas en la misma vertiente de la Sierra Madre Occidental ( SMO , lo que implica la influencia de patrones climáticos comunes, cuyos frentes húmedos impactan simultáneamente una extensa área del noroeste de México. Un análisis espectral de potencia indicó que los índices dendrocronológicos estuvieron afectados por ENSO y por otros patrones circuatorios, como se deduce de los picos espectrales dominantes (<10 años presentes en la cronología; también mostraron asociación significativa (r=0.52, n=111, p<0.000 con registros del PDSI para el suroeste de los Estados Unidos. Una reconstrucción de precipitación acumulada enero- julio para la misma región, mostró sequías prolongadas en los periodos 1772-1782, 1793-1803, 1999-2008 y perio - dos húmedos en 1742-1751 y 1809-1818. La proporción de años secos detectados en la reconstrucción, sugiere que existe 50% de probabilidad de su ocurrencia a nivel anual.

  18. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure.

    Science.gov (United States)

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P

    2016-01-01

    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.

  19. MOIST VAGINAL PACKING FOR UTERO-VAGINAL PROLAPSE-A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Manidip

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND : Utero-vaginal prolapse is a common condition in ag ed women and often they come to us with decubitus ulcer. Prolong ed vaginal packing not only will heal the decubitus ulcer but also it may help in returning th e normal rugosity of the vaginal skin. AIMS: To assess the role of prolonged moist vaginal packing in utero-vaginal prolpase. SETTINGS & DESIGN: It was an OPD based prospective study conducted at t he gynecology OPD of College of Medicine & JNM Hospital, WBUHS, Kalyani, Nadia, West Bengal and Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal, Manipur. METHODS & MATERIAL: Hundred (100 patients of utero-vaginal prolapse with decubitus ulce r were studied. After initial staging (POP- Q staging, daily moist (5% povidone-iodine solution soaked gauze vaginal packing at home was advised. After 2 weeks, re-examination done for decubitus ulcer healing. Packing continued till operation (interval 1- 1½ month. Preoperative s taging and modification of operation were noted. On follow up complication (mainly recurrence was noted. RESULTS: Initial staging was stage 3 - 39%, stage 4 - 61%. Preoperative scoring r evealed stage 3 became stage 2 in 54% cases and stage 4 became stage 3 in 49% cases. This improv ement helped us to avoid excessive excision of vaginal mucosa. CONCLUSION: Prolonged pre-operative moist gauze vaginal packing may improve the outcome of the disease.

  20. What Are the Symptoms of Vaginitis?

    Science.gov (United States)

    ... the type of vaginitis a woman has 1 : Bacterial vaginosis often causes a thin, milky discharge from the ... How is it diagnosed? » Related A-Z Topics Bacterial Vaginosis Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...

  1. Vaginitis: MedlinePlus Health Topic

    Science.gov (United States)

    ... sprays Use a condom when having sex Avoid clothes that hold in heat and moisture Wear cotton underwear ... Institute of Child Health and Human Development) What Are the Symptoms of Vaginitis? (National ...

  2. Vaginal itching and discharge - Adult and adolescent

    Science.gov (United States)

    ... spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis. Vaginal yeast infection, caused by a ... fitting clothes and not wearing panty hose. Wearing cotton underwear (rather than synthetic), or underwear that has ...

  3. Urinary incontinence - tension-free vaginal tape

    Science.gov (United States)

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... suspension Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  4. Place of Schauta's radical vaginal hysterectomy.

    Science.gov (United States)

    Roy, Michel; Plante, Marie

    2011-04-01

    Women affected by early stage invasive cancer of the cervix are usually treated by surgery. Radical abdominal hysterectomy with pelvic lymphadenectomy is the most widely used technique. Because the morbidity of the abdominal approach can be important, the radical vaginal hysterectomy has gained acceptance in gynaecologic oncology. New instrumentation in laparoscopy also opens the possibility of treating cervical cancer by laparoscopically assisted vaginal radical hysterectomy and also total laparoscopic radical hysterectomy. Before these techniques become widely accepted, it has to be shown that safety and efficacy are comparable with the 'standard' abdominal approach. In this chapter, we review the technique of radical vaginal hysterectomy with pelvic lymphadenectomy and evaluate results of published studies, comparing the abdominal, vaginal and laparoscopic approaches.

  5. Características de la educación sexual escolar recibida y su asociación con la edad de inicio sexual y uso de anticonceptivos en adolescentes chilenas sexualmente activas

    OpenAIRE

    González A,Electra; Molina G,Temístocles; Luttges D,Carolina

    2015-01-01

    Antecedentes: La educación sexual integral en el contexto escolar es uno de los pilares fundamentales para prevenir embarazos e infecciones de transmisión sexual en adolescentes. Objetivo: Analizar las características de la educación sexual escolar recibida y su asociación con la edad de inicio sexual y uso de anticonceptivo en adolescentes consultantes en un centro de salud sexual y reproductiva. Método: Estudio analítico de corte transversal realizado en 1.232 adolescentes mujeres de nivel ...

  6. Nivel de conocimiento y uso de métodos anticonceptivos y su relación con embarazos en adolescentes SCS Recreo-Durán propuesta educativa enero - diciembre 2011

    OpenAIRE

    Orozco Dávila, Carmen Alicia

    2012-01-01

    El presente estudio se lo realizó para determinar el nivel de conocimiento y uso de métodos anticonceptivos y su relación con embarazos en adolescentes, para que tanto personal de salud y educadores unan esfuerzos orientados a la prevención primaria para evitar que las adolescentes se embaracen de forma no planificada. Por la importancia de esta problemática, el presente es un estudio descriptivo ? correlacional ? prospectivo no experimental realizado en 120 pacientes adolescentes embar...

  7. Conocimientos previos acerca de métodos anticonceptivos y su relación con conocimientos adquiridos después de una intervención educativa con simulador

    OpenAIRE

    2015-01-01

    Introducción. El objetivo de este trabajo es relacionar conocimientos previos (pre-saberes) acerca de métodos anticonceptivos con los conocimientos adquiridos (saberes), después una intervención educativa con simulador.Método. Es un estudio realizado con 295 adolescentes escolarizados que cursan noveno, décimo y undécimo en una institución educativa pública. Es de tipo descriptivo. El proceso estuvo compuesto por tres fases; en la primera se midió conocimientos o saberes previos acerca de mét...

  8. Induced vaginal birth after previous caesarean section

    OpenAIRE

    Akylbek Tussupkaliyev; Andrey Gayday; Bibigul Karimsakova; Saule Bermagambetova; Lunara Uteniyazova; Guldana Iztleuova; Gulkhanym Kusherbayeva; Meruyert Konakbayeva; Assylzada Merekeyeva; Zamira Imangaliyeva

    2016-01-01

    Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC) remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administra...

  9. Effect of vaginal estrogen on pessary use

    Science.gov (United States)

    Dessie, Sybil G.; Armstrong, Katherine; Modest, Anna M.; Hacker, Michele R.

    2016-01-01

    Introduction and hypothesis Many providers recommend concurrent estrogen therapy with pessary use to limit complications; however, limited data exist to support this practice. We hypothesized that vaginal estrogen supplementation decreases incidence of pessary-related complications and discontinuation. Methods We performed a retrospective cohort study of women who underwent a pessary fitting from 1 January 2007 through 1 September 2013 at one institution; participants were identified by billing code and were eligible if they were post-menopausal and had at least 3 months of pessary use and 6 months of follow-up. All tests were two sided, and P values < 0.05 were considered statistically significant. Results Data from 199 women were included; 134 used vaginal estrogen and 65 did not. Women who used vaginal estrogen had a longer median follow-up time (29.5 months) compared with women who did not (15.4 months) and were more likely to have at least one pessary check (98.5 % vs 86.2 %, P < 0.001). Those in the estrogen group were less likely to discontinue using their pessary (30.6 % vs 58.5 %, P < 0.001) and less likely to develop increased vaginal discharge than women who did not [hazard ratio (HR) 0.31, 95 % confidence interval (CI) 0.17–0.58]. Vaginal estrogen was not protective against erosions (HR 0.93, 95 % CI 0.54–1.6) or vaginal bleeding (HR 0.78, 95 % CI 0.36–1.7). Conclusions Women who used vaginal estrogen exhibited a higher incidence of continued pessary use and lower incidence of increased vaginal discharge than women who did not. PMID:26992727

  10. Twin vaginal delivery: innovate or abdicate.

    Science.gov (United States)

    Easter, Sarah Rae; Taouk, Laura; Schulkin, Jay; Robinson, Julian N

    2017-02-07

    Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins, particularly in the case of the noncephalic second twin. Yet, the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raises concerns about the availability of providers who are skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin. Among 107 responding providers, only 57% would deliver a noncephalic second twin by breech extraction. Providers who preferred breech extraction had a higher rate of maternal-fetal medicine subspecialty training (26.2% vs 4.3%; P30 sets of twins annually (57.4% vs 34.8%; P=.02). Most providers (54.2%) were familiar with the findings from the recent randomized trial that demonstrated the safety of twin vaginal birth. However, knowledge of the trial was not associated statistically with a preference for breech extraction (62.3% vs 43.5%; P=.05). Providers who preferred breech extraction were more likely to agree with recent society guidelines that encourage the vaginal birth of twins (86.9% vs 63.0%; Pinnovation. Without novel provider-focused strategies, we may relinquish passively the requisite skills for not only our patients but also for future generations of obstetricians.

  11. ANILLOS ANUALES Y CLIMA EN RHIZOPHORA MANGLE L. DE LA BAHÍA DE CISPATÁ, COLOMBIA ANNUAL GROWTH RINGS AND CLIMATE IN RHIZOPHORA MANGLE L. FROM THE CISPATÁ BAY, COLOMBIA

    Directory of Open Access Journals (Sweden)

    Jorge Andrés Ramírez Correa

    2010-12-01

    Full Text Available Por su localización en el ecotono tierra-mar Rhizophora mangle es un organismo con gran sensibilidad al cambio climático. La existencia de anillos anuales climáticamente sensibles en esta especie revela un enorme potencial para la dendroclimatologia tropical. Aunque se ha documentado la existencia de anillos anuales en el género Rhizophora delimitados por cambios en la densidad de poros, aquí se demuestra mediante el uso de la tomografía computarizada que los anillos en R. mangle también están definidos por cambios de densidad de la madera. La comparación entre el número de máximos de densidad de madera (DM y de poros (DP en secciones trasversales con la edad de los árboles, reveló la anualidad de los anillos de crecimiento de R. mangle. A mayor precipitación mayor DP y menor DM; y viceversa. La DM y la DP se interpretan como rasgos adaptativos que le permiten a R. mangle adaptarse a los pulsos anuales en salinidad relacionados con las descargas de los ríos en la bahía de Cispatá.Because of its location in the land-sea ecotone Rhizophora mangle is an organism with great sensitivity to climate change. The existence of climate sensitive annual rings in this specie highlights its potential relevance for tropical dendroclimatology. Even though had been previously established the existence of annual rings, delimited by changes in pore-density, in Rhizophora genus, using computed tomographies, is also possible demonstrate, that the rings in R. mangle can also be defined by changes in wood density. Comparing wood density maxima (DM and pore density maxima (PD in tree cross-sections reveal the annual nature of R. mangle tree-rings. With increased rainfall PD increases and DM decreases, and vice versa. PD and DM are interpreted as adaptive traits that allow R. mangle to adapt to the conditions produced by annual pulses in salinity in the bay of Cispatá related to high and low discharges of the rivers.

  12. Local join therapy of vaginal infections by nifuratel-nistatin

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    Amra Habibović,

    2010-02-01

    Full Text Available A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiologycal examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiologycal examination of vaginal and cervical smears. An analiysis of vaginalsecretion found bacterial flora in 34 smears (65%, fungus (Candida albicans in 15 (24%and Trichomonas vaginalis in 7 (11%. Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients,vaginitis caused by Candida albicans was successly treated in 14 (93% patients. Bacterial vaginitis was cured in 29 (71% patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.

  13. Semaphorin 4D induces vaginal epithelial cell apoptosis to control mouse postnatal vaginal tissue remodeling.

    Science.gov (United States)

    Ito, Takuji; Bai, Tao; Tanaka, Tetsuji; Yoshida, Kenji; Ueyama, Takashi; Miyajima, Masayasu; Negishi, Takayuki; Kawasaki, Takahiko; Takamatsu, Hyota; Kikutani, Hitoshi; Kumanogoh, Atsushi; Yukawa, Kazunori

    2015-02-01

    The opening of the mouse vaginal cavity to the skin is a postnatal tissue remodeling process that occurs at approximately five weeks of age for the completion of female genital tract maturation at puberty. The tissue remodeling process is primarily composed of a hormonally triggered apoptotic process predominantly occurring in the epithelium of the distal section of the vaginal cavity. However, the detailed mechanism underlying the apoptotic induction remains to be elucidated. In the present study, it was observed that the majority of BALB/c mice lacking the class 4 semaphorin, semaphorin 4D (Sema4D), developed imperforate vagina and hydrometrocolpos resulting in a perpetually unopened vaginal cavity regardless of a normal estrogen level comparable with that in wild‑type (WT) mice. Administration of β‑estradiol to infant Sema4D‑deficient (Sema4D‑/‑) mice did not induce precocious vaginal opening, which was observed in WT mice subjected to the same β‑estradiol administration, excluding the possibility that the closed vaginal phenotype was due to insufficient estrogen secretion at the time of vaginal opening. In order to assess the role of Sema4D in the postnatal vaginal tissue remodeling process, the expression of Sema4D and its receptor, plexin‑B1, was examined as well as the level of apoptosis in the vaginal epithelia of five‑week‑old WT and Sema4D‑/‑ mice. Immunohistochemical analyses confirmed the localization of Sema4D and plexin‑B1 in the mouse vaginal epithelia. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay and immunohistochemistry detecting activated caspase‑3 revealed significantly fewer apoptotic cells in situ in the vaginal mucosa of five‑week‑old Sema4D‑/‑ mice compared with WT mice. The addition of recombinant Sema4D to Sema4D‑/‑ vaginal epithelial cells in culture significantly enhanced apoptosis of the vaginal epithelial cells, demonstrating the apoptosis‑inducing activity of Sema4D. The

  14. Electromagnetic modeling of the rings of the squirrel cage of an induction motor; Modelado electromagnetico de los anillos de la jaula de ardilla de un motor de induccion

    Energy Technology Data Exchange (ETDEWEB)

    Limones Montoya, Juan Carlos

    2004-03-15

    An electromagnetic lineal model of a three-phase induction motor was developed in this thesis. The Finite element method in two dimensions was used. The model formulation takes into account the coupling with the stator wires and solid conductors of the rotor. In other words, the stator phases and squirrel-cage end-rings are considered in the model. The resulting set of electric-circuit and magnetic-field equations are solved simultaneously with the Incomplete Cholesky Bi-Conjugate Gradient Method using a matrix storage technique known as symmetric coordinate storage. The model was programmed in the C programming language. The magnetic field model is represented by the diffusion equation, which allows to compute the induced Eddy currents in the conducting material due to the sinusoidal stator excitation. The modelled induction motor has a rated power of 2.2 kW, 220 V, 9.6/11.0 A, 60 Hz and it can be operated at the speeds of 1750/1150 rpm. It is located in the Laboratorio de Propulsion at the Instituto Tecnologico de la Laguna. [Spanish] En este trabajo de tesis se desarrollo un modelo electromagnetico lineal de un motor de induccion trifasico utilizando el Metodo de Elemento Finito en dos dimensiones, en el cual se incluye la formulacion de sistemas acoplados para los conductores delgados y gruesos presentes en el estator y rotor respectivamente. Es decir, se incluyen en el modelo las fases de alimentacion y los anillos de cortocircuito del rotor de jaula de ardilla. Las ecuaciones electricas y magneticas derivadas del modelo se resuelven de manera acoplada con el Metodo del Gradiente BiConjugado con Precondicionamiento de Cholesky Incompleto empleando el sistema de Empaquetamiento de Coordenadas, cuyo codigo se desarrollo en el lenguaje de programacion C. En este modelo se resuelve la ecuacion de difusion, mediante la cual se determinan las corrientes de Eddy que se inducen en el material conductor debido a la presencia de fuentes de alimentacion senoidales. El

  15. A comprehensive review of vaginitis phytotherapy.

    Science.gov (United States)

    Azimi, Hanieh; Fallah-Tafti, Mehrnaz; Karimi-Darmiyan, Maliheh; Abdollahi, Mohammad

    2011-11-01

    To overview phytotherapy of vaginitis in order to identify new approaches for new pharmacological treatments. All related literature databases were searched for herbal medicinal treatment in vaginitis. The search terms were plant, herb, herbal therapy, phytotherapy, vaginitis, vaginal, anti-candida, anti-bacterial and anti-trichomonas. All of the human, animal and in vitro studies were included. Anti-candida, anti-bacterial and anti-trichomonas effects were the key outcomes. The plants including carvacrol, 1,8-cineole, geranial, germacrene-D, limonene, linalool, menthol, terpinen-4-ol and thymol exhibited anti-candida effects. A very low concentration of geranium oil and geraniol blocked mycelial growth, but not yeast. Tea tree oil including terpinen-4-ol, alpha-terpinene, gamma-terpinene and alpha-terpineol showed anti-bacterial, anti-fungal and anti-protozoal properties against trichomonas. Allium hirtifolium (persian shallot) comparable to metronidazole exhibited anti-trichomonas activity due to its components such as allicin, ajoene and other organosulfides. The plants having beneficial effects on vaginitis encompass essential oils that clear the pathway that future studies should be focused to standardize theses herbs.

  16. Screening of mucoadhesive vaginal gel formulations

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    Ana Ochoa Andrade

    2014-12-01

    Full Text Available Rational design of vaginal drug delivery formulations requires special attention to vehicle properties that optimize vaginal coating and retention. The aim of the present work was to perform a screening of mucoadhesive vaginal gels formulated with carbomer or carrageenan in binary combination with a second polymer (carbomer, guar or xanthan gum. The gels were characterised using in vitroadhesion, spreadability and leakage potential studies, as well as rheological measurements (stress and frequency sweep tests and the effect of dilution with simulated vaginal fluid (SVF on spreadability. Results were analysed using analysis of variance and multiple factor analysis. The combination of polymers enhanced adhesion of both primary gelling agents, carbomer and carrageenan. From the rheological point of view all formulations presented a similar behaviour, prevalently elastic and characterised by loss tangent values well below 1. No correlation between rheological and adhesion behaviour was found. Carbomer and carrageenan gels containing the highest percentage of xanthan gum displayed good in vitro mucoadhesion and spreadability, minimal leakage potential and high resistance to dilution. The positive results obtained with carrageenan-xanthan gum-based gels can encourage the use of natural biocompatible adjuvants in the composition of vaginal products, a formulation field that is currently under the synthetic domain.

  17. Reviewing the options for local estrogen treatment of vaginal atrophy

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    Lindahl SH

    2014-03-01

    Full Text Available Sarah H Lindahl Sutter East Bay Medical Foundation, SEBMF – Diablo Division, Castro Valley, CA, USA Background: Vaginal atrophy is a chronic condition with symptoms that include vaginal dryness, pain during sex, itching, irritation, burning, and discharge, as well as various urinary problems. Up to 45% of postmenopausal women may be affected, but it often remains underreported and undertreated. This article aims to review the current recommendations for treatment of vaginal atrophy, and current data on the effectiveness and safety of local vaginal estrogen therapies. Methods: Literature regarding vaginal atrophy (2007–2012 was retrieved from PubMed and summarized, with emphasis on data related to the treatment of vaginal atrophy with local vaginal estrogen therapy. Results: Published data support the effectiveness and endometrial safety of low-dose local estrogen therapies. These results further support the general recommendation by the North American Menopause Society that a progestogen is not needed for endometrial protection in patients using low-dose local vaginal estrogen. Benefits of long-term therapy for vaginal atrophy include sustained relief of symptoms as well as physiological improvements (eg, decreased vaginal pH and increased blood flow, epithelial thickness, secretions. Conclusion: Currently available local vaginal estrogen therapies are well tolerated and effective in relieving symptoms of vaginal atrophy. Recent data support the endometrial safety of low-dose regimens for up to 1 year. Keywords: menopause, estrogen, local estrogen therapy, vaginal atrophy

  18. Vaginal Biogenic Amines: Biomarkers of Bacterial Vaginosis or Precursors to Vaginal Dysbiosis?

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    Tiffanie Maree Nelson

    2015-09-01

    Full Text Available Bacterial vaginosis (BV is the most common vaginal disorder among reproductive age women. One clinical indicator of BV is a ‘fishy’ odor. This odor has been associated with increases in several biogenic amines (BAs that may serve as important biomarkers. Within the vagina, BA production has been linked to various vaginal taxa, yet their genetic capability to synthesize BAs is unknown. Using a bioinformatics approach, we show that relatively few vaginal taxa are predicted to be capable of producing BAs. Many of these taxa (Dialister, Prevotella, Parvimonas, Megasphaera, Peptostreptococcus, and Veillonella spp. are more abundant in the vaginal microbial community state type (CST IV, which is depleted in lactobacilli. Several of the major Lactobacillus species (L. crispatus, L. jensenii, and L. gasseri were identified as possessing gene sequences for proteins predicted to be capable of putrescine production. Finally, we show in a small cross sectional study of 37 women that the BAs putrescine, cadaverine and tyramine are significantly higher in CST IV over CSTs I and III. These data support the hypothesis that BA production is conducted by few vaginal taxa and may be important to the outgrowth of BV-associated (vaginal dysbiosis vaginal bacteria.

  19. Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis.

    Science.gov (United States)

    Shen, Jian; Song, Ning; Williams, Christopher J; Brown, Celeste J; Yan, Zheng; Xu, Chen; Forney, Larry J

    2016-01-01

    Atrophic vaginitis (AV) is common in postmenopausal women, but its causes are not well understood. The symptoms, which include vaginal itching, burning, dryness, irritation, and dyspareunia, can usually be alleviated by low doses of estrogen given orally or locally. Regrettably, the composition of vaginal bacterial communities in women with AV have not been fully characterized and little is known as to how these communities change over time in response to hormonal therapy. In the present intervention study we determined the response of vaginal bacterial communities in postmenopausal women with AV to low-dose estrogen therapy. The changes in community composition in response to hormonal therapy were rapid and typified by significant increases in the relative abundance of Lactobacillus spp. that were mirrored by a decreased relative abundance of Gardnerella. These changes were paralleled by a significant four-fold increase in serum estradiol levels and decreased vaginal pH, as well as nearly a two-fold increase in the Vaginal Maturation Index (VMI). The results suggest that after menopause a vaginal microbiota dominated by species of Lactobacillus may have a beneficial role in the maintenance of health and these findings that could lead to new strategies to protect postmenopausal women from AV.

  20. The Effectiveness of Vaginal Contraceptive Sponge

    Institute of Scientific and Technical Information of China (English)

    金毓翠; 丁家佩; 董吟秋; 董炳麟; 许雪芬

    1994-01-01

    The vaginal contraceptive sponge is made of polyurethane containing 1 g of nonoxynot-9, The gross cumulative twelve month life table pregnancy rate of 352 cases using vaginal contraceptive sponge was 5.7/ 100 women and the method pregnancy rate was 2. 3/ 100 women. The gross cumulative continuation rate per 100 women was 74. Only 2 patients (1,0/ 100 women) suffering from vaginitis and itching of vulva no longer wished to continue in the stud). Over the course of the study no significant changes were observed in any of the laboratory parameters such as vagina & cervix smear etc. that had been monitored. This modality associated with few side effects and its effectiveness rate and also indicated a protection from the risk of acquring of sex-transmitted diseases.

  1. Nonbarrier contraceptives and vaginitis and vaginosis.

    Science.gov (United States)

    Roy, S

    1991-10-01

    Within the limitations of the available data, it has been reported that oral contraceptive use versus other contraceptive methods is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of chlamydia trachomatis, and a reduced frequency of bacterial vaginosis and trichomoniasis. The impact of contraceptive steroids on cellular and humoral immunologic factors may explain these observations. Intrauterine contraceptive device use is reported to be associated with an increased rate of bacterial vaginosis and anaerobic organism recovery from the vagina regardless of symptoms. Patients having a contraceptive vaginal ring were found to have the same number and types of vaginal organisms as oral contraceptive users. Levonorgestrel-releasing subdermal implant (Norplant, Wyeth-Ayerst, Philadelphia, Pa.) users have been reported to have approximately half the rate of vaginitis and vaginosis compared with that of Copper T-200 intrauterine device users.

  2. Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis.

    Science.gov (United States)

    Boselli, F; Petrella, E; Campedelli, A; Muzi, M; Rullo, V; Ascione, L; Papa, R; Saponati, G

    2012-01-01

    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0-3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV.

  3. Pregnancy's stronghold on the vaginal microbiome.

    Directory of Open Access Journals (Sweden)

    Marina R S Walther-António

    Full Text Available OBJECTIVE: To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. METHODS: Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8-12, 17-21, 27-31, and 36-38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3-V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. RESULTS: Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n = 8, the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. CONCLUSION: Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for

  4. Parto vaginal tras cesárea

    OpenAIRE

    San Martín Bragado, María

    2016-01-01

    Cuando una mujer ha sido sometida a una cesárea previa existen dos opciones para ella en el caso de que se quede embarazada: repetir cesárea o intentar un parto vaginal. A pesar de los riesgos, el parto vaginal después de una cesárea es una situación atractiva para muchas pacientes y dará lugar a un resultado exitoso en un alto porcentaje de casos. Se ha de tener en cuenta que la realización de una cesárea electiva no está exenta de riesgos Grado en Medicina

  5. Prepubertal vaginal discharge: Vaginoscopy to rule out foreign body.

    Science.gov (United States)

    Ekinci, Saniye; Karnak, İbrahim; Tanyel, Feridun Cahit; Çiftçi, Arbay Özden

    2016-01-01

    Medical records of all prepubertal patients who underwent vaginoscopy to rule out vaginal foreign body between 2004 and 2013 were reviewed retrospectively. All patients were evaluated by pediatricians prior to surgical consultation. Vaginoscopy is performed in the operating room under general anesthesia. During the study period, 20 girls with persistent vaginal discharge with a mean age of 6.8 years (1-13 years) underwent vaginoscopy to rule out vaginal foreign body. Six patients had bloody vaginal discharge and 4 had recurrent vaginal bleeding lasting for more than one month. Ten patients had purulent vaginal discharge lasting for 1-7 months. None of vaginal cultures revealed pathological bacteria or candida species. Preoperative imaging techniques revealed vaginal foreign body in one patient only. Vaginoscopy demonstrated vaginal foreign bodies in four patients. Foreign bodies were grass inflorescence, safety pin and undefined brownish particles (n=2), which may be pieces of toilet paper or feces. There was no complication related to vaginoscopy and removal of foreign body. Hymen integrity was preserved in all patients. Persistent or recurrent vaginal discharge in prepubertal girls should raise the suspect of vaginal foreign body. Continuous flow vaginoscopy is mandatory to detect and remove any vaginal foreign body. Early diagnosis would prevent complications secondary to long-standing foreign bodies.

  6. Fenología del anillo de crecimiento de Pinus uncinata Ramond y Pinus sylvestris L. en un gradiente altitudinal en los Pirineos Centrales

    Directory of Open Access Journals (Sweden)

    Camarero, J. Julio

    1996-12-01

    Full Text Available In this study, we describe tree-ring growth and structure of Pinus uncinata Ram. and Pinus sylvestris L. along an altitudinal gradient in the Central Pyrenees. We measured monthly ring width increase and the number of cells added during 1993. Both species formed most of the ring from mid june to mid July 1993. Latewood development -formation, darkening and lignification of cell walls- starts in July and ends in October. The ring begins before its development in P. sylvestris than in P. uncinata that lives at higher elevation. P. uncinata formed narrower rings with less cells and greater color heterogeneity in the latewood than P. sylvestris. There is a high variability between trees in the earlywood and latewood cells position in the ring. The different phenological patterns of tree-ring growth along the selected altitudinal gradient could be partially explained by the influence of different climatic conditions, mainly thermic.

    [es] En el presente trabajo, describimos el desarrollo y la estructura del anillo anual de crecimiento de Pinus uncinata Ramondy Pinus sylvestris L. en un gradiente altitudinal en los Pirineos centrales. Medimos mensualmente el aumento de la anchura del anillo y el número de traqueidas añadidas a lo largo de 1993. En ambas especies, la mayor parte del anillo se forma desde mediados de jimio hasta mediados de julio de 1993. El desarrollo de la madera tardía -formación, coloración y engrasamiento y lignificación de las paredes celulares- comienza en julio y acaba en octubre. El anillo comienza antes su formación en los bosques estudiados de P. sylvestris que en P. uncinata, el cual vive a mayor altitud. P. uncinata forma anillos más estrechos, con menor múmero de células y con mayor heterogeneidad de color de la madera tardía que P. sylvestris. Existe una gran variabilidad entre árboles en la posición de las células de

  7. Women's socioeconomic factors associated to the choice of contraceptive method in Spain Factores socioeconómicos de las mujeres asociados a la elección del método anticonceptivo en España

    Directory of Open Access Journals (Sweden)

    Dolores Ruiz-Muñoz

    2013-02-01

    Full Text Available Objective: To describe the influence of socioeconomic characteristics on the choice of the contraceptive method used among women in Spain in 2006. Methods: This is a cross-sectional study of women aged 15-49 who reported the contraceptive method used during the first sexual intercourse (n = 3352 and during the 4 weeks prior to the interview (n = 2672. Data were analyzed taking into account women's socioeconomic characteristics. Results: The mostly used method during the first sexual intercourse was the condom. Women from developing countries more frequently used the pill than native-born Spanish women. The condom was also the most commonly used method in the 4 weeks prior to the interview. The use of other contraceptive methods increased with age. Being older and having children were both associated with an increased use of permanent methods. Conclusions: The choice of a specific contraceptive method seems to be more strongly influenced by women's stage of life than by socioeconomic characteristics.Objetivos: Describir la influencia de las características socioeconómicas en la elección del método anticonceptivo utilizado por las mujeres en España en 2006. Métodos: Estudio transversal de las mujeres de 15-49 años de edad que declararon el método anticonceptivo utilizado en la primera relación sexual (n = 3352 y durante las cuatro últimas semanas (n = 2672, teniendo en cuenta sus características socioeconómicas. Resultados: El preservativo fue el método más utilizado durante la primera relación sexual. Las mujeres de países en vías de desarrollo usaron más frecuentemente la píldora que las autóctonas. El preservativo fue también el método más utilizado durante las cuatro últimas semanas. El uso del resto de los métodos aumenta con la edad. Tener una edad más alta e hijos se asoció con un mayor uso de métodos permanentes. Conclusiones: La elección de un método anticonceptivo concreto parece estar más influenciada por

  8. Detection of protozoal Trichomonas vaginalis and abnormal vaginal flora in high vaginal smear

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    Wills G. Sheela

    2017-01-01

    Conclusions: This study reflects on our responsibility to create awareness among women regarding abnormal vaginal discharge through proper health education routine screening targeted treatment to envisage healthy quality life.

  9. Lactobacilli Dominance and Vaginal pH: Why is the Human Vaginal Microbiome Unique?

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Miller

    2016-12-01

    Full Text Available The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N=21 mammals for pH and 14 mammals for lactobacilli abundance. We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4 to 7.8. Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99. Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

  10. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

    Science.gov (United States)

    Miller, Elizabeth A; Beasley, DeAnna E; Dunn, Robert R; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N = 21 mammals for pH and 14 mammals for lactobacilli relative abundance). We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4-7.8). Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli relative abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99). Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

  11. VULVO VAGINAL CANDIDIASIS : IMPORTANCE OF SPECIES IDENTIFICATION

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    Swarajya Lakshmi

    2014-01-01

    Full Text Available OBJECTIVES : Vulvo Vaginal Candidiasis is a common nagging problem faced by 75% of women in reproductive age group. Present study was undertaken to determine the prevalence of Candida in patients suffering from vaginitis , to assess predisposing factors and correlate the symptoms with gram stain for presumptive diagnosis of Candidiasis. METHODS : A prospective study of the laboratory diagnosis of vulvovaginal candidiasis (VVC was carried out in 100 women presenting with symptoms suggestive of vaginosis in the reproductive age group. Investigation s included microscopy and culture for yeast. Candida is identified, based on growth on SDA, corn meal agar and Saba raud’s Triphenyl tetrazolium agar, and assimilation and fermentation of sugars. RESULTS : Candida was isolated in 33% of women. Clue cells on gram stain suggestive of bacterial vaginosis was seen in equal number of women, whereas mixed infection was found in 9%. Candida albicans accounted for 15% and nonalbicans species for 85% . O f the non albicans species, Candida glabrata was the commonest (4 2%. Pruritus with or without vaginal discharge and vaginal erythema were the most common symptoms and signs in women with positive Candida culture. CONCLUSION : On comparing the significance of gram stain and culture for presumptive diagnosis of candidiasi s, culture was more significant than gram stain alone. In present study, the rate of culture positivity was 33% and C. glabrata was the predominant species. VVC cannot be diagnosed by clinical criteria alone and requires confirmation by culture including i dentification of species.

  12. VAGINAL HYSTERECTOMY - CEFUROXIME, METRONIDAZOLE OR BOTH

    NARCIS (Netherlands)

    KAUER, FM; WIJMA, J; MANSON, WL

    1990-01-01

    A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients). I

  13. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media links Share this: Page Content To find out ...

  14. An isolated vaginal metastasis from rectal cancer

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    Ai Sadatomo

    2016-02-01

    Conclusion: We should keep the vagina within the field of view of pelvic MRI, which is one of the preoperative diagnostic tools for colorectal cancer. If female patients show gynecological symptoms, gynecological examination should be recommended. Isolated vaginal metastases are an indication for surgical resection, and adjuvant chemotherapy is also recommended.

  15. Vaginal plethysmography in women with dyspareunia

    NARCIS (Netherlands)

    Wouda, JC; Hartman, PM; Bakker, RM; Bakker, JO; van de Wiel, HBM; Schultz, WCMW

    1998-01-01

    We investigated by means of vaginal plethysmography the extent to which the genital reactions of women with dyspareunia (N = 18) differed from those of women without dyspareunia (N = 16) during sexual arousal. In addition, we used questionnaires to investigate whether the genital reaction was correl

  16. Vaginal Lacerations from Consensual Intercourse in Adolescents

    Science.gov (United States)

    Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

    2011-01-01

    Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

  17. Lactobacilli Dominance and Vaginal pH: Why is the Human Vaginal Microbiome Unique?

    OpenAIRE

    Miller, Elizabeth A.; Beasley, DeAnna E.; Dunn, Robert R.; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain hu...

  18. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

    OpenAIRE

    Miller, Elizabeth A.; Beasley, DeAnna E.; Dunn, Robert R.; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain hu...

  19. In Vitro Activity of Tea Tree Oil Vaginal Suppositories against Candida spp. and Probiotic Vaginal Microbiota.

    Science.gov (United States)

    Di Vito, Maura; Mattarelli, Paola; Modesto, Monica; Girolamo, Antonietta; Ballardini, Milva; Tamburro, Annunziata; Meledandri, Marcello; Mondello, Francesca

    2015-10-01

    The aim of this work is to evaluate the in vitro microbicidal activity of vaginal suppositories (VS) containing tea tree oil (TTO-VS) towards Candida spp. and vaginal probiotics. A total of 20 Candida spp. strains, taken from patients with vaginitis and from an established type collection, including reference strains, were analysed by using the CLSI microdilution method. To study the action of VS towards the beneficial vaginal microbiota, the sensitivity of Bifidobacterium animalis subsp. lactis (DSM 10140) and Lactobacillus spp. (Lactobacillus casei R-215 and Lactobacillus acidophilus R-52) was tested. Both TTO-VS and TTO showed fungicidal activity against all strains of Candida spp. whereas placebo-VS or the Aloe gel used as controls were ineffective. The study of fractional fungicidal concentrations (FFC) showed synergistic interaction with the association between Amphotericin B and TTO (0.25 to 0.08 µg/ml, respectively) against Candida albicans. Instead, the probiotics were only affected by TTO concentration ≥ 4% v/v, while, at concentrations < 2% v/v, they remained viable. TTO-VS exhibits, in vitro, a selective fungicidal action, slightly affecting only the Bifidobacteriun animalis strain growth belonging to the vaginal microbiota. In vivo studies are needed to confirm the efficacy to prevent acute or recurrent vaginal candidiasis.

  20. Laparoscopic repair of vaginal evisceration: a case report.

    Science.gov (United States)

    Lledó, Jose Bueno; Roig, Manuel Planells; Serra, Alfonso Serralta; Astaburuaga, Carmen Rodero; Giménez, Fernando Dobón

    2002-12-01

    Vaginal evisceration, although rare, is usually present in postmenopausal women with a history of vaginal surgery and high-grade pelvic floor dysfunction. Operative management is directed toward resecting any compromised bowel, repairing vaginal defect, and correcting the defect in the pelvic floor, which is associated with most cases, either in the same intervention or in a second procedure. Laparoscopy allows for assessment of the viability of the compromised bowel and the vaginal defect suture with advantages common to minimally invasive techniques. We report the first case in the international literature of vaginal evisceration managed by laparoscopy.

  1. The vaginal microflora in relation to gingivitis

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    Weibel Marianne

    2009-01-01

    Full Text Available Abstract Background Gingivitis has been linked to adverse pregnancy outcome (APO. Bacterial vaginosis (BV has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty. Methods Vaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range: 18 to 46, and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species. BV was defined by Gram stain (Nugent criteria. Gingivitis was defined as bleeding on probing at ≥ 20% of tooth sites. Results A Nugent score of 0–3 (normal vaginal microflora was found in 83 women (46.1%, and a score of > 7 (BV in 49 women (27.2%. Gingivitis was diagnosed in 114 women (63.3%. Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01. Independent of gingival conditions, vaginal bacterial counts were higher (p Prevotella bivia (p Prevotella disiens (p P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p 1.0 × 104 cells and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p P. disiens (95%CI: 1.8–7.5, p P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p Conclusion Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.

  2. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

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    Joanne Lester

    2015-03-01

    Full Text Available Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

  3. Complete vaginal outlet stenosis in a patient with Sheehan's syndrome.

    Science.gov (United States)

    Choo, Minji; Park, Hana; Yi, Kyong Wook

    2016-11-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

  4. [Vaginal metastasis of renal carcinoma (author's transl)].

    Science.gov (United States)

    Carl, P; Marx, F J

    1977-11-01

    Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear.

  5. Vaginal Evisceration: An Unexpected Complication of Conization

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    Ali Ghassani

    2014-01-01

    Full Text Available Background. Large loop excision of the transformation zone (LLETZ is routinely performed for the management of high grade intracervical neoplasia (CIN. Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management. Case. A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair. Conclusions. Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management.

  6. Instrumental vaginal delivery--back to basics.

    Science.gov (United States)

    Keriakos, R; Sugumar, S; Hilal, N

    2013-11-01

    Assisted vaginal delivery using forceps or a vacuum extractor is an essential part of obstetric practice. Operative vaginal delivery rates in the UK have remained stable between 10% and 15%, yielding safe and satisfactory outcomes for the majority of mothers and their babies. However, there has been an increase in medico-legal cases due to an increasing awareness of the potential morbidity for both the mother and the baby. There are many factors that can play a part in both the maternal and fetal complications resulting from instrumental deliveries. The aim of this educational review is to address these factors and identify measures to reduce them by adherence to the basics and relevant evidence.

  7. Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

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    Vanessa S. Pereira

    2014-10-01

    Full Text Available Background: The proper evaluation of the pelvic floor muscles (PFM is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05. Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90. In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively. Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.

  8. Ultra-low-dose vaginal estrogen tablets for the treatment of postmenopausal vaginal atrophy.

    Science.gov (United States)

    Simon, J A; Maamari, R V

    2013-08-01

    Vaginal atrophy is a common chronic condition affecting up to 57% of postmenopausal women. The decrease in estrogen following cessation of menses can lead to bothersome symptoms that include vaginal dryness and irritation, pain and burning during urination (dysuria), urinary tract infections, and pain (dyspareunia) and bleeding during sexual activities. These symptoms can be safely and effectively managed with the use of local estrogen therapy, which reduces the risks associated with long-term systemic hormone therapy. The ultra-low-dose 10 μg estradiol vaginal tablet is the lowest approved dose available and has an annual estradiol exposure of only 1.14 mg. Its development addresses recommendations from regulatory agencies and women's health societies regarding the use of the lowest hormonal dose. The 10 μg vaginal tablet displays minimal estradiol absorption, causes no increased risk of endometrial hyperplasia or carcinoma, and provides significant symptom relief. The clinical evidence presented here may offer greater reassurance to health-care professionals and postmenopausal women that vaginal atrophy can be treated safely and effectively.

  9. Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections.

    Science.gov (United States)

    Alam, Mohd Aftab; Ahmad, Farhan Jalees; Khan, Zeenat Iqbal; Khar, Roop Krishen; Ali, Mushir

    2007-12-14

    An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4), which is an attribute of a healthy vagina. The effervescent mixture (citric acid and sodium bicarbonate) along with a superdisintegrant (Ac-Di-sol) was used to enhance the swellability of the bioadhesive tablet. The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as an antibacterial) were used in the formulation along with Lactobacillus acidophilus spores to treat mixed vaginal infections. From the ex vivo retention study it was found that the bioadhesive polymers hold the tablet for more than 24 hours inside the vaginal tube. The hardness of the acid-buffering bioadhesive vaginal tablet was optimized, at 4 to 5 kg hardness the swelling was found to be good and the cumulative release profile of the developed tablet was matched with a marketed conventional tablet (Infa-V). The in vitro spreadability of the swelled tablet was comparable to the marketed gel. In the in vitro antimicrobial study it was found that the acid-buffering bioadhesive tablet produces better antimicrobial action than marketed intravaginal drug delivery systems (Infa-V, Candid-V and Canesten 1).

  10. Pregnancy and Vaginal Delivery after Sacrohysteropexy

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    Deniz Balsak

    2015-01-01

    Full Text Available Pregnancy and birth after a Pelvic Organ Prolapse (POP surgery is a rare condition and less is known about the method for delivery. A 31-year-old women with gravida 3 para 3 underwent abdominal sacrohysteropexy and transobturatuar tape (TOT procedures for stage III prolapse who delivered via vaginal birth and showed no relapse. Sacrohysteropexy is a good option for women with POP who desire fertility with a long term follow-up period.

  11. [Saforelle - a new approach to treat vaginitis].

    Science.gov (United States)

    Karamisheva, V; Nachev, A

    2015-01-01

    Infections of the vulva and vagina are one of the most common gynecological diseases. They can be determined by a variety of physical, chemical and biological factors. The main risk factors contributing to vaginitis are aerobic and anaerobic bacterias, fungal and viral infections, and irritants. Subjective complaints are pruritus, vulvar and/or perivulvar erytema and different in volume and characterization discharge. Excepting etiological treatment in most cases it is necessary to use additional agents, for example Saforelle.

  12. Mesenteric venous thrombosis following vaginal delivery

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    Roopa Sachidananda

    2013-01-01

    Full Text Available Acute abdomen following an uneventful vaginal delivery is a rare occurrence. Diagnosis may be delayed due to pregnancy related comorbid conditions such as preeclampsia, hemolysis elevated, liver enzymes, low platelet (HELLP count syndrome, acute fatty liver of pregnancy (AFLP, etc. We describe a 21-year-old woman with pre-eclampsia, HELLP syndrome and AFLP with acute abdomen that was managed successfully in our intensive care unit.

  13. Comparison of detection methods for vaginal lactobacilli.

    Science.gov (United States)

    Smidt, I; Kiiker, R; Oopkaup, H; Lapp, E; Rööp, T; Truusalu, K; Štšepetova, J; Truu, J; Mändar, R

    2015-01-01

    Vaginal lactobacilli offer protection against microbiota imbalance and genitourinary tract infections. We compared vaginal lactobacilli in 50 Estonian women of child-bearing age applying culture-based methods, quantitative PCR and next-generation sequencing (NGS). The culture-based methods found three different lactobacilli: Lactobacillus crispatus, Lactobacillus jensenii and Lactobacillus gasseri. Using NGS revealed the presence of L. crispatus in 76%, Lactobacillus iners in 52%, L. jensenii in 47% and L. gasseri in 33% of the samples. According to qPCR, L. iners was present in 67% and L. crispatus in 64% of the samples. The proportions of L. crispatus revealed by qPCR and NGS were in good correlation (R=0.79, P0.05). Good concordance for L. crispatus was also found between the results of the culture-based method and qPCR. Finally, good overlap between the results of the culture-based method and NGS was revealed: in case of a positive NGS result for L. crispatus, the same species was isolated in 95% of samples. The corresponding percentages were 82% for L. jensenii and 86% for L. gasseri. Our data indicate fairly general concordance of the three methods for detecting vaginal lactobacilli, except for L. iners. This points out the importance of standardisation of techniques, and the respective studies should involve cultures applying a medium suitable for the fastidious L. iners.

  14. Effect of Vaginal or Systemic Estrogen on Dynamics of Collagen Assembly in the Rat Vaginal Wall1

    Science.gov (United States)

    Montoya, T. Ignacio; Maldonado, P. Antonio; Acevedo, Jesus F.; Word, R. Ann

    2014-01-01

    ABSTRACT The objective of this study was to compare the effects of systemic and local estrogen treatment on collagen assembly and biomechanical properties of the vaginal wall. Ovariectomized nulliparous rats were treated with estradiol or conjugated equine estrogens (CEEs) either systemically, vaginal CEE, or vaginal placebo cream for 4 wk. Low-dose local CEE treatment resulted in increased vaginal epithelial thickness and significant vaginal growth without uterine hyperplasia. Furthermore, vaginal wall distensibility increased without compromise of maximal force at failure. Systemic estradiol resulted in modest increases in collagen type I with no change in collagen type III mRNA. Low-dose vaginal treatment, however, resulted in dramatic increases in both collagen subtypes whereas moderate and high dose local therapies were less effective. Consistent with the mRNA results, low-dose vaginal estrogen resulted in increased total and cross-linked collagen content. The inverse relationship between vaginal dose and collagen expression may be explained in part by progressive downregulation of estrogen receptor-alpha mRNA with increasing estrogen dose. We conclude that, in this menopausal rat model, local estrogen treatment increased total and cross-linked collagen content and markedly stimulated collagen mRNA expression in an inverse dose-effect relationship. High-dose vaginal estrogen resulted in downregulation of estrogen receptor-alpha and loss of estrogen-induced increases in vaginal collagen. These results may have important clinical implications regarding the use of local vaginal estrogen therapy and its role as an adjunctive treatment in women with loss of vaginal support. PMID:25537371

  15. Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer

    Science.gov (United States)

    2014-04-21

    Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

  16. TRANSVERSE VAGINAL SEPTUM - A RARE CASE PRESENTATION AS PRIMARY INFERTILITY

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    Anjali

    2013-10-01

    Full Text Available ABSTRACT : Transverse Vaginal Septum is a vertical fusion or canalization disorder of mullerian ducts and urogenital si nus and result of a female sex - limited autosomal recessive transmission. The incidence of transverse vaginal septum varies from 1in 2100 to 1in 72,000. We report a case of perforated complete transverse vaginal septum presenting as a case of primary infert ility.

  17. Efectos del extracto de croton schiedeanus sobre la producción de oxido nítrico en la preparación de anillos aislados de aorta / Effects of croton schiedeanus extract on nitric oxide production in the preparation of isolated aortic rings

    OpenAIRE

    Chaves Torres, Ninfa Marlen

    2010-01-01

    En este trabajo se determinó la importancia de la ruta metabólica del óxido nítrico y la guanilato ciclasa en el efecto vasodilatador inducido por el extracto de Croton Schiedeanus Schlecht utilizando la preparación de anillos aislados de aorta de ratas Wistar. El extracto de C. Shiedeanus relaja anillos precontraídos con fenilefrina, agonista del receptor adrenérgico alfa, en función de la dosis, con una CE50 de 1,3x10-5 g/mL (9,1x10-6 – 2x10-5). Este efecto es superior al ejercido sobre ani...

  18. Adenocarcinoma arising from vaginal stump: unusual vaginal carcinogenesis 7 years after hysterectomy due to cervical intraepithelial neoplasia.

    Science.gov (United States)

    Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya

    2013-11-01

    Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.

  19. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study.

    Science.gov (United States)

    Biglia, Nicoletta; Peano, Elisa; Sgandurra, Paola; Moggio, Giulia; Panuccio, Enrico; Migliardi, Marco; Ravarino, Nicoletta; Ponzone, Riccardo; Sismondi, Piero

    2010-06-01

    The study aim is to evaluate the efficacy and safety of two low-dose vaginal estrogen treatments (ETs) and of a non-hormonal vaginal moisturizer in postmenopausal breast cancer survivors with urogenital atrophy. Eighteen patients receiving estriol cream 0.25 mg (n = 10) or estradiol tablets 12.5 microg (n = 8) twice/week for 12 weeks were evaluated and compared with eight patients treated with polycarbophil-based moisturizer 2.5 g twice/week. Severity of vaginal atrophy was assessed using subjective [Vaginal Symptoms Score (VSS), Profile of Female Sexual Function (PFSF)] and objective [Vaginal Health Index (VHI), Karyopycnotic Index (KI)] evaluations, while safety by measuring endometrial thickness and serum sex hormones levels. After 4 weeks, VSS and VHI were significantly improved by both vaginal ETs, with further improvement after 12 weeks. PFSF improved significantly only in estriol group (p = 0.02). Safety measurements did not significantly change. Vaginal moisturizer improved VSS at week 4 (p = 0.01), but score returned to pre-treatment values at week 12; no significant modification of VHI, KI, PFSF was recorded. Both low-dose vaginal ET are effective for relieving urogenital atrophy, while non-hormonal moisturizer only provides transient benefit. The increase of serum estrogens levels during treatment with vaginal estrogen at these dosages is minimal.

  20. Induced vaginal birth after previous caesarean section

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    Akylbek Tussupkaliyev

    2016-11-01

    Full Text Available Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administration of E1 prostaglandin (Misoprostol, and intravenous infusion of Oxytocin-Richter. The assessment of rediness of parturient canals was conducted by Bishop’s score; the labour course was assessed by a partogram. The effectiveness of labour induction techniques was assessed by the number of administered doses, the time of onset of regular labour, the course of labour and the postpartum period and the presence of complications, and the course of the early neonatal period, which implied the assessment of the child’s condition, described in the newborn development record. The foetus was assessed by medical ultrasound and antenatal and intranatal cardiotocography (CTG. Obtained results were analysed with SAS statistical processing software. Results The overall percentage of successful births with intravaginal administration of Misoprostol was 93 per cent (83 of cases. This percentage was higher than in the amniotomy group (relative risk (RR 11.7 and was similar to the oxytocin group (RR 0.83. Amniotomy was effective in 54 per cent (39 of cases, when it induced regular labour. Intravenous oxytocin infusion was effective in 94 per cent (89 of cases. This percentage was higher than that with amniotomy (RR 12.5. Conclusions The success of vaginal delivery after previous Caesarean section can be achieved in almost 70 per cent of cases. At that, labour induction does not decrease this indicator and remains within population boundaries.

  1. Efecto del levonorgestrel como anticonceptivo oral de emergencia en la ovulación, el endometrio y los espermatozoides Effect of levonorgestrel in the ovulation, endometrium, and spermatozoa for emergency oral contraception

    Directory of Open Access Journals (Sweden)

    Víctor J. Suárez

    2010-06-01

    Full Text Available Existe amplia controversia acerca del mecanismo de acción del levonorgestrel como anticonceptivo oral de emergencia; numerosas organizaciones, tanto científicas como de la sociedad civil, muestran su disconformidad con su uso, debido a su posible acción como inductor de aborto. Con el objetivo de evaluar la evidencia científica disponible sobre los mecanismos de acción del levonorgestrel utilizado como anticonceptivo oral de emergencia (AOE, se realizó una revisión sistemática en las bases de datos Medline y Cochrane Library donde se encontró 444 artículos; después de revisar los resúmenes, se seleccionó 22 artículos, los cuales fueron evaluados a texto completo. Se encontró que el principal mecanismo de acción del levonorgestrel, a las dosis recomendadas como AOE, es la inhibición o retraso de la ovulación; no afecta a los espermatozoides en su capacidad de migración ni de penetración al óvulo. No se ha demostrado alteraciones morfológicas ni moleculares en el endometrio que puedan interferir con la implantación del huevo fecundado. No existe evidencia científica actual disponible que sustente que el uso de levonorgestrel como AOE sea abortivo.There is wide controversy about the mechanism of action of the levonorgestrel used for emergency oral contraception, and many organizations, both scientific as well as from the civil society, show their discrepancy with its use, due to its possible action as an abortion- inducer. In order to evaluate the scientific evidence available on the mechanisms of action of the levonorgestrel used for emergency oral contraception (EOC, a systematic revision was performed in the Medline and Cochrane library databases. We found 444 articles. After reviewing the abstracts, we selected 22 articles, whose complete texts were evaluated. We found that the main mechanism of action of the levonorgestrel, given at the doses recommended for EOC, is the inhibition or retardation of the ovulation, it

  2. Factors Influencing Selection of Vaginal, Open Abdominal, or Robotic Surgery to Treat Apical Vaginal Vault Prolapse

    Science.gov (United States)

    Anand, Mallika; Weaver, Amy L.; Fruth, Kristin M.; Gebhart, John B.

    2016-01-01

    Objectives To determine factors influencing selection of Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), or robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery between January 1, 2000, and June 30, 2012, at our institution. Baseline characteristics and explicit selection factors were abstracted from the electronic medical records. Factors were compared between groups using χ2 tests for categorical variables, ANOVA for continuous variables, and Kruskal-Wallis tests for ordinal variables. Results Among the 512 patients identified who met inclusion criteria, the MMC group (n=174) had more patients who were older, American Society of Anesthesiologists class 3+ or greater, had anterior vaginal prolapse grade 3+, desired to avoid abdominal surgery, and did not desire a functional vagina. Patients in the ASC (n=237) and RSC (n=101) groups had more failed prolapse surgeries, suspected abdominopelvic pathologic processes, and chronic pain. Advanced prolapse was more frequently cited as an explicit selection factor for ASC than for either MMC or RSC. Conclusions The most common factors that influenced the type of apical vaginal vault prolapse surgery overlapped with characteristics that differed at baseline. In general, MMC was chosen for advanced anterior vaginal prolapse and baseline characteristics that increased surgical risks, ASC for advanced apical prolapse, and ASC or RSC for recurrent prolapse, suspected abdominal pathology, and patients with chronic pain or lifestyles including heavy lifting. Thus, efforts should be made to attempt to control for selection bias when comparing these procedures. PMID:26945273

  3. Genome Sequences of 11 Human Vaginal Actinobacteria Strains.

    Science.gov (United States)

    Lewis, Amanda L; Deitzler, Grace E; Ruiz, Maria J; Weimer, Cory; Park, SoEun; Robinson, Lloyd S; Hallsworth-Pepin, Kymberlie; Wollam, Aye; Mitreva, Makedonka; Lewis, Warren G

    2016-01-01

    The composition of the vaginal microbiota is an important health determinant. Several members of the phylum Actinobacteria have been implicated in bacterial vaginosis, a condition associated with many negative health outcomes. Here, we present 11 strains of vaginal Actinobacteria (now available through BEI Resources) along with draft genome sequences.

  4. Genome Sequences of 11 Human Vaginal Actinobacteria Strains

    Science.gov (United States)

    Deitzler, Grace E.; Ruiz, Maria J.; Weimer, Cory; Park, SoEun; Robinson, Lloyd S.; Hallsworth-Pepin, Kymberlie; Wollam, Aye; Mitreva, Makedonka

    2016-01-01

    The composition of the vaginal microbiota is an important health determinant. Several members of the phylum Actinobacteria have been implicated in bacterial vaginosis, a condition associated with many negative health outcomes. Here, we present 11 strains of vaginal Actinobacteria (now available through BEI Resources) along with draft genome sequences. PMID:27688328

  5. PHARMACOKINETIC AND PHARMACODYNAMIC STUDIES ON VAGINALLY ADMINISTERED LEVONORGESTREL

    Institute of Scientific and Technical Information of China (English)

    HEChang-Hai; XUJian-Qiu; ZHUYue-Hua; SHIYong-En

    1989-01-01

    Comparative studies on pharmacokinetics of vaginally and orally administered levonorgestrel (LNG) tablet (Postinor) in one single dose containing 0,75mg LNG were performed. The pharmacokinetics of LNG and its effects on ovarian functions werealso studied after repeated vaginal administration.

  6. [Vaginal ecology, climate, landscapes and populations (xenoecies and facies)].

    Science.gov (United States)

    Nicoli, J M; Nourrit, J; Michel-Nguyen, A; Sempe, M; Nicoli, R M

    1994-06-01

    Brief study of vaginal populations, the human vagina being considered as a biotopic cavity. Allusion to dynamic aspects ("vaginal climate", "landscapes") and to various bacterial populations. Introduction of the concept of xenoecies and of facies. This study is preceded by essential definitions of terms widely used in ecology.

  7. The use of supersaturation for the vaginal application of microbicides

    DEFF Research Database (Denmark)

    Grammen, Carolien; Plum, Jakob; Van Den Brande, Jeroen;

    2014-01-01

    In this study, we investigated the potential of supersaturation for the formulation of the poorly water-soluble microbicide dapivirine (DPV) in an aqueous vaginal gel in order to enhance its vaginal tissue uptake. Different excipients such as hydroxypropylmethylcellulose, polyethylene glycol 1000...

  8. Mucoadhesive and thermogelling systems for vaginal drug delivery.

    Science.gov (United States)

    Caramella, Carla M; Rossi, Silvia; Ferrari, Franca; Bonferoni, Maria Cristina; Sandri, Giuseppina

    2015-09-15

    This review focuses on two formulation approaches, mucoadhesion and thermogelling, intended for prolonging residence time on vaginal mucosa of medical devices or drug delivery systems, thus improving their efficacy. The review, after a brief description of the vaginal environment and, in particular, of the vaginal secretions that strongly affect in vivo performance of vaginal formulations, deals with the above delivery systems. As for mucoadhesive systems, conventional formulations (gels, tablets, suppositories and emulsions) and novel drug delivery systems (micro-, nano-particles) intended for vaginal administration to achieve either local or systemic effect are reviewed. As for thermogelling systems, poly(ethylene oxide-propylene oxide-ethylene oxide) copolymer-based and chitosan-based formulations are discussed as thermogelling systems. The methods employed for functional characterization of both mucoadhesive and thermogelling drug delivery systems are also briefly described.

  9. Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse.

    NARCIS (Netherlands)

    Milani, A.L.; Withagen, M.I.J.; Vierhout, M.E.

    2009-01-01

    INTRODUCTION AND HYPOTHESIS: The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh. METHODS: We conducted a pro

  10. Evaluando los efectos del cambio global sobre el funcionamiento de los abetos ibéricos mediante análisis de isótopos de carbono en los anillos de crecimiento

    Directory of Open Access Journals (Sweden)

    J. C. Linares

    2010-01-01

    Full Text Available Evaluando los efectos del cambio global sobre el funcionamiento de los abetos ibéricos mediante análisis de isótopos de carbono en los anillos de crecimiento. La sequía es el principal factor limitante del crecimiento en las especies forestales de la cuenca mediterránea. Se ha propuesto que en ecosistemas limitados por el agua, el incremento global de CO2 atmosférico puede compensar el mayor cierre estomático inducido por la sequía sin reducirse notablemente las tasas de producción. En este trabajo se muestran las tasas de crecimiento secundario y la eficiencia intrínseca de uso de agua (WUEi de poblaciones de Abies alba y A. pinsapo. Se han comparado poblaciones con y sin síntomas externos de decaimiento. Desde comienzos de los años ochenta del pasado siglo la tasa de incremento de la WUEi en los sitios que presentan síntomas de decaimiento ha descendido hasta colocarse por debajo de la tasa de incremento de CO2. Nuestros datos muestran una buena correlación entre el momento en que el incremento de WUEi cae por debajo del incremento del CO2, el incremento regional de la temperatura media, la ocurrencia de varias sequías extremas, y la reducción de crecimiento radial.

  11. Prolapso vaginal e uterino em ovelhas

    Directory of Open Access Journals (Sweden)

    Maíra Bianchi R. Alves

    2013-02-01

    Full Text Available O presente trabalho objetivou realizar um estudo retrospectivo sobre os prolapsos vaginal e uterino em ovelhas atendidas no Serviço de Clínica de Bovinos e Pequenos Ruminantes (CBPR da FMVZ/USP no período compreendido entre 2000 a 2010, no qual, foram atendidas 56 ovinos com problemas inerentes ao sistema reprodutivo, dessas, 25 apresentaram prolapso vaginal ou uterino (44,6%. O prolapso vaginal total foi o de maior frequência (72%. As ovelhas acometidas, em sua maioria, possuíam idade superior a quatro anos (64%, eram sem raça definida (44% ou da raça Ile de France (40%. As manifestações clínicas observadas durante a maioria dos atendimentos foram: taquipnéia, taquicardia, mucosas oculares avermelhadas indicando estado de toxemia, decúbito esternal ou lateral, apatia e anorexia. O tratamento instituído para todos os casos foi a limpeza, desinfecção e reintrodução do órgão prolapsado. A sutura de Bühner foi feita em 84% dos casos e a histeropexia em um caso (4%. A evolução foi satisfatória em 80% dos casos atendidos, nos demais casos (20% observou-se óbito da fêmea acometida. Do total de óbitos, os prolapsos vaginais foram responsáveis por 60% (3/5 e os prolapsos uterinos por 40% (2/5. A etiologia dos prolapsos não foi definida nos casos atendidos, sendo esses associados com o período pós-parto em sua maioria (56%, provavelmente associados com quadros de hipocalcemia, altas concentrações séricas de estrógeno e hipertonia uterina. Além disso, a predisposição genética não pode ser descartada.

  12. Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy

    Directory of Open Access Journals (Sweden)

    SA Kingsberg

    2009-08-01

    Full Text Available SA Kingsberg¹, S Kellogg², M Krychman³1University Hospitals Case Medical Center, Case Western Reserve University Cleveland OH, USA; 2The Pelvic and Sexual Health Institute of Philadelphia, Drexel University College of Medicine, Philadelphia, USA; 3Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USAAbstract: Vulvovaginal atrophy (VVA and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms.Keywords: dyspareunia, postmenopausal vulvovaginal atrophy, vaginal estrogen therapy

  13. Mucus-penetrating nanoparticles for vaginal and gastrointestinal drug delivery

    Science.gov (United States)

    Ensign-Hodges, Laura

    A method that could provide more uniform and longer-lasting drug delivery to mucosal surfaces holds the potential to greatly improve the effectiveness of prophylactic and therapeutic approaches for numerous diseases and conditions, including sexually transmitted infections and inflammatory bowel disease. However, the body's natural defenses, including adhesive, rapidly cleared mucus linings coating nearly all entry points to the body not covered by skin, has limited the effectiveness of drug and gene delivery by nanoscale delivery systems. Here, we investigate the use of muco-inert mucus-penetrating nanoparticles (MPP) for improving vaginal and gastrointestinal drug delivery. Conventional hydrophobic nanoparticles strongly adhere to mucus, facilitating rapid clearance from the body. Here, we demonstrate that mucoadhesive polystyrene nanoparticles (conventional nanoparticles, CP) become mucus-penetrating in human cervicovaginal mucus (CVM) after pretreatment with sufficient concentrations of Pluronic F127. Importantly, the diffusion rate of large MPP did not change in F127 pretreated CVM, implying there is no affect on the native pore structure of CVM. Additionally, there was no increase in inflammatory cytokine release in the vaginal tract of mice after daily application of 1% F127 for one week. Importantly, HSV virus remains adherent in F127-pretreated CVM. Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that hypotonically-induced fluid uptake could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We evaluated hypotonic formulations for delivering water-soluble drugs and for drug delivery with MPP. Hypotonic formulations markedly increased the rate at which drugs and MPP reached the epithelial surface. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that isotonic formulations

  14. A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

    Science.gov (United States)

    Agnaeber, K; Bodalal, Z

    2013-08-01

    We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.

  15. Unraveling the Dynamics of the Human Vaginal Microbiome

    Science.gov (United States)

    Nunn, Kenetta L.; Forney, Larry J.

    2016-01-01

    Four Lactobacillus species, namely L. crispatus, L. iners, L. gasseri, and L. jensenii, commonly dominate the vaginal communities of most reproductive-age women. It is unclear why these particular species, and not others, are so prevalent. Historically, estrogen-induced glycogen production by the vaginal epithelium has been proffered as being key to supporting the proliferation of vaginal lactobacilli. However, the ‘fly in the ointment’ (that has been largely ignored) is that the species of Lactobacillus commonly found in the human vagina cannot directly metabolize glycogen. It would appear that this riddle has been solved as studies have demonstrated that vaginal lactobacilli can metabolize the products of glycogen depolymerization by α-amylase, and fortunately, amylase activity is found in vaginal secretions. These amylases are presumed to be host-derived, but we suggest that other bacterial populations in vaginal communities could also be sources of amylase in addition to (or instead of) the host. Here we briefly review what is known about human vaginal bacterial communities and discuss how glycogen-derived resources and resource competition might shape the composition and structure of these communities. PMID:27698617

  16. Effects of a One Year Reusable Contraceptive Vaginal Ring on Vaginal Microflora and the Risk of Vaginal Infection: An Open-Label Prospective Evaluation.

    Directory of Open Access Journals (Sweden)

    Yongmei Huang

    Full Text Available A contraceptive vaginal ring (CVR containing Nestorone® (NES and ethinyl estradiol (EE that is reusable for 1- year (13 cycles is under development. This study assessed effects of this investigational CVR on the incidence of vaginal infections and change in vaginal microflora.There were 120 women enrolled into a NES/EE CVR Phase III trial and a microbiology sub-study for up to 1- year of cyclic product use. Gynecological examinations were conducted at baseline, the first week of cycle 6 and last week of cycle 13 (or during early discontinuation visits. Vaginal swabs were obtained for wet mount microscopy, Gram stain and culture. The CVR was removed from the vagina at the last study visit and cultured. Semi-quantitative cultures for Lactobacillus, Gardnerella vaginalis, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, anaerobic gram negative rods (GNRs, Candida albicans and other yeasts were performed on vaginal and CVR samples. Vaginal infections were documented throughout the study.Over 1- year of use, 3.3% of subjects were clinically diagnosed with bacterial vaginosis, 15.0% with vulvovaginal candidiasis, and 0.8% with trichomoniasis. The detection rate of these three infections did not change significantly from baseline to either Cycle 6 or 13. Nugent scores remained stable. H2O2-positive Lactobacillus dominated vaginal flora with a non-significant prevalence increase from 76.7% at baseline to 82.7% at cycle 6 and 90.2% at cycle 13, and a median concentration of 107 colony forming units (cfu per gram. Although anaerobic GNRs prevalence increased significantly, the median concentration decreased slightly (104 to 103cfu per gram. There were no significant changes in frequency or concentrations of other pathogens. High levels of agreement between vaginal and ring surface microbiota were observed.Sustained use of the NES/EE CVR did not increase the risk of vaginal infection and was not disruptive to the vaginal ecosystem

  17. A STUDY OF VAGINAL BIRTH AFTER CAESAREAN

    Directory of Open Access Journals (Sweden)

    Ratana

    2015-06-01

    Full Text Available OBJECTIVE : To evaluate the efficacy and safety of attempted VBAC with a view to decrease the incidence of caesarean section . METHOD S : A prospective study is carried out on women with one previous LSCS for a non - recurrent cause attending ANC & labour room of RIMS for 2 years from 1 st Aug 2007 to 31 st July 2009. RESULTS : 100 eligible PCS women agreed to undergo trial of labour. Of these 50 delivered vaginally and the remaining 50 had to undergo emergency repeat caesarean section due to fetal distress, scar tenderness o r non - progress of labour resulting in a VBAC rate of 50%. CONCLUSION : A trial of labour in cases of previous caesarean section is the way to reduce the overall caesarean section rate. Physicians need to discuss the risks and benefits of VBAC following tria l of labour or elective repeat caesarean section with patients and patients’ choices must be considered.

  18. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  19. Colostrum in menopause effects on vaginal cytology/symptoms.

    Science.gov (United States)

    Tucci, S; Mancini, R; De Vitis, C; Noto, A; Marra, E; Lukic, A; Giovagnoli, M R; Moscarini, M

    2013-01-01

    The aim of this study was to assess the effects of three weeks of daily colostrum cream on vaginal cytology and local symptoms related to menopause. Genito-urinary symptoms and cell morphology were analyzed at time 0 (T0) and after three weeks (16 +/- days since the end of treatment) at time 1 (T1). Dyspareunia, vaginal dryness, and maturation index (MI) reached a statistically significant difference between T0 and T1. The results proved to be an alternative treatment for vaginal distress caused by lack of hormones in patients in which hormonal treatment is contraindicated.

  20. Vulvar and Vaginal Atrophy: Physiology, Clinical Presentation, and Treatment Considerations.

    Science.gov (United States)

    Lev-Sagie, Ahinoam

    2015-09-01

    Vulvovaginal atrophy is a common condition associated with decreased estrogenization of the vaginal tissue. Symptoms include vaginal dryness, irritation, itching, soreness, burning, dyspareunia, discharge, urinary frequency, and urgency. It can occur at any time in a woman's life cycle, although more commonly in the postmenopausal phase, during which the prevalence is approximately 50%. Despite the high prevalence and the substantial effect on quality of life, vulvovaginal atrophy often remains underreported and undertreated. This article aims to review the physiology, clinical presentation, assessment, and current recommendations for treatment, including aspects of effectiveness and safety of local vaginal estrogen therapies.

  1. Characterization of Human Vaginal Mucosa Cells for Autologous In Vitro Cultured Vaginal Tissue Transplantation in Patients with MRKH Syndrome

    Directory of Open Access Journals (Sweden)

    Cristina Nodale

    2014-01-01

    Full Text Available Mayer-Rokitansky-Küster-Hauser (MRKH is a rare syndrome characterized by congenital aplasia of the uterus and vagina. The most common procedure used for surgical reconstruction of the neovagina is the McIndoe vaginoplasty, which consists in creation of a vaginal canal covered with a full-thickness skin graft. Here we characterized the autologous in vitro cultured vaginal tissue proposed as alternative material in our developed modified McIndoe vaginoplasty in order to underlie its importance in autologous total vaginal replacement. To this aim human vaginal mucosa cells (HVMs were isolated from vaginal mucosa of patients affected by MRKH syndrome and characterized with respect to growth kinetics, morphology, PAS staining, and expression of specific epithelial markers by immunofluorescence, Western blot, and qRT-PCR analyses. The presence of specific epithelial markers along with the morphology and the presence of mucified cells demonstrated the epithelial nature of HMVs, important for an efficient epithelialization of the neovagina walls and for creating a functional vaginal cavity. Moreover, these cells presented characteristics of effective proliferation as demonstrated by growth kinetics assay. Therefore, the autologous in vitro cultured vaginal tissue might represent a highly promising and valid material for McIndoe vaginoplasty.

  2. Prolapso vaginal e uterino em ovelhas Uterine and vaginal prolapse in ewes

    Directory of Open Access Journals (Sweden)

    Maíra Bianchi R. Alves

    2013-02-01

    Full Text Available O presente trabalho objetivou realizar um estudo retrospectivo sobre os prolapsos vaginal e uterino em ovelhas atendidas no Serviço de Clínica de Bovinos e Pequenos Ruminantes (CBPR da FMVZ/USP no período compreendido entre 2000 a 2010, no qual, foram atendidas 56 ovinos com problemas inerentes ao sistema reprodutivo, dessas, 25 apresentaram prolapso vaginal ou uterino (44,6%. O prolapso vaginal total foi o de maior frequência (72%. As ovelhas acometidas, em sua maioria, possuíam idade superior a quatro anos (64%, eram sem raça definida (44% ou da raça Ile de France (40%. As manifestações clínicas observadas durante a maioria dos atendimentos foram: taquipnéia, taquicardia, mucosas oculares avermelhadas indicando estado de toxemia, decúbito esternal ou lateral, apatia e anorexia. O tratamento instituído para todos os casos foi a limpeza, desinfecção e reintrodução do órgão prolapsado. A sutura de Bühner foi feita em 84% dos casos e a histeropexia em um caso (4%. A evolução foi satisfatória em 80% dos casos atendidos, nos demais casos (20% observou-se óbito da fêmea acometida. Do total de óbitos, os prolapsos vaginais foram responsáveis por 60% (3/5 e os prolapsos uterinos por 40% (2/5. A etiologia dos prolapsos não foi definida nos casos atendidos, sendo esses associados com o período pós-parto em sua maioria (56%, provavelmente associados com quadros de hipocalcemia, altas concentrações séricas de estrógeno e hipertonia uterina. Além disso, a predisposição genética não pode ser descartada.This study aimed to conduct a retrospective study on vaginal and uterine prolapse in sheep seen at the Clinic and Surgery on Cattle and Small Ruminants (CBPR at University of São Paulo, from 2000 to 2010. During this period, 56 sheep were treated with problems of the reproductive system. Of these, 25 ewes had vaginal or uterine prolapse (44.6%. The total vaginal prolapse was the most frequently (72%. The majority of

  3. Giant primary vaginal calculus secondary to vesicovaginal fistula with partial vaginal outlet obstruction in a 12-year-old girl.

    Science.gov (United States)

    Chen, Shushang; Ge, Rong; Zhu, Lingfeng; Yang, Shunliang; Wu, Weizhen; Yang, Yin; Tan, Jianming

    2011-10-01

    A vesicovaginal fistula with vagina obstruction associated with vaginal calculi is an extremely rare medical condition. We report a giant primary vaginal calculus resulting from vesicovaginal fistula with partial vaginal outlet obstruction secondary to perineum trauma and surgery in a 12-year-old girl. Episiotomy was performed and the adhesive labia minora was split. After the removal of a giant calculus in the vagina, approximately 8 cm in diameter, the fistula tract was completely excised, followed by the repair of the vesicovagina fistula and the vagina. The patient was symptom-free at 6-month follow-up examination.

  4. Antibiotic Administration and Factors Influencing the Vaginal Microbiota during Pregnancy

    DEFF Research Database (Denmark)

    Stokholm, Jakob

    2012-01-01

    The commensal flora consists of non-pathogenic microbiota found on all body surfaces maintaining a well-balanced host-microbial symbiotic state. The vaginal microbiota represents a microbial ecosystem. A low pH level is maintained by acid producing bacteria, most often dominated by Lactobacillus....... The low pH level is together with the host immunity responsible for protection of the vagina. A vast number of other bacterial species are represented in the vaginal commensal microbiota and among these both Staphylococcus and E. coli are often found. Skewing of the vaginal commensal flora...... with a following increase in pH level can lead to an overgrowth of certain microbiota resulting in bacterial vaginosis or vaginal candidiasis. Humans are continuously exposed to a large amount of environmental factors providing a possible influence on their microbial ecology. Antibiotic administration is one...

  5. Abnormal vaginal microbiota may be associated with poor reproductive outcomes

    DEFF Research Database (Denmark)

    Haahr, Thor

    2016-01-01

    primers were specific for four common Lactobacillus spp., G. vaginalis and A. vaginae. Results: The prevalence of BV defined by Nugent score was 21% (27/130), whereas the prevalence of an abnormal vaginal microbiota was 28% (36/130) defined by qPCR with high concentrations of G. vaginalis and/or A....... vaginae. The qPCR diagnostic approach had a sensitivity and specificity of 93% and 93% for Nugent-defined BV. Eighty-four patients completed IVF treatment. The overall clinical pregnancy rate was 35% (29/84). Interestingly, only 9% (2/22) with qPCR defined abnormal vaginal microbiota obtained a clinical...... pregnancy (P = 0.004). Wider implications: If a negative correlation between abnormal vaginal microbiota and the clinical pregnancy rate is corroborated, patients could be screened and subsequently treated for abnormal vaginal microbiota prior to fertility treatment....

  6. WHO to concentrate HIV strategy on vaginal microbicide.

    Science.gov (United States)

    Cookson, C

    1993-11-27

    The World Health Organization (WHO), at a meeting in Geneva in November 1993, launched a campaign that will coordinate efforts of the pharmaceutical industry, academic research institutes, and drug regulatory bodies to find a vaginal antiviral agent that will either inactivate the human immunodeficiency virus (HIV) or prevent its attachment to vaginal cells, without harming the genital tract or killing sperm. Spermicides, such as nonoxynol 9, which kill HIV in test tubes may increase HIV transmission by harming the vaginal lining. However, this may be due to the carrier substance. Clinical research, using a protocol designed by the WHO and international regulatory authorities, will begin examining existing vaginal microbicides. Other candidates include sulphated polysaccharides and reverse transcriptase inhibitors. Included are comments by Dr. Michael Merson and Prof. Don Jefferies. The meeting was organized by the United Kingdom's Medical Research Council and Department of Health.

  7. Viability of lactobacillus acidophilus in various vaginal tablet formulations

    OpenAIRE

    Fazeli M.R.; Toliyat T.; Samadi N.; Hajjaran S.; Jamalifar H.

    2006-01-01

    The lactobacilli which are present in vaginal fluids play an important role in prevention of vaginosis and there are considerable interests in formulation of these friendly bacteria into suitable pharmaceutical dosage forms. Formulating these microorganisms for vaginal application is a critical issue as the products should retain viability of lactobacilli during formulation and also storage. The aim of this study was to examine the viability and release of Lactobacillus acidophilus from slow-...

  8. The aetiology of vaginal symptoms in rural Haiti.

    Science.gov (United States)

    Bristow, Claire C; Desgrottes, Tania; Cutler, Lauren; Cutler, David; Devarajan, Karthika; Ocheretina, Oksana; Pape, Jean William; Klausner, Jeffrey D

    2014-08-01

    Vaginal symptoms are a common chief complaint amongst women visiting outpatient clinics in rural Haiti. A systematic sample of 206 consecutive women over age 18 with gynaecological symptoms underwent gynaecologic examination and laboratory testing for chlamydia, gonorrhoea, syphilis, HIV infection, trichomoniasis, candidiasis, and bacterial vaginosis. Among 206 women, 174 (84%) presented with vaginal discharge, 165 (80%) with vaginal itching, 123 (60%) with vaginal pain or dysuria, and 18 (9%) with non-traumatic vaginal sores or boils. Laboratory results were positive forChlamydia trachomatisin 5.4% (11/203), syphilis in 3.5% (7/202), HIV in 1.0% (2/200), andNeisseria gonorrhoeaein 1.0% (2/203). Among those that had microscopy, hyphae suggestive of candidiasis were visualized in 2.2% (1/45) and no cases of trichomoniasis were diagnosed 0% (0/45). Bacterial vaginosis was diagnosed in 28.3% (13/46). The prevalence of chlamydia was 4.9 (95% CI: 1.3-17.7) times greater among those 25 years of age and under (10.8%) than those older (2.3%). Chlamydia and bacterial vaginosis were the most common sexually transmitted infection and vaginal condition, respectively, in this study of rural Haitian adult women. The higher risk of chlamydia in younger women suggests education and screening programmes in young women should be considered.

  9. Endogenous or exogenous origin of vaginal candidiasis in Polish women?

    Science.gov (United States)

    Mnichowska-Polanowskai, Magdalena; Wojciechowska-Koszko, Iwona; Klimowicz, Bogumia; Szymaniak, Ludmia; Krasnodebska-Szponder, Barbara; Szych, Zbigniew; Giedrys-Kalemba, Stefania

    2013-01-01

    Vaginal candidiasis is a common problem of clinical practice. Many studies have been conducted to explain its origin but only a few have included Polish women. The aim of the study was to determine the prevalence and similarity of oral, anal and vaginal Candida albicans strains isolated from Polish women with vaginal candidiasis. The study involved 20 from 37 recruited women. Swab samples were collected from their vagina, anus, and oral cavity at two-month intervals. All the women were treated with nystatin. Yeast were recovered and identified by the germ-tube test, API /Vitek system, typed by API ZYM and RAPD-PCR. Chi-square test was used to analyze the data. A total of 170 Candida albicans isolates were recovered from 180 samples collected 3 times from 3 sites of 20 women. Positive yeast vaginal cultures were found in all patients before administration of nystatin. Vaginal yeast recovery rate was decreased statistically significant in both follow-up visits (p= 0.001; p= 0.003). The same and different genotypes/biotypes were found concomitantly in a few body sites and/ or repeatedly at time interval from the same body site. The results support the concept of dynamic exchange of yeast within one woman and endogenous or exogenous origin of vaginal candidiasis.

  10. Correlação entre ansiedade e anéis de tensão Correlación entre ansiedad y anillos nerviosos Anxiety and contraction furrows correlations

    Directory of Open Access Journals (Sweden)

    Leia Fortes Salles

    2011-03-01

    Full Text Available A ansiedade vem sendo muito estudada pelas áreas de psicossomática e psiconeuroimunologia e tem sido apontada como fator predisponente em inúmeras doenças. Isso sugere que a minimização de comportamentos ansiosos traria benefícios à saúde. A análise da íris permite determinar as características de personalidade do indivíduo. Dentre os diversos sinais estudados pela iridologia, os anéis de tensão são relacionados com a ansiedade. O objetivo deste estudo é comparar os resultados do Inventário de Diagnóstico da Ansiedade Traço (IDATE com a análise da íris (quantidade de anéis de tensão. A pesquisa foi realizada nos meses de setembro e outubro de 2008, com todos os integrantes do Grupo de Estudos em Práticas Alternativas e Complementares em Saúde da Escola de Enfermagem da Universidade de São Paulo. Houve correspondência entre a íris e o inventário em 75% da população e o coeficiente de correlação de Spearman apontou uma correlação positiva e significativa entre o escore do Inventário de ansiedade (IDATE e a quantidade e classificação dos anéis de tensão. Este resultado sugere que a presença destes sinais na íris indica maior predisposição para a ansiedade.La ansiedad ha sido muy estudiada en las áreas de la psicosomática y de la psico-neuroinmunología y ha sido señalada como siendo un factor predisponente de innúmeras enfermedades. Esto sugiere que la minimización de comportamientos ansiosos podría traer beneficios para la salud. El análisis del iris permite determinar las características de personalidad del individuo. Dentro de las diversas señales estudiadas por la iridología, los anillos nerviosos están relacionados con la ansiedad. El objetivo de este estudio es comparar los resultados del Inventario de la Ansiedad Rasgo-Estado (IDARE con el análisis del iris (cantidad de anillos nerviosos. La investigación fue realizada en los meses de septiembre a octubre de 2008, con todos los

  11. Sexual functioning and vaginal changes after radical vaginal trachelectomy in early stage cervical cancer patients: a longitudinal study

    DEFF Research Database (Denmark)

    Froeding, LP; Ottesen, C; Rung-Hansen, H

    2014-01-01

    Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce....

  12. Preparation and characterisation of fluconazole vaginal films for the treatment of vaginal Candidiasis

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    L Kumar

    2013-01-01

    Full Text Available Objective of the present study was to develop and evaluate vaginal films with essential in vitro studies. Films were developed using hydroxypropyl methylcellulose as a polymer and formulations were coded. The developed films were evaluated with Fourier transform infrared spectroscopy, drug content, viscosity, surface pH, thickness, mechanical characterisation and in vitro drug release study. Fourier transform infrared spectroscopy results confirmed that there is no chemical interaction between drug and stabilisers/excipients. The batch variation was not more than 5% for average thickness and weight of the films. The drug content for the prepared formulation was in the range of 72.32±0.18% to 94.48±0.54%. Viscosity of the formulations increased with the increase in concentration of polymer. Mechanical characterisation revealed that tensile strength and percentage elongation of the films improved as there is increase in degree of substitution of the polymer, but the values of modulus decreased which confirmed that all the prepared films are soft in nature. The in vitro study indicated that 1 and 2% concentrations of polymer are the least concentrations to control the release of drug whereas the 4% concentration of polymer is a good and more effective concentration to control the release. Only one prepared formulation released the drug by following anomalous transport whereas other film formulations released the fluconazole by following Fickian diffusion mechanism. Prepared vaginal films may be an important alternative for the treatment of vaginal candidiasis, because these prepared films suggest the benefits of controlled release of fluconazole at the site of absorption.

  13. Novos conhecimentos sobre a flora bacteriana vaginal Vaginal bacterial flora: up to date

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    Iara Moreno Linhares

    2010-01-01

    Full Text Available O objetivo desta revisão foi apresentar os novos conhecimentos sobre o ecossistema vaginal, enfatizando os métodos não cultiváveis de identificação microbiana (amplificação de genes, as várias espécies de Lactobacillus que podem compor a flora vaginal e a interação desta com os mecanismos locais de imunidade inata e adquirida, dependentes dos constituintes genéticos. Foram pesquisados no Medline (Pubmed os artigos relacionados ao tema publicados entre 1997 e 2009, selecionando-se apenas os considerados relevantes. A utilização de técnicas não cultiváveis (técnicas de amplificação de genes tem possibilitado o melhor conhecimento sobre a composição do ecossistema vaginal. Na maioria das mulheres no menacme predominam na vagina uma ou mais espécies de Lactobacillus: L. crispatus, . L. inners e L gasseri. Entretanto, em outras mulheres aparentemente saudáveis pode haver deficiência ou mesmo ausência de Lactobacillus, que são substituídos por outras bactérias produtoras de ácido lático: espécies de Atopobium, Megasphaera e/ou Leptotrichia. A infecção e/ou a proliferação de bactérias patogênicas na vagina são suprimidas pela produção de ácido lático, por produtos gerados pelas bactérias e pela atividade local das imunidades inata e adquirida. As células epiteliais vaginais produzem diversos componentes com atividade antimicrobiana. Tais células ainda possuem receptores de membrana ("Toll-like receptors" que reconhecem padrões moleculares associados aos patógenos. O reconhecimento leva à produção de citocinas proinflamatórias e à estimulação da imunidade antigenoespecífica. A produção de anticorpos IgG e IgA também pode ser iniciada na endocérvice e na vagina em resposta à infecção. Conclui-se que a composição da flora vaginal e os mecanismos de imunidade representam importantes mecanismos de defesa. Os critérios de "flora normal" e "flora anormal" devem ser revistos; os polimorfismos

  14. Partial vaginal expulsion of a leiomyosarcoma

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    Kaori Yokochi

    2013-06-01

    Full Text Available Uterine sarcomas are an uncommon and heterogeneous group of tumors that account for 3-7% of the malignant neoplasms of the uterus and approximately 1% of all malignant tumors of the female genital system. The main clinical manifestations are abnormal uterine bleeding in pre- or postmenopausal women. Pelvic pain, abdominal distension, urinary urgency, and profuse and fetid leukorrhea are other frequent complaints. The authors present a case of a 48-year-old patient that was in amenorrhea for 2 years, who sought treatment for vaginal bleeding. On physical examination, the abdomen was distended, painful in the hypogastrium and upon examination of the external genitalia, it was observed the exteriorization of an amorphous “mass”. The patient was submitted to uterine curettage. The results of the histological examination revealed leiomyosarcoma. Staging workup showed an enlarged uterus with endometrial lesion, and non-calcified pulmonary nodules. The patient underwent a pan-hysterectomy and chemotherapy, and is under oncologic treatment. The authors call attention for the unusual form of presentation of this entity.

  15. Improving Vaginal Examinations Performed by Midwives

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    Rhoda S. Muliira

    2013-06-01

    Full Text Available A vaginal examination (VE is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant,embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management ofpain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE.

  16. THE PROFILE OF VAGINAL TEMPERATURE AND CYTOLOGY OF VAGINAL SMEAR IN BALI CATTLE DURING ESTRUS CYCLE PHASE

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    Indira P.N.

    2015-09-01

    Full Text Available The objective of the study was to evaluate physiological condition of Bali cattle during estrus. Ninecattles were used in the research. The method of the research was descriptive analysis. The measurementof vaginal temperature was conducted by using digital thermometer and cytology of vaginal smear wasdone by using cotton bud swabbed on object glass. It was washed by methanol and was stained withGiemsa staining and was observed by microscope. The results indicated that vaginal temperature were38.39 ± 0.29 oC; 38.05 ± 0.15 oC; 37.4 ± 0.74 oC; 37.86 ± 0.3 oC at estrus, metestrus, diestrus, proestrusphase, respectively. On the basis of the cytology of vaginal smear, estrus phase had more superficialcornification and intermediate cells causing estrogen concentration increased. In conclusion, the profileof vaginal temperature showed that each kind of estrus cycle phase had characteristic within estrus. Thecytology of vaginal smear showed various types of cells preferences in different phase of estrus cycle.

  17. Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa

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    Bailey Robin

    2005-03-01

    Full Text Available Abstract Background Bacterial vaginosis (BV – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS in The Gambia, West Africa. Methods We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire. Results BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 – 47.6 and anaerobes (P = 0.001 [OR] could not be calculated, but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 – 0.15, and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 – 0.28. Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12

  18. Vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy for enlarged myomatous uterus: a randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    Fan Rong; Zhu Lan; Lang Jing-he; Shi Hong-hui; Gong Xiao-ming

    2011-01-01

    Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy (VH) and laparoscopic assisted vaginal hysterectomy (LAVH) for enlarged myomatous uterus.Methods:Fifty patients from Peking Union Medical College Hospital (PUMCH) were randomly assigned to two treatment groups:VH (n=23) and LAVH (n=27).All procedures were performed by a single senior surgeon to maintain homogeneity.Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH (76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH (6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion.Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.

  19. Study of Candida Albicans Vaginitis Model in Kunming Mice

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhuo; KONG Xiaofeng

    2007-01-01

    The model of vaginal candidiasis in Kunming mice was constructed in order to search for the optima construction conditions and provide an economic animal model of Candida albicans (C.albicans) vaginitis. Estrogen benzoate (E2) was given to mice at different concentrations ranging from 0.0 to 0.05 mg/mouse (4 levels) beginning 72 h prior to vaginal inoculation, then mice were inoculated intravaginally with various concentrations of stationary-phase C. albicans blastoconidia (ATCC90028) (5 levels) in 20 μL of phosphate-buffered saline (PBS) in each F2 level. General state,scores of genital pathology, the hyphae and vaginal fungal burden (CFU) in vaginal lavage fluid, the hydrops rate of uterus and vaginal tissues for pathological section in mice were observed and obtained at day 2, 4, 7, 14 and 21 after inoculation. The results showed the infection rate in mice was related to the dosage of E2 and concentration of C. albicans blastoconidia. Additionally there was better cross-effect between the two treated factors. The infection rate was about 80% on the day 4,and could reach 100% on the day 7 until the end of experiment after inoculated intravaginally in groups of E2I3, E2 0.025 mg/mouse injected hypodermically and inoculated intravaginally with 5×104 C. albicans blastoconidia, and large amount of hyphae and blastoconidia could be observe in superficial layer tissue and canal of vaginal by PAS. From the results in our experiment it was concluded that E2I3 was the optima construction condition in kunming mice.

  20. Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

    1983-06-01

    Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery.

  1. OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES IN REFERRED CASES

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    Prameela

    2015-03-01

    Full Text Available INTRODUCTION: Instrumental vaginal deliveries are important procedures. Performed in indicated cases and attending to the well laid criterias will reduce the fetal and maternal morbidity. These assisted instrumental vaginal deliveries help in reducing the caesarean sec tion rate. AIMS AND OBJECTIVES: To determine the incidence and indications of instrumental vaginal deliveries. To know the maternal and fetal outcome in ventouse (vaccum assisted vaginal delivery and forceps deliveries. MATERIAL AND METHOD: This was a retrospective study carried between 01/06/2014 to 31/08/2014 at Cheluvamba Hospital, Mysore Medical College and Research Institute. The hospital records of all the referred patients who had ventouse (vaccum assisted vaginal delivery and forcep s deliveries were obtained and data on age, parity, referral and type of procedure performed, APGAR score and complications were entered into a proforma and analyzed. RESULT: During the period under review there were total of 3385 deliveries, LSCS 843 case s(24.9%, Total instrumental vaginal deliveries 110 cases(3.2%. 33 Ventouse (vaccum assisted vaginal delivery deliveries(0.9%, 57 Low forceps deliveries(1.68% and 20 Outlet forceps deliveries(0.59%.Most common indication for instrumental deliveries be ing fetal distress(62 cases , Prolonged second stage of labour and maternal exhaustion (36 cases.Cut short 2 nd stage of labour - previous LSCS(8cases and Eclampsia(2cases, RHD(1case, Sickle cell anemia with avascular necrosis femur neck(1case.Number of alive babies(103 babies, Perinatal mortality 7cases(0.20%, 8 babies required NICU admission for 3 - 4 days, 1 baby had subdural hematoma, 2 babies had forceps mark. Complications like vaginal tear (4 cases, episiotomy extension (18 cases. CONCLUSION: Ve ntouse and forceps remains appropriate tool in the armamentarium of the modern obstetrician. The major factor which determines the safety of the instrument is the operator rather than the

  2. Successful treatment of vaginal malakoplakia in a young cat

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    Ryan P Cattin

    2016-10-01

    Full Text Available Case summary A 3-year-old, female, spayed, domestic shorthair cat presented for dysuria and haematuria, unresponsive to antibiotic treatment. A small, fleshy, erythematous mass protruded from the vaginal vault. Ultrasound identified a vaginal mass effect with mixed echogenicity measuring in excess of 3 cm. Vaginoscopy confirmed an extensive, fleshy, irregular mass that was characterised histologically as pyogranulomatous vaginitis, with periodic acid–Schiff-positive macrophages containing gram-negative bacteria. Fluorescence in situ hybridisation analysis demonstrated invasive intracellular Escherichia coli. Vaginal malakoplakia was diagnosed. Tissue culture and antimicrobial susceptibility of E coli was used to guide treatment. A 6 week course of enrofloxacin 5 mg/kg q24h resulted in complete resolution of the mass and clinical signs. Relevance and novel information Malakoplakia is a rare chronic inflammatory condition that has been previously reported in the bladder of two cats. The pathogenesis of malakoplakia is thought to involve ineffective killing of bacteria (eg. E coli, similar to granulomatous colitis in Boxers and French Bulldogs. The literature on malakoplakia in cats is sparse. This is the first reported feline case with vaginal involvement, intracellular E coli and successful treatment with a fluoroquinolone. Malakoplakia is an important, non-neoplastic differential diagnosis when a mass is identified in the urogenital system of a young cat.

  3. Susceptibility to Vaginal Candidiasis under Different Conditions in Mice

    Institute of Scientific and Technical Information of China (English)

    TAN Juan; LI Jiawen; CHEN Shanjuan; WU Yan; QIN Fang; DING Juan; CAO Fei; ZHANG Shaoru

    2005-01-01

    In order to study the susceptibility of murine vaginal mucosa to Candida albicans under different conditions, vaginal lavage fluid and vaginal tissue of mice were observed and compared be tween murine models with normal immune system (estrogen-treated mice) and immunosuppressed murine model, and between primary infection model of vaginal candidiasis and secondary infection one. The average level of colony forming unit (CFU) from the immuosuppressed group was higher than that from estrogen-treated group at each time point and the peak time was delayed. The differences between the two groups were statistically significant (P<0.05) from the fourth day after in oculation. A significant difference existed in the average level of CFU between the control group and the estrogen-treated group (P<0.05), and between the control group and the immuosuppressed group (P<0.01). It was concluded that the vaginal mucosa from the immunosuppressed mice is more susceptible to Candida albicans and no difference is found in susceptibility between mice with primary infection and secondary infection.

  4. Potential Use of Antimicrobial Peptides as Vaginal Spermicides/Microbicides

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    Nongnuj Tanphaichitr

    2016-03-01

    Full Text Available The concurrent increases in global population and sexually transmitted infection (STI demand a search for agents with dual spermicidal and microbicidal properties for topical vaginal application. Previous attempts to develop the surfactant spermicide, nonoxynol-9 (N-9, into a vaginal microbicide were unsuccessful largely due to its inefficiency to kill microbes. Furthermore, N-9 causes damage to the vaginal epithelium, thus accelerating microbes to enter the women’s body. For this reason, antimicrobial peptides (AMPs, naturally secreted by all forms of life as part of innate immunity, deserve evaluation for their potential spermicidal effects. To date, twelve spermicidal AMPs have been described including LL-37, magainin 2 and nisin A. Human cathelicidin LL-37 is the most promising spermicidal AMP to be further developed for vaginal use for the following reasons. First, it is a human AMP naturally produced in the vagina after intercourse. Second, LL-37 exerts microbicidal effects to numerous microbes including those that cause STI. Third, its cytotoxicity is selective to sperm and not to the female reproductive tract. Furthermore, the spermicidal effects of LL-37 have been demonstrated in vivo in mice. Therefore, the availability of LL-37 as a vaginal spermicide/microbicide will empower women for self-protection against unwanted pregnancies and STI.

  5. Desarrollo de cronologías de ancho de anillos para alerce (Fitzroya cupressoides en Contao y Mirador, Chile Development of tree-ring chronologies for alerce (Fitzroya Cupressoides in Contao and Mirador, Chile

    Directory of Open Access Journals (Sweden)

    EDUARDO NEIRA

    2000-12-01

    Full Text Available Se desarrollaron dos cronologías de ancho de anillos de crecimiento a partir de muestras de alerce (Fitzroya cupressoides (Molina Johnston, colectadas en dos sitios: Contao, Cordillera de los Andes (41º 33'S, 72º 38'W, y Mirador, en la Cordillera de la Costa (40º 10'S, 73º 42'W. En la elaboración de las cronologías se utilizó el programa COFECHA para verificar el cofechado y se desarrolló para cada sitio una cronología utilizando el programa computacional ARSTAN. Se compararon las cronologías Contao y Mirador, con otras existentes para alerce encontrándose una alta similitud de la cronología Contao con la desarrollada para Lenca (41º 33'S, 72º 36' W. Contao presentó los valores más altos en los estadígrafos analizados con relación a las demás cronologías. Se observaron diferencias entre las cronologías provenientes de la Cordillera de la Costa y de los Andes en los últimos 150 años, probablemente producto de explotaciones humanas e incendios ocurridos en la cordillera de la Costa. La correlación con variables climáticas fue similar en su tendencia a la de otros estudios previos, documentando una correlación negativa con las temperaturas y positiva con las precipitaciones del verano anterior al período de crecimientoTwo ring-width chronologies were developed using samples from alerce (Fitzroya cupressoides (Molina Johnston. These were collected from two different sites; Contao, in the Andean Range and Mirador, in the Coastal Range. The series from the each site were cross-dated and COFECHA program was used to verify this process. Once correctly cross-dated, ARSTAN program was used to build up a chronology for each site (Contao and Mirador. These chronologies were compared with other existing chronologies. Contao presented the best statistics when compared to the other chronologies. Differences between chronologies from the Coastal and Andes Ranges were detected mainly during the last 150 years. Before this period

  6. Local Expression of Vaginal Th1 and Th2 Cytokines in Murine Vaginal Candidiasis under Different Immunity Conditions

    Institute of Scientific and Technical Information of China (English)

    Shanjuan CHEN; Shaohua LI; Yan WU; Zhixiang LIU; Jiawen LI

    2008-01-01

    To investigate the expression of vaginal Th1 and Th2 cytokines in rats with experimental vaginal candidiasis under different immune conditions, ICR murine vaginal candidiasis model was established and immno-suppressed murine models of vaginal cadidiasis were established in estrogen-treated mice. Non-estrogen-treated mice were used as controls. The mRNA level of Th1(IL-2)/Th2 (IL-4, IL-10, TGF-β1) cytokines in murine vaginal tissues was determined by RT-PCR.The cykotine in local tissues was increased to different extent under normal immune condition. IL-2mRNA was increased during early stage of infection, while IL-10 was increased transiently during late stage of infection. TGF-β1 production was found to be increased persistently. At same time, the expression of IL-2 mRNA was suppressed in immno-suppressed group, and the level of IL-4, IL-10,and TGF-β1 were higher than the normal immunity group to different degree during infection. The high level of IL-2 mRNA during early stage of infection was associated with clearance of mucosal Candidia albicans (C. albicans), and its expression suppressed leading to decreased clearance of mucosal C. albican in immuno-suppression. The over-expression of IL-4 and IL-10 could significantly enhance the susceptibility to C. albicans infection in mice.

  7. Large vesico-vaginal fistula caused by a foreign body.

    Science.gov (United States)

    Massinde, An; Kihunrwa, A

    2013-07-01

    Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

  8. The Human Vaginal Bacterial Biota and Bacterial Vaginosis

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    Sujatha Srinivasan

    2008-01-01

    Full Text Available The bacterial biota of the human vagina can have a profound impact on the health of women and their neonates. Changes in the vaginal microbiota have been associated with several adverse health outcomes including premature birth, pelvic inflammatory disease, and acquisition of HIV infection. Cultivation-independent molecular methods have provided new insights regarding bacterial diversity in this important niche, particularly in women with the common condition bacterial vaginosis (BV. PCR methods have shown that women with BV have complex communities of vaginal bacteria that include many fastidious species, particularly from the phyla Bacteroidetes and Actinobacteria. Healthy women are mostly colonized with lactobacilli such as Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus iners, though a variety of other bacteria may be present. The microbiology of BV is heterogeneous. The presence of Gardnerella vaginalis and Atopobium vaginae coating the vaginal epithelium in some subjects with BV suggests that biofilms may contribute to this condition.

  9. Acrometastasis to hand in vaginal carcinoma: A rare entity

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    Divya Khosla

    2012-01-01

    Full Text Available Although metastases to bones from solid tumors are very common, involvement of small bones of the hands is extremely rare. We report the first case of acrometastasis in vaginal carcinoma. We present a 65-year-old multiparous woman with FIGO Stage II vaginal carcinoma. The patient received treatment with external beam radiotherapy followed by brachytherapy. She had complete response to above treatment. Eleven months later, she presented with swelling on dorsum of hand. Investigations revealed metastasis to 4th metacarpal bone with lung metastasis. Hence, we present a patient with metastasis of carcinoma vagina to the 4 th metacarpal to draw the attention for the potential of such lesions to be developed in this region. It should be remembered that bone metastasis at unusual sites might be seen in vaginal carcinoma. We present this case because of its rarity and for documentation and discussion.

  10. Oral microflora in infants delivered vaginally and by caesarean section.

    Science.gov (United States)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron; Blomqvist, Susanne; Dahlén, Gunnar; Twetman, Svante

    2011-11-01

    BACKGROUND.  Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. AIM.  To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. DESIGN.  This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County Hospital in Halmstad, Sweden. Medically compromised and premature children (oral health need to be further investigated.

  11. Locus de Controle e escolha do método anticoncepcional Locus de Control y método anticonceptivo elegido Locus of Control and choice of contraceptive method

    Directory of Open Access Journals (Sweden)

    Aline Salheb Alves

    2007-06-01

    Full Text Available Objetivou-se avaliar a relação entre o Locus de Controle e o tipo de método contraceptivo escolhido. Foi utilizada a Escala Multidimensional de Locus de Controle de Levenson e entrevistadas 191 mulheres. As usuárias de preservativo masculino apresentaram maior Internalidade do que as usuárias de injetável mensal. Quanto ao locus Externalidade Outros Poderosos, as usuárias de implante apresentavam menor externalidade do que as usuárias de preservativo masculino, laqueadura, injetável trimestral e DIU. Considerando-se o locus Externalidade Acaso, as usuárias de implante apresentaram menores escores do que as mulheres que optaram pela laqueadura, injetável trimestral e DIU. Observou-se ainda, menor Externalidade Acaso entre as usuárias de injetável mensal em relação às mulheres que fizeram opção pelo injetável trimestral.El objetivo es validar la relación entre el Locus de Control y el tipo de método anticonceptivo elegido. Fue usada la Escala Multidimensional de Locus de Control de Levenson. Fueron entrevistadas 191 mujeres. Las usuarias de condón masculino presentaron Internalidad más grande que las usuarias de inyectable mensual. Considerado el Locus Externalidad - Otro poderoso, las usuarias de implante presentaron menor externalidad de que las usuarias de condón masculino, laqueadura, inyectable trimestral y DIU. Considerado el Locus Externalidad - Quizá, las usuarias del implante presentaron menores resultados que las mujeres que eligieron por la laqueadura, inyectable trimestral y DIU. Se observo que las mujeres usuarias de inyectable mensual presentaron menor Externalidad - Quizá que las mujeres usuarias de inyectable trimestral.The purpose was to assess the relationship between locus of control and the contraceptive method chosen. It was used the Levenson's Multidimensional Locus of Control Scale and 191 women was interviewed. Users of male condoms presented greater Internality than the monthly contraceptive

  12. Free glycogen in vaginal fluids is associated with Lactobacillus colonization and low vaginal pH.

    Directory of Open Access Journals (Sweden)

    Paria Mirmonsef

    Full Text Available Lactobacillus dominates the lower genital tract microbiota of many women, producing a low vaginal pH, and is important for healthy pregnancy outcomes and protection against several sexually transmitted pathogens. Yet, factors that promote Lactobacillus remain poorly understood. We hypothesized that the amount of free glycogen in the lumen of the lower genital tract is an important determinant of Lactobacillus colonization and a low vaginal pH.Free glycogen in lavage samples was quantified. Pyrosequencing of the 16S rRNA gene was used to identify microbiota from 21 African American women collected over 8-11 years.Free glycogen levels varied greatly between women and even in the same woman. Samples with the highest free glycogen had a corresponding median genital pH that was significantly lower (pH 4.4 than those with low glycogen (pH 5.8; p<0.001. The fraction of the microbiota consisting of Lactobacillus was highest in samples with high glycogen versus those with low glycogen (median = 0.97 vs. 0.05, p<0.001. In multivariable analysis, having 1 vs. 0 male sexual partner in the past 6 months was negatively associated, while BMI ≥30 was positively associated with glycogen. High concentrations of glycogen corresponded to higher levels of L. crispatus and L. jensenii, but not L. iners.These findings show that free glycogen in genital fluid is associated with a genital microbiota dominated by Lactobacillus, suggesting glycogen is important for maintaining genital health. Treatments aimed at increasing genital free glycogen might impact Lactobacillus colonization.

  13. 77 FR 8900 - Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal...

    Science.gov (United States)

    2012-02-15

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal... within the United States after importation of certain vaginal birth control devices by reason...

  14. Women Report Vaginal Ring for Preventing HIV had Little Effect on Sexual Intercourse

    Science.gov (United States)

    ... News Releases News Release Tuesday, October 18, 2016 Women report vaginal ring for preventing HIV had little ... social harm were associated with low adherence. Most women who used an experimental vaginal ring for HIV ...

  15. Effects of feminine hygiene products on the vaginal mucosal biome

    Directory of Open Access Journals (Sweden)

    Raina N. Fichorova

    2013-02-01

    Full Text Available Background: Over-the-counter (OTC feminine hygiene products come with little warning about possible side effects. This study evaluates in-vitro their effects on Lactobacillus crispatus, which is dominant in the normal vaginal microbiota and helps maintain a healthy mucosal barrier essential for normal reproductive function and prevention of sexually transmitted infections and gynecologic cancer. Methods: A feminine moisturizer (Vagisil, personal lubricant, and douche were purchased OTC. A topical spermicide (nonoxynol-9 known to alter the vaginal immune barrier was used as a control. L. crispatus was incubated with each product for 2 and 24h and then seeded on agar for colony forming units (CFU. Human vaginal epithelial cells were exposed to products in the presence or absence of L. crispatus for 24h, followed by epithelium-associated CFU enumeration. Interleukin-8 was immunoassayed and ANOVA was used for statistical evaluation. Results: Nonoxynol-9 and Vagisil suppressed Lactobacillus growth at 2h and killed all bacteria at 24h. The lubricant decreased bacterial growth insignificantly at 2h but killed all at 24h. The douche did not have a significant effect. At full strength, all products suppressed epithelial viability and all, except the douche, suppressed epithelial-associated CFU. When applied at non-toxic dose in the absence of bacteria, the douche and moisturizer induced an increase of IL-8, suggesting a potential to initiate inflammatory reaction. In the presence of L. crispatus, the proinflammatory effects of the douche and moisturizer were countered, and IL-8 production was inhibited in the presence of the other products. Conclusion: Some OTC vaginal products may be harmful to L. crispatus and alter the vaginal immune environment. Illustrated through these results, L. crispatus is essential in the preservation of the function of vaginal epithelial cells in the presence of some feminine hygiene products. More research should be invested

  16. Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization.

    Science.gov (United States)

    Patras, Kathryn A; Wescombe, Philip A; Rösler, Berenice; Hale, John D; Tagg, John R; Doran, Kelly S

    2015-09-01

    Streptococcus agalactiae (group B streptococcus [GBS]) colonizes the rectovaginal tract in 20% to 30% of women and during pregnancy can be transmitted to the newborn, causing severe invasive disease. Current routine screening and antibiotic prophylaxis have fallen short of complete prevention of GBS transmission, and GBS remains a leading cause of neonatal infection. We have investigated the ability of Streptococcus salivarius, a predominant member of the native human oral microbiota, to control GBS colonization. Comparison of the antibacterial activities of multiple S. salivarius strains by use of a deferred-antagonism test showed that S. salivarius strain K12 exhibited the broadest spectrum of activity against GBS. K12 effectively inhibited all GBS strains tested, including disease-implicated isolates from newborns and colonizing isolates from the vaginal tract of pregnant women. Inhibition was dependent on the presence of megaplasmid pSsal-K12, which encodes the bacteriocins salivaricin A and salivaricin B; however, in coculture experiments, GBS growth was impeded by K12 independently of the megaplasmid. We also demonstrated that K12 adheres to and invades human vaginal epithelial cells at levels comparable to GBS. Inhibitory activity of K12 was examined in vivo using a mouse model of GBS vaginal colonization. Mice colonized with GBS were treated vaginally with K12. K12 administration significantly reduced GBS vaginal colonization in comparison to nontreated controls, and this effect was partially dependent on the K12 megaplasmid. Our results suggest that K12 may have potential as a preventative therapy to control GBS vaginal colonization and thereby prevent its transmission to the neonate during pregnancy.

  17. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    Science.gov (United States)

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  18. Effect of sow parity on vaginal electrical impedance.

    Science.gov (United States)

    Rezác, P; Kukla, R; Pöschl, M

    2002-08-15

    The influence of sow parity on the changes of vaginal impedance after weaning was examined. Sows were monitored twice a day for oestrus via exposure to a sexually mature boar. The criterion for confirmation of ovulation was an increase in plasma progesterone levels above 12.5 nmol l(-1) 8 and 12 days after oestrus onset. The impedance measurements were carried out by a four-terminal method. In sows of all parities, the vaginal impedance decreased gradually after weaning (P four-terminal method.

  19. Uterine Arteriovenous Malformation with Sudden Heavy Vaginal Hemmorhage

    Directory of Open Access Journals (Sweden)

    Marianne Haughey

    2013-09-01

    Full Text Available Dysfunctional uterine bleeding (DUB is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility. [West J Emerg Med. 2013;14(5:411-414.

  20. [Primary amenorrhea by transverse vaginal septum: a case report and review of the literature].

    Science.gov (United States)

    González-Zárate, Alba Citlalli; Velásquez-Mamani, Jaime

    2014-09-01

    The transverse vaginal septum is one of the rarest anomalies of the reproductive tract classified depending on location. It is manifested by primary amenorrhea, cyclic pain and progressive mass growth at abdominopelvic level, ultrasound and magnetic resonance imaging provides the diagnosis, location and thickness of a transverse vaginal septum, treatment is surgical. We present a case of a teenage patient with primary amenorrhea due to lower transverse vaginal septum with surgical resection and satisfactory follow-up with successful vaginal patency.

  1. Analysis of Lactobacillus Products for Phages and Bacteriocins That Inhibit Vaginal Lactobacilli

    Directory of Open Access Journals (Sweden)

    Lin Tao

    1997-01-01

    Full Text Available Objective: Bacterial vaginosis is associated with an unexplained loss of vaginal lactobacilli. Previously, we have identified certain vaginal lactobacilli-released phages that can inhibit in vitro other vaginal lactobacilli. However, there is no apparent route for phages to be transmitted among women. The purpose of this study was to identify whether certain Lactobacillus products commonly used by women release phages or bacteriocins that can inhibit vaginal lactobacilli.

  2. Development of an in vitro alternative assay method for vaginal irritation

    OpenAIRE

    Ayehunie, Seyoum; Cannon, Chris; LaRosa, Karen; Pudney, Jeffrey; Anderson, Deborah J.; Klausner, Mitchell

    2010-01-01

    The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus-2. Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed u...

  3. 76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation

    Science.gov (United States)

    2011-03-29

    ... COMMISSION In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation AGENCY: U.S... certain vaginal ring birth control devices by reason of infringement of claim 1 of U.S. Patent No. 6,086... importation, or the sale within the United States after importation of certain vaginal ring birth...

  4. 21 CFR 529.1003 - Flurogestone acetate-impregnated vaginal sponge.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Flurogestone acetate-impregnated vaginal sponge... § 529.1003 Flurogestone acetate-impregnated vaginal sponge. (a) Specifications. Each vaginal sponge... ewes during their normal breeding season. (2) Limitations. Using applicator provided, insert...

  5. Qualitative accounts of patients' determinants of vaginal dilator use after pelvic radiotherapy

    NARCIS (Netherlands)

    R.M. Bakker (Rinske M.); W. Vermeer (Willemijn); C.L. Creutzberg (Carien); J.W.M. Mens (Jan); R.A. Nout; M.M. ter Kuile (Moniek)

    2015-01-01

    textabstractIntroduction: Treatment with pelvic external beam radiotherapy with brachytherapy (EBRT/BT) for gynecological cancers may cause sexual dysfunction because of vaginal shortening and tightening. Regular vaginal dilator use is thought to reduce vaginal shortening and/or tightening, but comp

  6. Comparison of the moisturization efficacy of two vaginal moisturizers: Pectin versus polycarbophil technologies.

    Science.gov (United States)

    Caswell, Michael; Kane, Michael

    2002-01-01

    This study was designed to compare the vaginal deposition and moisturization of two vaginal moisturizers, Summer's Eve (SE), based on pectin, and Replens (Rp), based on polycarbophil, in a double-blind crossover study design. Fifty-one female patients were each randomly assigned to one of two treatment groups. After a one-week washout period, the products were used for two weeks. After another one-week washout period, product assignments were switched. Colposcopy examinations were performed at the beginning and at the end of each product use. Of the forty-seven patients completing the study, 41 (87%) were found to have no vaginal residue after SE vaginal moisturizer, while only 25 (53%) were found to have no vaginal residue after using Rp vaginal moisturizer. No difference in relief of vaginal dryness or in product acceptance was found between the two products. This study shows that the use of SE vaginal moisturizer, based on pectin, resulted in significantly less vaginal residue compared to Rp vaginal moisturizer, based on polycarbophil, and in comparable relief of vaginal dryness. These results strongly suggest that bioadhesion is not important in vaginal moisturizers.

  7. ANILLOS DE BOOLE (2a. Parte)

    OpenAIRE

    Ruiz Salguero, Carlos; Departamento de Matemáticas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá

    2013-01-01

    The Function (and the Functor) Ac(t) of the open closed subsets of a Topological space (x,t) were analysed. The analysis was made first when X is fixed, in the context of the adjoint functions, with the corresponding study of fixed points of the adjoint pair (Tx, Acx). x i s variable we rep la ce the study in the context of the adjoi nt contravariant functors and analyse the sense of the adjoinction morphisms.

  8. Establishing and sustaining a healthy vaginal environment: analysis of data from a randomized trial of periodic presumptive treatment for vaginal infections.

    Science.gov (United States)

    Balkus, Jennifer E; Richardson, Barbra A; Mandaliya, Kishorchandra; Kiarie, James; Jaoko, Walter; Ndinya-Achola, Jeckoniah O; Marrazzo, Jeanne; Farquhar, Carey; McClelland, R Scott

    2011-07-15

    Data from a randomized trial of oral periodic presumptive treatment (PPT) to reduce vaginal infections were analyzed to assess the effect of the intervention on a healthy vaginal environment (normal flora confirmed by Gram stain with no candidiasis or trichomoniasis). The incidence of a healthy vaginal environment was 608 cases per 100 person-years in the intervention arm and 454 cases per 100 person-years in the placebo arm (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.17-1.58). Sustained vaginal health (healthy vaginal environment for ≥3 consecutive visits) was also more frequent in the intervention arm (HR, 1.69; 95% CI, 1.23-2.33). PPT is effective at establishing and sustaining a healthy vaginal environment.

  9. Vaginal Symptoms after Reconstructive Surgery for Prolapsed Pelvic Organ

    Directory of Open Access Journals (Sweden)

    Tahereh Eftekhar

    2010-09-01

    Full Text Available Objective: Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse.Materials and methods: In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ–VS questionnaire pre– and post operation 3 months later.Results: Mean age was 44.86 (31–74 years and %72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order (8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05.Conclusion: Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction.

  10. TROMBOSIS DE LA VENA OVARICA DERECHA POSTPARTO VAGINAL

    OpenAIRE

    Donoso S.,Enrique; Poblete L,José; Vargas L.,Mauricio

    2002-01-01

    Se presenta un caso clínico de trombosis de la vena ovárica derecha postparto vaginal. Se analizan los métodos de diagnóstico por imágenes, el diagnóstico diferencial, el tratamiento y la tromboprofilaxis en una futura gestación

  11. Granulomatous Vaginal Ulceration due to Metastatic Cutaneous Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1995-01-01

    Full Text Available A 28-year-old woman with a prior history of Crohn's disease was evaluated for painful vaginal ulceration in 1984. Subsequent studies revealed isolated involvement of the vagina with a granulomatous inflammatory process characteristic of metastatic cutaneous Crohn's disease. Conservative symptomatic treatment was associated with resolution and no subsequent recurrence of genital tract disease.

  12. Vaginal Practices of HIV-Negative Zimbabwean Women

    Directory of Open Access Journals (Sweden)

    Abigail Norris Turner

    2010-01-01

    Full Text Available Background. Vaginal practices (VPs may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n=2,185 participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84% reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR: 1.17, 95% CI: 1.04–1.32. Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86. Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored.

  13. Optimized Benzalkonium Chloride Gel: A Potential Vaginal Microbicides

    Institute of Scientific and Technical Information of China (English)

    Xun-cheng DING; Wei-hua LI; Jie-fei LI; Qiang-yi WANG

    2007-01-01

    Objective To develop an optimized BZK gel with good pharmaceutical effect and less toxicity to vaginal mucosa.Methods Four methods as below were used to research the spermicidal activity of BZK gel: 1)in vitro spermicidal test; 2) in vivo spermicidal test in rabbits; 3) anti-fertility test in rabbits; 4)contraceptive test in rabbits. Mucosal irritation test was used in rats to evaluate the safety of optimized BZK gel. Microbiological assessments were used to research anti-STI pathogens (including treponema pallidum, neisseria gonorrhoeae, trichomona vaginalis, candida albicans,ureaplama urealyticum, herpes simplex virus type-2, chlamydiae trachomatis) effect of optimized BZK gel.Results In vitro spermicidal test, EC50 of BZK gel was 0.029 mg/ml, a little higher than that of N-9 (0.019 mg/ml). The MIC of BZK gel was 0.25 mg/ml, similar to that of N-9 (0.20 mg/ml).The vaginal mucosal irritation test in rats showed that 0.429% BZK gel showed only minimal vaginal irritation, and did not damage the vaginal epithelium or cause local inflammation in rats. Microbiological assessments showed that optimized BZK gel could inhibit or inactivate common STI pathogens even after 3-fold or 5-fold dilution.Conclusion Optimized BZK gel was an effective microbicides.

  14. The Effect of Prolapse Surgery on Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; van der Vaart, C. Huub; Laan, Ellen; Roovers, Jan-Paul W. R.

    2011-01-01

    Introduction. Prolapse surgery has been shown to have major impact on sexual function. Since prolapse surgery not only influences psychological factors but might also influence physiological conditions such as vaginal innervation, there is a need for objective outcome measurements to better understa

  15. STUDY ON A NEW LEVONORGESTREL VAGINAL CONTRACEPTIVE RING

    Institute of Scientific and Technical Information of China (English)

    ZHANGHai-Wei; ZHENGHuai-Mei

    1989-01-01

    A new contraceptive vaginal ring was jointly produced by the Shanghai Medical University and the Shanghai Rubber Products Research Institute. It has an outer silicone elastomer shell and a tilling of 35 mg levonorgestrel gel in inner core. Amount of LNG release is

  16. Superoxide Radical Formation in Isolated PMN from Experimental Vaginal Trichomoniasis

    Directory of Open Access Journals (Sweden)

    Z Valadkhani

    2006-06-01

    Full Text Available Trichomoniasis, the most widespread sexually transmitted disease is caused by Trichomonas vaginalis. This parasite is site specific for the genitourinary tract and recruitment of macrophages as well as polymorphonuclear nutrophils (PMN to the site of infection is the first line of defense as a component of non-specific resistance and immunity. In this study, BALB/c mice were infected with 10 isolates from symptomatic and 10 from asymptomatic patients. Then PMN from vaginal washes, vaginal tissue and blood of infected mice was isolated and the rate of superoxide formation by intact stimulated PMN was measured. Results showed that, mice infected with symptomatic isolates indicated significant increase in polymorphs with increase in days of infection as compared with mice infected with asymptomatic isolate and control (uninfected animals. Vaginal tissue cells generated maximal amount of superoxide in symptomatic isolates infected animals (5.17 ± 0.36 as compared to asymptomatic isolates (4.54 ± 0.43, which brings out the maximal abnormality in PMN in this localized area. The amount of superoxide radicals generated by cells of vaginal washes and blood of symptomatic isolate infected mice 4.29 ± 0.25 and 2.16 ± 0.35 was less than the asymptomatic isolate (4.94 ± 0.49 and 3.18 ± 0.26, respectively. This study indicates that super oxide radical generation may play role in establishing the infection.

  17. Effects of vaginal lactobacilli in Chlamydia trachomatis infection.

    Science.gov (United States)

    Mastromarino, Paola; Di Pietro, Marisa; Schiavoni, Giovanna; Nardis, Chiara; Gentile, Massimo; Sessa, Rosa

    2014-07-01

    Increasing evidence indicates that abnormal vaginal flora lacking lactobacilli facilitates the acquisition of several sexually transmitted diseases including Chlamydia trachomatis. C. trachomatis, the most common bacterial agent of genital infections worldwide, can progress from the lower to upper reproductive tract and induce severe sequelae. The ability of C. trachomatis to develop into a persistent form has been suggested as key pathogenetic mechanism underlying chronic infections and sequelae. The aim of our study was to investigate the C. trachomatis interaction with vaginal microbiota analyzing the effects of Lactobacillus strains (L. brevis and L. salivarius) on the different phases of C. trachomatis developmental cycle. In addition, the effect of lactobacilli on persistent chlamydial forms induced by HSV-2 coinfection has also been evaluated. Our results demonstrated significant inhibition of C. trachomatis multiplication by vaginal lactobacilli. L. brevis was significantly more effective than L. salivarius (plactobacilli to protect from infection is strain-dependent. Lactobacilli had an adverse effect on elementary chlamydial bodies (plactobacilli toward persistent C. trachomatis forms induced by HSV-2 coinfection. A significant increase in the production of C. trachomatis infectious progeny was observed in C. trachomatis/HSV-2 coinfection in the presence of L. brevis (p=0.01) despite a significant inhibition of C. trachomatis multiplication (p=0.028). Our data suggest that a healthy vaginal microbiota can reduce the risk of acquiring C. trachomatis infection and counteract the development of persistent chlamydial forms.

  18. Benefits of Laser Therapy in Postmenopausal Vaginal Atrophy

    Science.gov (United States)

    Brînzan, Daniela; Pǎiuşan, Lucian; Daşcǎu, Voicu; Furǎu, Gheorghe

    2011-08-01

    Maybe the worst aspect of menopause is the decline of the quality of the sexual life. The aim of the study is to demonstrate the beneficial effects of laser therapy in comparison with topical application of estrogen preparations, for the treatment of vaginal atrophy and sexual dysfunctions induced by menopause. A total of 50 menopausal patients were examined during a one year period. The methods used for objectifying vaginal atrophy and sexual dysfunctions were history taking, local clinical exam and PAP smear. From this group, 40 patients had vaginal atrophy with sexual dysfunctions. They have been treated differently, being included in four groups: patients treated with local estrogens, patients treated with intravaginal laser therapy, patients treated with both laser therapy and estrogens, patients treated with estrogens and placebo laser therapy. Therapeutic benefit, improvement of vaginal atrophy and quality of sexual life, were objectified by anamnesis (questionnaire), local and general clinical examination and PAP smear. The best results have been obtained, by far, in the 3rd group, followed by the women treated only with laser. In conclusion, we can say that laser therapy is the best way for solving the sexual inconveniences of menopause.

  19. Genome Sequences of Nine Gram-Negative Vaginal Bacterial Isolates

    Science.gov (United States)

    Deitzler, Grace E.; Ruiz, Maria J.; Lu, Wendy; Weimer, Cory; Park, SoEun; Robinson, Lloyd S.; Hallsworth-Pepin, Kymberlie; Wollam, Aye; Mitreva, Makedonka

    2016-01-01

    The vagina is home to a wide variety of bacteria that have great potential to impact human health. Here, we announce reference strains (now available through BEI Resources) and draft genome sequences for 9 Gram-negative vaginal isolates from the taxa Citrobacter, Klebsiella, Fusobacterium, Proteus, and Prevotella. PMID:27688330

  20. Posterior vaginal wall Gartner′s duct cyst

    Directory of Open Access Journals (Sweden)

    Ripan Bala

    2015-01-01

    Full Text Available Cyst of posterior vaginal wall is very rare. This case relates to a patient who presented with polypoidal mass protruding out from vagina which could have been easily mistaken as uterovaginal prolapse, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.

  1. Antibiotic use during pregnancy alters the commensal vaginal microbiota

    DEFF Research Database (Denmark)

    Stokholm, J.; Schjørring, S.; Eskildsen, Carl Emil Aae

    2014-01-01

    Antibiotics may induce alterations in the commensal microbiota of the birth canal in pregnant women. Therefore, we studied the effect of antibiotic administration during pregnancy on commensal vaginal bacterial colonization at gestational week 36. Six hundred and sixty-eight pregnant women from...

  2. Vaginal birth after two or more previous cesarean sections.

    Science.gov (United States)

    Farmakides, G; Duvivier, R; Schulman, H; Schneider, E; Biordi, J

    1987-03-01

    The recommendation from the American College of Obstetricians and Gynecologists is to allow vaginal delivery after one cesarean section. This report is an update of our experience of 57 women with two or more cesarean sections who were allowed to labor.

  3. New techniques to characterise the vaginal microbiome in pregnancy

    Directory of Open Access Journals (Sweden)

    Nadeem O. Kaakoush

    2016-03-01

    Full Text Available Understanding of the vaginal microbiome in health and disease is essential to screen, detect and manage complications in pregnancy. One of the major complications of pregnancy is preterm birth, which is the leading world-wide cause of death and disability in children under five years of age. The aetiology of preterm birth is multifactorial, but a causal link has been established with infection. Despite the importance of understanding the vaginal microbiome in pregnancy in order to evaluate strategies to prevent and manage PTB, currently used culture based techniques provide limited information as not all pathogens are able to be cultured.The implementation of culture-independent high-throughput techniques and bioinformatics tools are advancing our understanding of the vaginal microbiome. New methods employing 16S rRNA and metagenomics analyses make possible a more comprehensive description of the bacteria of the human microbiome. Several studies on the vaginal microbiota of pregnant women have identified a large number of taxa. Studies also suggest reduced diversity of the microbiota in pregnancy compared to non-pregnant women, with a relative enrichment of the overall abundance of Lactobacillus species, and significant differences in the diversity of Lactobacillus spp. A number of advantages and disadvantages of these techniques are discussed briefly. The potential clinical importance of the new techniques is illustrated through recent reports where traditional culture-based techniques failed to identify pathogens in high risk complicated pregnancies whose presence subsequently was established using culture-independent, high-throughput analyses.

  4. Adaptive plasticity of vaginal innervation in term pregnant rats.

    Science.gov (United States)

    Liao, Zhaohui; Smith, Peter G

    2011-12-01

    Changes in reproductive status place varied functional demands on the vagina. These include receptivity to male intromission and sperm transport in estrus, barrier functions during early pregnancy, and providing a conduit for fetal passage at parturition. Peripheral innervation regulates vaginal function, which in turn may be influenced by circulating reproductive hormones. We assessed vaginal innervation in diestrus and estrus (before and after the estrous cycle surge in estrogen), and in the early (low estrogen) and late (high estrogen) stages in pregnancy. In vaginal sections from cycling rats, axons immunoreactive for the pan-neuronal marker protein gene product 9.5 (PGP 9.5) showed a small reduction at estrus relative to diestrus, but this difference did not persist after correcting for changes in target size. No changes were detected in axons immunoreactive for tyrosine hydroxylase (sympathetic), vesicular acetylcholine transporter (parasympathetic), or calcitonin gene-related peptide and transient receptor potential vanilloid type 1 (TRPV-1; sensory nociceptors). In rats at 10 days of pregnancy, innervation was similar to that observed in cycling rats. However, at 21 days of pregnancy, axons immunoreactive for PGP 9.5 and each of the subpopulation-selective markers were significantly reduced both when expressed as percentage of sectional area or after correcting for changes in target size. Because peripheral nerves regulate vaginal smooth muscle tone, blood flow, and pain sensitivity, reductions in innervation may represent important adaptive mechanisms facilitating parturition.

  5. Vaginal hygiene and douching: perspectives of Hispanic men.

    Science.gov (United States)

    McKee, Diane; Baquero, Maria; Anderson, Matthew; Karasz, Alison

    2009-02-01

    Vaginal douching is widely practised by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction and sexuality. Little previous research has addressed the beliefs and practices of Latina women and none has included the perspective of men, though limited data suggests that women may douche to please male partners. The present study seeks to identify the socially and culturally shaped beliefs and attitudes that influence douching practices from the perspective of Latino men. We conducted in-depth qualitative interviews in English or Spanish with adult Latino men seeking primary care at a community health centre in New York City. Results indicate that these Latino men (mostly of Caribbean descent) are emphatic about the role of cleanliness in vaginal health, reporting that it substantially influences their choice of partner. Most are very supportive of douching, which they consider a necessary hygiene activity. Vaginal health is perceived as a state that must be attained and maintained through proactive hygiene measures that remove seminal residue, menstrual blood, sweat and bacteria that contaminate the vagina. The implications of these findings for interventions with Latina women are discussed.

  6. Amnioinfusion among women attempting vaginal birth after cesarean delivery.

    Science.gov (United States)

    Strong, T H; Vega, J S; O'Shaughnessy, M J; Feldman, D B; Koemptgen, J G

    1992-05-01

    Eighteen of 901 women (2%) attempting vaginal birth after cesarean delivery (VBAC) received amnioinfusion. No untoward effects occurred in the subjects or their fetuses. We conclude that, though amnioinfusion in the setting of a VBAC attempt is needed only infrequently, it appears to be a reasonable intrapartum management option. The usual safeguards for a VBAC attempt should be followed.

  7. Throwing the dice for the diagnosis of vaginal complaints?

    Directory of Open Access Journals (Sweden)

    Taras David

    2006-02-01

    Full Text Available Abstract Backround Vaginitis is among the most common conditions women are seeking medical care for. Although these infections can easily be treated, the relapse rate is high. This may be due to inadequate use of the diagnostic potential. Methods We evaluated the misjudgement rate of the aetiology of vaginal complaints. A total of 220 vaginal samples from women with a vaginal complaint were obtained and analysed for numbers of total lactobacilli, H2O2-producing lactobacilli, total aerobic cell counts and total anaerobic cell counts including bifidobacteria, Bacteroides spp., Prevotella spp. Additionally, the presence of Atopobium vaginae, Gardnerella vaginalis, Candida spp. and Trichomonas vaginalis was evaluated by DNA-hybridisation using the PCR and Affirm VPIII Microbial Identification Test, respectively. Results The participating physicians diagnosed Bacterial vaginosis (BV as origin of discomfort in 80 cases, candidiasis in 109 cases and mixed infections in 8 cases. However, a present BV, defined as lack of H2O2-lactobacilli, presence of marker organisms, such as G. vaginalis, Bacteroides spp. or Atopobium vaginae, and an elevated pH were identified in only 45 cases of the women examined. Candida spp. were detected in 46 cases. Interestingly, an elevated pH corresponded solely to the presence of Atopobium vaginae, which was detected in 11 cases. Conclusion Errors in the diagnosis of BV and candida vulvovaginitis (CV were high. Interestingly, the cases of misjudgement of CV (77% were more numerous than that of BV (61%. The use of Amsel criteria or microscopy did not reduce the number of misinterpretations. The study reveals that the misdiagnosis of vaginal complaints is rather high.

  8. Nanoparticle incorporation of melittin reduces sperm and vaginal epithelium cytotoxicity.

    Directory of Open Access Journals (Sweden)

    Andrew P Jallouk

    Full Text Available Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001. However, melittin nanoparticles were not cytotoxic to sperm (p = 0.42 or vaginal epithelium (p = 0.48 at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ≥20 µM (p<0.001 and were toxic to sperm at equivalent melittin concentrations ≥40 µM (p<0.001. Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy.

  9. Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia.

    Science.gov (United States)

    Senturk, Mehmet Baki; Cakmak, Yusuf; Atac, Halit; Budak, Mehmet Sukru

    2015-01-01

    Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients' requests influenced outcome. Trial of labor should take into consideration the patient's preference, together with the proper setting.

  10. Application of the low-level laser therapy for the treatment of vaginitis

    Science.gov (United States)

    Passeniouk, A. N.; Mikhailov, V. A.

    2000-06-01

    Vaginitis is the most common female infectious disease. Females suffering from this disorder are annually increasing in number. There are a lot of modalities of treatment of vaginitis, but because of drug allergy and microbe's stability to drug the treatment of vaginitis is difficult. Our study compares the efficacy of laser-therapy with drug therapy in the treatment of non-specific vaginitis and vaginal candidiasis. Thirty women reci4eed the LLLT by local action with antiseptic liquid daily during ten days, 20 women received metronidazole and fluconozole and vaginal application of metronidazole. The results suggest that local laser-therapy is able to remove sights of vaginitis more efficiently and faster than drug therapy. Repair of normal vaginal microflora, which is the best indicator of recovery, was significantly at a faster rate in laser-therapy group. There were no report of adverse reaction with vaginal laser- therapy, whereas there were women on drug therapy who reported side effects. In conclusion, vaginal aser-therapy with antiseptic liquid is a suitable, effective, safe and chip alternative to drug therapy in the treatment of vaginitis.

  11. Complete vaginal outlet stenosis in a patient with Sheehan’s syndrome

    Science.gov (United States)

    Choo, Minji; Park, Hana

    2016-01-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety. PMID:27896263

  12. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer

    Science.gov (United States)

    Dominguez-Bello, Maria G.; De Jesus-Laboy, Kassandra M.; Shen, Nan; Cox, Laura M.; Amir, Amnon; Gonzalez, Antonio; Bokulich, Nicholas A.; Song, Se Jin; Hoashi, Marina; Rivera-Vina, Juana I.; Mendez, Keimari; Knight, Rob; Clemente, Jose C.

    2016-01-01

    Exposure of newborns to the maternal vaginal microbiota is interrupted with cesarean birthing. Babies delivered by Cesarean section (C-section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders. Here we conducted a pilot study in which infants delivered by C-section are exposed to maternal vaginal fluids at birth. Similar to vaginally delivered babies, the gut, oral, and skin microbiome of these newborns during the first 30 days of life was enriched in vaginal bacteria underrepresented in unexposed C-section infants, albeit similarity to vaginally-delivered infants was higher in oral and skin than in anal samples. Although the long-term health consequences of restoring the microbiota of C-section born infants remain unclear, our results demonstrate that vaginal microbes can be partially restored at birth in C-section delivered babies. PMID:26828196

  13. Forensic interlaboratory evaluation of the ForFLUID kit for vaginal fluids identification.

    Science.gov (United States)

    Giampaoli, Saverio; Alessandrini, Federica; Berti, Andrea; Ripani, Luigi; Choi, Ajin; Crab, Roselien; De Vittori, Elisabetta; Egyed, Balazs; Haas, Cordula; Lee, Hwan Young; Korabecná, Marie; Noel, Fabrice; Podini, Daniele; Tagliabracci, Adriano; Valentini, Alessio; Romano Spica, Vincenzo

    2014-01-01

    Identification of vaginal fluids is an important step in the process of sexual assaults confirmation. Advances in both microbiology and molecular biology defined technical approaches allowing the discrimination of body fluids. These protocols are based on the identification of specific bacterial communities by microfloraDNA (mfDNA) amplification. A multiplex real time-PCR assay (ForFLUID kit) has been developed for identifying biological fluids and for discrimination among vaginal, oral and fecal samples. In order to test its efficacy and reliability of the assay in the identification of vaginal fluids, an interlaboratory evaluation has been performed on homogeneous vaginal swabs. All the involved laboratories were able to correctly recognize all the vaginal swabs, and no false positives were identified when the assay was applied on non-vaginal samples. The assay represents an useful molecular tool that can be easily adopted by forensic geneticists involved in vaginal fluid identification.

  14. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid

    Science.gov (United States)

    Moncla, Bernard J.; Chappell, Catherine A.; Debo, Brian M.; Meyn, Leslie A.

    2016-01-01

    In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use) and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed. The activities of four of six glycosidases in the samples from women with bacterial vaginosis were significantly increased when compared to normal or intermediate women: sialidase, P = IUDs (P = 0.02). The number of sialic acid binding sites was lower in the postmenopausal group (P = 0.04), but the number of high mannose binding sites, measured with Griffithsin, was not significantly different among the 6 hormonal groups. The glycosidase levels in the cervical-vaginal mucus were rather low in the groups, with exception of α-glucosidase activity that was much lower in the postmenopausal group (Pmicroorganisms. These effects were so influential that it required us to remove subjects with BV for data interpretation of the impact of hormones. We also suggest that certain changes occurring in vaginal/cervical proteins are due to bacteria or their products. Therefore, the quantitation of vaginal mucins and lectin binding offers a new method to monitor bacteria-host interactions in the female reproductive tract. The data suggest that some of the changes in these components are the result of host processing, such as the increases in mucin content, while the microflora is responsible for the increases in glycosidases and the decreases in lectin binding. The methods should be considered a valid marker for insult to the female genital tract. PMID:27437931

  15. A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

    Directory of Open Access Journals (Sweden)

    Binti R. Bhatiyani

    2017-01-01

    Full Text Available Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed. Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6 were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs. Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol. Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

  16. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    Science.gov (United States)

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

  17. MTN-001: randomized pharmacokinetic cross-over study comparing tenofovir vaginal gel and oral tablets in vaginal tissue and other compartments.

    Directory of Open Access Journals (Sweden)

    Craig W Hendrix

    Full Text Available BACKGROUND: Oral and vaginal preparations of tenofovir as pre-exposure prophylaxis (PrEP for human immunodeficiency virus (HIV infection have demonstrated variable efficacy in men and women prompting assessment of variation in drug concentration as an explanation. Knowledge of tenofovir concentration and its active form, tenofovir diphosphate, at the putative vaginal and rectal site of action and its relationship to concentrations at multiple other anatomic locations may provide key information for both interpreting PrEP study outcomes and planning future PrEP drug development. OBJECTIVE: MTN-001 was designed to directly compare oral to vaginal steady-state tenofovir pharmacokinetics in blood, vaginal tissue, and vaginal and rectal fluid in a paired cross-over design. METHODS AND FINDINGS: We enrolled 144 HIV-uninfected women at 4 US and 3 African clinical research sites in an open label, 3-period crossover study of three different daily tenofovir regimens, each for 6 weeks (oral 300 mg tenofovir disoproxil fumarate, vaginal 1% tenofovir gel [40 mg], or both. Serum concentrations after vaginal dosing were 56-fold lower than after oral dosing (p<0.001. Vaginal tissue tenofovir diphosphate was quantifiable in ≥90% of women with vaginal dosing and only 19% of women with oral dosing. Vaginal tissue tenofovir diphosphate was ≥130-fold higher with vaginal compared to oral dosing (p<0.001. Rectal fluid tenofovir concentrations in vaginal dosing periods were higher than concentrations measured in the oral only dosing period (p<0.03. CONCLUSIONS: Compared to oral dosing, vaginal dosing achieved much lower serum concentrations and much higher vaginal tissue concentrations. Even allowing for 100-fold concentration differences due to poor adherence or less frequent prescribed dosing, vaginal dosing of tenofovir should provide higher active site concentrations and theoretically greater PrEP efficacy than oral dosing; randomized topical dosing PrEP trials

  18. Identification and genotyping of bacteria from paired vaginal and rectal samples from pregnant women indicates similarity between vaginal and rectal microflora

    Directory of Open Access Journals (Sweden)

    Temmerman Marleen

    2009-10-01

    Full Text Available Abstract Background The vaginal microflora is important for maintaining vaginal health and preventing infections of the reproductive tract. The rectum has been suggested as the major source for the colonisation of the vaginal econiche. Methods To establish whether the rectum can serve as a possible bacterial reservoir for colonisation of the vaginal econiche, we cultured vaginal and rectal specimens from pregnant women at 35-37 weeks of gestation, identified the isolates to the species level with tRNA intergenic length polymorphism analysis (tDNA-PCR and genotyped the isolates for those subjects from which the same species was isolated simultaneously vaginally and rectally, by RAPD-analysis. One vaginal and one rectal swab were collected from a total of each of 132 pregnant women at 35-37 weeks of gestation. Swabs were cultured on Columbia CNA agar and MRS agar. For each subject 4 colonies were selected for each of both sites, i.e. 8 colonies in total. Results Among the 844 isolates that could be identified by tDNA-PCR, a total of 63 bacterial species were present, 9 (14% only vaginally, 26 (41% only rectally, and 28 (44% in both vagina and rectum. A total of 121 (91.6% of 132 vaginal samples and 51 (38.6% of 132 rectal samples were positive for lactobacilli. L. crispatus was the most frequently isolated Lactobacillus species from the vagina (40% of the subjects were positive, followed by L. jensenii (32%, L. gasseri (30% and L. iners (11%. L. gasseri was the most frequently isolated Lactobacillus species from the rectum (15%, followed by L. jensenii (12%, L. crispatus (11% and L. iners (2%. A total of 47 pregnant women carried the same species vaginally and rectally. This resulted in 50 vaginal/rectal pairs of the same species, for a total of eight different species. For 34 of the 50 species pairs (68%, isolates with the same genotype were present vaginally and rectally and a high level of genotypic diversity within species per subject was also

  19. Rescreening for abnormal vaginal flora in pregnancy and re-treating with clindamycin vaginal cream significantly increases cure and improvement rates

    DEFF Research Database (Denmark)

    Lamont, R F; Taylor-Robinson, D; Bassett, P

    2012-01-01

    We investigated 199 pregnant women with bacterial vaginosis (BV) who received clindamycin vaginal cream (CVC) for three days and compared with 205 women treated with placebo. The vaginal flora was assessed at each visit. At the second visit, 71% in the CVC group were cured/improved, compared...

  20. Does vaginal reconstructive surgery with or without vaginal hysterectomy or trachelectomy improve sexual well being? A prospective follow-up study.

    NARCIS (Netherlands)

    Stoutjesdijk, J.; Vierhout, M.E.; Spruijt, J.; Massolt, E.T.

    2006-01-01

    OBJECTIVE: To compare sexual well being in women with pelvic organ prolapse before and after vaginal reconstructive surgery. METHODS: Sixty-seven women, mean age 61 (36-85) years, who underwent vaginal reconstructive surgery, were asked to complete detailed questionnaires before and after surgery. I

  1. Eggs containing larvae of Enterobius vermicularis in vaginal smear

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    Jyothi B Shetty

    2012-01-01

    Full Text Available Enterobius vermicularis also known commonly as pinworm is the most common intestinal parasite. It is a nematode that inhabits the human terminal ileum, colon and appendix. The fertilized female migrates to the perianal area where eggs are deposited but occasionally introduces itself into adjacent orifices, most commonly the female genitourinary tract. Thus the eggs can be seen in the vaginal smear as a result of contamination. We report a case wherein the patient presented with signs and symptoms of vulvovaginitis. In her vaginal smear there were eggs of Enterobius vermicularis which showed a coiled larva within it. In the background there were plenty of acute inflammatory cells. This patient responded favorably to antihelminthics. We report this case to highlight the morphology of the parasite and also to emphasize that such findings should not be neglected. Timely reporting and appropriate treatment of such cases will prevent further complications of this parasite including endometritis, salphingitis and peritonitis.

  2. Posterior vaginal wall cyst of Mullerian origin: a case report

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    Sunita Samal

    2015-02-01

    Full Text Available Cystic lesions of vagina are relatively uncommon and an incidental finding during routine gynaecological examination. Mullerian cysts are congenital cysts of vagina, usually reported during childbearing age group. These cysts mostly arise at the level of cervix and extend anteriorly in relation to bladder, but very rarely they may also extend posteriorly. This is a rare case of posterior vaginal wall cyst of Mullerian origin. A 36-year-old multi para (P2L2 both SVD, presented with a mass descending through vagina since 2-3 months. Pelvic examination revealed a 5x5 cm cystic mass arising from the posterior vaginal wall. Complete excision of the cyst was done. The cyst was filled with chocolate coloured material and histopathology confirmed a Mullerian cyst. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 245-246

  3. Missed Iatrogenic Bladder Rupture Following Normal Vaginal Delivery.

    Science.gov (United States)

    Baheti, Vidyasagar H; Wagaskar, Vinayak G; Patwardhan, Sujata K

    2015-10-01

    Bladder rupture following caesarian section is well documented complications. Intraperitoneal bladder rupture following normal vaginal delivery is very rare. Hereby, we present a case report of intraperitoneal bladder rupture presented late following normal vaginal delivery. We report a case of spontaneous intraperitoneal urinary bladder rupture following uneventful outlet forceps delivery in a 22-year-old primi gravid woman with gestational diabetes mellitus and fetal macrosomia who presented with large urinary ascites, anuria and renal failure. Emergent exploratory laparotomy with repair of the intraperitoneal bladder rupture helped to prevent its potential complications. Postpartum patients who undergo episiotomy or perineal repair may land up in unnoticed urinary retention which may rarely terminate in spontaneous urinary bladder rupture. Awareness of its manifestations amongst emergency physician would help to initiate appropriate timely management.

  4. Vaginal myofibroblastoma with glands expressing mammary and prostatic antigens.

    Science.gov (United States)

    Wallenfels, I; Chlumská, A

    2012-01-01

    A case of unusual vaginal myofibroblastoma containing glands which expressed mammary and prostatic markers is described. The tumor occurred in 70-year-old woman in the proximal third of the vagina. It showed morphology and immunophenotype typical of so-called cervicovaginal myofibroblastoma. The peripheral zone of the lesion contained a few groups of glands suggesting vaginal adenosis or prostatic-type glands on initial examination. The glands showed a surprising simultaneous expression of mammary markers mammaglobin and GCDFP-15 and prostatic markers prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP). Immunostains for alpha-smooth muscle actin, p63 and CD10 highlighted the myoepithelial cell layer of the glands. The finding indicates that simultaneous use of both mammary and prostatic markers for examination of unusual glandular lesions in the vulvovaginal location can be helpful for an exact diagnosis, and can contribute to better understanding of prostatic and mammary differentiations in the female lower genital tract.

  5. Speciation and susceptibility testing of Candida isolates from vaginal discharge

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    Swapna Muthusamy

    2016-09-01

    Full Text Available Candida is a normal commensal that takes the role of a pathogen under compromised conditions. Increased longevity of human life and immunocompromised conditions together paves the way for the increase in opportunistic infections like candidiasis. Vulvovaginal candidiasis (VVC is the second most common cause of vaginal discharge next to Chlamydia.1 VVC is the leading cause of abnormal vaginal discharge due to microbial causes. Untreated VVC is a possible risk factor for acquisition of HIV.2 Prevention of sexually transmitted infections (STIs including VVC can reduce the transmission of HIV since STIs and HIV have the common mode of transmission and one enhances the risk of infection with the other. Early diagnosis and treatment of candidiasis can reduce the pregnancy related morbidity

  6. Sugar expressions on the vaginal epithelium in pregnant mice.

    Science.gov (United States)

    Yasunaga, Youhei; Takeuchi, Takashi; Shimokawa, Tetsuya; Nabeta, Motowo; Matsuu, Aya; Asano, Atsushi; Ohta, Yasuhiko

    2012-06-01

    Sugar expressions were examined on the epithelium of both the middle portion of the vagina and the vaginal portion of the cervical canal (CC) in pregnant mice to understand the pathogenesis of bacterial infection in the female reproductive organ by using a panel of lectins. As a result, N-acetylglucosamine was positive before pregnant day (P) 7 but negative after P10 and at diestrus on both the vagina and the CC. In addition, some differences in sugar expressions were seen between them. These results suggest that sugar expressions on the mucosal surface would change not only site-specifically but also time-dependently, and these sugar differences indicate the possibility of the alteration of the settled bacterial species on the vaginal mucosa in pregnancy.

  7. Subserosal hematoma of the sigmoid colon after vaginal delivery

    Science.gov (United States)

    Bacalbașa, N; Bohîlțea, RE; Dumitru, M; Turcan, N; Cîrstoiu, MM

    2017-01-01

    Postpartum hemorrhage is an obstetrical emergency that represents the leading cause of maternal mortality. Severe hemorrhagic complications that could appear postpartum are the abdomino-pelvic hematomas, which result from the rupture of the pelvic vessels. We reported a very rare case of puerperal retroperitoneal subserosal hematoma of sigmoid colon following vaginal delivery, which was successfully managed by conservative methods. As far as we know, there are only a few case reports of intramural hematoma of sigmoid colon in literature, having other etiologies than vaginal delivery trauma. The particularities of the case consisted in the association of hemangiomas and the low risk thrombophilia. Diagnosis was based on the clinical exam and the paraclinical founding. Laparotomy is generally considered the last choice, in life threatening cases with hemodynamic instability, compression signs, and presence of contrast leakage on noninvasive imaging methods, but avoiding colonic resection after dissection represented the true challenge of the case. PMID:28255383

  8. Novel three-dimensional autologous tissue-engineered vaginal tissues using the self-assembly technique.

    Science.gov (United States)

    Orabi, Hazem; Saba, Ingrid; Rousseau, Alexandre; Bolduc, Stéphane

    2017-02-01

    Many diseases necessitate the substitution of vaginal tissues. Current replacement therapies are associated with many complications. In this study, we aimed to create bioengineered neovaginas with the self-assembly technique using autologous vaginal epithelial (VE) and vaginal stromal (VS) cells without the use of exogenous materials and to document the survival and incorporation of these grafts into the tissues of nude female mice. Epithelial and stromal cells were isolated from vaginal biopsies. Stromal cells were driven to form collagen sheets, 3 of which were superimposed to form vaginal stromas. VE cells were seeded on top of these stromas and allowed to mature in an air-liquid interface. The vaginal equivalents were implanted subcutaneously in female nude mice, which were sacrificed after 1 and 2 weeks after surgery. The in vitro and animal-retrieved equivalents were assessed using histologic, functional, and mechanical evaluations. Vaginal equivalents could be handled easily. VE cells formed a well-differentiated epithelial layer with a continuous basement membrane. The equivalent matrix was composed of collagen I and III and elastin. The epithelium, basement membrane, and stroma were comparable to those of native vaginal tissues. The implanted equivalents formed mature vaginal epithelium and matrix that were integrated into the mice tissues. Using the self-assembly technique, in vitro vaginal tissues were created with many functional and biological similarities to native vagina without any foreign material. They formed functional vaginal tissues after in vivo animal implantation. It is appropriate for vaginal substitution and disease modeling for infectious studies, vaginal applicants, and drug testing.

  9. Prediction of scar integrity and vaginal birth after caesarean delivery.

    OpenAIRE

    Valentin, Lil

    2013-01-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has bee...

  10. [Vaginal microscopic evidence in women with symptoms of genital infection].

    Science.gov (United States)

    Cerbini, S; Greco, M; Lalli, P; Santucci, A; Pitzurra, M

    1985-01-01

    Vaginal living organisms have been defined as the most complete in human ecology. As many as 100 million colonies of microorganisms can live in a single ml of vaginal liquid. More common are the anaerobic types, particularly the lactobacillus and bacteroides. The low pH of the vagina, normally 4, is due to the high lactic acid content of the lactobacillus. Pathogenic bacteria is inhibited at 4.5 pH. Conversely, it proliferates at a high pH. The slightest alteration of this delicate equilibrium allows potentially pathogenic bacteria to grow to a concentration high enough to produce symptoms. Researchers have sought to identify new pathological microorganisms, due to the increase in reported cases of vaginal infection in recent years. New strains such as microplasmas and chlamydia are assuming greater importance. Evidence of the numerous vaginal microbes comes from anamnestic, symptomatological data and from simple laboratory tests conducted in gynecological clinics with microscopes and Gram coloration. 663 women were examined in 6 laboratories. The computerized data revealed that only 29, or 4.37%, showed no symptoms at all and had gone to the lab for a mere check up; 175, or 26.40%, complained of pain, burning and itching; 361, or 54.45%, revealed symptoms associated with leukorrhea; 98, or 14.78%, showed only leukorrhea. The epidemiological study shows the importance of candida albicans in the infectious pathology of the female genital organ. Trichomonas vaginalis and grambacteria infection have been detected particularly when an IUD is used. The negative result of numerous bacterioscopic exams has shown the necessity of more in-depth study of genital infections, using analytical cultural methodology.

  11. Vaginal tuberculosis in an elderly kidney transplant recipient

    Directory of Open Access Journals (Sweden)

    Nemati Eghlim

    2009-01-01

    Full Text Available Female genital tuberculosis (FGTB is extremely rare in post-menopausal women. A 59-year-old woman developed vaginal tuberculosis one year after receiving a kidney transplant from a living donor. Her complaints included abdominal pain, fever, and weight loss. Furthermore, her tu-berculin skin test was negative. She was successfully treated with quadruple anti-TB therapy for 6 months.

  12. Diabetes Insipidus after normal vaginal delivery: a case report

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    Farideh Keypour

    2014-07-01

    Treatment was continuing, when the symptoms of central diabetes insipidus resolve and urinary concentrating ability was preferred. Maximum urinary osmolality over the next 11 hours was assessed, 730 mosm/kg was considered normal. Conclusion: Close attention to electrolyte and fluid balance is important in the postpartum period. The symptoms of transient vasopressin-resistant diabetes insipidus resolve in few days to a few weeks after vaginal delivery or when hepatic function returns to normal.

  13. DNA typing from vaginal smear slides in suspected rape cases

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    Dayse Aparecida da Silva

    Full Text Available In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.

  14. Viability of lactobacillus acidophilus in various vaginal tablet formulations

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    Fazeli M.R.

    2006-07-01

    Full Text Available The lactobacilli which are present in vaginal fluids play an important role in prevention of vaginosis and there are considerable interests in formulation of these friendly bacteria into suitable pharmaceutical dosage forms. Formulating these microorganisms for vaginal application is a critical issue as the products should retain viability of lactobacilli during formulation and also storage. The aim of this study was to examine the viability and release of Lactobacillus acidophilus from slow-release vaginal tablets prepared by using six different retarding polymers and from two effervescent tablets prepared by using citric or adipic acid. The Carbomer–based formulations showed high initial viablility compared to those based on HPMC-LV, HPMC-HV, Polycarbophil and SCMC polymers which showed one log decrease in viable cells. All retarding polymers in slow release formulations presented a strong bacterial release at about 2 h except Carbomer polymers which showed to be poor bacterial releasers. Although effervescent formulations produced a quick bacterial release in comparison with polymer based slow-release tablets, they were less stable in cold storage. Due to the strong chelating characteristic of citric acid, the viability was quickly lost for aqueous medium of citric acid in comparison with adipic acid based effervescent tablets.

  15. Vaginal epithelial dendritic cells renew from bone marrow precursors.

    Science.gov (United States)

    Iijima, Norifumi; Linehan, Melissa M; Saeland, Sem; Iwasaki, Akiko

    2007-11-27

    Dendritic cells (DCs) represent key professional antigen-presenting cells capable of initiating primary immune responses. A specialized subset of DCs, the Langerhans cells (LCs), are located in the stratified squamous epithelial layer of the skin and within the mucosal epithelial lining of the vaginal and oral cavities. The vaginal mucosa undergoes cyclic changes under the control of sex hormones, and the renewal characteristics of the vaginal epithelial DCs (VEDCs) remain unknown. Here, we examined the origin of VEDCs. In contrast to the skin epidermal LCs, the DCs in the epithelium of the vagina were found to be repopulated mainly by nonmonocyte bone-marrow-derived precursors, with a half-life of 13 days under steady-state conditions. Upon infection with HSV-2, the Gr-1(hi) monocytes were found to give rise to VEDCs. Furthermore, flow cytometric analysis of the VEDCs revealed the presence of at least three distinct populations, namely, CD11b(+)F4/80(hi), CD11b(+)F4/80(int), and CD11b(-)F4/80(-). Importantly, these VEDC populations expressed CD207 at low levels and had a constitutively more activated phenotype compared with the skin LCs. Collectively, our results revealed mucosa-specific features of the VEDCs with respect to their phenotype, activation status, and homeostatic renewal potential.

  16. Vaginal contraceptive rings: option for the new millennium.

    Science.gov (United States)

    1998-05-01

    Vaginal contraceptive rings, currently in advanced clinical trials, offer a simple, long-acting, woman-controlled method of fertility control. A ring developed by the Population Council's Center for Biomedical Research, with continual release of 20 mcg of ethinyl estradiol and 1 mg of norethindrone acetate, has been accepted by a commercial partner for further studies leading to market introduction. Another Population Council-developed ring combines an even lower dose of estrogen (15 mcg) with its own patented progestin, NESTORONE. Organon is in phase III trials of a ring combining 15 mcg of ethinyl estradiol and the progestin etonogestrel and expects to complete its research by mid-1999. Of particular interest is the potential for vaginal irritation. The one-size ring is smaller than most diaphragms and does not require fitting. Once a woman has received instructions, she can insert and remove the ring herself. The ring's regimen of 3 weeks of use and 1 week of rest is similar to the schedule for oral contraceptives (OCs), but provides better cycle control than a combined OC that delivers one-third more of the same progestin and estrogen. Finally, a progestin-only vaginal ring for lactating women has been licensed for manufacture and distribution in Latin America.

  17. Analysis of the Vaginal Microbiome by Next-Generation Sequencing and Evaluation of its Performance as a Clinical Diagnostic Tool in Vaginitis

    Science.gov (United States)

    Hong, Ki Ho; Hong, Sung Kuk; Cho, Sung Im; Ra, Eunkyung; Han, Kyung Hee; Kang, Soon Beom; Kim, Eui-Chong; Park, Sung Sup

    2016-01-01

    Background Next-generation sequencing (NGS) can detect many more microorganisms of a microbiome than traditional methods. This study aimed to analyze the vaginal microbiomes of Korean women by using NGS that included bacteria and other microorganisms. The NGS results were compared with the results of other assays, and NGS was evaluated for its feasibility for predicting vaginitis. Methods In total, 89 vaginal swab specimens were collected. Microscopic examinations of Gram staining and microbiological cultures were conducted on 67 specimens. NGS was performed with GS junior system on all of the vaginal specimens for the 16S rRNA, internal transcribed spacer (ITS), and Tvk genes to detect bacteria, fungi, and Trichomonas vaginalis. In addition, DNA probe assays of the Candida spp., Gardnerella vaginalis, and Trichomonas vaginalis were performed. Various predictors of diversity that were obtained from the NGS data were analyzed to predict vaginitis. Results ITS sequences were obtained in most of the specimens (56.2%). The compositions of the intermediate and vaginitis Nugent score groups were similar to each other but differed from the composition of the normal score group. The fraction of the Lactobacillus spp. showed the highest area under the curve value (0.8559) in ROC curve analysis. The NGS and DNA probe assay results showed good agreement (range, 86.2-89.7%). Conclusions Fungi as well as bacteria should be considered for the investigation of vaginal microbiome. The intermediate and vaginitis Nugent score groups were indistinguishable in NGS. NGS is a promising diagnostic tool of the vaginal microbiome and vaginitis, although some problems need to be resolved. PMID:27374709

  18. COMPARATIVE STUDY OF THE EFFICACY OF MIFEPRISTONE WITH VAGINAL MISOPROSTOL AND VAGINAL MISOPROSTOL ALONE FOR FIRST TRIMESTER ABORTION

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    Hemalatha Kulandai Raj

    2016-08-01

    Full Text Available OBJECTIVES To assess the efficacy of mifepristone with misoprostol combination in first trimester abortion. To compare this combination with vaginal misoprostol alone for the first trimester MTP. To compare the various parameters involved in MTP in both the methods and assess the most suitable method for first trimester MTP. METHODS An interventional prospective study conducted in the Department of Obstetrics and Gynaecology at Government Thoothukudi Medical College, Thoothukudi, during 2013-2015. During this study, 125 patients who attended the family planning clinic requesting first trimester termination of pregnancy were selected based on the inclusion, exclusion criteria. Out of 125 patients, 100 were randomly assigned to vaginal misoprostol group and 25 to mifepristone with misoprostol group. The study was approved by the hospital ethical committee. RESULTS On analysing both the methods had less induction abortion interval, but 93% of abortions occurred within 4 hours of administration in mifepristone and vaginal misoprostol. CONCLUSION Thus, the combined regimen has more rate of complete abortion with less induction abortion interval than when misoprostol alone was used

  19. Induction of labor in term pregnancy: Sublingual versus vaginal misoprostol

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    Beigi A

    2010-06-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Induction of labor implies stimulation of contractions before the spontaneous onset of labor and is indicated when have benefits to eighter mother or fetus. Uterine contractions and an appropriate cervix are two important factors in labor and are contributed to good outcomes. Nowadays, there are many therapeutic modalities for it such as misoprostol. Both vaginal and oral misoprostol may be used for eighter cervical ripening or labor induction. The tablets are stable at room temperature. Regarding the issue importance and lack of similar studies in Iran, this study was conducted to compare the efficacy of sublingual and vaginal misoprostol for labor induction."n"nMethods: This study was conducted as a randomized double-blind clinical trial. In this survey, 250 women were randomly assigned to receive 25 mg vaginal misoprostol plus sublingual placebo or 25 mg sublingual misoprostol plus vaginal placebo in Arash hospital Tehran, Iran from 2008 to 2010. The maternal and fetal complications, Bishop Score, and time of pain onset and it's interval with labor were monitored in two groups analyzed."n"nResults: Mean Bishop Score, and time of pain onset and its interval with labor were similar in two groups (p>0

  20. Foreign body in vagina: a cause of persistent vaginal discharge in children

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    P. Pallavee

    2013-04-01

    Full Text Available Vulvovaginitis and vaginal discharge in pediatric patients, while not uncommon, is commonly believed to be due to such causes as absence of the protective effect on the vaginal mucosa. However, other causes need also to be kept in mind. We report a case of chronic vaginal discharge in a 5 yr old, who had retained a foreign body in her vagina for 6-7 months. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 224-225

  1. Comparison of Sublingual and Vaginal Misoprostol for Second-Trimester Pregnancy Terminations

    OpenAIRE

    Forozan Milani; Seyede Hajar Sharami; Saeedeh Arjmandi

    2014-01-01

    Objective Comparing sublingual and vaginal misoprostol in second trimester pregnancy termination. Materials and methods In this study 268 women at 12-24 weeks of gestation candidate for pregnancy termination were enrolled. Women were randomly divided in two groups. The first group received 400 µg sublingual misoprostol and vaginal placebo and the second group received 400 µg vaginal misoprostol and sublingual placebo every 4 hours for a maximum of five doses. The course of misoprostol was rep...

  2. Safety Study of an Antimicrobial Peptide Lactocin 160, Produced by the Vaginal Lactobacillus rhamnosus

    OpenAIRE

    Dover, Sara E.; Aroutcheva, Alla A.; Faro, S; Chikindas, Michael L.

    2007-01-01

    Objective. To evaluate the safety of the antimicrobial peptide, lactocin 160. Methods. Lactocin 160, a product of vaginal probiotic Lactobacillus rhamnosus 160 was evaluated for toxicity and irritation. An in vitro human organotypic vaginal-ectocervical tissue model (EpiVaginal) was employed for the safety testing by determining the exposure time to reduce tissue viability to 50% (ET-50). Hemolytic activity of lactocin160 was tested using 8% of human erythrocyte suspens...

  3. The Relation of Recent Tampon Use, Douching, Coitus, and Vaginal Medications for Reported Cervical Cytology Results

    Science.gov (United States)

    1993-01-01

    or cervical intraepithelial neoplasia (CIN) on the pathology report. Assumptions Tampon use is drying to the vaginal epithelium and has been...SUBTITLE 5, FUNDING NUMBERS The Relation of Recent Tamplon Use, Douching, Coitus, and Vaginal Medications for Reported Cervical Cytology Results. 6. AUTHOR...11¾ .. ?j’ 󈧎 U..- THE RELATION OF RECENT TAMPON USE, DOUCHING, COITUS, AND VAGINAL MEDICATIONS TO REPORTED CERVICAL CYTOLOGY RESULTS By MARYANN

  4. BICORNUATE UTERUS WITH CERVICAL ATRESIA AND VAGINAL AGENESIS ASSOCIATED WITH OVARIAN ENDOMETRIOSIS - A CASE REPORT

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    Alpana

    2013-06-01

    Full Text Available ABSTRACT: Vaginal agenesis combined with a functional uterus is a rare type of Mullerian duct an omaly. Only 7 – 8% of patients with vaginal agenesis have a functional uterus. Women born with vaginal agenesis, cervical atresia combined with a functioning endometrium typically present with hematometra , disabling pelvic pain and progressively worsening en dometriosis. Almost all need an abdominal hysterectomy for relief. We report a case of severe endometriosis in a 29 years old woman having a bicornuate uterus with cervical atresia and vaginal agenesis.

  5. A simple identification method for vaginal secretions using relative quantification of Lactobacillus DNA.

    Science.gov (United States)

    Doi, Masanori; Gamo, Shinsuke; Okiura, Tatsuyuki; Nishimukai, Hiroaki; Asano, Migiwa

    2014-09-01

    In criminal investigations there are some cases in which identifying the presence of vaginal secretions provides crucial evidence in proving sexual assault. However, there are no methods for definitively identifying vaginal secretions. In the present study, we focused on Lactobacillus levels in vaginal secretions and developed a novel identification method for vaginal secretions by relative quantification based on real time PCR. We designed a Lactobacillus conserved region primer pair (LCP) by aligning 16S rRNA gene sequences from major vaginal Lactobacillus species (Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners and Lactobacillus jensenii), and selected the human specific primer pair (HSP) as an endogenous control for relative quantification. As a result, the ΔCt (ΔCt=Ct[LCP]-Ct[HSP]) values of vaginal secretions (11 out of 12 samples) were significantly lower than those of saliva, semen and skin surface samples, and it was possible to discriminate between vaginal secretions and other body fluids. For the one remaining sample, it was confirmed that the predominant species in the microflora was not of the Lactobacillus genus. The ΔCt values in this study were calculated when the total DNA input used from the vaginal secretions was 10pg or more. Additionally, the ΔCt values of samples up to 6-months-old, which were kept at room temperature, remained unchanged. Thus, we concluded in this study that the simple ΔCt method by real time PCR is a useful tool for detecting the presence of vaginal secretions.

  6. Primary vaginal calculus in a middle-aged woman with mental and physical disabilities.

    Science.gov (United States)

    Ikeda, Yuji; Oda, Katsutoshi; Matsuzawa, Naoki; Shimizu, Ken

    2013-07-01

    Vaginal calculi are rarely encountered and are often misdiagnosed as bladder calculi because of the difficulty in achieving an appropriate diagnosis. Most vaginal calculi result from the presence of a urethrovaginal fistula; those occurring in the absence of such fistulas are extremely rare. We present a case of a 42-year-old bedridden woman with mental and physical disabilities who had been misdiagnosed for a decade as having a bladder calculus. We removed the calculus nonsurgically and the analyzed the components. Results demonstrated the presence of a primary vaginal calculus. Vaginal calculi may occasionally occur in disabled women, but further investigation of the etiology of such calculi is required.

  7. Long-term results of vaginal repairs with and without xenograft reinforcement

    DEFF Research Database (Denmark)

    Mouritsen, Lone; Kronschnabl, M.; Lose, G.

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. METHODS: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated by a vali......INTRODUCTION AND HYPOTHESIS: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. METHODS: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated......: Recurrence rates defined by POPQ plus symptoms were low compared to literature. Xenograft reinforcement might improve results....

  8. Electrochemical vaginal potential during the estral cycle and pregnancy in the rat.

    Science.gov (United States)

    Zipper, J; Angelo, S

    1980-01-01

    Potentials were measured with nonpolarizable salt electrodes (agar KCl-AgCl) during the estral cycle and pregnancy of the rat. The vaginal fundus is positive in regard to the external end of the vagina and does not present changes associated with the estral cycle. Vaginal-tongue potentials present biphasic cyclic changes associated with the estral cycle, the vagina being (-) during estro and (+) during diestro. Vaginal-abdominal skin potentials present monophasic modifications associated with the estral cycle. Vaginal-tongue potentials registered during pregnancy were (-) on the first day of pregnancy, (+) throughout pregnancy, and (-) on the first day postpartum.

  9. A biofidelic computational model of the female pelvic system to understand effect of bladder fill and progressive vaginal tissue stiffening due to prolapse on anterior vaginal wall.

    Science.gov (United States)

    Chanda, Arnab; Unnikrishnan, Vinu; Richter, Holly E; Lockhart, Mark E

    2016-11-01

    Treatment of anterior vaginal prolapse (AVP), suffered by over 500,000 women in the USA, is a challenge in urogynecology because of the poorly understood mechanics of AVP. Recently, computational modeling combined with finite element method has been used to model AVP through the study of pelvic floor muscle and connective tissue impairments on the anterior vaginal wall (AVW). Also, the effects of pelvic organ displacements on the AVW were studied numerically. In our current work, an MRI-based full-scale biofidelic computational model of the female pelvic system composed of the urinary bladder, vaginal canal, and the uterus was developed, and a novel finite element method framework was employed to simulate vaginal tissue stiffening and also bladder filling due to expansion for the first time. A mesh convergence study was conducted to choose a computationally efficient mesh, and a non-linear hyperelastic Yeoh's material model was adopted for the study. The AVW displacements, mechanical stresses, and strains were estimated at varying degrees of bladder fills and vaginal tissue stiffening. Both bladder filling and vaginal stiffening were found to increase the stress concentration on the AVW with varying trends, which have been discussed in detail in the paper. To our knowledge, this study is the first to estimate the individual and combined effects of bladder filling and vaginal tissue stiffening due to prolapse on the AVW. Copyright © 2016 John Wiley & Sons, Ltd.

  10. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid.

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    Bernard J Moncla

    Full Text Available In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed. The activities of four of six glycosidases in the samples from women with bacterial vaginosis were significantly increased when compared to normal or intermediate women: sialidase, P = <0.001; α-galactosidase, P = 0.006; β-galactosidase, P = 0.005; α-glucosidase, P = 0.056. Sialic acid binding sites as measured by two lectins, Maackia amurensis and Sambucus nigra binding, were significantly lower in women with BV compared to women with normal and intermediate scores (P = <0.0001 and 0.008 respectively. High mannose binding sites, a measure of innate immunity were also significantly lower in women with BV (P = <0.001. Additionally, we observed significant increases in MUC1, MUC4, MUC5AC, and MUC7 concentrations in women with BV (P = <0.001, 0.001, <0.001, 0.02 respectively. Among normal women we found that the membrane bound mucin MUC4 and the secreted MUC5AC were decreased in postmenopausal women (P = 0.02 and 0.07 respectively, while MUC7 (secreted was decreased in women using levonorgestrel-containing IUDs (P = 0.02. The number of sialic acid binding sites was lower in the postmenopausal group (P = 0.04, but the number of high mannose binding sites, measured with Griffithsin, was not significantly different among the 6 hormonal groups. The glycosidase levels in the cervical-vaginal mucus were rather low in the groups, with exception of

  11. Comparison of the Hyaluronic Acid Vaginal Cream and Conjugated Estrogen Used in Treatment of Vaginal Atrophy of Menopause Women: A Randomized Controlled Clinical Trial

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    Azam Jokar

    2016-01-01

    Full Text Available Background: Vaginal atrophy is a common complication in menopause which does not improve with time and, if untreated, can affect the quality of life for women. The aim of this study was to compare the effectiveness of the vaginal cream of hyaluronic acid and conjugated estrogen (Premarin in treatment of vaginal atrophy. Methods: This study was a randomized controlled clinical trial on 56 menopausal women with symptoms of vaginal atrophy; they were randomly allocated to two groups (recipient conjugated estrogen and hyaluronic acid. The severity of each sign of atrophy was evaluated by visual analog signals (VAS and on the basis of a four point scale. Also to recognize the cellular maturation with pap smear and the maturation degree were calculated according to the formula and scores 0-100. As to the vaginal PH, we used PH marker band, the rate of which was divided into 4 degrees. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of this study showed that the symptoms of vaginal atrophy compared with the baseline level were relieved significantly in both groups. Dryness, itching, maturation index, PH and composite score of the vaginal symptoms were relieved significantly in both groups (P<0.001. Dyspareunia in Premarin (P<0.05 and hyaluronic acid (P<0.001 decreased compared with pre-treatment. Urinary incontinence only showed improvement in the hyaluronic acid group (P<0.05. Improvement in urinary incontinence, dryness, maturation index (P<0.05 and composite score of vaginal symptoms (P<0.001 in the hyaluronic acid group was better than those in the Premarin group. Conclusion: According to the results of the present study, hyaluronic acid and conjugated estrogen improved the symptoms of vaginal atrophy. But hyaluronic acid was more effective and this drug is suggested for those who do not want to or cannot take local hormone treatment.

  12. Outcome of Treatment of Anterior Vaginal Wall Prolapse and Stress Urinary Incontinence with Transobturator Tension-Free Vaginal Mesh (Prolift and Concomitant Tension-Free Vaginal Tape-Obturator

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    Sameh Azazy

    2008-12-01

    Full Text Available Objective. It is to assess the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O system as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI. Patients and Methods. Between December 2006 and July 2007, 20 patients with anterior genital prolapse and voiding dysfunction were treated with the transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O. Sixteen patients had stress urinary incontinence and 4 patients were considered at risk for development of de novo stress incontinence after the prolapse is repaired. All patients underwent a complete urodynamic assessment. All the patients underwent pelvic examination 4–6 weeks after the operation, and anatomical and functional outcomes were recorded. Results. Twenty cystocoeles were repaired: 6 grade II, 12 grade III, and 2 grade IV. There were no vessel or bladder injuries. Eighteen patients had optimal anatomic results and 2 patients had persistent asymptomatic stage I prolapse. Conclusion. These preliminary results suggest that Prolift system offers a safe and effective treatment for female anterior vaginal wall prolapse. However, a long-term followup is necessary in order to support the good result maintenance.

  13. Quality of Life after Cesarean and Vaginal Delivery

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    Seyed Abbas Mousavi

    2013-07-01

    Full Text Available Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery.Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum.Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65 ± 12.7 and 72.12 ± 11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05. In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350] and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023] domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]. While multiparas, there was no relationship between QOL and type of delivery.Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery.

  14. Estradiol-progesterone interaction during the preparation of vaginal rings.

    Science.gov (United States)

    Saleh, Saleh I; Khidr, Sayed H; Ahmed, Sayed M; Jackanicz, Theodore M; Nash, Harold A

    2003-02-01

    An unexpected enhanced release, in vitro, of estradiol (E2) was observed on the preparation of vaginal rings containing E2 and progesterone (P) in a silicone elastomer. The present work deals with exploring the reason(s) behind this enhanced E2 release. The effect of the ring design (i.e., putting P and E2 in the same compartment or in adjacent or separate compartments) was studied. The effects of the curing temperature as well as the curing time were also investigated. The possible interaction(s) between P and E2 on simple heating of their mixtures was investigated using infrared (IR), differential scanning calorimetry (DSC), and nuclear magnetic resonance (NMR) techniques. Also, the dissolution behavior of P, E2, and their mixture before and after heating was studied. The ring design, with respect to the position of the steroid layer(s), affected the release of P and E2 from the vaginal rings. Curing the rings at higher temperatures (>/=140 degrees C) for >/=30 min resulted in an enhanced release of the steroids, especially E2. The IR, DSC, phase diagram, and NMR results indicate that an interaction between P and E2, leading to the formation of a molecular complex, took place. It was concluded that putting P and E2 in the same compartment and curing by heating at a high temperature and for an extended time promoted this kind of interaction. The greater hydrophobicity of the interaction product, relative to that of E2, was considered the main reason behind the enhanced in vitro release of E2 from the vaginal rings.

  15. Prevention of vaginal SHIV transmission in macaques by a coitally-dependent Truvada regimen.

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    Jessica Radzio

    Full Text Available BACKGROUND: Daily pre-exposure prophylaxis (PrEP with Truvada (a combination of emtricitabine (FTC and tenofovir (TFV disoproxil fumarate (TDF is a novel HIV prevention strategy recently found to prevent HIV transmission in men who have sex with men and heterosexual couples. We previously showed that a coitally-dependent Truvada regimen protected macaques against rectal SHIV transmission. Here we examined FTC and tenofovir TFV exposure in vaginal tissues after oral dosing and assessed if peri-coital Truvada also protects macaques against vaginal SHIV infection. METHODS: The pharmacokinetic profile of emtricitabine (FTC and tenofovir (TFV was evaluated at first dose. FTC and TFV levels were measured in blood plasma, rectal, and vaginal secretions. Intracellular concentrations of FTC-triphosphate (FTC-TP and TFV-diphosphate (TFV-DP were measured in PBMCs, rectal tissues, and vaginal tissues. Efficacy of Truvada in preventing vaginal SHIV infection was assessed using a repeat-exposure vaginal SHIV transmission model consisting of weekly exposures to low doses of SHIV162p3. Six pigtail macaques with normal menstrual cycles received Truvada 24 h before and 2 h after each weekly virus exposure and six received placebo. Infection was monitored by serology and PCR amplification of SHIV RNA and DNA. RESULTS: As in humans, the concentration of FTC was higher than the concentration of TFV in vaginal secretions. Also as in humans, TFV levels in vaginal secretions were lower than in rectal secretions. Intracellular TFV-DP concentrations were also lower in vaginal tissues than in rectal tissues. Despite the low vaginal TFV exposure, all six treated macaques were protected from infection after 18 exposures or 4 full menstrual cycles. In contrast, all 6 control animals were infected. CONCLUSIONS: We modeled a peri-coital regimen with two doses of Truvada and showed that it fully protected macaques from repeated SHIV exposures. Our results open the possibility

  16. Characterization of vaginal lactobacilli in women after kidney transplantation.

    Science.gov (United States)

    Martirosian, G; Radosz-Komoniewska, H; Pietrzak, B; Ekiel, A; Kamiński, P; Aptekorz, M; Doleżych, H; Samulska, E; Jóźwiak, J

    2012-04-01

    Limited number of publications described vaginal microflora after kidney transplantation. Our PubMed search revealed only 18 publications including words "vaginal bacteria & kidney transplant" in the period of 1978-2011. The aim of this study was to characterize lactobacilli isolated from vaginal swabs of women after kidney transplantation, compared with healthy women. Eighteen renal transplant recipients (mean age 36.1) and 20 healthy women (mean age 36.0) were evaluated. Lactobacilli were cultured on MRS and Columbia blood agars. Biochemical identification with API 50 CHL (bioMerieux, Marcy L'Etoile, France) and multiplex PCR according to Song et al. was performed. Lactobacilli were tested for production of H(2)O(2). Minimal inhibitory concentrations (MICs) of selected antimicrobial agents were determined with E-tests (bioMerieux, Marcy L'Etoile, France) and interpreted with CLSI and EUCAST criteria. No bacterial vaginosis was found among studied women. Two strains of group I were identified as Lactobacillus delbrueckii; 18 strains as Lactobacillus gasseri and 15 strains as Lactobacillus crispatus. Only 3 strains from group II were not identified by species-specific mPCR. Group IV was represented with 2 unidentified strains. Vaginal lactobacilli isolated from healthy women represented more homogenous group compared with heterogenous renal transplant recipients. Biochemical identification of lactobacilli by API 50 CHL kits was concordant with mPCR results only in 7 cases (17.5%), all 7 strains were identified as L. crispatus. Majority (93%) of lactobacilli were H(2)O(2) producers. All isolated lactobacilli (100%) demonstrated high resistance to metronidazole (MIC > 256 μg/ml). Only 2 strains resistant to vancomycin (MICs: 32 and 256 μg/ml respectively), in the study and control group, and one to moxifloxacin (MIC = 32 μg/ml), were found. Resistance to metronidazole and vancomycin was concordant in CLSI and EUCAST (2010) criteria. Although significant

  17. Recommendations for the management of postmenopausal vaginal atrophy

    DEFF Research Database (Denmark)

    Sturdee, D W; Panay, N; Ulrich, Lian

    2010-01-01

    for hormone replacement therapy (HRT) over recent years that has suggested an increased risk of breast cancer, heart disease and stroke. But, regardless of whether these scares are justified, local treatment of vaginal atrophy is not associated with these possible risks of systemic HRT. Other reasons...... dryness can be helped by simple lubricants but the best and most logical treatment for urogenital atrophy is to use local estrogen. This is safe, effective and with few contraindications. It is hoped that these guidelines and recommendations, produced to coincide with World Menopause Day 2010, will help...

  18. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  19. Evaluation of immune system function in neonatal pigs born vaginally or by Cesarean section

    Science.gov (United States)

    Eight full term crossbred sows were selected for study of the interaction of the immune system, hypothalamus-pituitary-adrenal axis, and growth in pigs born by Cesarean section (C-section) or vaginal-birth (n=4 each for vaginal-birth and C-section). Gestation length and birth weight did not differ b...

  20. Risk factors for cesarean section and instrumental vaginal delivery after successful external cephalic version.

    Science.gov (United States)

    de Hundt, Marcella; Vlemmix, Floortje; Bais, Joke M J; de Groot, Christianne J; Mol, Ben Willem; Kok, Marjolein

    2016-01-01

    Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful external cephalic version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the Netherlands. With the data of this trial, we performed a cohort study among women attempting vaginal delivery after successful ECV. We evaluated whether maternal age, gestational age, parity, time interval between ECV and delivery, birth weight, neonatal gender, and induction of labor were predictive for a vaginal delivery on one hand or a CS or instrumental vaginal delivery on the other hand. Unadjusted and adjusted odds ratios were calculated with univariate and multivariate logistic regression analysis. Among 301 women who attempted vaginal delivery after a successful external cephalic version attempt, the cesarean section rate was 13% and the instrumental vaginal delivery rate 6%, resulting in a combined instrumental delivery rate of 19%. Nulliparity increased the risk of cesarean section (OR 2.7 (95% CI 1.2-6.1)) and instrumental delivery (OR 4.2 (95% CI 2.1-8.6)). Maternal age, gestational age at delivery, time interval between external cephalic version and delivery, birth weight and neonatal gender did not contribute to the prediction of failed spontaneous vaginal delivery. In our cohort of 301 women with a successful external cephalic version, nulliparity was the only one of seven factors that predicted the risk for cesarean section and instrumental vaginal delivery.

  1. Using vaginal cytology to assess the estrogenic activity of phytoestrogen-rich herb.

    Science.gov (United States)

    Malaivijitnond, Suchinda; Chansri, Kullakanya; Kijkuokul, Pisamai; Urasopon, Nontakorn; Cherdshewasart, Wichai

    2006-10-11

    To assess the estrogenic activities of synthetic estrogen, synthetic phytoestrogen, Pueraria lobata and three distinct cultivars of Pueraria mirifica, a phytoestrogen-rich herb, a vaginal cytology assay in ovariectomized rats were used. Rats were ovariectomized and treated with DW, estradiol valerate (1 mg/kg BW), genistein (0.25-2.5 mg/kg BW), Pueraria lobata and Pueraria mirifica (10-1,000 mg/kg BW) for 14 days. The vaginal cytology was checked daily and the uteri were dissected and weighed at the end of treatment or post-treatment periods. The treatments of DW, genistein and Pueraria lobata did not influence the vaginal epithelium, but the injection of estradiol valerate induced a vaginal cornification from day-3 of treatment to day-14 of post-treatment period. The occurrence of vaginal cornification after treatment and the recovery after the cessation was dependent on dosages and cultivars of Pueraria mirifica. The increments of uterus weight in all rats agreed with the cornification of vaginal epithelium. Although both uterotropic and vaginal cytology assays can be used to assess the estrogenic activity of phytoestrogen-rich herb, however, using vaginal cytology assay has two advantages: (1) we do not need to kill the animals and (2) we can follow up the recovery after the cessation of treatment.

  2. Changes in vaginal breech delivery rates in a single large metropolitan area.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-06-01

    Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

  3. Pilot study of vaginal plethysmography in women treated with radiotherapy for gynecological cancer

    NARCIS (Netherlands)

    Pras, E; Wouda, J; Willemse, PHB; Midden, ME; Zwart, M; de Vries, EGE; Schultz, WCMW

    2003-01-01

    Objectives. After pelvic radiotherapy for gynecological cancer, changes in the vaginal epithelium might influence sexual arousal and satisfaction, leading to dyspareunia and relational problems. The aim of the study was to determine the feasibility of vaginal plethysmography in order to measure phys

  4. Detection of virulence factors of Uropathoigenic Escherichia coli isolates from infertile women high vaginal swabs

    Directory of Open Access Journals (Sweden)

    Farhad Safarpourdehkourdi

    2014-03-01

    Conclusion: The high vaginal Escherichia coli harbored certain virulence genes of uropathogenic Escherichia coli strains. The urinary tract infections should be treated well to diminish its upstream transfer into vagina. Some more investigation should be perform for identifying the epidemiological aspects of uropathogenic Escherichia coli in high vaginal part of infertile women.

  5. Trocar-guided mesh compared with conventional vaginal repair in recurrent prolapse: a randomized controlled trial

    NARCIS (Netherlands)

    Withagen, M.I.J.; Milani, A.L.; Boon, J. den; Vervest, H.A.; Vierhout, M.E.

    2011-01-01

    OBJECTIVE: To compare efficacy and safety of trocar-guided tension-free vaginal mesh insertion with conventional vaginal prolapse repair in patients with recurrent pelvic organ prolapse. METHODS: Patients with recurrent pelvic organ prolapse stage II or higher were randomly assigned to either conven

  6. Vaginal symptoms of unknown etiology - a study in dutch general-practice

    NARCIS (Netherlands)

    Dekker, Janny H.; Boeke, A. Joan P.; Janssens, J; van Eijk, J.Th.M.

    1993-01-01

    Vaginal symptoms are frequently presented by women to general practitioners. In many cases, the aetiology of these symptoms remains unknown. This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors

  7. Comparative study of vaginal hysterectomy and abdominal hysterectomy for enlarged uterus

    Directory of Open Access Journals (Sweden)

    Chandrika S.

    2016-09-01

    Conclusions: Bulk reducing techniques were used to remove the moderately enlarged uterus through vaginal route. Vaginal hysterectomy is invasive route, safe and feasible in cases with enlarged uteri up to 14 weeks due to benign causes. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3116-3120

  8. Lactobacilli require physical contact to reduce staphylococcal TSST-1 secretion and vaginal epithelial inflammatory response

    NARCIS (Netherlands)

    Younes, Jessica A.; Reid, Gregor; van der Mei, Henny C.; Busscher, Henk J.

    2016-01-01

    Staphylococcus aureus biofilms can be found on vaginal epithelia, secreting toxins and causing inflammation. The co-vaginal species Lactobacillus can alter staphylococcal-induced epithelial secretion of inflammatory cytokines and quench staphylococcal toxic shock syndrome toxin-1 secretion. It is hy

  9. Commensal bacteria modulate innate immune responses of vaginal epithelial cell multilayer cultures.

    Science.gov (United States)

    Rose, William A; McGowin, Chris L; Spagnuolo, Rae Ann; Eaves-Pyles, Tonyia D; Popov, Vsevolod L; Pyles, Richard B

    2012-01-01

    The human vaginal microbiome plays a critical but poorly defined role in reproductive health. Vaginal microbiome alterations are associated with increased susceptibility to sexually-transmitted infections (STI) possibly due to related changes in innate defense responses from epithelial cells. Study of the impact of commensal bacteria on the vaginal mucosal surface has been hindered by current vaginal epithelial cell (VEC) culture systems that lack an appropriate interface between the apical surface of stratified squamous epithelium and the air-filled vaginal lumen. Therefore we developed a reproducible multilayer VEC culture system with an apical (luminal) air-interface that supported colonization with selected commensal bacteria. Multilayer VEC developed tight-junctions and other hallmarks of the vaginal mucosa including predictable proinflammatory cytokine secretion following TLR stimulation. Colonization of multilayers by common vaginal commensals including Lactobacillus crispatus, L. jensenii, and L. rhamnosus led to intimate associations with the VEC exclusively on the apical surface. Vaginal commensals did not trigger cytokine secretion but Staphylococcus epidermidis, a skin commensal, was inflammatory. Lactobacilli reduced cytokine secretion in an isolate-specific fashion following TLR stimulation. This tempering of inflammation offers a potential explanation for increased susceptibility to STI in the absence of common commensals and has implications for testing of potential STI preventatives.

  10. Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; vaginal versus other sites.

    Science.gov (United States)

    Moschiano, Elizabeth J; Barbuto, Denise A; Walsh, Christine; Singh, Kanwaljit; Euscher, Elizabeth D; Roma, Andres A; Ali-Fehmi, Rouba; Frauenhoffer, Elizabeth E; Montiel, Delia P; Kim, Insun; Djordjevic, Bojana; Malpica, Anais; Hong, Sung Ran; Silva, Elvio G

    2014-05-01

    Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

  11. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J.M. Macklaim (Jean); J.E. Bisanz (Jordan); J.-A. Hammond; A. McMillan (Amy); R. Vongsa (Rebecca); D. Koenig (David); G.B. Gloor (Gregory); G. Reid (Gregor)

    2011-01-01

    textabstractAfter menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an imp

  12. Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth and obstetric techniques

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren; Djurhuus, Jens Christian

    1999-01-01

    showed increases in relation to urinary incontinence during pregnancy, urinary incontinence immediately after a vaginal childbirth, and age of 30 years or more at the second vaginal childbirth. No multivariate associations were found for forceps delivery or vacuum extraction delivery, episiotomy...

  13. 75 FR 3745 - NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice

    Science.gov (United States)

    2010-01-22

    ... HUMAN SERVICES National Institutes of Health NIH Consensus Development Conference on Vaginal Birth After... ``NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights'' to be held March... baby through an incision made in the abdominal wall and uterus), many clinicians believed that all...

  14. Moyamoya disease and pregnancy: case reports and criteria for successful vaginal delivery

    OpenAIRE

    2015-01-01

    Key Clinical Message Based on our experience with seven deliveries (five cesarean and two vaginal deliveries) in five women with Moyamoya disease, we discussed the appropriate method of delivery and anesthesia for patients with Moyamoya disease. In certain conditions, women with Moyamoya disease can successfully undergo vaginal delivery.

  15. Prolapso de tuba uterina após histerectomia vaginal: relato de caso Fallopian tube prolapse after vaginal hysterectomy: a case report

    Directory of Open Access Journals (Sweden)

    Maurício B. Noviello

    2003-12-01

    Full Text Available O prolapso de tuba uterina é complicação rara após histerectomia, com aproximadamente 80 casos descritos na literatura. A sintomatologia é inespecífica, podendo incluir sangramento genital, dispareunia e dor pélvica crônica. O diagnóstico diferencial deve ser feito com granuloma de cúpula vaginal e carcinoma de vagina. O tratamento deve ser individualizado, podendo ser realizado por via vaginal, abdominal ou laparoscópica. Relatamos o caso de uma paciente, 47 anos, com miomatose uterina, submetida a histerectomia vaginal, evoluindo com prolapso de tuba uterina após 11 meses de pós-operatório. O exame especular evidenciava lesão vegetante, friável e sangrante localizada na cúpula vaginal. Esses achados clínicos sugeriam o diagnóstico de prolapso de tuba uterina. A paciente foi submetida a nova intervenção cirúrgica, com ressecção da tuba uterina por via vaginal. O exame natomopatológico confirmou o diagnóstico e a paciente evoluiu com remissão completa da sintomatologia.Fallopian tube prolapse is a rare complication after hysterectomy, with approximately 80 cases described in the literature. The symptoms are nonspecific including vaginal bleeding, dyspareunia and chronic pelvic pain. The differential diagnosis must be done with granulation tissue of the vaginal cuff and vaginal carcinoma. The treatment should be individualized, and is possible to be done by vaginal, abdominal or laparoscopic approach. We report a case of a 47-year-old woman with myoma who was submitted to a vaginal hysterectomy and evolved with fallopian tube prolapse 11 months after surgery. Specular examination showed a fungating, friable and bleeding lesion at the vaginal cuff. The clinical findings suggested the diagnosis of fallopian tube prolapse. The patient was submitted to a new surgical intervention with resection of the left fallopian tube. The histologic examination confirmed the diagnosis and the patient evolved with complete remission of

  16. The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Kiarie, James; Seuc, Armando; Mogasale, Vittal; Latif, Ahmed; Broutet, Nathalie

    2016-01-01

    Background This review aimed to synthesize and analyze the diagnostic accuracy and the likelihood of providing correct treatment of the syndromic approach Vaginal Discharge Flowchart in managing cervical infections caused by Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), and vaginal infections caused by Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) and Candida albicans. This review will inform updating the WHO 2003 guidelines on Vaginal Discharge syndromic case management. Methods A systematic review was conducted on published studies from 01-01-2000 to 30-03-2015 in multiple databases. Studies evaluating the diagnostic accuracy and validation of the WHO Vaginal Discharge Flowchart were included. Validation parameters including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and the 95% confidence intervals for the different types of the flowchart were taken as outcomes, re-calculated, and analysed using a fixed model meta-analysis for data pooling. The level of agreement between the index and reference test were determined by the Cohen’s Kappa co-efficiency test. Each individual study was assessed on quality using the QUADAS-2 tool. Findings The search yielded 2,845 studies of which 16 met the eligibility criteria for final analysis. The diagnostic performance to identify cervical infections was low and resulted in a high proportion of over and missed treatment. The four flowcharts had a sensitivity between 27.37% in history and risk assessment and 90.13% with microscopy, with the inverse in specificity rates. The treatment performances between the flowcharts were inconsistent. The same applies to the use of vaginal discharge flowchart for treating vaginal infections. For vaginal infections the vaginal discharge flowchart had a good performance in flowchart 3 with 91.68% of sensitivity; 99.97% specificity; 99.93% PPV and 0.02% who missed their treatment and 8.32% of women who were over treated

  17. Raised Vaginal Fluid Fibronectin Level Indicates Premature Rupture of Membrane

    Directory of Open Access Journals (Sweden)

    Amrita Bhowmik

    2012-07-01

    Full Text Available Background: Premature rupture of membrane (PROM is one of the common complications of pregnancy that has major impact on fetal and neonatal outcome. It is the commonest clinical event where a normal pregnancy becomes suddenly a high-risk one for mother and fetus or neonate. Objective: The study was undertaken to investigate whether raised fibronectin level in vaginal fluid may indicate premature rupture of membrane. Materials and Methods: This cross sectional study was conducted in the department of Obstetrics and Gynecology in Sir Salimullah Medical College & Mitford Hospital, Dhaka during the period of January 2006 to December 2007. A total of 114 pregnant women with gestational age 28th week up to 40th week were included. Sixty were PROM (Group I and 54 were non-PROM (Group II subjects. Fibronectin in vaginal fluid was measured by an immunochemical reaction by nephelometer. Statistical analysis was done by SPSS version 10.0. Results: The PROM patients had significantly higher concentration of fibronectin (225.77 ± 115.18 ng/mL compared to that in non-PROM subjects (8.04 ± 16.17 ng/mL (p < 0.001. Conclusion: It can be concluded that in cases of unequivocal rupture or intactness of the membranes, the result of the fibronectin test corresponds well with the clinical situation. So fibronectin is a sensitive test for detection of amniotic fluid in the vagina.

  18. Release of Tenofovir from Carrageenan-Based Vaginal Suppositories

    Directory of Open Access Journals (Sweden)

    Toral Zaveri

    2014-07-01

    Full Text Available Microbicides are an active area of research for HIV prevention, being developed as a woman-initiated method of prevention during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have produced microbicide prototypes in the form of semisoft vaginal suppositories prepared from carrageenan and conducted both qualitative and quantitative studies using these prototypes to determine the physical properties that drive acceptability and possibly adherence. In order to ensure that the suppositories function as effective drug delivery vehicles, we have conducted in vitro dissolution studies in water, vaginal simulant fluid (VSF and semen simulant fluid (SSF with suppositories loaded with the antiretroviral drug, tenofovir (TFV. TFV was released via diffusion and matrix erosion in water or by diffusion out of the matrix in VSF and SSF. Diffusion studies were conducted in two different volumes of VSF and SSF. The volume of VSF/SSF into which TFV diffused and the size of the suppositories determined the rate of diffusion from the suppositories. About 45%–50% of the encapsulated TFV diffused out of the suppositories within the first two hours, irrespective of suppository size, diffusion medium (VSF/SSF and the volume of medium. Prior work indicates that a short waiting period between insertion and coitus is highly desired by women; present data suggest our microbicide prototypes have rapid initial release followed by a slow release curve over the first 24 h.

  19. Chitosan in Mucoadhesive Drug Delivery: Focus on Local Vaginal Therapy

    Directory of Open Access Journals (Sweden)

    Toril Andersen

    2015-01-01

    Full Text Available Mucoadhesive drug therapy destined for localized drug treatment is gaining increasing importance in today’s drug development. Chitosan, due to its known biodegradability, bioadhesiveness and excellent safety profile offers means to improve mucosal drug therapy. We have used chitosan as mucoadhesive polymer to develop liposomes able to ensure prolonged residence time at vaginal site. Two types of mucoadhesive liposomes, namely the chitosan-coated liposomes and chitosan-containing liposomes, where chitosan is both embedded and surface-available, were made of soy phosphatidylcholine with entrapped fluorescence markers of two molecular weights, FITC-dextran 4000 and 20,000, respectively. Both liposomal types were characterized for their size distribution, zeta potential, entrapment efficiency and the in vitro release profile, and compared to plain liposomes. The proof of chitosan being both surface-available as well as embedded into the liposomes in the chitosan-containing liposomes was found. The capability of the surface-available chitosan to interact with the model porcine mucin was confirmed for both chitosan-containing and chitosan-coated liposomes implying potential mucoadhesive behavior. Chitosan-containing liposomes were shown to be superior in respect to the simplicity of preparation, FITC-dextran load, mucoadhesiveness and in vitro release and are expected to ensure prolonged residence time on the vaginal mucosa providing localized sustained release of entrapped model substances.

  20. An emerging mycoplasma associated with trichomoniasis, vaginal infection and disease.

    Directory of Open Access Journals (Sweden)

    Jennifer M Fettweis

    Full Text Available Humans are colonized by thousands of bacterial species, but it is difficult to assess the metabolic and pathogenic potential of the majority of these because they have yet to be cultured. Here, we characterize an uncultivated vaginal mycoplasma tightly associated with trichomoniasis that was previously known by its 16S rRNA sequence as "Mnola." In this study, the mycoplasma was found almost exclusively in women infected with the sexually transmitted pathogen Trichomonas vaginalis, but rarely observed in women with no diagnosed disease. The genomes of four strains of this species were reconstructed using metagenome sequencing and assembly of DNA from four discrete mid-vaginal samples, one of which was obtained from a pregnant woman with trichomoniasis who delivered prematurely. These bacteria harbor several putative virulence factors and display unique metabolic strategies. Genes encoding proteins with high similarity to potential virulence factors include two collagenases, a hemolysin, an O-sialoglycoprotein endopeptidase and a feoB-type ferrous iron transport system. We propose the name "Candidatus Mycoplasma girerdii" for this potential new pathogen.

  1. Perineal trauma after vaginal delivery in healthy pregnant women

    Directory of Open Access Journals (Sweden)

    Larissa Santos Oliveira

    Full Text Available CONTEXT AND OBJECTIVE:Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS in healthy pregnant women after vaginal delivery.DESIGN AND SETTING:Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.METHODS:A standardized questionnaire was prepared and applied to medical files that had been completely filled out (classification of the Royal College of Obstetricians and Gynecologists, RCOG in order to identify OASIS and analyze risk factors associated with mild and severe perineal lacerations.RESULTS:The women's mean age was 25 years; more than half (54.4% were primiparae. Almost 38% of the participants had perineal lacerations; these were severe in 0.9% of the cases. Previous vaginal delivery (odds ratio, OR: 1.64 [1.33-2.04] and forceps delivery (OR: 2.04 [1.39-2.97] were risk factors associated with mild perineal injuries (1st and 2nd OASIS classifications. Only remaining standing for prolonged periods during professional activity (OR: 2.85 [1.34-6.09] was associated with severe perineal injuries.CONCLUSION:The prevalence of severe perineal injuries was concordant with data in the literature. The variable of standing position was considered to be a risk factor for severe perineal injury and should be further investigated.

  2. Imiquimod in cervical, vaginal and vulvar intraepithelial neoplasia: a review.

    Science.gov (United States)

    de Witte, C J; van de Sande, A J M; van Beekhuizen, H J; Koeneman, M M; Kruse, A J; Gerestein, C G

    2015-11-01

    Human papillomavirus (HPV) infection is in the vast majority of patients accountable for the development of vulvar, cervical and vaginal intraepithelial neoplasia (VIN, CIN, VAIN); precursors of vulvar, cervical and vaginal cancers. The currently preferred treatment modality for high grade VIN, CIN and VAIN is surgical excision. Nevertheless surgical treatment is associated with adverse pregnancy outcomes and recurrence is not uncommon. The aim of this review is to present evidence on the efficacy, safety and tolerability of imiquimod (an immune response modifier) in HPV-related VIN, CIN and VAIN. A search for papers on the use of imiquimod in VIN, CIN and VAIN was performed in the MEDLINE, EMBASE and Cochrane library databases. Data was extracted and reviewed. Twenty-one articles met the inclusion criteria and were analyzed; 16 on VIN, 3 on CIN and 2 on VAIN. Complete response rates in VIN ranged from 5 to 88%. Although minor adverse effects were frequently reported, treatment with imiquimod was well tolerated in most patients. Studies on imiquimod treatment of CIN and VAIN are limited and lack uniformly defined endpoints. The available evidence however, shows encouraging effect. Complete response rates for CIN 2-3 and VAIN 1-3 ranged from 67 to 75% and 57 to 86% respectively. More randomized controlled trials on the use of imiquimod in CIN, VAIN and VIN with extended follow-up are necessary to determine the attributive therapeutic value in these patients.

  3. Foley Catheter versus Vaginal Misoprostol for Labour Induction

    Directory of Open Access Journals (Sweden)

    Nasreen Noor

    2015-01-01

    Full Text Available Objectives. To compare the efficacy and safety of intravaginal misoprostol with transcervical Foley catheter for labour induction. Material and Methods. One hundred and four women with term gestation, with Bishop score < 4, and with various indications for labour induction were randomly divided into two groups. In Group I, 25 μg of misoprostol tablet was placed intravaginally, 4 hourly up to maximum 6 doses. In Group II, Foley catheter 16F was placed through the internal os of the cervix under aseptic condition and then inflated with 50 cc of sterile saline. Statistical analysis was done using SPSS software. Results. The induction to delivery interval was 14.03 ± 7.61 hours versus 18.40 ± 8.02 hours (p<0.01. The rate of vaginal delivery was 76.7% versus 56.8% in misoprostol and transcervical Foley catheter group, respectively. Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups. Conclusion. Intravaginal misoprostol is associated with a shorter induction to delivery interval as compared to Foley’s catheter and it increases the rate of vaginal delivery in cases of unripe cervix at term. Transcervical Foley catheter is associated with a lower incidence of uterine hyperstimulation during labour.

  4. Expression of Candida Albicans Secreted Aspartyl Proteinase in Acute Vaginal Candidiasis

    Institute of Scientific and Technical Information of China (English)

    LIN Nengxing; FENG Jing; TU Yating; FENG Aiping

    2007-01-01

    In order to analyze the in vivo expression of Candida albicans secreted aspartyl proteinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was collected by vaginal swab, and the expression of SAP1-SAP6 was detected by reverse-transcriptase polymerase chain reaction using specific primer sets. It was found that Sap2 and Sap5 were the most common genes expressed during infection; Sap3 and Sap4 were detected in all subjects and all 6 SAP genes were simultaneously expressed in some patients with vaginal candidiasis. It was suggested that the SAP family is expressed by Candida albicans during infection in human and that Candida albicans infection is associated with the differential expression of individual SAP genes which may be involved in the pathogenesis of vaginal candidiasis.

  5. Perceptions of dyspareunia in postmenopausal women with vulvar and vaginal atrophy: findings from the REVIVE survey.

    Science.gov (United States)

    Freedman, Murray A

    2014-07-01

    Symptoms of vulvar and vaginal atrophy (VVA), including dyspareunia and vaginal dryness, have a distinct negative impact on a woman's quality of life. The REVIVE survey highlighted the lack of awareness of VVA symptoms among postmenopausal women with vaginal symptoms, with many women reluctant to initiate discussions with their healthcare professionals despite the presence of vaginal symptoms. The REVIVE survey also provided insights into women's views of VVA treatments. Women reported displeasure with the vaginal administration route, lack of symptom relief with over-the-counter products, and concerns about the safety of estrogen therapies. With the high prevalence of VVA, obstetricians/gynecologists should become vigilant in identifying women with VVA by implementing screening and discussion of symptoms during routine office visits - providing patients with information about appropriate therapies based on the severity and impact of symptoms, keeping in mind individual preferences and perceptions.

  6. High-intensity focused ultrasound treatment of abnormal vaginal bleeding secondary to uterine myoma.

    Science.gov (United States)

    Lim, Jung Hyun; Chung, Dong Jin; Lim, Young Tec; Cho, Sae Hyun; Lee, Jae Mun; Hahn, Seong-Tae

    2011-03-01

    We describe the use of high-intensity focused ultrasound for acute vaginal bleeding secondary to uterine myoma in 2 young female patients. Both patients had episodes of abnormal vaginal bleeding with severe dysmenorrhea that was not efficiently controlled by medical treatment. After high-intensity focused ultrasound ablation, both vaginal bleeding control and symptom relief were achieved without postinterventional complications. The patients remained free of symptoms during 2 months of follow-up and regained normal menstruation after high-intensity focused ultrasound therapy. High-intensity focused ultrasound treatment is one of the least invasive options for dysfunctional vaginal bleeding and may be an effective and safe alternative to other procedures in women of reproductive age with abnormal vaginal bleeding secondary to uterine myoma.

  7. FG90 chitosan as a new polymer for metronidazole mucoadhesive tablets for vaginal administration.

    Science.gov (United States)

    Perioli, Luana; Ambrogi, Valeria; Pagano, Cinzia; Scuota, Stefania; Rossi, Carlo

    2009-07-30

    Topical administration of the antibacterial metronidazole (MET) represents the most common therapy in the treatment of bacterial vaginosis (BV). The formulations generally available for BV therapy are creams, gels, vaginal lavages and vaginal suppositories. In this study, a new dosage form, containing MET, was developed with the aim to realize vaginal mucoadhesive tablets by including bioadhesive polymers as chitosan (FG90C), polyvinylpyrrolidone (PVPK90) and polycarbophil (PCPAA1), blended in different ratios. All formulations were characterized by studies of DSC, friability, hardness, hydration, mucoadhesion, in vitro release and antibacterial activity. All polymer mixtures employed were used to prepare tablets with the compactness and hardness so as allow the application on vaginal mucosa. FG90C performances improved in particular when mixed to PVPK90 (1:1 ratio). This kind of delivery system is suitable for formulating MET for topical application representing a good alternative to traditional dosage forms for vaginal topical administration.

  8. Misoprostol vaginal insert for induction of labor: a delivery system with accurate dosing and rapid discontinuation.

    Science.gov (United States)

    Stephenson, Megan L; Hawkins, J Seth; Powers, Barbara L; Wing, Deborah A

    2014-01-01

    Labor induction and cervical ripening are widely utilized and new methods are constantly being investigated. Prostaglandins have been shown to be effective labor induction agents and, in particular, were compared with other prostaglandin preparations; vaginal misoprostol used off-label was associated with reduced failure to achieve vaginal delivery. The challenge is to provide this medication with the correct dosing for this indication and with the ability to discontinue the medication if needed, all while ensuring essential maternal and neonatal safety. The misoprostol vaginal insert initiates cervical ripening using a delivery system that controls misoprostol release and can be rapidly removed. This article reviews the development, safety and efficacy of the misoprostol vaginal insert for induction of labor and cervical ripening, and will focus on vaginally administered prostaglandins.

  9. A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia.

    Science.gov (United States)

    Leblanc, Eric; Bresson, Lucie; Merlot, Benjamin; Puga, Marco; Kridelka, Frederic; Tsunoda, Audrey; Narducci, Fabrice

    2016-01-01

    Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent. Indications were 2 extensive recurrent vaginal intraepithelial neoplasias grade 3 and 6 radical hysterectomies for cervical cancer. Mean vaginal length before surgery was 3.8 cm (standard deviation, 1.6). Median operative time was 50 minutes (range, 45-90). Blood loss was minimal (50-100 mL). No perioperative complications occurred. Median vaginal length at discharge was 11.3 cm (range, 9-13). Sexual intercourse could be resumed around 10 weeks after surgery. At a median follow-up of 33.8 months (range, 2.4-51.3), 6 patients remained sexually active but 2 had stopped. Although this experience is small, this laparoscopic modified Davydov's procedure seems to be an effective procedure, adaptable to each patient's anatomy. If the initial postoperative regular self-dilatation is carefully observed, vaginal patency is durably restored and enables normal sexual function.

  10. The vaginal microbiome is stable in prepubertal and sexually mature Ellegaard Göttingen Minipigs throughout an estrous cycle

    DEFF Research Database (Denmark)

    Lorenzen, Emma; Kudirkiene, Egle; Gutman, Nicole

    2015-01-01

    Although the pig has been introduced as an advanced animal model of genital tract infections in women, almost no knowledge exists on the porcine vaginal microbiota, especially in barrier-raised Göttingen Minipigs. In women, the vaginal microbiota plays a crucial role for a healthy vaginal environ...

  11. Undiagnosed Long-Lasting Ulcerative Colitis Engaging Transplant after Vaginal Plastic Surgery with Colon: a Case Report

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    Ivaylo Vazharov, PhD¹

    2013-06-01

    Full Text Available This is the report of a 59-year-old woman suffering from recurrent vaginal pain and bleeding and episodes of anal bleeding. At the age of 16 she underwent vaginal plastic surgery. The case demonstrates the ulcerative engagement of the vaginal transplant.

  12. Bioavailability of the Yuzpe and levonorgestrel regimens of emergency contraception: vaginal vs. oral administration.

    Science.gov (United States)

    Kives, Sari; Hahn, Philip M; White, Emily; Stanczyk, Frank Z; Reid, Robert L

    2005-03-01

    Separate crossover studies compared the bioavailability of oral vs. vaginal routes of administration for the Yuzpe (n=5) and levonorgestrel regimens (n=4) of emergency contraception. Twice the standard dose of the Yuzpe regimen (200 microg of ethinyl estradiol, 1000 microg of levonorgestrel) or the levonorgestrel regimen (1500 microg of levonorgestrel) was self-administered vaginally. One week later, each subject received orally the standard dose of the assigned medication. Serial blood samples were collected over 24 h and assayed for levonorgestrel and ethinyl estradiol (for the Yuzpe regimen only). Paired t tests were used to compare oral vs. vaginal administration for maximum concentration (Cmax), time to maximum concentration (Tmax) and area under the curve over 24 h (AUC0-24). Relative bioavailability (vaginal/oral) was derived from AUC0-24. Vaginal administration of double the standard dose of the Yuzpe regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=14.6 ng/mL, p=.038) and a later Tmax (5.9 vs. 2.0 h, p=.066) for levonorgestrel, compared to oral administration. Corresponding ethinyl estradiol concentrations were higher (786 vs. 391 pg/mL, p=.039) and peaked later (4.0 vs. 1.9 hr, p=.154) with vaginal administration. Relative bioavailabilities for levonorgestrel and ethinyl estradiol were 58% and 175%, respectively. Similarly, vaginal administration of the levonorgestrel regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=15.2 ng/mL, p=.006) and a later Tmax (7.4 vs. 1.3 h, p=.037) for levonorgestel, compared to oral administration. The relative bioavailability was 62%. Our preliminary data suggest that vaginal administration of these emergency contraception regimens appears to require at least three times the standard oral dose to achieve equivalent systemic levonorgestrel concentrations.

  13. Dietary supplementation with probiotics during late pregnancy: outcome on vaginal microbiota and cytokine secretion

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    Vitali Beatrice

    2012-10-01

    Full Text Available Abstract Background The vaginal microbiota of healthy women consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the genus Lactobacillus. The activity of lactobacilli helps to maintain the natural healthy balance of the vaginal microbiota. This role is particularly important during pregnancy because vaginal dismicrobism is one of the most important mechanisms for preterm birth and perinatal complications. In the present study, we characterized the impact of a dietary supplementation with the probiotic VSL#3, a mixture of Lactobacillus, Bifidobacterium and Streptococcus strains, on the vaginal microbiota and immunological profiles of healthy women during late pregnancy. Results An association between the oral intake of the probiotic VSL#3 and changes in the composition of the vaginal microbiota of pregnant women was revealed by PCR-DGGE population profiling. Despite no significant changes were found in the amounts of the principal vaginal bacterial populations in women administered with VSL#3, qPCR results suggested a potential role of the probiotic product in counteracting the decrease of Bifidobacterium and the increase of Atopobium, that occurred in control women during late pregnancy. The modulation of the vaginal microbiota was associated with significant changes in some vaginal cytokines. In particular, the decrease of the anti-inflammatory cytokines IL-4 and IL-10 was observed only in control women but not in women supplemented with VSL#3. In addition, the probiotic consumption induced the decrease of the pro-inflammatory chemokine Eotaxin, suggesting a potential anti-inflammatory effect on the vaginal immunity. Conclusion Dietary supplementation with the probiotic VSL#3 during the last trimester of pregnancy was associated to a modulation of the vaginal microbiota and cytokine secretion, with potential implications in preventing preterm birth. Trial registration ClinicalTrials.gov NCT01367470

  14. Determination of Vaginal Candidiasis in Women Referred to Shahid

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    Nasrollahi omran A

    2011-01-01

    Full Text Available Background and objectives: Genital tract infections are among the mostcommon causes of patients referred to therapeutic centers. Nearly 75% ofwomen suffer from genital Candida infection, at least once in their lifetime.The aim of present study was detection of Candida species causing vaginitisand the evaluation of antimycotic effects of ketoconazol, clotrimazole andfluconazole against Candida species.Material and Methods: In this study, 210 vaginal samples were obtainedfrom the patients suspected of Vaginal Candidiasis. Direct examination andculture were carried out for all specimens to detect the yeast. The isolatedyeast species were then identified, using various different tests such as cultureon corn meal agar, tween-80, germ tube test, and assimilation test by API 20Ckit by using Sabouraud Dextrose Agar and microdilution broth, MIC90 andMIC50 of drug were measured and determined their drug resistance.Results: In the present study, 100 yeast colonies were isolated from patients;%80 are C. albicans and the rest are C. parapsilosis(2%, C. tropicalis(6%, C.glabrata(4%, C. krusei(2%, C. guilliermondii (3%, C.stellatoidea(3%. Interms of drug resistance test MIC50 and MIC90 of fluconazole for candidaalbicans are 5.33 and 35.27μg/ ml, respectively, and for non-albicans candidaare 3 and 21.4μg/ml, respectively. Clotrimazole MIC for Candida albicans(MIC50, MIC90 0.97 and 4.9μg/ml, respectively, and for non-albicans 0.63and 3.4/ml, respectively. Kectoconazole MIC for Candida albicans 2.43 and16.45μg/ml, respectively, and for non-albicans 1.12 and 6.6μg/ml,respectively.Conclusion: Clotrimazole has been better than the two other drugs forCandida species on the whole, non albicans species are more sensitive thanalbicans species in the presence of the drugs used in this study.Key words: Candida, vaginal candidiasis, Resistance drug , Tonekabon.

  15. Oral misoprostol versus dinoprostone vaginal tablets for labor induction

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    Khaled Ibrahim Abu El aish

    2013-06-01

    Full Text Available Background: Induction of labour is common in obstetric practice. We conducted this study to find the appropriate and safe drug for labour induction and to compare the safety and efficacy of oral misoprostol and vaginal dinoprostone for labour induction. Methods: In a provisional, prospective and cross-sectional study, one hundred and fifty five singleton cephalic presentation full term pregnancies with medical or obstetric indication for labour induction were allocated in two groups. First group received oral 50 micrograms for nulliparas and low parity group (1-4, and 25micrograms for grand multiparas (≥ 5 misoprostol orally every 6 hours to a maximum of four doses daily. In the second group vaginal tablets of dinoprostone 3mg then 1.5mg for nulliparas and 1.5mg for low parity and grand multiparas groups were inserted in the posterior fornix, every 8 hours. Primary outcome measures were: induction success, induction-delivery interval and number of used doses. Secondary outcome measures included: maternal side effects, caesarean section rate, mode of delivery and neonatal outcome. Data was collected from patient case notes and analyzed using software SPSS (version 13.0 and p-value < 0.05 was used as statistical significance of differences. Results: In our study there were no significant differences in baseline parameters in the two groups nor in the indications for labor induction except misoprostol was used in premature rupture of membrane. Induction of labor succeeded in 123 (79.35% women without other interventions from other methods (80.26%misoprostol group versus 78.5% dinoprostone p=0.492. It was observed that there were no significant differences between the two groups in final outcomes nor in obstetrical complications. There was no significance in differences between misoprostol and dinoprostone groups in induction-delivery interval (15.2 ± 14.5 hours versus 16.4 ± 11.3 hours p=0.6 resp.. Conclusions: This study demonstrated that oral

  16. Primary vaginal calculus secondary to urethrovaginal fistula with imperforate hymen in a 6-year-old girl.

    Science.gov (United States)

    Oguzkurt, Pelin; Ince, Emine; Ezer, Semire Serin; Temiz, Abdülkerim; Demir, Senay; Hicsonmez, Akgun

    2009-07-01

    Primary vaginal stones are extremely rare in children and may be mistaken for bladder calculi on plain radiography. We present a case of a large vaginal calculus in a 6-year-old girl who had an imperforate hymen and urethrovaginal fistula. Hymenotomy and urethrovaginal fistula repair were performed, and the vaginal stone was extracted. It was postulated that the vaginal calculus originated from stasis of urine through the urethrovaginal fistula in the obstructed vagina. This is a unique case of a vaginal calculus with a congenital urethrovaginal fistula associated with an imperforate hymen.

  17. Evaluation of the estrogenic activity of the wild Pueraria mirifica by vaginal cornification assay.

    Science.gov (United States)

    Cherdshewasart, Wichai; Kitsamai, Yosaporn; Malaivijitnond, Suchinda

    2007-04-01

    The aim of this study was to evaluate the estrogenic activity of tuberous samples of phytoestrogen-rich Pueraria mirifica collected from 25 of 76 provinces in Thailand by vaginal cornification assay. Tuberous powders were prepared and administered to ovariectomized rats for 14 consecutive days at dosages of 10, 100 and 1,000 mg/kg BW respectively, and were compared with a daily treatment with 2 mg/kg BW 17beta-estradiol (E(2)). Rats treated with 10 mg/kg BW Pueraria mirifica showed no vaginal cornification. Treatment with 100 mg/kg BW Pueraria mirifica from 13 out of 25 plant samples resulted in development of vaginal cornification. The cell count percentages of the vaginal smeared cells for the treatment with the 2 plant samples that exhibited the fastest vaginal cornification revealed large variation in their estrogenic activities. Treatment with 1,000 mg/kg BW Pueraria mirifica from all plant samples produced vaginal cornification with the mean value for the period (day) of first appearance of cornified cells being 4.08 days compared to 2 days with 2 mg/kg BW E(2). The overall appearance period (day) of cornified cells during the treatment and post-treatment period with 1,000 mg/kg BW per day Pueraria mirifica was shorter than treatment with 2 mg/kg BW E(2). The results demonstrate that the plant population shows differential estrogenic activity as evaluated by vaginal cornification assay.

  18. Analysis of vaginal microenvironment in 435 cases with nonneoplastic epithelial disorders of vulva

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    Lan XIE

    2016-03-01

    Full Text Available Objective  To explore the relationship of vaginal micro-ecological condition with the nonneoplastic epithelial disorders of vulva (NNEDV in order to provide clues on diagnosis and treatment of NNEDV. Methods  The outpatient data of 435 cases of NNEDV as diagnosed by biopsy, collected from Jan. 2012 to Jun. 2015 at the Second Affiliated Hospital of Chongqing Medical University, were retrospectively analyzed to evaluate their vaginal microflora. Results  Fifty-four of the 435 patients (12.4% were proved to harbor normal vaginal microflora, and in 381 patients imbalanced vaginal microflora was found (87.6%, and among them the pathogens were clearly diagnosed in 161 cases, accounting for 37.0% (161/435; the incidence of bacterial vaginosis (BV and vulvovaginal candidiasis (VVC was 13.1% and 10.4%, respectively, and it was significantly higher than the incidence of other vaginitis (P<0.05. Conclusion  Most of NNEDV patients are suffering from unbalanced vaginal micro-ecological imbalance, and vaginitis such as BV and VVC may be associated with the NNEDV. DOI: 10.11855/j.issn.0577-7402.2016.02.10

  19. [Possible role of enterotoxigenic Bacteroides fragilis in the etiology of infectious vaginitis].

    Science.gov (United States)

    Polanco, Nina; Manzi, Lorna; Carmona, Oswaldo

    2012-03-01

    Vaginitis is a common gynecologic disorder. It is due to several causes, some even unknown. Bacteroides fragilis is the most important anaerobe in clinical bacteriology, some strains of this group are notable for being enterotoxigenic and they have been associated with intestinal and extraintestinal syndromes. They have recently been isolated from patients with vaginitis. The purpose of this study was to investigate a possible association of enterotoxigenic B. fragilis with infectious vaginitis. 265 samples of vaginal exudate were processed, 202 from symptomatic patients and 63 healthy women. The identification of the microorganisms was carried out by conventional methods. In 31.2% of symptomatic patients were identified: Gardnerella vaginalis, Mobiluncus, Candida albicans, Mycoplasma hominis, Ureaplasma urealyticum and Streptococcus agalactiae. B. fragilis was identified in 27 symptomatic patients and 5 healthy women. These strains were cultivated in liquid medium and incubated during 48 h at 36 degrees C in anaerobe chambers. Supernatant activity was assayed in HT-29 cells. Eighteen B. fragilis strains isolated from symptomatic patients were enterotoxigenic, because induced alterations in target cell morphology. It was not identified in healthy women (P < 0.05). 77.7% of enterotoxigenic B. fragilis strains were not associated with other specific pathogens. This fact suggests that enterotoxigenic B. fragilis could be a cause for vaginitis. The effect of enterotoxin on E-cadherin of vaginal epithelium could facilitate invasion and its possible pathogenic role in the vagina. This is the first report that associates enterotoxigenic Bacteroides fragilis as a possible cause of infectious vaginitis.

  20. Fetal Head Position during the First Stage of Labor: Comparison between Vaginal Examination and Transabdominal Ultrasound

    Science.gov (United States)

    Shetty, Jyothi; Aahir, Vinod; Adiga, Prashanth; Kamath, Asha

    2014-01-01

    Introduction. Recent evidence indicates that clinical examination, for determination of fetal head position, is subjective and inaccurate. Present study was aimed to compare transabdominal ultrasound for fetal head position with vaginal examination during first stage of labor. Material and Methods. This prospective study was performed at a tertiary center during a two-year period. Before or after clinically indicated vaginal examinations, transverse suprapubic transabdominal real-time ultrasound fetal head position assessment was done. Frequencies of various ultrasound depicted fetal head positions were compared with position determined at vaginal examination. Results. In only 31.5% of patients, fetal head position determinations by vaginal examinations were consistent with those obtained by ultrasound. Cohen's Kappa test of concordance indicated a poor concordance of 0.15. Accuracy of vaginal examination increased to 66% when fetal head position at vaginal examination was recorded correct if reported within +45° of the ultrasound assessment. Rate of agreement between the two assessment methods for consultants versus residents was 36% and 26%, respectively (P = 0.17). Conclusion. We found that vaginal examination was associated with a high error rate in fetal head position determination. Data supports the idea that intrapartum transabdominal ultrasound enhances correct determination of fetal head position during first stage of labor. PMID:25006479

  1. Prolonged antifungal effects of clotrimazole-containing mucoadhesive thermosensitive gels on vaginitis.

    Science.gov (United States)

    Chang, Jung Yun; Oh, Yu-Kyoung; Kong, Hak Soo; Kim, Eun Jung; Jang, Dong Deuk; Nam, Ki Taek; Kim, Chong-Kook

    2002-07-18

    To develop more effective treatment for vaginal candidasis, clotrimazole (CT) was formulated in mucoadhesive thermosensitive gels (MTG). Several MTG formulations composed of poloxamers (P) 407, 188, and polycarbophil (PC) were prepared. P188 and PC increased the mucoadhesiveness but reduced the syringebility of liquid forms of the gels. Based on the balance between the mucoadhesiveness and syringebility, MTG composed of P407/P188/PC (15/15/0.2 or 15/20/0.2) were further studied. Of the two MTG, the formulation with 15% of P188 gelled at higher temperature and revealed lower elastic modulus. In vitro, sustained release of CT from MTG was observed. In vivo antifungal activity of CT, tested against Candida albicans vaginitis in female rats, was significantly prolonged after vaginal delivery using MTG. At 10 days post-dose, the c.f.u. of C. albicans was more than 10(4)-fold decreased in MTG-treated groups. Moreover, the vaginal delivery of CT in MTG enhanced the viability of epithelial cells without affecting the morphology of vaginal mucosa. These results indicate that CT-containing vaginal MTG might be further developed for safe, convenient, and effective treatment of vaginal candidasis with reduced dosing interval.

  2. Chlamydia caviae infection alters abundance but not composition of the guinea pig vaginal microbiota.

    Science.gov (United States)

    Neuendorf, Elizabeth; Gajer, Pawel; Bowlin, Anne K; Marques, Patricia X; Ma, Bing; Yang, Hongqiu; Fu, Li; Humphrys, Michael S; Forney, Larry J; Myers, Garry S A; Bavoil, Patrik M; Rank, Roger G; Ravel, Jacques

    2015-06-01

    In humans, the vaginal microbiota is thought to be the first line of defense again pathogens including Chlamydia trachomatis. The guinea pig has been extensively used as a model to study chlamydial infection because it shares anatomical and physiological similarities with humans, such as a squamous vaginal epithelium as well as some of the long-term outcomes caused by chlamydial infection. In this study, we aimed to evaluate the guinea pig-C. caviae model of genital infection as a surrogate for studying the role of the vaginal microbiota in the early steps of C. trachomatis infection in humans. We used culture-independent molecular methods to characterize the relative and absolute abundance of bacterial phylotypes in the guinea pig vaginal microbiota in animals non-infected, mock-infected or infected by C. caviae. We showed that the guinea pig and human vaginal microbiotas are of different bacterial composition and abundance. Chlamydia caviae infection had a profound effect on the absolute abundance of bacterial phylotypes but not on the composition of the guinea pig vaginal microbiota. Our findings compromise the validity of the guinea pig-C. caviae model to study the role of the vaginal microbiota during the early steps of sexually transmitted infection.

  3. Prostaglandin production by rat vaginal tissue, in vitro, in response to ethanol, a mild mucosal irritant.

    Science.gov (United States)

    Dubin, N H; Wolff, M C; Thomas, C L; DiBlasi, M C

    1985-05-01

    Toxicological testing of vaginal irritants currently involves in vivo testing in rabbits. While chemical-induced irritation or inflammation involves numerous biologic responses, these responses appear to be to a large extent mediated by prostaglandin release. Since vaginal tissue of the rat produces prostaglandins, this tissue was studied in vitro to determine if it would respond to ethanol, a mild irritant. Small vaginal segments were rinsed in Krebs-Ringer bicarbonate buffer (pH 7.0) and exposed to various concentrations of ethanol. The segments were then transferred to fresh buffer and incubated for 30 min in a shaking 37 degrees C water bath. Ethanol (70%) exposure for 30 sec increased prostaglandin E2 and F2 alpha production by vaginal tissue. While ethanol exposure resulted in increases in prostaglandin production regardless of the stage of the cycle from which the tissue was derived, the relative increase was greatest in tissues from the diestrous stage of the cycle. The prostaglandin production response of vaginal tissue, and of cervical and uterine tissue, was related to the concentration of ethanol to which these tissues were exposed. Indomethacin blocked this response in a dose-dependent manner. These experiments demonstrate that vaginal tissue responds to ethanol by increasing production of PGF2 alpha and PGE2. This in vitro system may prove useful as an alternative to live-animal testing in the screening of irritants of the vaginal mucosa or other tissues as well.

  4. Bilateral pulmonary thromboembolism and Budd-Chiari syndrome in a patient with Crohn's disease on oral contraceptives Tromboembolismo de pulmón bilateral y síndrome de Budd-Chiari en paciente con enfermedad de Crohn y toma de anticonceptivos orales

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    M. Valdés Mas

    2009-09-01

    Full Text Available Budd-Chiari syndrome can be defined as an interruption or diminution of the normal blood flow out of the liver. Patients with Budd-Chiari syndrome present with varying degrees of symptomatology that can be divided into the following categories: fulminant, acute, subacute and chronic. The subacute form is the most common presentation. A majority of patients with Budd-Chiari syndrome have an underlying hypercoagulability state. We present the case of a young woman with Crohn's disease on oral contraceptives who developed bilateral pulmonary thromboembolism and Budd-Chiari syndrome.El síndrome de Budd-Chiari consiste en la interrupción o disminución de flujo de las venas suprahepáticas. Tiene una gran variabilidad clínica en cuanto a su forma de presentación siendo la más frecuente la forma subaguda. La gran mayoría de los pacientes responden a estados de hipercoagulabilidad. Presentamos el caso de una paciente joven con enfermedad de Crohn que estaba en tratamiento con anticonceptivos orales y desarrolló un cuadro clínico de tromboembolismo de pulmón bilateral y síndrome de Budd-Chiari.

  5. Ultrastructural localization of acid phosphatase in nonhuman primate vaginal epithelium.

    Science.gov (United States)

    King, B F

    1985-01-01

    The vagina of the rhesus monkey is lined by a stratified squamous epithelium. However, little is known regarding the cytochemical composition of its cell organelles and the substances found in the intercellular spaces. In this study we have examined the ultrastructural distribution of acid phosphatase in the vaginal epithelium. In basal and parabasal cells reaction product was found in some Golgi cisternae and vesicles and in a variety of cytoplasmic granules. Reaction product was also found in some, but not all, membrane-coating granules. In the upper layers of the epithelium, the membrane-coating granules extruded their contents and acid phosphatase was localized in the intercellular spaces. The possible roles of acid phosphatase in keratinization, desquamation, or modification of substances in the intercellular compartment are discussed.

  6. Use of vaginal prostaglandin gel before induction of labour.

    Science.gov (United States)

    Murphy, A J; Jalland, M; Pepperell, R J; Quinn, M A

    1980-05-01

    Tylose gel containing either 1.5 mg, 3.0 mg or 10.0 mg of prostaglandin F2 alpha was inserted into the posterior vaginal fornix of 165 patients on the evening before induction of labour. A control group of 100 patients received the gel alone. There was a significant reduction in the induction-delivery interval in nulliparae receiving at least 3.0 mg of prostaglandin, whereas, in multiparae all doses achieved this effect. There was also a significant reduction in the incidence of forceps delivery in nulliparae who received 3.0 mg or more of the prostaglandin gel; however, there was no difference in the incidence of spontneous labour, epidural anaesthesia or Caesarean section between the patients who received prostaglandin or those receiving gel alone.

  7. Clitoral blood flow increases following vaginal pressure stimulation.

    Science.gov (United States)

    Lavoisier, P; Aloui, R; Schmidt, M H; Watrelot, A

    1995-02-01

    The vascular responses of clitoral arteries to vaginal pressure stimulation in 10 volunteer women were evaluated by Doppler ultrasonography. Pressure stimulations (20-160 mm Hg) along the lower third of the vagina increased blood velocity and flow into clitoral arteries in 9 of the 10 women. The latency and duration of the Doppler responses ranged from 0.1 to 1.6 sec and from 3.2 to 9.5 sec, respectively, and the response was associated with a blood flow increase of 4 to 11 times the baseline prestimulation level. This response parallels that recorded in the cavernous arteries in men when a similar range of pressure stimulations are applied to the glans penis. Similar responses evoked in the male and female suggest a sexual synergy that may occur during intercourse in that such physiological responses and reflexes may be reciprocally reinforced.

  8. Adenocarcinoma in an ano-vaginal fistula in Crohn's disease

    Science.gov (United States)

    Alfa-Wali, Maryam; Atinga, Angela; Mohsen, Yasser; Anthony, Andrew; Myers, Alistair

    2013-01-01

    INTRODUCTION Fistulas are a relatively common occurrence in Crohn's disease (CD), and often present early in the disease process. Additionally, patients suffering from either CD or ulcerative colitis are shown to have an increased risk of colorectal malignancies compared with the general population. PRESENTATION OF CASE We present a case of adenocarcinoma in an ano-vaginal fistula in a patient with longstanding CD. DISCUSSION Various pathogenic mechanisms for the development of carcinoma in fistulas have been suggested, but there is no consensus and indeed this risk may be cumulative. In this case report, we also discuss the pathogenesis of mucinous adenocarcinoma in fistulas secondary to CD. CONCLUSION Better detection of adenocarcinoma in patients presenting with persistent non-resolving fistulas in the presence of CD should be undertaken with regular biopsies following examinations under anaesthetic of the anorectum. PMID:23702362

  9. Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle.

    Science.gov (United States)

    Chen, Z; Chen, C; Chen, M; Zhang, J; Wu, N; Wang, J

    1991-03-01

    A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps.

  10. Vaginal lactobacilli as potential probiotics against Candida spp

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    Natalia F. Gil

    2010-03-01

    Full Text Available Urogenital infections affect millions of people every year worldwide. The treatment of these diseases usually requires the use of antimicrobial agents, and more recently, the use of probiotic lactic acid bacteria (LAB cultures for the management of vaginal infections has been extensively studied. In this work, 11 vaginal lactobacilli isolates, previously obtained from healthy patients, were studied to screen microorganisms with probiotic properties against Candida spp. The LAB were tested for their ability of auto-aggregation, coaggregation with C. albicans, C. glabrata, C. krusei, and C. tropicalis, adhesion to Caco-2 epithelial cells and production of lactic acid and hydrogen peroxide (H2O2. All lactobacilli isolates tested were able to auto-aggregate (ranging from 25.3% to 75.4% assessed at 4 hours of incubation and to co-aggregate with the four Candida species into different degrees; among them L. crispatus showed the highest scores of coaggregation. The highest amount of lactic acid was produced by L. salivarius (13.9 g/l, followed by L. johnsonii (6.5 g/l, L. acidophilus (5.5 g/l, and L. jensenii (5.4 g/l. All isolates produced H2O2 , but the highest levels (3 -10 mg/l were observed for L. acidophilus, L. crispatus, L. gasseri, L. johnsonii, and L. vaginalis. Only L. agilis, L. jensenii, L. johnsonii and L. ruminus were able to adhere to epithelial Caco-2 cells. Among the isolates evaluated, L agilis, L. jensenii, L. johnsonii, and L. ruminus exhibited simultaneously several desirable properties as potential probiotic strains justifying future studies to evaluate their technological properties in different pharmaceutical preparations for human use.

  11. Risk factors for the development of vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    LI Hua; GUO Yan-li; ZHANG Jing-xu; QIAO Jie; GENG Li

    2012-01-01

    Background Vaginal intraepithelial neoplasia (VAIN),as aprecursor of vaginal cancer,is a rare disease.Its prevalence has not been well analyzed.This research is to ascertain the risk factors for VAIN in a Chinese population.@@Methods A case-control study was conducted,including 63 VAIN cases and 64healthy controls.In all subjects Pap smear and HPV tests were performed.A questionnaire survey was distributed,covering information on socio-demographic characteristics,smoking,past history,reproductive and sexual histories.The clinical pathological data were collected from medical records including symptoms,Pap smear results,grade of lesions,and human papillomavirus (HPV) status.@@Results Postmenopausal women had a 2.09 times higher risk for VAIN than pre-menopausal women (95% C/:1.10-3.85; P=0.024).The patients with previous hysterectomy had an increased risk of VAIN (OR=4.69; P=0.003).Patients with a history of cervical cancer or CIN were predisposed to VAIN (OR=78.75; P <0.0001).The rate of HPV infection in VAIN was significantly higher than in controls,and an increased risk of VAIN was observed in patients with higher viral load (OR=126.00; P=0.000).Multivariate analysis showed that HPV infection and a history of CIN or cervical cancer were still found to be significant in patients.@@Conclusion HPV infection and a history of CIN or cervical cancer are the main risk factors for the development of VAIN.

  12. [To rescue a vanishing obstetric skill--vaginal breech delivery].

    Science.gov (United States)

    Glezerman, Marek

    2011-02-01

    In 2000, a large randomized controlled trial was published (Term Breech Trial - TBT). The authors concluded that cesarean section (CS) was safer for newborns in breech presentation than vaginal breech delivery (VBD). This conclusion was endorsed by major professional institutions, was adopted almost immediately by the medical community and led to a wholesale abandonment of planned VBD in the western world, including Israel. In past years, serious criticism has been voiced related to the methodology applied in the TBT and numerous studies have contradicted the recommendations. Subsequently, the professional institutions published revised guidelines with the recommendation that pregnant women with breech presentation should, under certain circumstances, be given the choice between CS and VBD. Yet, in most delivery wards, following a decade of abandonment of VBD, the expertise for this technique had almost vanished. An unbearable situation had materialized: CS increases maternal mortality and morbidity when compared to vaginal delivery but most obstetricians are no longer capable of offering women the choice of VBD. Recently, and with the support of the Israel Societies of Obstetrics and Gynecology and Feto-Maternal Medicine, representatives of 17 obstetrical departments convened and decided on urgent steps to revive VBD, including updating the relevant clinical guidelines and informed consent forms and, most importantly, to issue a call to train obstetricians in VBD. In March 2010, a workshop dedicated to breech delivery was conducted at the Beilinson Hospital, with the representatives of most Israeli hospitals and specialists from abroad. Subsequently, and at the same hospital, a week-long program for VBD was conducted at which approximately 30 obstetricians received hands-on training. Time will show if "turning back the tide" will help to progress into a safer future for women with breech presentation and to annually avoid between 1000 and 2000 needless cesarean

  13. Evaluation of vaginal pH for detection of bacterial vaginosis

    Directory of Open Access Journals (Sweden)

    R Hemalatha

    2013-01-01

    Full Text Available Background & objectives : Bacterial vaginosis (BV is highly prevalent among women in reproductive age group. Little information exists on routine vaginal p H measurement in women with BV. We undertook this study to assess the utility of vaginal p H determination for initial evaluation of bacterial vaginosis. Methods : In this cross-sectional study vaginal swabs were collected from women with complaints of white discharge, back ache and pain abdomen attending a government hospital and a community health clinic, and subjected to vaginal p H determination, Gram stain, wet mount and whiff test. Nugent score and Amsel criteria were used for BV confirmation. Results : Of the 270 women included in the analysis, 154 had BV based on Nugents′ score. The mean vaginal p H in women with BV measured by p H strips and p H glove was 5 and 4.9, respectively. The vaginal p H was significantly higher in women with BV. Vaginal discharge was prevalent in 84.8 per cent women, however, only 56.8 per cent of these actually had BV by Nugent score (NS. Presence of clue cells and positive whiff test were significant for BV. Vaginal p H >4.5 by p H strips and p H Glove had a sensitivity of 72 and 79 per cent and specificity of 60 and 53 per cent, respectively to detect BV. Among the combination criteria, clue cells and glove p H >4.5 had highest sensitivity and specificity to detect BV. Interpretation & conclusions : Vaginal p H determination is relatively sensitive, but less specific in detecting women with BV. Inclusion of whiff test along with p H test reduced the sensitivity, but improved specificity. Both, the p H strip and p H glove are equally suitable for screening women with BV on outpatient basis.

  14. Effects of tamoxifen on vaginal blood flow and epithelial morphology in the rat

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    Goldstein Irwin

    2006-09-01

    Full Text Available Abstract Background Tamoxifen, a selective estrogen receptor modulator with both estrogenic and anti-estrogenic activity, is widely used as adjuvant therapy in breast cancer patients. Treatment with tamoxifen is associated with sexual side effects, such as increased vaginal dryness and pain/discomfort during sexual activity. There have been limited investigations of the effect of tamoxifen on estrogen-dependent peripheral genital arousal responses. The objective of this study was to investigate the effects of tamoxifen on vaginal physiology in the rat. Methods Female Sprague-Dawley rats were subjected to sham surgery or bilateral ovariectomy. After 2 weeks, sham-operated rats were implanted with subcutaneous osmotic infusion pumps containing vehicle (control or tamoxifen (150 μg/day. Ovariectomized rats were similarly infused with vehicle. After an additional 2 weeks, vaginal blood flow responses to pelvic nerve stimulation were measured by laser Doppler flowmetry and vaginal tissue was collected for histological and biochemical assay. Results Tamoxifen treatment did not change plasma estradiol concentrations relative to control animals, while ovariectomized rats exhibited a 60% decrease in plasma estradiol. Tamoxifen treatment caused a significant decrease in mean uterine weight, but did not alter mean vaginal weight. Vaginal blood flow was significantly decreased in tamoxifen-infused rats compared to controls. Similar to ovariectomized animals, estrogen receptor binding was increased and arginase enzyme activity was decreased in tamoxifen-infused rats. However, different from control and ovariectomized animals, the vaginal epithelium in tamoxifen-infused rats appeared highly mucified. Periodic acid-Schiff staining confirmed a greater production of carbohydrate-rich compounds (e.g. mucin, glycogen by the vaginal epithelium of tamoxifen-infused rats. Conclusion The observations suggest that tamoxifen exerts both anti-estrogenic and pro

  15. Vaginal delivery versus cesarean section for term breech delivery

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    Babović Ivana

    2010-01-01

    Full Text Available Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD in 139 patients; the group II - urgent cesarean section (UCS in 128 patients; and the group III - elective cesarean section (ECS in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW, the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, χ2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ± 4.97 years, in the group II 29.68 ± 5.92 years and in the group III 30.06 ± 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022. In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%. We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706. Lowset maneuver was performed in 88.5% of

  16. Effect of vaginal douching and different semen extenders on bacterial load and fertility in turkeys.

    Science.gov (United States)

    Omprakash, A V; Venkatesh, G

    2006-08-01

    1. A study on artificial insemination of Beltsville Small White turkeys investigated the effect on bacterial load and fertility of vaginal douching with diluents containing Gentamicin 400 microg/ml and different semen extenders. 2. Irrespective of the extenders used, vaginal douching with Gentamicin reduced the microbial load of the vagina with resultant improvement in fertility and hatchability and corresponding reduction in embryonic mortality. 3. Eggs from hens inseminated with semen extended with Beltsville Poultry Semen Extender (BPSE) diluent along with vaginal douching showed a trend towards higher per cent fertility and per cent hatchability of total and fertile eggs set compared to other extenders, though this was non-significant.

  17. [Surgical technique of saphenous vein harvesting using a Cusco vaginal speculum].

    Science.gov (United States)

    Kikuchi, Keita; Suzuki, Kotaro; Endo, Yoshiki; Matsuyama, Takayoshi; Osaka, Shin-ichi; Kurata, Atsushi

    2014-11-01

    We used Cusco vaginal speculum in harvesting saphenous vein graft (SVG) as an assist device for making a skin tunnel. After making 2 incisions of 3 to 4 cm, the SVG was dissected in a usual procedure. Then Cusco vaginal speculum was inserted into the skin tunnel between the 2 incisions. The SVG was dissected in a usual fashion under direct vision with the speculum. This procedure requires only small incisions, short learning curve and low cost. The new technique using Cusco vaginal speculum can be a reliable option for harvesting SVG.

  18. Characterization of vaginal microbiotic yeasts of bitches in distinct stages of the oestrous cycle

    OpenAIRE

    M.B. Cleff; M.O. Xavier; MARTINS, A. A; SANTIN,R.; M.C.A. Meireles

    2007-01-01

    Hongos levaduriformes son aislados frecuentemente de los animales domésticos y silvestres, siendo algunos comensales del tegumento y mucosas. Las levaduras son frecuentes en la mucosa vaginal de las mujeres, pero en perras son escasos los estudios referentes a la microbiota fúngica vaginal, sin conocerse su relación con el ciclo reproductivo. En este estudio se buscó aislar e identificar levaduras de la microbiota vaginal de perras, y establecer si hay alteración de la microbiota levaduriform...

  19. Indigenous technique of fabricating vaginal mould for vaginal reconstruction and uterine drainage in McIndoe vaginoplasty using 10 ml syringe

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    Brijesh Mishra

    2016-01-01

    Full Text Available Absence of vagina poses multitude of physical and psychosocial problems in woman's life. 10% of Mayer- Rokitansky-üster-Hauser (MRKH syndrome patients with high vaginal septum and vaginal atreisa has additional issue of draining uterine cavity. MC Indoe vaginoplasty is universally acceptable and widely practiced procedure for neocolposis reconstruction. Simultaneous reconstruction of vagina with simultaneous continued uterine drainage presents surgical challenge. We offer a simple solution of creating a vaginal mould using a 10 ml disposable syringe, which enables graft application of neovaginal cavity with simultaneous protected uterine drainage per vaginum. Total 10 patients were included in this study of which 4 needed uterine drainage procedure in addition to neovaginal creation. All the patients fared well, there were no problems regarding graft loss or vaginal mould extrusion etc. Fabrication of mould for graft enables easy dressing changes with out disturbing the skin graft. This innovation offers a simple easily reproducible and cheap way of fabricating vaginal mould for McIndoe vaginoplasty. It is especially useful for neovaginal graft application and simultaneous uterine drainage.

  20. The modified method of two-step differential extraction of sperm and vaginal epithelial cell DNA from vaginal fluid mixed with semen.

    Science.gov (United States)

    Yoshida, K; Sekiguchi, K; Mizuno, N; Kasai, K; Sakai, I; Sato, H; Seta, S

    1995-03-21

    This investigation was undertaken as an efficient method for isolating sperm DNA from a mixed fluid sample which contains vaginal epithelial cells in a greater amount. The modified method of the two-step differential extraction procedure was found to be suitable for separating sperm DNA and vaginal epithelial cell DNA from the mixed stains. As the first step of digestion, vaginal epithelial cells in the mixed stains were lysed with Proteinase K and SDS, and sperm heads remaining in the lysed solution were collected by centrifugation. As the second step digestion, the sperm heads were lysed with the buffer containing Proteinase K, SDS and DTT as reducing agent. DNA fractions extracted from the two lysed solutions were enriched, one with sperm DNA and the other with vaginal epithelial cell DNA. MCT118(D1S80), ApoB VNTR and HLADQ alpha types of sperm DNA were detected and were confirmed by matching with corresponding male blood DNA. In the case of vaginal secretion mixed with semen of two males, the mixture of MCT118 types of the two males was detected in sperm DNA fraction.

  1. [Septate uterus with cervical duplication and vaginal partition: a rare malformation].

    Science.gov (United States)

    García-León, F; Kably-Ambe, A; Von-der-Meden, W; Dosal, M; Escarcega, H

    1998-12-01

    It presents three cases of Mullerian anomalies with septate uterus and cervical duplication and longitudinal vaginal septum. There are a few previous cases reported. The cases are discussed and the literature is revised.

  2. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate

    DEFF Research Database (Denmark)

    Alsbjerg, Birgit; Polyzos, Nikolaos P; Elbaek, Helle Olesen

    2013-01-01

    The aim of this study was to evaluate the reproductive outcome in patients receiving frozen-thawed embryo transfer before and after doubling of the vaginal progesterone gel supplementation. The study was a retrospective study performed in The Fertility Clinic, Skive Regional Hospital, Denmark....... A total of 346 infertility patients with oligoamenorrhoea undergoing frozen-thawed embryo transfer after priming with oestradiol and vaginal progesterone gel were included. The vaginal progesterone dose was changed from 90 mg (Crinone) once a day to twice a day and the reproductive outcome during the two...... rate (8.7% versus 20.5%, respectively; P=0.002). Doubling of the vaginal progesterone gel supplementation during frozen-thawed embryo transfer cycles decreased the early pregnancy loss rate, resulting in a significantly higher delivery rate. This study evaluated the reproductive outcome of 346 women...

  3. 78 FR 19271 - Draft Guidance for Industry on Bioequivalence Recommendations for Metronidazole Vaginal Gel...

    Science.gov (United States)

    2013-03-29

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Bioequivalence... guidance for industry entitled ``Bioequivalence Recommendations for Metronidazole Vaginal Gel.'' The guidance provides specific recommendations on the design of bioequivalence (BE) studies to...

  4. The Effect of Cognitive Behavior Therapy on Anxiety Reduction of First Normal Vaginal Delivery

    Directory of Open Access Journals (Sweden)

    R Imanparast

    2014-04-01

    Conclusions: Consequently the cognitive behavior therapy causes to decrease the anxiety with enduring effect at first normal vaginal delivery. Therefore, this treatment is proposed to reduce the anxiety of first delivery women.

  5. Vaginal Exposure to Zika Virus during Pregnancy Leads to Fetal Brain Infection.

    Science.gov (United States)

    Yockey, Laura J; Varela, Luis; Rakib, Tasfia; Khoury-Hanold, William; Fink, Susan L; Stutz, Bernardo; Szigeti-Buck, Klara; Van den Pol, Anthony; Lindenbach, Brett D; Horvath, Tamas L; Iwasaki, Akiko

    2016-08-25

    Zika virus (ZIKV) can be transmitted sexually between humans. However, it is unknown whether ZIKV replicates in the vagina and impacts the unborn fetus. Here, we establish a mouse model of vaginal ZIKV infection and demonstrate that, unlike other routes, ZIKV replicates within the genital mucosa even in wild-type (WT) mice. Mice lacking RNA sensors or transcription factors IRF3 and IRF7 resulted in higher levels of local viral replication. Furthermore, mice lacking the type I interferon (IFN) receptor (IFNAR) became viremic and died of infection after a high-dose vaginal ZIKV challenge. Notably, vaginal infection of pregnant dams during early pregnancy led to fetal growth restriction and infection of the fetal brain in WT mice. This was exacerbated in mice deficient in IFN pathways, leading to abortion. Our study highlights the vaginal tract as a highly susceptible site of ZIKV replication and illustrates the dire disease consequences during pregnancy.

  6. Sublingual versus vaginal misoprostol for medical termination of pregnancy: a comparative study

    Directory of Open Access Journals (Sweden)

    Ayswary Shanmugam

    2016-10-01

    Conclusions: There is no significant difference in efficacy and side effects between sublingual and vaginal route of misoprostol for termination of pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3398-3403

  7. Peri-Vesical Fat Interposition Flap Reinforcement in High Vesico-Vaginal Fistulas

    OpenAIRE

    Singh, R.B; Dalal, S.; Nanda, S

    2010-01-01

    Background and Aim: The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginal fistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap. Materials and Methods: An interposition flap of peri-vesical fat was raised from the anterior, superior and posterior surfaces of the urinary bladder and was interposed between the right angle closed vaginal vault and the urinary ...

  8. Vaginal Atrophy following Long-Term Depot Medroxyprogesterone Acetate Use: A Case Report

    Directory of Open Access Journals (Sweden)

    Christie Walker

    2013-01-01

    Full Text Available Depot medroxyprogesterone acetate (DMPA is a commonly used form of contraception, with noncontraceptive benefits for the user. The mode of action is through the suppression of ovulation. It leads to hypoestrogenism which causes dryness of the vagina and dyspareunia. We present in this paper a patient that was very symptomatic with regard to vaginal atrophic changes determined by vaginal cytology. This side effect may become increasingly more common as we see more long-term use of DMPA.

  9. Modern state of the assortment drugs for the treatment of vaginal candidosis

    OpenAIRE

    Юлия Валентиновна Левачкова; Татьяна Григорьевна Ярных; Валентина Николаевна Чушенко; Снежана Николаевна Пушок

    2015-01-01

    Today the problem of treatment of vaginal candidosis and creation of effective drugs for the treatment of this disease is actual for modern gynecology and pharmacy.Aim: to explore the structure of the assortment of drugs for the treatment of vaginal candidosis, presented in the Ukrainian pharmaceutical market.Methods: Statistical and marketing methods of investigation of electronic and paper sources of information. Implemented analysis assortment based on the materials of the State Register d...

  10. Management of recto-vaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    Mehdi; Ouassi; Silvia; Cresti; Urs; Giger; Igor; Sielezneff; Nicolas; Pirrò; Bruno; Berthet; Philippe; Grandval; Bernard; Consentino; Bernard; Sastre

    2010-01-01

    AIM: To communicate our findings on successful treat-ment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with pros-thetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febri...

  11. A polymerase chain reaction for detection of Brucella canis in vaginal swabs of naturally infected bitches.

    Science.gov (United States)

    Keid, L B; Soares, R M; Vasconcellos, S A; Chiebao, D P; Salgado, V R; Megid, J; Richtzenhain, L J

    2007-12-01

    A PCR assay for the detection of Brucella canis in canine vaginal swab samples was evaluated, comparing its performance with that of bacterial isolation, serological tests, and a blood PCR assay. One hundred and forty-four female dogs were clinically examined to detect reproductive problems and they were tested by the rapid slide agglutination test, with and without 2-mercaptoethanol (2ME-RSAT and RSAT, respectively). In addition, microbiological culture and PCR were performed on blood and vaginal swab samples. The results of the vaginal swab PCR were compared to those of the other tests using the Kappa coefficient and McNemar test. Of the 144 females that were examined, 66 (45.8%) were RSAT positive, 23 (15.9%) were 2ME-RSAT positive, 49 (34.02%) were blood culture positive, 6 (4.1%) were vaginal swab culture positive, 54 (37.5%) were blood PCR positive, 52 (36.2%) were vaginal swab PCR positive, and 50.69% (73/144) were positive by the combined PCR. The PCR was able to detect as few as 3.8 fg of B. canis DNA experimentally diluted in 54 ng of canine DNA, extracted from vaginal swab samples of non-infected bitches. In addition, the PCR assay amplified B. canis genetic sequences from vaginal swab samples containing 1.0 x 10(0) cfu/mL. In conclusion, vaginal swab PCR was a good candidate as a confirmatory test for brucellosis diagnosis in bitches suspected to be infected, especially those negative on blood culture or blood PCR; these animals may be important reservoirs of infection and could complicate attempts to eradicate the disease in confined populations.

  12. Evaluation of two clinical protocols for the management of women with vaginal discharge in southern Thailand

    OpenAIRE

    Chandeying, V; Skov, S.; Kemapunmanus, M.; Law, M; Geater, A.; P. Rowe

    1998-01-01

    OBJECTIVES: (1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. DESIGN: Alternate allocation of subjects to one of two management protocols. SUBJECTS: Women pres...

  13. Outcomes of vaginal delivery and cesarean in Mashhad Ghaem University Hospital

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2014-03-01

    Conclusion: The results of this study showed in comparison with cesarean delivery, normal vaginal delivery provides better outcomes in terms of breast problems, breast feeding status, duration of labor and duration of maternal hospitalization for both mother and infant. So, adopting careful instructions in management and administration of deliveries will help the prevalence of making decisions for normal vaginal delivery and the recovery of delivery outcomes.

  14. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness.

    Science.gov (United States)

    Hummelen, Ruben; Macklaim, Jean M; Bisanz, Jordan E; Hammond, Jo-Anne; McMillan, Amy; Vongsa, Rebecca; Koenig, David; Gloor, Gregory B; Reid, Gregor

    2011-01-01

    After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding pathogens. The objectives of this study were twofold: first to identify the microbiome of post-menopausal women with and without vaginal dryness and symptoms of atrophy; and secondly to examine any differences in epithelial gene expression associated with atrophy. The vaginal microbiome of 32 post-menopausal women was profiled using Illumina sequencing of the V6 region of the 16S rRNA gene. Sixteen subjects were selected for follow-up sampling every two weeks for 10 weeks. In addition, 10 epithelial RNA samples (6 healthy and 4 experiencing vaginal dryness) were acquired for gene expression analysis by Affymetrix Human Gene array. The microbiota abundance profiles were relatively stable over 10 weeks compared to previously published data on premenopausal women. There was an inverse correlation between Lactobacillus ratio and dryness and an increased bacterial diversity in women experiencing moderate to severe vaginal dryness. In healthy participants, Lactobacillus iners and L. crispatus were generally the most abundant, countering the long-held view that lactobacilli are absent or depleted in menopause. Vaginal dryness and atrophy were associated with down-regulation of human genes involved in maintenance of epithelial structure and barrier function, while those associated with inflammation were up-regulated consistent with the adverse clinical presentation.

  15. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness.

    Directory of Open Access Journals (Sweden)

    Ruben Hummelen

    Full Text Available After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding pathogens. The objectives of this study were twofold: first to identify the microbiome of post-menopausal women with and without vaginal dryness and symptoms of atrophy; and secondly to examine any differences in epithelial gene expression associated with atrophy. The vaginal microbiome of 32 post-menopausal women was profiled using Illumina sequencing of the V6 region of the 16S rRNA gene. Sixteen subjects were selected for follow-up sampling every two weeks for 10 weeks. In addition, 10 epithelial RNA samples (6 healthy and 4 experiencing vaginal dryness were acquired for gene expression analysis by Affymetrix Human Gene array. The microbiota abundance profiles were relatively stable over 10 weeks compared to previously published data on premenopausal women. There was an inverse correlation between Lactobacillus ratio and dryness and an increased bacterial diversity in women experiencing moderate to severe vaginal dryness. In healthy participants, Lactobacillus iners and L. crispatus were generally the most abundant, countering the long-held view that lactobacilli are absent or depleted in menopause. Vaginal dryness and atrophy were associated with down-regulation of human genes involved in maintenance of epithelial structure and barrier function, while those associated with inflammation were up-regulated consistent with the adverse clinical presentation.

  16. The Effect of Cognitive Behavior Therapy on Anxiety Reduction of First Normal Vaginal Delivery

    OpenAIRE

    R Imanparast; H Bermas; S.Danesh; Z Ajoudani

    2014-01-01

    Introduction: Anxiety has an impressive effect on normal vaginal delivery. Since no study has been conducted in this regard, this research is designed to determine the effect of cognitive behavior therapy on the reduction of anxiety at first normal vaginal delivery. Methods: A semi-experimental study was carried out on 40 nulliparous women with six months age of pregnancy and without abortion and infertility background. After the completion of testimonial, the rate of anxiety was evaluated...

  17. Causes of abortion in pregnant women applying with vaginal bleeding and pain: fetal- maternal causes

    OpenAIRE

    Çevik, Semra Akköz; Başer, Mürüvvet

    2013-01-01

    Abstract Objective: Aim of this study was to investigate causes of abortion in pregnant woman applying with vaginal bleeding and pain and diagnosed abortion to Gaziantep 75. year maternatiy hospital.Material and method: This study was conducted on pregnant woman applying with vaginal bleeding and pain and diagnosed abortion to Gaziantep 75. Year maternatiy hospital between 13 September- 29 December 2009 and total 53 pregnant woman were used as a materials( in the first and second trimester). ...

  18. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    OpenAIRE

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-01-01

    Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar...

  19. Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Mahmut Kuntay kuntay Kokanali

    2015-03-01

    Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000: 63-71

  20. WOMEN FACING HEAVY VAGINAL DISCHARGE (LEUCORRHEA) BY VIRTUE OF UNHEALTHY LIFE STYLE

    OpenAIRE

    Somia Gul; Hina Qamar; Wardha Jawaid; Urooj Bukhari; Yumna Javed

    2013-01-01

    Leucorrhea also spelled leucorrhoea, flow of a whitish, yellowish, or greenish discharge from the vagina of the female that may be normal or that may be a sign of infection. It is mucous discharge which represents desquamation of vaginal epithelial cells because of the effects of estrogen on the vaginal mucosa. It is important to distinguish leucorrhea from pathologic discharge. Leucorrhea usually does not cause irritation but some adolescents worry that it may represent an infection. A total...

  1. Endometriosis-Induced Vaginal Hyperalgesia in the Rat: Role of the Ectopic Growths and their Innervation

    OpenAIRE

    McAllister, Stacy L.; McGinty, Kristina A.; Resuehr, David; Berkley, Karen J

    2009-01-01

    Endometriosis is a painful disorder defined by extrauteral endometrial growths whose contribution to pain symptoms is poorly understood. Endometriosis is created in rats by autotransplanting on abdominal arteries pieces of either uterus (ENDO), which form cysts, or fat (shamENDO), which do not form cysts. ENDO, but not shamENDO induces vaginal hyperalgesia. We tested the hypothesis that the cysts are necessary to maintain vaginal hyperalgesia by assessing the effect of surgically removing the...

  2. PRIMARY VAGINAL ADENOCARCINOMA WITH BICORNUATE BICOLLIS UTERUS WITH RENAL INVOLVEMENT: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Praffulla Chandra

    2016-03-01

    Full Text Available BACKGROUND Primary carcinoma of vagina is a rare entity in Gynaecological oncology. A tumour should be considered as a primary vaginal carcinoma when cervix is uninvolved. Here we are reporting a case of primary vaginal adenocarcinoma with a rare uterine malformation, right renal agenesis and enlarged left kidney. This case was confirmed by meticulous physical examination, histopathology and relevant radiological investigations which excluded the possibility of carcinoma cervix, endometrium and ovary. This patient was treated solely by chemotherapy

  3. Perineal Trauma in Primiparous Women with Spontaneous Vaginal Delivery: Episiotomy or Second Degree Perineal Tear?

    OpenAIRE

    Irene Mora-Hervás; Emília Sánchez; Francisco Carmona

    2015-01-01

    Objectives: To estimate the incidence of perineal trauma in primiparous women with spontaneous vaginal delivery and to identify the factors associated with second-degree lacerations. Materials and Methods: A subset analysis of women with spontaneous vaginal deliveries (n=489) from an institutional review board-approved parent study in healthy, nulliparous, continent pregnant women, attending the public health care system of Catalonia (northeast Spain). Primary outcome measure was perineal ...

  4. Comparison of Sensitivity of FSH Levels and Vaginal pH in Diagnosis of Menopause, Estradiol Levels and Menopausal Signs

    Directory of Open Access Journals (Sweden)

    N Zafarqandi

    2011-05-01

    Full Text Available Introduction: As immunoassay and Eliza are used nowadays for checking levels of FSH and estradiol, the role of vaginal acidity as a sign of responding vaginal cells to estrogen has been forgotten, although its role in this field is known. The purpose of this study was to assess the sensitivity of vaginal pH in diagnosis of menopause, estradiol levels, hot flashes and vaginal dryness that are frequent problems. Methods: This descriptive – cross sectional study included 250 women aged 45- 60 years. Population sampling was nonrandom and inclusion factors included absence of hormonal therapy, absence of vaginal douche or coitus during the past three days. Vaginal pH, FSH and estradiol levels were determined. The analysis was carried out using SPSS. For comparing two variables, Spearman, Pearson and chi-square tests were used. Results: The mean age of the population sample was 50.4 years(SD ± 4.4 of which 45.7% were menopause and 54.3% were in menopausal transition. Mean vaginal pH was 5.57±0.66. The association between vaginal pH, FSH and estradiol was significant (P=0.047, P=0.000. In this study, the cut off point of FSH for diagnosing menopause was ≥20 mu/ml. The sensitivity of vaginal pH>5 with this level of FSH was determined to be 60%. Sensitivity of vaginal pH>5 in diagnosing estradiol ≤40pg/ml was determined to be 55%. The association between hot flashes and vaginal dryness with vaginal acidity was significant. Conclusion: Vaginal pH is an easy, noninvasive, alternative and cheap assay for diagnosing menopause, estradiol levels and menopausal signs.

  5. Evaluation of sexual function outcomes in women undergoing vaginal rejuvenation/vaginoplasty procedures for symptoms of vaginal laxity/decreased vaginal sensation utilizing validated sexual function questionnaire (PISQ-12).

    Science.gov (United States)

    Moore, Robert D; Miklos, John R; Chinthakanan, Orawee

    2014-03-01

    Sexual function outcomes were analyzed in a group of women (n = 78) presenting for vaginal rejuvenation/vaginoplasty procedure for a chief complaint of vaginal laxity and decreased sensation with intercourse. Outcomes were analyzed utilizing the validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) before and at least 6 months after repair with vaginal rejuvenation/vaginoplasty procedure (VR). Mean age was 43.6 ± 7.9 (range 25-62), and 19 patients (24.3%) were found to have prolapse at time of initial exam and underwent vaginal vault suspension in addition to VR. Compared preoperatively and postoperatively, the overall sexual function (Total PISQ-12) statistically improved (30.3 ± 6.6 vs. 38.2 ± 5.2, P sexual satisfaction improved as well as subcategories of increased sexual excitement during intercourse and overall increase in intensity of orgasms. Pain with intercourse subscores were found to be no different from preoperatively to postoperatively. Previous studies have shown that sexual function improves with repair of prolapse; however, this is the first study to show improved function using a validated questionnaire in patients undergoing VR for laxity.

  6. Prevalence of pathogens of abnormal vaginal discharges in a Nigerian tertiary hospital

    Institute of Scientific and Technical Information of China (English)

    Samue Nwadioha; Julie O Egesie; Henry Emejuo; Elizabeth Iheanacho

    2010-01-01

    Objective:To investigate the prevalence of pathogens of abnormal vaginal discharges and to improve the current syndromic management of abnormal vaginal discharge. Methods:A prospective study of pathogens of abnormal vaginal discharge was carried out from December 2007 to December 2008. Samples of female genital swabs were collected from Obstetrics and Gynecology Units of Aminu Kano Teaching Hospital, Kano, Nigeria, and analyzed by microscopy, culture and sensitivity test in Medical Microbiology Laboratory of Aminu Kano Teaching Hospital. Results:Microorganisms were detected in 70%(1 400) of a total 2 000 female genital swabs studied. Candida species peaked with 42.0% (840), followed by Gardnerella vaginalis, a pathogen of bacteria vaginosis with 26.0%. The distribution of abnormal vaginal discharge was highest in young adults aged from 21 to 30 years. Conclusions:The commonest Microorganisms of infective vaginal discharge were Candida species, followed by Gardnerella vaginalis, a pathogen of bacterial vaginosis. Vaginal discharge was prevalent among young adults. We recommend prevention, early diagnosis and prompt treatment of infected female, especially among the young, sexually active group in order to reduce the menace of HIV transmission.

  7. A Murine Model of Candida glabrata Vaginitis Shows No Evidence of an Inflammatory Immunopathogenic Response

    Science.gov (United States)

    Nash, Evelyn E.; Peters, Brian M.; Lilly, Elizabeth A.; Noverr, Mairi C.; Fidel, Paul L.

    2016-01-01

    Candida glabrata is the second most common organism isolated from women with vulvovaginal candidiasis (VVC), particularly in women with uncontrolled diabetes mellitus. However, mechanisms involved in the pathogenesis of C. glabrata-associated VVC are unknown and have not been studied at any depth in animal models. The objective of this study was to evaluate host responses to infection following efforts to optimize a murine model of C. glabrata VVC. For this, various designs were evaluated for consistent experimental vaginal colonization (i.e., type 1 and type 2 diabetic mice, exogenous estrogen, varying inocula, and co-infection with C. albicans). Upon model optimization, vaginal fungal burden and polymorphonuclear neutrophil (PMN) recruitment were assessed longitudinally over 21 days post-inoculation, together with vaginal concentrations of IL-1β, S100A8 alarmin, lactate dehydrogenase (LDH), and in vivo biofilm formation. Consistent and sustained vaginal colonization with C. glabrata was achieved in estrogenized streptozotocin-induced type 1 diabetic mice. Vaginal PMN infiltration was consistently low, with IL-1β, S100A8, and LDH concentrations similar to uninoculated mice. Biofilm formation was not detected in vivo, and co-infection with C. albicans did not induce synergistic immunopathogenic effects. This data suggests that experimental vaginal colonization of C. glabrata is not associated with an inflammatory immunopathogenic response or biofilm formation. PMID:26807975

  8. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?

    Science.gov (United States)

    Edwards, D.; Panay, N.

    2016-01-01

    Abstract Vaginal dryness is a common condition that is particularly prevalent during and after the menopause, and is one of the symptoms of vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, and this condition is often underreported and undertreated. Greater education about vaginal dryness and the range of available treatments is essential to encourage more women to seek help for this condition. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. However, there is a distinction between lubricants and moisturizers, and notable differences between commercially available products. Women should be advised to choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions. A series of recommendations for the use of vaginal lubricants and moisturizers, either on their own or in combination with systemic or topical hormone replacement therapy, is presented. PMID:26707589

  9. Conception rate of artificially inseminated Holstein cows affected by cloudy vaginal mucus, under intense heat conditions

    Directory of Open Access Journals (Sweden)

    Miguel Mellado

    2015-06-01

    Full Text Available The objective of this work was to obtain prevalence estimates of cloudy vaginal mucus in artificially inseminated Holstein cows raised under intense heat, in order to assess the effect of meteorological conditions on its occurrence during estrus and to determine its effect on conception rate. In a first study, an association was established between the occurrence of cloudy vaginal mucus during estrus and the conception rate of inseminated cows (18,620 services, raised under intense heat (mean annual temperature of 22°C, at highly technified farms, in the arid region of northern Mexico. In a second study, data from these large dairy operations were used to assess the effect of meteorological conditions throughout the year on the occurrence of cloudy vaginal mucus during artificial insemination (76,899 estruses. The overall rate of estruses with cloudy vaginal mucus was 21.4% (16,470/76,899; 95% confidence interval = 21.1-21.7%. The conception rate of cows with clean vaginal mucus was higher than that of cows with abnormal mucus (30.6 vs. 22%. Prevalence of estruses with cloudy vaginal mucus was strongly dependent on high ambient temperature and markedly higher in May and June. Acceptable conception rates in high milk-yielding Holstein cows can only be obtained with cows showing clear and translucid mucus at artificial insemination.

  10. Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.

    Science.gov (United States)

    Saffari, Elnaz; Mohammad-Alizadeh-Charandabi, Sakineh; Adibpour, Mohammad; Mirghafourvand, Mojgan; Javadzadeh, Yousef

    2016-11-23

    This triple-blind trial examined the effects of Calendula officinalis vaginal cream on the treatment of vaginal Candidiasis (primary outcome) and sexual function (secondary outcome). Married women aged 18-45 years with vaginal Candidiasis (n = 150) were recruited from April to October 2014 and randomized into Calendula and clotrimazole groups, using 5-g vaginal cream every night for seven nights. Clinical and laboratory assessments were conducted at 10-15 and 30-35 days after intervention and the female sexual function index was assessed at 30-35 days. Six women were lost to follow-up. The frequency of testing negative for Candidiasis in the Calendula group was significantly lower at the first (49% vs. 74%; odds ratio (OR) 0.32; 95% confidence interval (CI) 0.16-0.67) but higher at the second (77% vs. 34%; OR 3.1; 95% CI 1.5-6.2) follow-up compared to the clotrimazole group. The frequency of most signs and symptoms were almost equal in the two groups at the first follow-up, but were significantly lower in the Calendula group at the second follow-up. Sexual function had almost equal significant improvement in both groups. Calendula vaginal cream appears to have been effective in the treatment of vaginal Candidiasis and to have a delayed but greater long-term effect compared to clotrimazole.

  11. Systematic review of sexual function and satisfaction following the management of vaginal agenesis.

    Science.gov (United States)

    McQuillan, Sarah K; Grover, Sonia R

    2014-10-01

    Historically, sexual satisfaction following the management of vaginal agenesis was assessed subjectively. Standardized sexual function questionnaires are being used more frequently as instruments to accurately and more objectively assess the subjective nature of sexual outcomes as part of a more holistic approach to the care of women with vaginal agenesis. Articles concerning the management of vaginal agenesis were systematically reviewed, with specific focus on those that discussed functional outcomes, sexual satisfaction and psychosomatic outcomes, and in particular attempted to measure these outcomes. A total of 6,691 articles on vaginal agenesis were identified, with 106 of these reporting sexual satisfaction and psychosomatic outcomes. Only 1 randomized control trial (RCT) was identified, the remaining articles being made up of case series or case reports. Only 17 articles used standardized objective assessment of sexual satisfaction. While the bowel technique had the longest vaginal length at 12.87 cm, it had the most number of complaints of dyspareunia (4.8%), stenosis (10.5%) and the lowest average subjective sexual satisfaction. The Davydov method used standardized sexual function assessments most frequently. This technique had a higher average score than both the bowel vaginoplasty technique in the only RCT and the Vecchietti method in a prospective assessment. Overall, the management of vaginal agenesis requires a multidisciplinary approach to fully support these patients from initial diagnosis, through management decision-making and long-term follow-up, through transition to adulthood.

  12. Anal sex, vaginal sex and HIV risk among female sex workers in Papua New Guinea.

    Science.gov (United States)

    Kelly-Hanku, Angela; Rawstorne, Patrick; Kupul, Martha; Worth, Heather; Shih, Patti; Man, Wing Young Nicola

    2014-03-01

    Female sex workers (FSW) are considered one of the key affected populations in Papua New Guinea at risk of acquiring HIV. An integrated bio-behavioral survey of sex workers in Port Moresby was conducted to determine the nature and extent of this risk. About half (51.1 %) of the 411 FSW who reported having any sexual intercourse with clients had engaged in both anal and vaginal intercourse with clients in the last 6 months. In spite of having poorer HIV knowledge (OR95 % CI = 0.14-0.34), FSW who had anal intercourse with clients were significantly more likely to have used a condom at the last vaginal intercourse with a client (OR95 % CI = 1.04-2.87). Similarly, FSW who had anal intercourse with regular and casual partners were significantly more likely to have used a condom at the last vaginal intercourse. Those who engaged in both anal and vaginal intercourse with clients had similar condom use for both vaginal and anal intercourse, with the majority (78.1 %) using a condom at the last occasion for both vaginal and anal intercourse. These FSW may have different risk and protective factors that affect their use of condom during sexual intercourse. Further research is needed to investigate this difference between those who practice anal intercourse and those who do not in order to provide evidence for better programming.

  13. Species Distribution and Susceptibility to Azoles of Vaginal Yeasts Isolated Prostitutes

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    Norma T. Gross

    2007-01-01

    Full Text Available Objective. We investigated the use of miconazole among female prostitutes in Costa Rica as well as the distribution of vaginal yeasts and the susceptibility pattern to azoles of strains obtained from this population. Our intention was to relate a frequent use of miconazole to occurrence of vaginal yeasts resistant to azoles. Methods. Vaginal samples were taken from 277 patients that have previously used azoles. Vaginal swabs were obtained for direct microscopy and culture. Yeast isolates were identified by germ tube test and assimilation pattern. Susceptibility testing was determined using a tablet diffusion method. Results. The number of clinical Candida isolates (one from each patient was 57 (20.6%. C. albicans was the predominant species (70%, followed by C. parapsilosis (12%, C. tropicalis (5.3%, C. glabrata and C. famata (3.5% each, C. krusei, C. inconspicua and C. guilliermondii (1.7% each. The majority of vaginal Candida isolates were susceptible to ketoconazole (91%, fluconazole (96.5%, and itraconazole (98%. A lower susceptibility of some isolates to miconazole (63% was observed as compared to the other azoles tested. Moreover, the strains, nonsusceptible to miconazole, were more often obtained from patients that have used this antifungal at least four times within the last year before taking the samples as compared to those with three or less treatments (P<.01. Conclusion. An indiscriminate use of miconazole, such as that observed among female prostitutes in Costa Rica, results in a reduced susceptibility of vaginal yeasts to miconazole but not to other azoles.

  14. Evaluation of immune system function in neonatal pigs born vaginally or by Cesarean section.

    Science.gov (United States)

    Daniel, J A; Carroll, J A; Keisler, D H; Kojima, C J

    2008-07-01

    Full term crossbred sows were selected to study the interaction of the immune system, hypothalamus-pituitary-adrenal axis, and growth in pigs born by Cesarean section (c-section; n=4 sows) or vaginal birth (n=4 sows). Gestation length and birth weight did not differ between vaginal birth and c-section pigs (P=0.34 and 0.62, respectively). Blood and tissue samples were collected from 44 pigs at birth. Forty-five pigs were weaned at 13 d. On d 14, pigs received an i.p. injection of lipopolysaccaride (LPS; 150 microg/kg) or saline at min 0, and blood samples were collected at -20, -10, 0, 5, 10, 20, 40, 60, 90, and 120 min. Vaginal birth pigs had 21% greater average daily gain than c-section pigs on d 14 (Ppigs at birth (P0.22). Basal serum concentrations of TNF-alpha tended to be greater in c-section vs vaginal birth pigs at 14 d (P=0.0967); however, basal serum concentrations of IFN-gamma tended to be lower in c-section pigs vs vaginal birth pigs at 14 d (P=0.0787). Expression of interleukin (IL)-6, IL-6 receptor, IL-1beta, and TNF-alpha mRNA did not differ between vaginal birth and c-section pigs but changed in an age and tissue dependent manner. Thus, reduced growth rate of c-section pigs is associated with altered immune system function.

  15. Detection of bacterial 16S ribosomal RNA genes for forensic identification of vaginal fluid.

    Science.gov (United States)

    Akutsu, Tomoko; Motani, Hisako; Watanabe, Ken; Iwase, Hirotaro; Sakurada, Koichi

    2012-05-01

    To preliminarily evaluate the applicability of bacterial DNA as a marker for the forensic identification of vaginal fluid, we developed and performed PCR-based detection of 16S ribosomal RNA genes of Lactobacillus spp. dominating the vagina and of bacterial vaginosis-related bacteria from DNA extracted from body fluids and stains. As a result, 16S ribosomal RNA genes of Lactobacillus crispatus, Lactobacillus jensenii and Atopobium vaginae were specifically detected in vaginal fluid and female urine samples. Bacterial genes detected in female urine might have originated from contaminated vaginal fluid. In addition, those of Lactobacillus iners, Lactobacillus gasseri and Gardnerella vaginalis were also detected in non-vaginal body fluids such as semen. Because bacterial genes were successfully amplified in DNA samples extracted by using the general procedure for animal tissues without any optional treatments, DNA samples prepared for the identification of vaginal fluid can also be used for personal identification. In conclusion, 16S ribosomal RNA genes of L. crispatus, L. jensenii and A. vaginae could be effective markers for forensic identification of vaginal fluid.

  16. Management of fecal incontinence - focus on a vaginal insert for bowel control

    Directory of Open Access Journals (Sweden)

    Sokol ER

    2016-05-01

    Full Text Available Eric R Sokol Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA Abstract: Fecal incontinence, also referred to as accidental bowel leakage, is a debilitating condition that impacts quality of life in a significant number of women. Current treatments for fecal incontinence include behavioral modification, biofeedback, drug therapy, and invasive surgical procedures. However, these treatments have suboptimal efficacy due to patient adherence, variability of presentation across patients, cost, and additional health risks. A vaginal bowel control system (EclipseTM System was developed to offer a low-risk, effective, and patient-managed approach to treating accidental bowel leakage. The vaginal bowel control system consists of a vaginal insert and user-controlled, pressure-regulated pump. Once inflated, the balloon of the vaginal insert is directed posteriorly to occlude the rectum, allowing the woman to immediately regain control of bowel function. This article will introduce the design evolution and feasibility studies of the Eclipse System. In addition, this review will discuss the results from a recent clinical trial that demonstrated the safety and efficacy of the vaginal bowel control system in managing fecal incontinence and other symptoms of bowel dysfunction. Keywords: accidental bowel leakage, fecal urgency, vaginal bowel control system, Eclipse System, bowel function

  17. Vaginal estrogen products in hormone receptor-positive breast cancer patients on aromatase inhibitor therapy.

    Science.gov (United States)

    Sulaica, Elisabeth; Han, Tiffany; Wang, Weiqun; Bhat, Raksha; Trivedi, Meghana V; Niravath, Polly

    2016-06-01

    Atrophic vaginitis represents a major barrier to compliance with aromatase inhibitor (AI) therapy in breast cancer (BC) survivors. While local estrogen therapy is effective for postmenopausal vaginal dryness, the efficacy of such therapies has not been evaluated systematically in hormone receptor-positive (HR+) BC patients on AI therapy. Furthermore, the potential risk of breast cancer recurrence with vaginal estrogen therapy represents a long-term safety concern for the patients with HR + BC. Unfortunately, there is no standardized assay to measure very low concentrations of estradiol (E2) in these women being treated with AI therapy. This makes it difficult to evaluate even indirectly the potential risk of BC recurrence with vaginal estrogen therapy in HR + BC patients on AI therapy. In this review, we describe available assays to measure very low concentrations of E2, discuss the Food and Drug Administration-approved vaginal estrogen products on the market, and summarize published and ongoing clinical trials evaluating the safety and efficacy of vaginal estrogen in HR + BC patients on AI therapy. In the absence of any randomized controlled clinical trials, this review serves as a summary of available clinical data and ongoing studies to aid clinicians in selecting the best available option for their patients.

  18. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?

    Science.gov (United States)

    Edwards, D; Panay, N

    2016-04-01

    Vaginal dryness is a common condition that is particularly prevalent during and after the menopause, and is one of the symptoms of vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, and this condition is often underreported and undertreated. Greater education about vaginal dryness and the range of available treatments is essential to encourage more women to seek help for this condition. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. However, there is a distinction between lubricants and moisturizers, and notable differences between commercially available products. Women should be advised to choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions. A series of recommendations for the use of vaginal lubricants and moisturizers, either on their own or in combination with systemic or topical hormone replacement therapy, is presented.

  19. Local IL-23 Expression in Murine Vaginal Candidiasis and Its Relationship with Infection and Immune Status

    Institute of Scientific and Technical Information of China (English)

    WU Yan; TAN Zhijian; LIU Zhixiang; XIA Dechao; LI Jiawen

    2006-01-01

    To investigate the expression of vaginal IL-23 and its role in experimental murine vaginal candidiasis and its relationship with infection and immune status, immuno-competent (group A) and immuno-suppressed (group B) murine models of vaginal candidiasis were established in estrogentreated mice. Non-estrogen-treated mice were used as controls (group C). The level of IL-23 p19 mRNA in murine vaginal tissue was determined by RT-PCR. Significantly increased levels of IL23p19mRNA were observed on the 4th, the 7th and 14th day after inoculation in immuno-competent group when compared with that in control group (P<0.01, P<0.05), However, significant increase of IL-23 p19mRNA were only observed on the 7th day and the 14th day after inoculatuon in immuno-suppressed groups (P<0.05). On the 4th and 7th day, the levels of IL-23 p19mRNA were significantly increased in immuno-competent group than those in immuno-suppressed group (P <0.05). Local IL-23 may play a role in the pathogenesis of murine vaginal candidiasis and has a protective function during infection. Low vaginal IL-23 level may correlate with the increased susceptibility to Candida albicans in immuno-suppressed group.

  20. 3D ultrasound Nakagami imaging for radiation-induced vaginal fibrosis

    Science.gov (United States)

    Yang, Xiaofeng; Rossi, Peter; Shelton, Joseph; Bruner, Debrorah; Tridandapani, Srini; Liu, Tian

    2014-03-01

    Radiation-induced vaginal fibrosis is a debilitating side-effect affecting up to 80% of women receiving radiotherapy for their gynecological (GYN) malignancies. Despite the significant incidence and severity, little research has been conducted to identify the pathophysiologic changes of vaginal toxicity. In a previous study, we have demonstrated that ultrasound Nakagami shape and PDF parameters can be used to quantify radiation-induced vaginal toxicity. These Nakagami parameters are derived from the statistics of ultrasound backscattered signals to capture the physical properties (e.g., arrangement and distribution) of the biological tissues. In this paper, we propose to expand this Nakagami imaging concept from 2D to 3D to fully characterize radiation-induced changes to the vaginal wall within the radiation treatment field. A pilot study with 5 post-radiotherapy GYN patients was conducted using a clinical ultrasound scanner (6 MHz) with a mechanical stepper. A serial of 2D ultrasound images, with radio-frequency (RF) signals, were acquired at 1 mm step size. The 2D Nakagami shape and PDF parameters were calculated from the RF signal envelope with a sliding window, and then 3D Nakagami parameter images were generated from the parallel 2D images. This imaging method may be useful as we try to monitor radiation-induced vaginal injury, and address vaginal toxicities and sexual dysfunction in women after radiotherapy for GYN malignancies.

  1. Psychological Stress-Derived Prolactin Modulates Occludin Expression in Vaginal Epithelial Cells to Compromise Barrier Function

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    Xueyan Li

    2015-08-01

    Full Text Available Background/Aims: The causative factors of the vaginitis are not fully understood yet. Epithelial barrier dysfunction plays a critical role in the pathogenesis of vaginitis. This study aims to investigate the role of prolactin (PRL in the causing the vaginal epithelial barrier dysfunction. Methods: Adult rats were treated with water-avoid-stress. The serum levels of PRL were determined by ELISA. T84 cell (T84 cells; a vaginal epithelial cell line monolayers were prepared to be used assessing the epithelial barrier functions. The expression of occludin in T84 cells was assessed by Chromatin immunoprecipitation assay, methylation specifIc PCR, real time quantitative RT-PCR and Western blotting. Results: The results showed that psychological stress markedly increased the serum levels of PRL in the rat vaginal epithelia. Exposure of T84 cells to PRL in the culture markedly increased the phosphorylation of STAT3 and suppressed the expression of occludin in the cells; the transepithelial electric resistance was decreased and the permeability to a macromolecular tracer was increased in the T84 monolayers, which was mimicked by blocking STAT3, or abolished by over expression of occludin in the epithelial cells. Conclusions: Psychological stress-derived PRL induces vaginal epithelial barrier dysfunction by inhibiting the expression of occludin.

  2. Vaginal Versus Oral Misoprostol for Second-Trimester Pregnancy Termination: A Randomized Trial

    Directory of Open Access Journals (Sweden)

    Sh Aghdaee

    2008-10-01

    Full Text Available Introduction: The purpose of this study was to compare the efficacy and side effects of two different misoprostol regimens for second-trimester pregnancy termination. Methods: 60 consenting women who were at 14 to 28 weeks of gestation with indications for pregnancy termination were randomly assigned to two equal groups to receive either vaginal or oral misoprostol. The dosing regimen was 400µg as the initial dose followed by 400µg and up to 3 doses (1200µg if needed in each group. Efficacy and side effects were compared. Results: 30 patients randomly assigned to vaginal and 30 to oral misoprostol group. Demographic characteristics were similar in both the groups. The percentage of women who delivered was significantly higher in vaginal group than the oral group (86.7 vs.43.3, P=0.0006.The average induction to delivery interval was shorter in vaginal group, but this difference was not significant (9.7±4.2 vs. 12.7±7.3 P=0.083. No significant differences in complication rates or side effects were noted between the two groups. Conclusion: Vaginal administration of misoprostol resulted in a higher success rate for second trimester pregnancy termination, whereas, no significant differences in induction to delivery time and complication rates were noted between vaginal and oral groups.

  3. Firmness Perception Influences Women’s Preferences for Vaginal Suppositories

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    Toral Zaveri

    2014-09-01

    Full Text Available Microbicides are being actively researched and developed as woman-initiated means to prevent HIV transmission during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have developed carrageenan-based semisoft vaginal suppositories and have previously evaluated how physical properties such as firmness, size and shape influence women’s willingness to try them. Firmness has previously been quantified in terms of small-strain storage modulus, G’, however large-strain properties of the gels may also play a role in the firmness perception. In the current study we prepared two sets of suppositories with the same G’ but different elongation properties at four different G’ values (250, 2500, 12,500, 25,000 Pa: For convenience we refer to these as “brittle” and “elastic”, although these terms were never provided to study participants. In the first of two tests conducted to assess preference, women compared pairs of brittle and elastic suppositories and indicated their preference. We observed an interaction, as women preferred brittle suppositories at lower G’ (250, 2500 Pa and elastic ones at a higher G’ (25,000 Pa. In the second test, women evaluated samples across different G’, rated the ease-of-insertion and willingness-to-try and ranked the samples in order of preference. Brittle suppositories at G’ of 12,500 Pa were most preferred. In vitro studies were also conducted to measure the softening of the suppositories in contact with vaginal simulant fluid (VSF. Release of antiretroviral drug tenofovir in VSF was quantified for the brittle and elastic suppositories at G’ of 12,500 Pa to determine the effect of suppository type on release. The initial rate of release was 20% slower with elastic suppositories as compared to brittle suppositories. Understanding how different physical properties simultaneously affect women’s preferences

  4. Brachytherapy at the Institut Gustave-Roussy: Personalized vaginal mould applicator: technical modification and improvement; Curietherapie a l'Institut Gustave-Roussy: applicateur moule vaginal personnalise: modification et amelioration techniques

    Energy Technology Data Exchange (ETDEWEB)

    Albano, M.; Dumas, I.; Haie-Meder, C. [Institut Gustave-Roussy, Service de curietherapie, 94 - Villejuif (France)

    2008-12-15

    Brachytherapy plays an important role in the treatment of patients with gynaecological cancers. At the Institut Gustave-Roussy, the technique of vaginal mould applicator has been used for decades. This technique allows a personalized tailored irradiation, integrating tumour shape, size and extension and vaginal anatomy. Vaginal expansion reduces the dose to the vaginal mucosa and to the organs at risk. We report a modification of the material used for vaginal mould manufacture. The advantages of the new material are a lighter weight, and transparency allowing a better accuracy in the placement of catheters for radioactive sources. This material is applicable for low dose-rate, pulse dose-rate and high dose-rate brachytherapy. Since 2001, more than 700 vaginal moulds have been manufactured with this new approach without any intolerance. (authors)

  5. [In vitro biofilm formation and relationship with antifungal resistance of Candida spp. isolated from vaginal and intrauterine device string samples of women with vaginal complaints].

    Science.gov (United States)

    Calışkan, Seyda; Keçeli Özcan, Sema; Cınar, Selvi; Corakçı, Aydın; Calışkan, Eray

    2011-10-01

    Intrauterin device (IUD) application is a widely used effective, safe and economic method for family planning. However IUD use may cause certain changes in vaginal ecosystem and may disturb microflora leading to increased colonization of various opportunistic pathogen microorganisms. The aims of this study were (i) to detect the biofilm production characteristics of Candida spp. isolated from vaginal and IUD string samples of women with IUDs, and (ii) to investigate the relationship between biofilm production and antifungal resistance. A total of 250 women (mean age: 34.4 ± 7.6 years) admitted to gynecology outpatient clinics with vaginal symptoms (discharge and itching) were included in the study. The patients have been implanted CuT380a type IUDs for a mean duration of 59.8 ± 42.4 months. Without removing IUD, string samples were obtained by cutting and simultaneous vaginal swab samples were also collected. Isolated Candida spp. were identified by conventional methods and API 20C AUX (BioMerieux, Fransa) system. Minimal inhibitory concentrations (MIC) of fluconazole, itraconazole and amphotericin B were determined by broth microdilution method according to the CLSI guidelines. Biofilm formation was evaluated by crystal violet staining and XTT-reduction assays, and the isolates which yielded positive results in both of the methods were accepted as biofilm-producers. In the study, Candida spp. were isolated from 33.2% (83/250) of the vaginal and 34% (85/250) of the IUD string samples, C.albicans being the most frequently detected species (54 and 66 strains for the samples, respectively). The total in vitro biofilm formation rate was 25% (21/83) for vaginal isolates and 44.7% (38/85) for IUD string isolates. Biofilm formation rate of vaginal C.albicans isolates was significantly lower than vaginal non-albicans Candida spp. (14.8% and 44.8%, respectively; p= 0.003). Biofilm formation rate of C.albicans strains isolated from vaginal and IUD string samples were found

  6. Histerectomia Vaginal Assistida por Laparoscopia em Pacientes com Necessidade de Anexectomia Laparoscopically Assisted Vaginal Histerectomy in Patients Requiring Adnexectomy

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    Francisco José Cândido dos Reis

    1998-12-01

    Full Text Available Objetivos: avaliar as vantagens da laparoscopia como instrumento para conversão de histerectomias abdominais em vaginais em pacientes com indicação de anexectomia concomitante, considerando-se a segurança e os custos hospitalares adicionais relativos ao procedimento. Pacientes e Métodos: estudo de caso controle envolvendo 9 pacientes submetidas à Histerectomia Vaginal Assistida por Laparoscopia (HVAL e 18 pacientes-controle submetidas à Histerectomia Abdominal (HA, associadas à anexectomia. Foram avaliadas as características pré-operatórias e os resultados do procedimento. Os grupos HVAL e HA são semelhantes quanto à idade, paridade, cesáreas anteriores, cirurgias prévias e IMC. Resultados: o grupo HVAL apresentou tempo cirúrgico médio de 163,9 minutos e o grupo HA de 142,8 minutos. Não ocorreram complicações pós-operatórias no grupo HVAL, ao passo que no grupo HA houve 2 casos de deiscência de sutura e 1 caso de hérnia incisional. A mediana do tempo de internação foi de 1 dia no grupo HVAL e 2 dias no grupo HA; a mediana do período de convalescença por sua vez foi de 2 e 4 semanas respectivamente. No grupo HVAL, 55,6% das pacientes necessitaram de medicação analgésica no pós-operatório, o que ocorreu em 100% das pacientes do grupo HA. Conclusões: a HVAL mostrou-se vantajosa em relação à HA em termos de melhor recuperação e menor incidência de complicações no pós-operatório. O procedimento é factível com segurança em um Hospital Universitário, não implicando tampouco em custos adicionais com equipamentos ou instrumental.Purpose: to evaluate the advantages of the laparoscopic approach for conversion of abdominal hysterectomies in vaginal hysterectomies in patients with indication of concomitant adnexectomy, being considered the safety and the additional costs of the procedure. Patients and Methods: cases: 9 patients submitted to Laparoscopically Assisted Vaginal Hysterectomy (LAVH associated with

  7. Prediction of scar integrity and vaginal birth after caesarean delivery.

    Science.gov (United States)

    Valentin, Lil

    2013-04-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has been published. A thin lower uterine segment at 35-40 weeks, as measured by ultrasound in women with a caesarean hysterotomy scar, increases the risk of uterine rupture or dehiscence. No cut-off for lower uterine segment thickness, however, can be suggested because of study heterogeneity, and because prospective validation is lacking. Large caesarean hysterotomy scar defects in non-pregnant women seen at ultrasound examination increase the risk of uterine rupture or dehiscence in subsequent pregnancy, but the strength of the association is unknown. To sum up, we currently lack a method that can provide a reliable estimate of the risk of uterine rupture or dehiscence during a trial of labour in women with caesarean hysterotomy scar(s).

  8. Spontaneous unscarred fundal rupture after normal vaginal delivery

    Directory of Open Access Journals (Sweden)

    Shreya Thapa

    2014-06-01

    Full Text Available Uterine rupture is one of the most dangerous obstetric situation carrying an increased risk of maternal and perinatal morbidity and mortality, associated with poorly managed labour. The incidence of spontaneous rupture of unscarred uterus is around 1 in 8000 to 1 in 15000 deliveries. We report this unusual case of spontaneous unscarred fundal rupture after normal vaginal delivery. This case under reference developed shock soon after delivery and was explored due to suspected intraperitoneal hemorrhage. This case is being reported to emphasis the need for proper post-delivery monitoring not only to diagnose post-partum hemorrhage but also to suspect uterine rupture as a cause of unexplained shock developing after delivery inspite of all resuscitative measures. Although unexpected in a woman with an unscarred uterus, rupture should be considered as a possible cause of unusual pain or hypotension in the mother. The most effective way to reduce the number of morbidity and mortality would be to prevent unwanted pregnancies by informed and effective use of contraception. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 780-782

  9. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  10. Validitet af kodning og indberetning ved vaginal prolapskirurgi

    DEFF Research Database (Denmark)

    Ottesen, Marianne

    2009-01-01

    -level. However, the validity of such register data is affected by the risk of errors when drawing such data, and by coding errors. The main problems are lack of consensus on which codes to use, and that codes for very different procedures are very much alike. To improve the quality and usefulness of register......INTRODUCTION: To validate the coding and local registration of vaginal prolapse surgery in 1996-1998, and reporting of such data to the Danish National Patient registry (LPR). MATERIAL AND METHODS: Comparison of different sets of data from the local data base (GS) and LPR, and retrospective study...... of 296 patient files. RESULTS: The concordance between two GS-data sets was 96.4%, and 0-100% between different LPR-data sets. The validity of reporting of data from GS to LPR was 96.2% on the level of patient ID (cpr), and 99.3% concerning length of hospital stay. If a procedure was registered...

  11. Vaginal vault suspension during hysterectomy for benign indications

    DEFF Research Database (Denmark)

    Bonde, Lisbeth; Noer, Mette Calundann; Møller, Lars Alling

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history of hyste......INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history...... of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD...... (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method. RESULTS...

  12. The perinatal microbiome and pregnancy: moving beyond the vaginal microbiome.

    Science.gov (United States)

    Prince, Amanda L; Chu, Derrick M; Seferovic, Maxim D; Antony, Kathleen M; Ma, Jun; Aagaard, Kjersti M

    2015-03-16

    The human microbiome, the collective genome of the microbial community that is on and within us, has recently been mapped. The initial characterization of healthy subjects has provided investigators with a reference population for interrogating the microbiome in metabolic, intestinal, and reproductive health and disease states. Although it is known that bacteria can colonize the vagina, recent metagenomic studies have shown that the vaginal microbiome varies among reproductive age women. Similarly, the richness and diversity of intestinal microbiota also naturally fluctuate among gravidae in both human and nonhuman primates, as well as mice. Moreover, recent evidence suggests that microbiome niches in pregnancy are not limited to maternal body sites, as the placenta appears to harbor a low biomass microbiome that is presumptively established in early pregnancy and varies in association with a remote history of maternal antenatal infection as well as preterm birth. In this article, we will provide a brief overview on metagenomics science as a means to investigate the microbiome, observations pertaining to both variation and the presumptive potential role of a varied microbiome during pregnancy, and how future studies of the microbiome in pregnancy may lend to a better understanding of human biology, reproductive health, and parturition.

  13. Comparison of molecular abnormalities in vulvar and vaginal melanomas.

    Science.gov (United States)

    Aulmann, Sebastian; Sinn, Hans P; Penzel, Roland; Gilks, C Blake; Schott, Sarah; Hassel, Jessica C; Schmidt, Dietmar; Kommoss, Friedrich; Schirmacher, Peter; Kommoss, Stefan

    2014-10-01

    Malignant melanoma of the vulva and vagina is relatively uncommon and accounts for melanomas in women. The aim of our study was to establish the biological properties and evaluate potential therapeutic targets in these tumors. We collected a series of 65 cases from three centers and re-evaluated the tumor tissue for predominant growth pattern (superficial spreading, nodular, and mucosal lentiginous) and tumor thickness. KIT (CD117) expression was detected immunohistochemically. In addition, tumors were screened for BRAF, NRAS, and KIT mutations by PCR and DNA sequencing as well as for KIT amplifications by fluorescence in situ hybridization. None of the cases contained BRAF mutations. NRAS mutations and KIT amplifications were detected in similar frequency (∼12%) in tumors of the vulva and vagina. In contrast, KIT mutations were present in 18% of primary melanomas of the vulva, but in none of the tumors arising in the vagina. Moderate or strong KIT protein expression was detected in 30 cases, including all tumors with KIT mutations and 6 of the 7 with KIT amplifications. In conclusion, BRAF mutations are virtually absent in melanomas originating from the vulva or vagina, whereas NRAS mutations and KIT amplifications occur in both locations. KIT mutations appear to be specific for melanomas of the vulva, suggesting that in spite of the anatomic proximity, the development of vulvar and vaginal melanomas involves different molecular alterations which may be targeted by novel treatment approaches.

  14. Clinical approach to canine vaginitisAbordagem clínica da vaginite canina

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    Maria Isabel Mello Martins

    2012-08-01

    Full Text Available Vaginitis is a rare disease in adult female dogs. However, knowledge regarding this illness is important because, if secondary to reproductive tract anomalies that go uncorrected, it can cause ascending uterine infections and, consequently, subfertility or even infertility. Usually, these infections are caused by Enterobacter or microorganisms from the urogenital inferior system, such as Staphylococcus spp, Streptococcus spp, Escherichia coli, Proteus spp, Pseudomonas aeruginosa, Pasteurella, etc. In some cases, vaginitis may be caused by primary infections with Brucella canis, which is zoonotic, or by canine herpesvirus; both of these agents have the potential to cause reproductive failure. The disease can occur in any age, breed or ovarian condition and can be identified by vaginal cytology, vaginoscopy and culture of vaginal secretions. The most common clinical signs are erythema of the vaginal mucous, vaginal discharge, pollakiuria, licking of the vulva and attraction of male dogs, independent of the phase of the estrous cycle. This disease is generally self-limiting, and the treatment, when necessary, consists of antibiotic therapy, vaginal cleaning with antiseptic and, eventually, surgical correction of predisposing abnormalities. A vaginite é uma afecção rara em cadelas adultas. É uma causa importante de subfertilidade ou infertilidade, quando secundária à anomalias do trato reprodutivo. Normalmente, são causadas por enterobactérias ou pela microbiota do sistema urogenital inferior, tais como Staphylococcus spp, Streptococcus spp, Escherichia coli, Proteus spp, Pseudomonas aeruginosa, Pasteurella, entre outras. Em alguns casos, pode ser primária como infecções por Brucella canis, a qual é uma zoonose ou herpesvírus canino, importante causa de falhas reprodutivas. A afecção acomete fêmeas de qualquer idade, raça ou condição ovariana. Os sinais clínicos envolvem mucosa vaginal hiperêmica, corrimento vulvar, polaqui

  15. Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia

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    Senturk MB

    2015-07-01

    Full Text Available Mehmet Baki Senturk,1 Yusuf Cakmak,2 Halit Atac,2 Mehmet Sukru Budak3 1Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey; 2Department of Obstetrics and Gynecology, Batman State Hospital, Batman, Turkey; 3Department of Obstetrics and Gynecology, Diyarbakir Research Hospital, Diyarbakir, Turkey Abstract: Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01, but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05. In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of

  16. A comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis

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    Mansoure Masoudi

    2017-02-01

    Full Text Available Objective: Due to the high incidence of bacterial vaginosis (BV and its resistance to chemical medications and considering the anti-bacterial and anti-fungal effects of Myrtus communis, the present study aimed to compare the therapeutic effects of the vaginal gel of M. communis 2% (in metronidazole base with metronidazole vaginal gel 0.75% alone on BV.Materials and Methods: This research was a random­ized controlled clinical trial conducted on 80 women of 18-40 years old with BV. Patients were divided into two groups of 40 women. Diagnostic criteria were Amsel's criteria and Gram staining. The first group received vaginal gel of metronidazole plus M. communis 2% and the second group received metronidazole vaginal gel alone for five consecutive nights. Therapeutic effects and Amsel’s criteria were assessed after one week. Finally, the data were analyzed by SPSS 16 using t-test and Chi square tests.Results: There was a significant difference in the therapeutic response between the two groups. The results demonstrated that the combination of metronidazole and M. communis had a higher efficiency (p

  17. A comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis) extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis

    Science.gov (United States)

    Masoudi, Mansoureh; Rafieian Kopaei, Mahmoud; Miraj, Sepideh

    2017-01-01

    Objective: Due to the high incidence of bacterial vaginosis (BV) and its resistance to chemical medications and considering the anti-bacterial and anti-fungal effects of Myrtus communis, the present study aimed to compare the therapeutic effects of the vaginal gel of M. communis 2% (in metronidazole base) with metronidazole vaginal gel 0.75% alone on BV. Materials and Methods: This research was a randomized controlled clinical trial conducted on 80 women of 18-40 years old with BV. Patients were divided into two groups of 40 women. Diagnostic criteria were Amsel's criteria and Gram staining. The first group received vaginal gel of metronidazole plus M. communis 2% and the second group received metronidazole vaginal gel alone for five consecutive nights. Therapeutic effects and Amsel’s criteria were assessed after one week. Finally, the data were analyzed by SPSS 16 using t-test and Chi square tests. Results: There was a significant difference in the therapeutic response between the two groups. The results demonstrated that the combination of metronidazole and M. communis had a higher efficiency (p<0.05). The patients receiving M. communis in metronidazole gel base did not experience any recurrent BV, but 30% of patients taking metronidazole alone faced recurrent BV after three weeks of follow up. Conclusion: Findings of the study suggested that adding M. communis extract to metronidazole increases the efficiency of BV treatment. PMID:28348968

  18. Treatment of patients with a congenital transversal vaginal septum or a partial aplasia of the vagina. The vaginal pull-through versus the push-through technique.

    NARCIS (Netherlands)

    Bijsterveldt, C.D. van; Willemsen, W.N.P.

    2009-01-01

    STUDY OBJECTIVE: The aim of this study is to describe the different modalities of congenital obstructing vaginal malformations and the evaluation of techniques to solve the problem. DESIGN: A retrospective study. SETTING: The University Hospital Nijmegen, the Netherlands. PARTICIPANTS: The medical r

  19. Colpossacrofixação para correção do prolapso da cúpula vaginal Abdominal sacropexy to repair vaginal vault prolapse

    Directory of Open Access Journals (Sweden)

    Eliana Viana Monteiro Zucchi

    2003-12-01

    Full Text Available OBJETIVO: avaliar o resultado da técnica da colpossacrofixação (CSF para tratamento de pacientes que apresentaram prolapso de cúpula vaginal pós-histerectomia e que foram tratadas no período de 1995 a 2000. MÉTODOS: foram incluídas, retrospectivamente, 21 pacientes com prolapso de cúpula vaginal pós-histerectomia e correção prévia de cistocele e retocele. Foram analisados a idade, paridade, peso e índice de massa corpórea (IMC o intervalo entre a histerectomia e o aparecimento do prolapso. A colpossacrofixação foi realizada em 15 pacientes, das quais se avaliaram o tempo cirúrgico, perda sangüínea e recidiva. As pacientes submeteram-se a CSF com ou sem interposição de prótese de material sintético entre a cúpula vaginal e o sacro. RESULTADOS: para 15 das 21 pacientes acompanhadas em nosso serviço, a técnica de CSF foi a de eleição. Em um caso houve dificuldade técnica intra-operatória e optou-se pela correção a Te Linde. A média de idade das pacientes foi de 63,7 (47 a 95 anos, paridade 4,6 e o IMC 26,9. A CSF foi realizada, em média, 18 anos após histerectomia total abdominal e 3 anos após histerectomia vaginal. O tempo cirúrgico médio foi de 2 horas e 15 minutos, sem necessidade de transfusão sanguínea. Não houve recidiva do prolapso ou dos sintomas pré-operatórios (seguimento de 1 a 5 anos. CONCLUSÕES: o tratamento cirúrgico do prolapso de cúpula vaginal pode ser realizado pela via vaginal (colpocleise ou fixação ao ligamento sacroespinhoso e pela via abdominal (colpossacrofixação. Esta última apresenta a vantagem de restaurar o eixo vaginal preservando sua profundidade, o que, além de melhorar o prolapso, permite o restabelecimento das funções sexuais, intestinal e urinária (principalmente quando associada a colpofixação - Burch. Assim, quando o diagnóstico e tratamento são adequados e a equipe cirúrgica tem pleno conhecimento da anatomia pélvica, podemos afirmar que a CSF atinge

  20. Use of porcine vaginal tissue ex-vivo to model environmental effects on vaginal mucosa to toxic shock syndrome toxin-1

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Catherine C.; Baccam, Mekhine [Feminine Care Global Product Stewardship, 6110 Center Hill Road, The Procter and Gamble Company, Cincinnati, OH 45224 (United States); Mantz, Mary J. [Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242 (United States); Osborn, Thomas W.; Hill, Donna R. [Feminine Care Product Development, 6110 Center Hill Road, The Procter and Gamble Company, Cincinnati, OH 45224 (United States); Squier, Christopher A. [Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242 (United States)

    2014-01-15

    Menstrual toxic shock syndrome (mTSS) is a rare, recognizable, and treatable disease that has been associated with tampon use epidemiologically. It involves a confluence of microbial risk factors (Staphylococcus aureus strains that produce the superantigen—TSST-1), as well as environmental characteristics of the vaginal ecosystem during menstruation and host susceptibility factors. This paper describes a series of experiments using the well-characterized model of porcine vaginal mucosa ex-vivo to assess the effect of these factors associated with tampon use on the permeability of the mucosa. The flux of radiolabeled TSST-1 and tritiated water ({sup 3}H{sub 2}O) through porcine vaginal mucosa was determined at various temperatures, after mechanical disruption of the epithelial surface by tape stripping, after treatment with surfactants or other compounds, and in the presence of microbial virulence factors. Elevated temperatures (42, 47 and 52 °C) did not significantly increase flux of {sup 3}H{sub 2}O. Stripping of the epithelial layers significantly increased the flux of labeled toxin in a dose-dependent manner. Addition of benzalkonium chloride (0.1 and 0.5%) and glycerol (4%) significantly increased the flux of {sup 3}H{sub 2}O but sodium lauryl sulfate at any concentration tested did not. The flux of the labeled toxin was significantly increased in the presence of benzalkonium chloride but not Pluronic® L92 and Tween 20 and significantly increased with addition of α-hemolysin but not endotoxin. These results show that the permeability of porcine vagina ex-vivo to labeled toxin or water can be used to evaluate changes to the vaginal environment and modifications in tampon materials, and thus aid in risk assessment. - Highlights: • Model assessed local effects of tampon use on vaginal mucosa. • Risks were evaluated using two tracers to assess permeability in an ex vivo model. • Mechanical damage to the epithelial surface increased tracer penetration.

  1. Misoprostol sublingual versus vaginal para indução do parto a termo Sublingual versus vaginal misoprostol for labor induction of term pregnancies

    Directory of Open Access Journals (Sweden)

    Olímpio Barbosa de Moraes Filho

    2005-01-01

    Full Text Available OBJETIVO: comparar efetividade e segurança de uso de comprimido sublingual de 25 µg de misoprostol com o comprimido vaginal de 25 µg do misoprostol na indução do parto com idade gestacional e > 37 semanas e colo uterino desfavorável. MÉTODOS: realizou-se ensaio clínico controlado e aleatorizado, não cego, na Maternidade Monteiro de Morais (CISAM-UPE, em Recife, no período de outubro de 2003 a fevereiro de 2004. Participaram do estudo 123 gestantes com idade gestacional e > 37 semanas, índice de Bishop PURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg versus vaginal misoprostol (25 µg (Prostokos® for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE, in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22, or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11. The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95, meconium incidence (5.2 vs 4.8%, p=0.74, Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98 and other adverse effects. CONCLUSION: twenty-five micrograms of

  2. Accuracy of a self-collection kit for the microbiological study of the vaginal content

    Directory of Open Access Journals (Sweden)

    Mauro Romero L. Passos

    2007-04-01

    Full Text Available Diagnosis of vaginal discharge is frequently performed in an empirical way, leading to inadequate treatment. This study tested the accuracy of a self-collection kit for microbiological study of the vaginal content. One hundred and forty-two women of Family Health Program units in Niterói and Piraí cities were enrolled in order to have their vaginal content studied. A brief explanation and a self-collection kit were provided in order to sample the vaginal content. The self-collection kit was composed of one empty plastic tube, two glass slides, a long handle cytobrush, an identification card and guideline notes. The vaginal sample was applied on the glass slides by the women and stained by Gram technique. A second sampling was done by the medical personnel. The microbiological diagnosis in a blinded analysis was made under optical microscopy. A validation diagnosis test was done taking the medical collection results as a gold standard. A total of 106 women had followed the protocol and were included in the study. Microbiological analysis was unsatisfactory in 12 cases (6 cases of self-collection material and 6 cases of medical collection. The microbiological analyses in the self-collection and in the medical collection material were respectively: bacterial vaginosis in 21.7% and 17.9%, non bacillar flora in 10.3% and 11.3%, vaginal trichomoniasis in 5.66% and 5.6%, candidiasis in 3.78% and 2.8% and a normal microbiota in 52.8% and 56.6%. The Kappa coefficient suggested a "very good correlation" of the microbiological results between the two methods of collection (K=0.7945. The self-collection kit provides samples for microbiological analysis of the vaginal microbiota as good as medical collection.

  3. The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics.

    Science.gov (United States)

    Ling, Zongxin; Liu, Xia; Chen, Weiguang; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, Karen E; Huang, Shaolei; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie

    2013-04-01

    Whether or not treatment with antibiotics or probiotics for bacterial vaginosis (BV) is associated with a change in the diversity of vaginal microbiota in women was investigated. One hundred fifteen women, consisting of 30 healthy subjects, 30 BV-positive control subjects, 30 subjects with BV treated with a 7-day metronidazole regimen, and 25 subjects with BV treated with a 10-day probiotics regimen, were analyzed to determine the efficacy and disparity of diversity and richness of vaginal microbiota using 454 pyrosequencing. Follow-up visits at days 5 and 30 showed a greater BV cure rate in the probiotics-treated subjects (88.0 and 96 %, respectively) compared to the metronidazole-treated subjects (83.3 and 70 %, respectively [p = 0.625 at day 5 and p = 0.013 at day 30]). Treatment with metronidazole reduced the taxa diversity and eradicated most of the BV-associated phylotypes, while probiotics only suppressed the overgrowth and re-established vaginal homeostasis gradually and steadily. Despite significant interindividual variation, the microbiota of the actively treated groups or participants constituted a unique profile. Along with the decrease in pathogenic bacteria, such as Gardnerella, Atopobium, Prevotella, Megasphaera, Coriobacteriaceae, Lachnospiraceae, Mycoplasma, and Sneathia, a Lactobacillus-dominated vaginal microbiota was recovered. Acting as vaginal sentinels and biomarkers, the relative abundance of Lactobacillus and pathogenic bacteria determined the consistency of the BV clinical and microbiologic cure rates, as well as recurrent BV. Both 7-day intravaginal metronidazole and 10-day intravaginal probiotics have good efficacy against BV, while probiotics maintained normal vaginal microbiota longer due to effective and steady vaginal microbiota restoration, which provide new insights into BV treatment.

  4. Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis.

    Directory of Open Access Journals (Sweden)

    Nicole M Gilbert

    Full Text Available Bacterial vaginosis (BV is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells. G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and

  5. Evaluation of Rapidly Disintegrating Vaginal Tablets of Tenofovir, Emtricitabine and Their Combination for HIV-1 Prevention

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    Meredith R. Clark

    2014-12-01

    Full Text Available Vaginal tablets are being developed as an alternative to gels as an inexpensive, discreet dosage form for the administration of microbicides. This work describes the pharmacokinetic (PK evaluation of rapidly disintegrating vaginal tablets containing tenofovir (TFV, 10 mg, emtricitabine (FTC, 10 mg, and the combination of TFV and FTC (10 mg each under in vitro and in vivo conditions, and in direct comparison to the clinical TFV 1% gel, a microbicide product in Phase III clinical testing. The PK of TFV and FTC from tablets were also evaluated in female rabbits following intravaginal administration. Direct comparison of a single dose of TFV tablets (intact or predissolved at 10 mg/mL and TFV 1% gel showed no differences in the vaginal PK of TFV between groups; however systemic bioavailability of TFV was significantly higher from the gel. When rabbits were dosed either once or daily for seven days with intact tablets of TFV, FTC, or the combination of TFV/FTC, vaginal and systemic concentrations of TFV and FTC were unaffected by co-formulation. Moreover, plasma PK parameters were similar following a single dose or seven once-daily doses. Tissue concentrations of TFV and FTC in the cranial vagina 4 h after administration ranged between 104 and 105 ng/g. Concentrations of TFV-diphospate (TFV-DP, the active metabolite were also high (over 103 ng/g or about 3000 to 6000 fmol/mg in the cranial vagina 4 h after administration and similar to those measured following administration of TFV 1% gel. These data demonstrate that rapidly disintegrating vaginal tablets may be a suitable topical microbicide dosage form providing similar vaginal TFV PK to that of TFV 1% gel. The data also support co-administration of FTC with TFV in a single vaginal tablet to create a combination microbicide in a simple and inexpensive dosage form.

  6. Bioadhesive emulsions for control release of progesterone resistant to vaginal fluids clearance.

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    Campaña-Seoane, Maria; Peleteiro, Aaron; Laguna, Reyes; Otero-Espinar, Francisco J

    2014-12-30

    The aim of this study is to propose that mucoadhesive vaginal emulsions can be able to resist the clearance effect of vaginal fluid and to have an effective control release of progesterone. With this goal, silicon derivative, cyclomethicone pentamer, was selected as the bioadhesive and water resistant material. In order to obtain a system which is insensitive to the dilution of aqueous fluids, water in silicone (W/S) emulsions were prepared and different proportions of cyclomethicone as well as 8% or 15% w/w of progesterone were employed. The rheological, mechanical and mucoadhesive properties of emulsions were characterized and the drug release was measured for each formulation. Mucoadhesive behavior was determined and the influence of simulated vaginal fluid (SVF) at bioadhesion was assessed using three commercial mucoadhesive vaginal gels (Crinone(®), K-Y jelly(®) and Zidoval(®)) as the bioadhesive references. All assayed emulsions have good rheological and mechanical properties and their consistence and viscosity increase when the proportion of the internal phase increases. Related to mucoadhesion, in the absence of SVF, W/S emulsions showed similar bioadhesive levels like the commercial formulations. However, in the presence of SVF, W/S emulsions are able to keep their mucoadhesive properties while the marketed references drastically lose their consistency and adherence to the vaginal mucosa. Drug release profiles from W/S emulsion show that progesterone is released with pseudo-order zero kinetics and a constant release rate is maintained for at least two weeks. The results of the in vivo studies developed in rats show that after a single vaginal administration, bioadhesive W/S emulsions increase the uterine tissue progesterone levels in young and postmenopausal rats. Moreover in postmenopausal rats, they provide high uterine levels of progesterone compared to the bioadhesive-marketed gel used as a reference. Therefore, W/S emulsions have an interesting

  7. Comparison of clinical diagnosis and microbiological test results in vaginal infections.

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    Karaca, M; Bayram, A; Kocoglu, M E; Gocmen, A; Eksi, F

    2005-01-01

    Lower genital tract infections continue to be a problem due to the fact that the clinical diagnosis is usually inadequate, and subsequent care is suboptimal. This study aimed at evaluating the accuracy of clinical diagnosis by comparing it with microbiologic test results, and to determine the causative agents of vaginal infections. Sixty-seven nonpregnant women (18-45 years of age) with the clinical diagnosis of lower genital tract infection were enrolled in the study. Patients were not included if they had a history of vaginal infection during the previous three-month period or intrauterine device. The clinical diagnosis was based on the combinations of symptoms, direct observation of wet mount, homogeneous discharge, vaginal pH > 4.5, and detection of the amine odor after exposure of vaginal secretions to 10% KOH. Vaginal samples were taken with two cotton swabs, one was used for pH determination, and the second was utilized for microbiological tests. Gram staining and cultures with Sabouraud agar and chocolate agar were performed for microbiological diagnosis, and the results were compared. The clinical diagnoses included 26 (38.8%) candidiasis, 18 (26.8%) bacterial vaginosis, three (4.5%) trichomoniasis, and 20 (29.9%) mixed vaginal infections. Of the 26 patients with clinical diagnoses of candidiasis, 12 (46.1%) revealed Candiada albicans, nine (34.6) patients revealed microorganisms other than candida species, and five (19.2%) patients had no growth. Five (27.8%) bacterial vaginosis patients revealed Gardnarella vaginalis and 12 patients (66.6%) did not grow any microorganism. The overall rate of accurate clinical diagnoses confirmed by microbiological test results was 43.2%. Seventeen (43.6) of the 39 microbiological test results correlated with clinical diagnosis, and no growth was observed in 28 (41.8%) cultures. We conclude that the clinical diagnosis of vaginal infection is inadequate and should be confirmed with microbiological testing if the resources

  8. WOMEN FACING HEAVY VAGINAL DISCHARGE (LEUCORRHEA BY VIRTUE OF UNHEALTHY LIFE STYLE

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    Somia Gul

    2013-01-01

    Full Text Available Leucorrhea also spelled leucorrhoea, flow of a whitish, yellowish, or greenish discharge from the vagina of the female that may be normal or that may be a sign of infection. It is mucous discharge which represents desquamation of vaginal epithelial cells because of the effects of estrogen on the vaginal mucosa. It is important to distinguish leucorrhea from pathologic discharge. Leucorrhea usually does not cause irritation but some adolescents worry that it may represent an infection. A total health building scheme is essential for the removal of the systemic toxicity which is primarily responsible for the disease Leucorrhoea. The study aimed to examine whether women presenting with a primary complaint of vaginal discharge is more likely to be normal or infectious. We have done a survey in women of Karachi (sample size n=200 and age group= 14-40 presented at clinics, hospitals, colleges and other different public places with and without a primary complaint of vaginal discharge. Survey was scrutinized using common language of General Health Questionnaire and general Interviews. Women presenting with a primary complaint of vaginal discharge were significantly more likely due to extreme fatigue, not performing healthy lifestyle (eating disorder, never exercise, sleeplessness, dirty environmental sanitation, during pregnancy, before and after normal menstrual cycle, a marker of poverty, and low social integration. It is a domain of gender disadvantage, psychosomatic and women who live under severe stress and worries develop leucorrhea were associated with vaginal discharge in the multivariate model. Pakistani women presenting with vaginal discharge by virtue of unhealthy lifestyle. This research highlights the need for training of medical professionals and council to maintain hygiene. A total health-building scheme is essential for the removal of the systemic toxicity which is primarily responsible for the disease leucorrhoea. Such a scheme should

  9. NON–DESCENT VAGINAL HYSTERECTOMY FOR BENIGN GYNAECOLOGICAL DISEASE – A PROSPECTIVE STUDY

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    Thulasi

    2016-04-01

    Full Text Available OBJECTIVE To assess safety and feasibility of non-descent vaginal hysterectomy for benign gynaecological disease. METHODS A prospective study was conducted at the Department of Obstetrics and Gynaecology of P K Das Institute of Medical Sciences from January 2013 to December 2013. An effort was made to perform hysterectomies vaginally in women with benign or premalignant conditions in the absence of prolapse. A suspected adnexal pathology, endometriosis, immobility of uterus, uterus size more than 16 weeks was excluded from the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus, morcellation techniques like bisection, debulking, coring, myomectomy, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, intraoperative and postoperative complications and hospital stay were recorded. RESULTS A total of 100 cases were selected for non-descent vaginal hysterectomy. Among them, 97 cases successfully underwent nondescent vaginal hysterectomy. Majority of the patients (55% were in age group 40-45 yrs. Four patients were nulligravida and eight patients had previous LSCS. Uterine size was ≤ 12 weeks in 84 cases and > 12-16 weeks in 16 cases. Commonest indication was leiomyoma of uterus (43%. Mean duration of surgery was 70±20.5 minutes. Mean blood loss was 150±65 mL. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. Intra–operatively, one case had bladder injury (1% that had previous 2 LSCS. Postoperatively, complications were minimal which included postoperative fever (11%, UTI (8% and vaginal cuff infection was (4%. Mean hospital stay was 3.5 days. CONCLUSION Vaginal hysterectomy is safe, feasible in most of the women requiring hysterectomy for benign conditions with less

  10. Determination of factors affecting relapse of vaginitis among reproductive-aged women: An experimental study

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    Parsapour, Roxana; Majlessi, Fereshteh; Rahimiforoushani, Abbas; Sadeghi, Roya

    2017-01-01

    Introduction Vaginitis is a common problem for women, especially in reproductive-aged women. It is a worldwide health problem with many side effects but could be prevented by a health-promoting lifestyle related to vagina health. The aim of this study was to determine the factors affecting relapse of vaginitis. Methods In this experimental study, 350 reproductive-aged women with vaginitis were selected from 10 health centers in Kermanshah (Iran) during 2015 and were equally included in the intervention and control groups. To collect data, a researcher-created questionnaire, which included sociodemographic and health-promoting lifestyle questions, was used. The educational intervention was performed over 20 sessions, each lasting 25–35 minutes. An intervention group was educated by face-to-face education, pamphlets, phone contacts, text messages, and social media. Another group continued the routine clinic education and treatment without contacting the intervention group. Data were analyzed through chi-square and a logistics regression model using IBM-SPSS version 20. Results The results of the study indicated a significant relation between sociodemographic characteristics such as women and their husbands’ literacy, job, family size, income, area for each member of family, tendency of pregnancy, body mass index (BMI), and caesarean experience (plifestyle dimensions and prevention of vaginitis were identified. Relapse after intervention in the intervention group was 27.7% and 72.3% in the control group. According to the logistic regression analysis, chance for relapse of vaginitis in the group that did not receive intervention was more than the same chance in the intervention group (OR=5.14). Conclusion Health-promoting lifestyle intervention influences prevention of vaginitis. Health-promoting lifestyle, literacy promotion, prevention of caesarian, and obesity are beneficial to improvement in lifestyle dimensions associated with vagina health could be

  11. Identification and evaluation of potential forensic marker proteins in vaginal fluid by liquid chromatography/mass spectrometry.

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    Igoh, Akihisa; Doi, Yusuke; Sakurada, Koichi

    2015-09-01

    Vaginal fluid is one of the most common body fluids found at crime scenes. Discriminating vaginal fluid from other body fluids is important in forensic science; however, few potential protein markers have been reported to date. Proteomic methods for identifying protein markers have gained attention, although few reports have applied this technology to forensic protein markers. Therefore, to identify characteristic vaginal proteins, we examined various body fluids (nasal secretions, saliva, urine, semen, vaginal fluids, and sweat) using liquid chromatography/electrospray ionization time-of-flight mass spectrometry and peptide mass fingerprinting. We identified three components (average molecular mass values 17,237 ± 2, 18,063 ± 2, and 15,075 ± 1) detectable only in vaginal samples: two human small proline-rich protein 3 (SPRR3) isoforms and a human fatty acid-binding protein 5 (FABP5) with an acetylated (+42) N-terminal region lacking the initiator methionine residue (-131). Using ELISA, these yielded markedly high average values in vaginal fluids. The mass spectra of these proteins were not detected in infant saliva but were detected in the vaginal fluid throughout the menstrual cycle. The results of forensic analysis (detection limit, mixed body fluid samples, casework samples, and blind samples) suggest that these proteins are potential forensic markers. In conclusion, high SPRR3 and FABP5 expression levels, which may be used as potential markers for vaginal fluid identification in forensic science, were detected in vaginal fluids from healthy adults.

  12. Cervico-vaginal monitoring in pregnancy in Italy

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    Antonietta Cavallaro

    2009-03-01

    Full Text Available Background Reproductive tract infections (RTIs in pregnancy are an important cause of fetal and neonatal morbidity, sometimes with serious complications. Chlamydia trachomatis causes ectopic pregnancy, conjunctivitis, pneumonia and RTIs in newborn babies. Listeria monocytogenes and Streptococcus agalactiae can give neonatal sepsis and meningitis, and Trichomonas vaginalis causes premature birth. Objectives To update local epidemiology of RTIs in pregnancy in order to to implement efficacious screening and prevention programs. Methods Between January- December 2006, at the Padua’s Hospital Microbiology and Virology Service,we investigated 2000 asimptomatic pregnant women, 18-45 years old, Italian and foreigners.We collected vaginal and cervical swabs for the microscopy, the culture for Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma spp., Streptococcus agalactiae, Listeria monocytogenes, and other bacteria and yeasts, and for the molecular assay for Chlamydia trachomatis. Results The prevalence of Chlamydia trachomatis and Trichomonas vaginalis in our population were 2.06% and 0.20%, respectively. Neisseria gonorrhoeae was not detected. Sexually transmitted infections (STIs were more frequent among foreigners, and in women aged 18-30.The prevalence of Streptococcus agalactiae was 8.69% for Italian, and 7.54% for foreigners.We didn’t find any case of maternal colonization by Listeria monocytogenes. Conclusions From the obtained results ideas have emerged to arrange a qualitative and quantitative optimization of the diagnosis of RTIs, implementing diagnostic paths based on the different typologies of patients and on the local epidemiology. The cultural research of Listeria monocytogenes takes a long time, perhaps a molecular one, because of fastness and sensitivity, could be more useful.

  13. Feasibility and safety of vaginal myomectomy:analysis of 90 cases

    Institute of Scientific and Technical Information of China (English)

    WEI Feng-hua; ZHAO Xiao-dong; ZHANG Yi

    2006-01-01

    Background Vaginal myomectomy was firstly reported in 1994, however, it is a relatively new technique in China. The feasibility and safety of the procedure is still controversial in this country. The aim of this study was to analyze the outcomes of vaginal myomectomy in 90 patients and to investigate the feasibility and safety of the surgery.Methods From June 2001 to June 2004, 90 patients with uterine leiomyoma were treated with vaginal myomectomy in our hospital (vaginal group).. The indications, operative performance, postoperative complications, and recovery of the patients were analyzed and compared with those of 93 patients with uterine leiomyoma treated by laparotomic myomectomy from January 2000 to January 2001 (laparotomy group). The Student's t test was used to compare the continuous variables between the two groups, and the chi-square test was used to compare the categorical variables. The vaginal and laparotomy groups were followed up for 10-34 months (median, 21) and 15-24 months (median, 30), respectively.Results Vaginal myomectomy was performed successfully in 87 of the 90 patients (96.7%). In the other 3 patients, the procedure failed and laparotomy was carried out. In both groups, the uterus was enlarged to 8- 16 weeks gestational size (median, 10 gestational weeks). The number of resected tumors was 1-12 (median, 2) in the vaginal group and 1-15 (median, 4) in the laparotomy group, respectively (P>0.05). The mean operating time, intraoperative blood loss, and postoperative hospital stay were (52 ± 21) minutes, (230± 44) ml, and (7.0 ±1.2) days in the vaginal group, and (65±32) minutes, (200±56) mi, and (7.0±1.5) days in the laparotomy group (P>0.05). The mean top postoperative temperature was (38.4±1.1)℃ and (37.8±0.6)℃ in the two groups respectively (P<0.05). Both groups had one recurrent case during the follow-up (P>0.05).Conclusions Vaginal myomectomy is feasible and safe in treating uterine leiomyoma. To some extent, it is

  14. Mechanistic Insights Underlying Tolerance to Acetic Acid Stress in Vaginal Candida glabrata Clinical Isolates

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    Cunha, Diana V.; Salazar, Sara B.; Lopes, Maria M.; Mira, Nuno P.

    2017-01-01

    During colonization of the vaginal tract Candida glabrata cells are challenged with the presence of acetic acid at a low pH, specially when dysbiosis occurs. To avoid exclusion from this niche C. glabrata cells are expected to evolve efficient adaptive responses to cope with this stress; however, these responses remain largely uncharacterized, especially in vaginal strains. In this work a cohort of 18 vaginal strains and 2 laboratory strains (CBS138 and KUE100) were phenotyped for their tolerance against inhibitory concentrations of acetic acid at pH 4. Despite some heterogeneity has been observed among the vaginal strains tested, in general these strains were considerably more tolerant to acetic acid than the laboratory strains. To tackle the mechanistic insights behind this differential level of tolerance observed, a set of vaginal strains differently tolerant to acetic acid (VG281∼VG49 < VG99 < VG216) and the highly susceptible laboratory strain KUE100 were selected for further studies. When suddenly challenged with acetic acid the more tolerant vaginal strains exhibited a higher activity of the plasma membrane proton pump CgPma1 and a reduced internal accumulation of the acid, these being two essential features to maximize tolerance. Based on the higher level of resistance exhibited by the vaginal strains against the action of a β-1,3-glucanase, it is hypothesized that the reduced internal accumulation of acetic acid inside these strains may originate from them having a different cell wall structure resulting in a reduced porosity to undissociated acetic acid molecules. Both the vaginal and the two laboratory strains were found to consume acetic acid in the presence of glucose indicating that metabolization of the acid is used by C. glabrata species as a detoxification mechanism. The results gathered in this study advance the current knowledge on the mechanisms underlying the increased competitiveness of C. glabrata in the vaginal tract, a knowledge that can

  15. Association of Lactobacillus crispatus with fructo-oligosaccharides and ascorbic acid in hydroxypropyl methylcellulose vaginal insert.

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    Vitali, Beatrice; Abruzzo, Angela; Parolin, Carola; Palomino, Rogers Alberto Ñahui; Dalena, Francesco; Bigucci, Federica; Cerchiara, Teresa; Luppi, Barbara

    2016-01-20

    The aim of this work was to develop a synbiotic vaginal insert containing the probiotic strain Lactobacillus crispatus BC5, the prebiotic substrate fructo-oligosaccharide and the antioxidant agent ascorbic acid, for the prophylaxis and therapy of vaginal infections. Mucoadhesive in situ gelling vaginal inserts based on hydroxypropyl methylcellulose were prepared by freeze-drying, stored at +2-8 °C for 90 days and characterized in terms of technological and functional properties. Complete survival of L. crispatus BC5 was found immediately after insert preparation (96.08%) as well as after 90 days of storage (95.82%) in the vaginal inserts containing fructo-oligosaccharide, ascorbic acid and skimmed milk. Synbiotic inserts showed improved mucoadhesion ability (from three- to five-fold) with respect to a standard formulation based on hydroxypropyl methylcellulose alone. Moreover, inserts allowed to modulate lactobacilli release in virtue of the different amounts of fructo-oligosaccharide. Finally, antimicrobial activity was exerted by L. crispatus BC5 released from the vaginal formulation.

  16. Role of Oxidative Stress on Vaginal Bleeding during The First Trimester of Pregnant Women

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    Rüya Deveer

    2014-01-01

    Full Text Available Background: Reactive oxygen species (ROS are produced in many metabolic and physiologic processes. Antioxidative mechanisms remove these harmful species. Our aim was to assess whether serum total antioxidant capacity and total oxidant status altered during first trimester pregnancies with vaginal bleeding. Materials and Methods: In this cross-sectional study, A group of pregnant women at less than 10 weeks of gestation with vaginal bleeding (n=25 and a control group of healthy pregnancies with similar characteristics (n=25 were included. All of the patients in the two groups were matched for age, gestational age and body mass index. Serum total antioxidant capacity and total oxidant status levels were determined using a Hitachi 912 analyzer and compared between the two groups. Results: Characteristics, including maternal age, parity, and gestational age were similar between the two groups. Serum total antioxidant capacity levels were significantly lower in the women with vaginal bleeding than in control women (1.16 ± 0.20 vs. 1.77 ± 0.08 mmol Trolox Equiv./L; p=0.001, whereas higher total oxidant status measurements were found in women with vaginal bleeding compared to the control group (4.01 ± 0.20 vs. 2.57 ± 0.65 μmol H2O2 Equiv./L; p=0.001. Conclusion: Increased total oxidant status might be involved in the pathophysiology of vaginal bleeding during early first trimester pregnancies.

  17. Mucoadhesive cellulosic derivative sponges as drug delivery system for vaginal application.

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    Furst, Tania; Piette, Marie; Lechanteur, Anna; Evrard, Brigitte; Piel, Géraldine

    2015-09-01

    Vaginal delivery of active drugs has been largely studied for local and systemic applications. It is well known that vagina is a complex route, due to physiological and non-physiological changes. Therefore, in order to achieve a prolonged local effect, these variations have to be considered. The aim of this study was to formulate and to characterize a solid system, called sponges, obtained by lyophilization of cellulosic derivative (HEC 250M) hydrogels. These sponges have to meet particular criteria to be adapted for vaginal application: they have to adhere to the vaginal cavity and to be rehydrated by the small amount of vaginal fluids. Moreover, they have to be easily manipulated and to be stable. Three freezing temperatures have been tested to prepare sponges (-15°C, -25°C, -35°C). By SEM analyzes, it was observed that the pores into the sponges were smaller and numerous as the freezing temperature decreases. However, this temperature did not have any influence on the rehydration speed that was rather influenced by the HEC concentration. Viscosity and mucoadhesive strength of hydrogels and corresponding sponges were also measured. It appeared that these parameters are mainly dependent on the HEC concentration. These mucoadhesive sponges can be considered as potential drug delivery systems intended for vaginal application.

  18. [Clinical observation on treatment of mycotic vaginitis with Sophora gel combined with Fluconazole capsules].

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    Wang, Na-mei; Cui, Lin; Ma, Chun-fen; Wang, Hui-xia

    2015-03-01

    Mycotic vaginitis is a common and frequently-occurring gynaecopathia and easy to attack repeatedly, so painful to patients. In this study, the authors observed the clinical efficacy of Sophora gel combined with Fluconazole capsules in treating mycotic vaginitis, in order to seek an effective method for treating mycotic vaginitis. Totally 85 patients with mycotic vaginitis treated in our hospital between December 2012 and July 2014 were randomly divided into the treatment group (43 patients) and the control group (42 patients). The treatment group was given vaginally Sophora gel (one piece every night for 14 days) and orally Fluconazole capsules (150 mg, once every three days, four times in total); The control group was only administered with Fluconazole capsules. The total efficacy, cure rate, recurrence rate and clinical symptom improvements of the two groups were observed. The results show that the total efficacy, the cure rate and the recurrence rate of the treatment group vs. the control group were respectively 97.7%, 90.7% and 2.6% vs. 83.3%, 71.4% and 20.0%, with statistical significance in their differences (P Fluconazole capsules can improve antifungal activity of drugs, relieve clinical symptoms, shorten the course of disease, enhance the cure rate and reduce the recurrence rate; So this therapy can be widely applied in clinic.

  19. Dehydroepiandrosterone intra vaginal administration for the management of postmenopausal vulvovaginal atrophy.

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    Archer, David F

    2015-01-01

    The effects of intravaginal administration of dehydroepiandrosterone (DHEA) for the management of symptomatic vulvovaginal atrophy are reviewed. A literature search related to vulvovaginal atrophy, vaginal atrophy, atrophic vaginitis, estrogen, dehydroepiandrosterone, vulvar itching, burning, dryness, dyspareunia, and libido was performed. Relevant articles addressing the incidence, management, and outcome of DHEA therapy were identified and used for this Expert Opinion. DHEA compared to a placebo is an effective treatment improving symptoms of vaginal atrophy: dyspareunia, burning, itching, and dryness. Objective parameters of vaginal atrophy, specifically pH, vaginal maturation index (VMI), and investigator-evaluated changes in the vagina: moisture, epithelia integrity and color were improved compared to baseline and placebo. There were significant improvements in libido and dyspareunia with the intravaginal use of DHEA that contribute to improved quality of life for postmenopausal women. Dehydroepiandrosterone administered intravaginally on a daily basis is an effective treatment for symptoms, and signs of vulvovaginal atrophy along with libido in postmenopausal women. This article is part of a Special Issue entitled 'Essential role of DHEA'.

  20. Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.

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    Quiroz, Lieschen H; Blomquist, Joan L; Macmillan, Deborah; McCullough, Alexis; Handa, Victoria L

    2011-10-01

    We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (P  =  0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, P  <  0.001). This research furthers our understanding of women's attitudes regarding cesarean childbirth and definitions of a successful birth experience.

  1. Vaginal delivery of carboplatin-loaded thermosensitive hydrogel to prevent local cervical cancer recurrence in mice.

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    Wang, Xue; Wang, Jin; Wu, Wenbin; Li, Hongjun

    2016-11-01

    Local tumor recurrence after cervical cancer surgery remains a clinical problem. Vaginal delivery of thermosensitive hydrogel may be suited to reduce tumor relapse rate with more efficacy and safety. A pilot study was carried out to evaluate the efficacy of carboplatin-loaded poloxamer hydrogel to prevent local recurrence of cervical cancer after surgery. In vivo vaginal retention evaluation of 27% poloxamer hydrogel in mice was proven to be a suitable vaginal drug delivery formulation due to its low gelation temperature. A mimic orthotopic cervical/vaginal cancer recurrence model after surgery was established by injecting murine cervical cancer cell line U14 into the vaginal submucosa to simulate the residual tumor cells infiltrated in the surgical site, followed by drug administration 24 h later to interfere with the formation/recurrence of the tumor. By infusing fluorescein sodium-loaded hydrogel into the vagina of mice, a maximized accumulation of fluorescein sodium (Flu) in the vagina was achieved and few signals were observed in other organs. When used in the prevention of the cervical cancer formation/recurrence in mice, the carboplatin-loaded poloxamer hydrogel exhibited great efficacy and systemic safety. In conclusion, thermosensitive hydrogel presents a simple, practical approach for the local drug delivery via vagina against cervical cancer recurrence.

  2. Vaginal breech birth: can we move beyond the Term Breech Trial?

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    Hunter, Linda A

    2014-01-01

    Since the publication of the Term Breech Trial in 2000, planned cesarean has become the preferred mode of birth for women whose fetus is in a breech presentation. Over the past 20 years, however, subsequent evidence has not shown conclusively that cesarean birth is safer than vaginal birth for a fetus in a breech presentation when certain criteria are met. Many obstetric organizations support the option of planned vaginal birth for women with a breech presentation under strict prelabor selection criteria and intrapartum management guidelines. The growing trend toward cesarean unfortunately has left midwives and other intrapartum care providers in training with dwindling opportunities to competently master skills for vaginal breech birth. Although simulation training offers opportunities to practice infrequently encountered skills such as vaginal breech birth, it is unknown if this alternative will provide sufficient experience for future generations of clinicians. As a result, women with a breech presentation at term who desire a trial of labor often have limited choices. This article reviews the controversies surrounding the ideal mode of birth created by the Term Breech Trial. Criteria for vaginal breech birth are summarized and the role of simulation explored. Implications for midwifery practice when a breech presentation is diagnosed are also included.

  3. Vaginal birth after cesarean section: an update on physician trends and patient perceptions.

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    Penso, C

    1994-10-01

    The increased number of women having a vaginal birth after a cesarean section can be attributed to changing physician trends. Women eligible for vaginal birth after cesarean section include those with previous low vertical incisions, multiple previous incisions and even unknown scars, regardless of the method of closure or previous indication. Limited data suggest that in carefully selected women a current twin gestation, breech presentation, or the presence of fetal macrosomia are not contraindications for a trial of labor, in the presence of a uterine scar. Changing trends in the management of labor may also contribute to an increase in successful trial of labor with the use of oxytocin for the induction or augmentation of labor, the administration of epidural anesthesia for pain relief, and the instillation of prostaglandin E2 gel for cervical ripening. External cephalic version and amnioinfusion may also be reasonable alternatives in appropriately selected cases. Despite the documented safety and success of vaginal birth after cesarean section, and the lack of increased morbidity of failed trial of labor, 50% of women who are eligible for vaginal birth after cesarean section will decline an attempt, even after extensive counseling and encouragement. Patient resistance, largely attributed to the fear and inconvenience of labor, is still a major deterrent to a further rise in vaginal birth after cesarean section rates.

  4. Safety Study of an Antimicrobial Peptide Lactocin 160, Produced by the Vaginal Lactobacillus rhamnosus

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    Sara E. Dover

    2007-01-01

    Full Text Available Objective. To evaluate the safety of the antimicrobial peptide, lactocin 160. Methods. Lactocin 160, a product of vaginal probiotic Lactobacillus rhamnosus 160 was evaluated for toxicity and irritation. An in vitro human organotypic vaginal-ectocervical tissue model (EpiVaginal was employed for the safety testing by determining the exposure time to reduce tissue viability to 50% (ET-50. Hemolytic activity of lactocin160 was tested using 8% of human erythrocyte suspension. Susceptibility of lactobacilli to lactocin160 was also studied. Rabbit vaginal irritation (RVI model was used for an in vivo safety evaluation. Results. The ET-50 value was 17.5 hours for lactocin 160 (4.9 hours for nonoxynol 9, N9. Hemolytic activity of lactocin 160 was 8.2% (N9 caused total hemolysis. Lactobacilli resisted to high concentrations of peptide preparation. The RVI model revealed slight vaginal irritation. An average irritation index grade was evaluated as “none.” Conclusions. Lactocin 160 showed minimal irritation and has a good potential for intravaginal application.

  5. Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause.

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    Gambacciani, M; Levancini, M; Cervigni, M

    2015-10-01

    Aim To evaluate the effects of the vaginal erbium laser (VEL) in the treatment of postmenopausal women suffering from genitourinary syndrome of menopause (GSM). Method GSM was assessed in postmenopausal women before and after VEL (one treatment every 30 days, for 3 months; n = 45); the results were compared with the effects of a standard treatment for GSM (1 g of vaginal gel containing 50 μg of estriol, twice weekly for 3 months; n = 25). GSM was evaluated with subjective (visual analog scale, VAS) and objective (Vaginal Health Index Score, VHIS) measures. In addition, in 19 of these postmenopausal women suffering from stress urinary incontinence (SUI), the degree of incontinence was evaluated with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after VEL treatments. Results VEL treatment induced a significant decrease of VAS of both vaginal dryness and dyspareunia (p vaginal dryness, dyspareunia and mild to moderate SUI. Further studies are needed to explore the role of laser treatments in the management of GSM.

  6. The Effect of Itraconazole on the Vaginal Candidiasis under Different Immunity Conditions in Mice

    Institute of Scientific and Technical Information of China (English)

    OUYANG Weixiang; CHEN Shanjuan; LI Shaohua; LIU Zhixiang; WU Yan; LI Jiawen

    2007-01-01

    To study the effect of itraconazole on the vaginal candidiasis caused by Candida under different immunity conditions, the fungal vaginitis model was established in female ICR mice by in- travaginal inoculation of suspension of C. albicans after the animal had been pretreated with estradiol or dexamethasone. Mice were divided at random into different groups and then treated with itracona- zole or IFN-γ given by gastrogavage. The burden of the fungus in the vaginal lavage fluids in the mice of the different groups was measured dynamically at different time points after the beginning of the drug treatment. The difference in the effect of itraconazole on the vaginal candidiasis between normal immune system group (group A) and control group (group D) was statistically significant (P<0.01). The difference in the efficacy of itraconazole among immunosuppressed group (group E), immuno-regulated group (group F) and the control group (group G) was statistically significant (P<0.01). But on the 5th, 6th, 7th, 9th, 11th day after the inoculation the average level of colony forming unit (CFU) of groups A, E and F showed no statistically significant difference (P0.05). It is concluded that the efficacy of itraconazole in the treatment of the vaginal candidiasis under different immunity conditions (groups A, E and F) in mice were all good, but there was no difference in the anti-fungal effect of itraconazole among the three groups.

  7. Successful treatment of combined vaginal and broad ligament hematoma using pelvic pressure pack and arterial embolization

    Institute of Scientific and Technical Information of China (English)

    Ma Runmei; Lao Terence T; Feng Yukun; Zhao Wei; Huang Jianqiang; Liang GuoHua; Li Hongyu; Chen Zhuo

    2005-01-01

    Objective:To assess using the pelvic pressure pack as temporizing treatment for combined vaginal and broad ligament hematoma before selective arterial embolization could be undertaken.Methods:A 29-year-old woman was transferred because of a 10cm right upper vaginal hematoma found shortly after the spontaneous delivery of a 3400g infant at term.Following evacuation of the clots,the patient's condition deteriorated with the appearance of a painful right pelvic mass,displacing the uterus.At laparotomy,the hematoma extended between the folds of the broad ligament into the pelvic sidewall.After evacuation of the clots,hemostasis failed despite subtotal hysterectomy.Eventually a pressure pack created from joined gauze rolls was used to fill up the pelvic cavity and achieved hemostasis before abdominal closure.When the vaginal pack was removed 30 hours later,vaginal bleeding recurred,and bilateral hypogastric embolization was performed with Gianturco coils.Results:The patient was successfully treated by this way and discharged uneventfully.Conclusion:In combined vaginal and broad ligament hematoma,pelvic pressure pack can be used to ensure maternal survival until definitive treatment with angiographic embolization.

  8. Comparison of sublingual and vaginal misoprostol for second-trimester pregnancy terminations.

    Directory of Open Access Journals (Sweden)

    Forozan Milani

    2014-03-01

    Full Text Available Comparing sublingual and vaginal misoprostol in second trimester pregnancy termination.In this study 268 women at 12-24 weeks of gestation candidate for pregnancy termination were enrolled. Women were randomly divided in two groups. The first group received 400 µg sublingual misoprostol and vaginal placebo and the second group received 400 µg vaginal misoprostol and sublingual placebo every 4 hours for a maximum of five doses. The course of misoprostol was repeated if the women did not abort within 24 hours.The median induction-to-abortion interval was shorter in sublingual group (12/72 hours in sublingual and 14/67 hours in vaginal. There was no significant difference in the success rate at 24 and 48 hours and in side effects. The preference for the sublingual route of administration was higher.Both vaginal and sublingual misoprostol are effective for medical abortion in second trimester termination. But it appears from shorter induction interval in sublingual and higher acceptability that sublingual route is a better choice.

  9. COMPARISON BETWEEN SUBLINGUAL AND VAGINAL ROUTE OF MISOPROSTOL IN MANAGEMENT OF FIRST TRIMESTER MISCARRIAGE MISSING

    Science.gov (United States)

    Dehbashi, Zahra; Moosazadeh, Mahmood; Afshari, Mahdi

    2016-01-01

    Background: Each year, more than forty million abortions are occurred whole of the world. Misoprostol is a prostaglandin analogue with a strong uterotonic effect. The present study aimed to compare the efficacy of Misoprostol in first trimester abortion through two sublingual and vaginal routes of administration. Methods: This randomized clinical trial was conducted on 52 consecutive women in first trimester candidate for pregnancy termination because of fetal IUFD or missed abortion in sonography reports. The patients were hospitalized and then randomly assigned to receive sublingual Misoprostol (400 µg, n 27) or vaginal Misoprostol (400 µg placed in posterior fornix, n = 25). Findings: None of the pregnant in the sublingual group developed complete abortion at the end of follow-up time, while 36% of women inducted with vaginal misoprostol experienced complete abortion indicating a intergroup significant difference (p = 0.001). Compared with vaginal group, those women in sublingual group experienced more complications including diarrhea (22.2% versus 20.0%), nausea and vomiting (22.2% versus 0.0%), and abdominal pain (3.7% versus 0.0%). Conclusion: The use of Misoprostol in vaginal route results in more abortion completeness as well as lower complication rate as compared to sublingual prescription of the drug. PMID:27698600

  10. Hallazgo de una leucorrea vaginal de carácter no inflamatoria en hembras bovinas. II. Pesquisaje microbiológico vaginal y uterino (Finding of a vaginal leucorrhea of non-inflammatory character in bovine females. II. Microbiological examination

    Directory of Open Access Journals (Sweden)

    Luis O. Alba Gómez

    2005-07-01

    Full Text Available Con el objetivo de demostrar que la leucorrea vaginal bovina no era producida por la acción agresiva de los agentes microbianos, se inspeccionaron 660 órganos genitales de vacas y novillas de diferentes razas y edades, sacrificadas en matadero. En 120 de esos órganos se encontraron seudoexudados vaginales para una frecuencia relativa de 18% de leucorrea vaginal.. En 40 de las muestras vaginales (33,3% y en 24 de los cuernos uterinos (20%, se aislaron bacterias aerobias de la flora saprofita normal. Las enterobacterias representaron el 50% de los microorganismos encontrados, principalmente E. coli. Los gérmenes piógenos estuvieron presentes en el 25% de los aislamientos. En los cuernos uterinos no se encontraron hongos. Para el pesquisaje microbiológico comparativo se seleccionaron 300 órganos genitales de vacas macroscópicamente sanos y sin colecciones de seudoexudados. Las especies bacterianas aisladas de sus vaginas y cuernos uterinos fueron prácticamente las mismas que las aisladas de las muestras con leucorrea. Se concluyó que la leucorrea vaginal no tuvo un origen inflamatorio ni infeccioso.

  11. Comparison of the Effect of Vaginal Zataria multiflora Cream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age.

    Science.gov (United States)

    Abdali, Khadijeh; Jahed, Leila; Amooee, Sedigheh; Zarshenas, Mahnaz; Tabatabaee, Hamidreza; Bekhradi, Reza

    2015-01-01

    Effect of Zataria multiflora on bacterial vaginosis and Trichomonas vaginalis is shown in vivo and in vitro. We compare the effectiveness of Zataria multiflora cream and oral metronidazole pill on results of treatment for vaginal infections including Trichomonas and bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis, Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. Vaginal Zataria multiflora cream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginal Zataria multiflora cream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p = 0.001 and p = 0.01). Vaginal Zataria multiflora cream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms of Trichomonas vaginitis.

  12. Comparison of the Effect of Vaginal Zataria multiflora Cream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age

    Directory of Open Access Journals (Sweden)

    Khadijeh Abdali

    2015-01-01

    Full Text Available Effect of Zataria multiflora on bacterial vaginosis and Trichomonas vaginalis is shown in vivo and in vitro. We compare the effectiveness of Zataria multiflora cream and oral metronidazole pill on results of treatment for vaginal infections including Trichomonas and bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis, Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. Vaginal Zataria multiflora cream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginal Zataria multiflora cream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p=0.001 and p=0.01. Vaginal Zataria multiflora cream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms of Trichomonas vaginitis.

  13. Effect of ultra-low-dose estriol and lactobacilli vaginal tablets (Gynoflor®) on inflammatory and infectious markers of the vaginal ecosystem in postmenopausal women with breast cancer on aromatase inhibitors.

    Science.gov (United States)

    Donders, G; Bellen, G; Neven, P; Grob, P; Prasauskas, V; Buchholz, S; Ortmann, O

    2015-10-01

    This study was a detailed microscopic analysis of the changes of vaginal microflora characteristics after application of 0.03 mg estriol-lactobacilli combination on the vaginal ecosystem in postmenopausal breast cancer (BC) survivors on aromatase inhibitors (AI) with severe atrophic vaginitis. A total of 16 BC women on AI applied daily one vaginal tablet of Gynoflor® for 28 days followed by a maintenance therapy of three tablets weekly for 8 weeks. During four follow up visits a smear from the upper lateral vaginal wall was analysed by phase contrast microscopy at 400 times magnification in order to classify the lactobacillary grades(LBG), bacterial vaginosis (BV), aerobic vaginitis (AV), vulvovaginal candidosis (VVC), proportional number of leukocytes and evidence of parabasal cells and epitheliolysis. LBG improved from 81% LBG-III at entry to 88% LBG-I&IIa after 2 weeks of initial therapy, which further improved upon follow up (p lactobacilli results in rapid and enduring improvement of all markers of the vaginal microflora and epithelial vaginal cell quality in women with breast cancer on AI with dyspareunia. Candida may develop soon after its use, but rapidly disappears again upon their prolonged use. Due to its excellent safety profiles and clinical efficacy we recommend this product as first choice in women on AI with severe dyspareunia.

  14. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola;

    2017-01-01

    INTRODUCTION: Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. METHODS......: The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. RESULTS......: In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery...

  15. Evaluation of causes of vaginal discharge in relation to pregnancy status

    Directory of Open Access Journals (Sweden)

    Puri K

    2003-03-01

    Full Text Available The purpose of this study was to determine incidence of vaginal discharge in pregnant and non-pregnant sexually active females of age group 20-40 years presenting with the chief complaint of vaginal discharge. One hundred sexually active females in the age group of 20-40 years, with vaginal discharge, were selected for this study at random. A detailed clinical history and a thorough examination of all the cases were done. After making the clinical diagnosis, appropriate tests for diagnosing candidiasis, trichomoniasis, gonorrhoea and bacterial vaginosis were done. It was observed that out of 100 cases, 13 (13% patients were pregnant and 87 (87% were non-pregnant.

  16. Recent Applications of Ion Mobility Spectrometry in Diagnosis of Vaginal Infections

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    Zeev Karpas

    2012-01-01

    Full Text Available Vaginal infections (vaginosis globally affect more than 15% of the female population of reproductive age. However, diagnosis of vaginosis and differentiating between the three common types: bacterial vaginosis (BV, vulvovaginal candidiasis (VVC, and trichomoniasis are challenging. Elevated levels of the biogenic amines, trimethylamine (TMA, putrescine, and cadaverine have been found in vaginal discharge fluid of women with vaginosis. Ion mobility spectrometry (IMS is particularly suitable for measurement of amines even in complex biological matrices due to their high proton affinity and has been shown to be suitable for the diagnosis of vaginal infections. Recent developments that have increased the accuracy of the technique for diagnosis of BV and simplified sample introduction are described here.

  17. Comparison of gemeprost and vaginal misoprostol in first trimester mifepristone-induced abortion

    DEFF Research Database (Denmark)

    Svendsen, Pernille Fog; Rørbye, Christina; Vejborg, Thomas;

    2005-01-01

    Abstract Background The aim of this study was to compare efficacy and side effects of gemeprost and vaginal misoprostol in mifepristone-induced abortions in women up to 63 days of gestation. Methods A retrospective study of 833 consecutive patients admitted for medical termination of first...... trimester pregnancy was conducted. Four-hundred ten patients received mifepristone 600 mg, followed 48 h later by gemeprost 1 mg (regimen I), and 423 patients received mifepristone 200 mg followed by vaginal misoprostol 800 µg (regimen II). Success rates were evaluated after 2 weeks and after 3 months......, gemeprost and vaginal misoprostol are equally effective for termination of first trimester abortion, but may be associated with varying intensity of side effects....

  18. Development of starch based mucoadhesive vaginal drug delivery systems for application in veterinary medicine.

    Science.gov (United States)

    Gök, Mehmet Koray; Özgümüş, Saadet; Demir, Kamber; Cirit, Ümüt; Pabuccuoğlu, Serhat; Cevher, Erdal; Özsoy, Yıldız; Bacınoğlu, Süleyman

    2016-01-20

    The aim of this study was to prepare and evaluate the mucoadhesive, biocompatible and biodegradable progesterone containing vaginal tablets based on modified starch copolymers for the estrus synchronization of ewes. Starch-graft-poly(acrylic acid) copolymers (S-g-PAA) were synthesized and characterized. The vaginal tablets were fabricated with S-g-PAA and their equilibrium swelling degree (Qe) and matrix erosion (ME%) were determined in lactate buffer solution. In vitro, mucoadhesive properties of the tablets were investigated by using ewe vaginal mucosa and in vivo residence time were also investigated. In vitro and in vivo progesterone release profiles from the tablets were compared with two commercial products. Tablet formulation containing wheat starch based grafted copolymer (WS-g-PAA)gc indicated promising results and might be convenient as an alternative product to the commercial products in veterinary medicine.

  19. RNA/DNA co-analysis from human menstrual blood and vaginal secretion stains

    DEFF Research Database (Denmark)

    Haas, Claus; Hanson, E; Anjos, M J;

    2014-01-01

    The European DNA Profiling Group (EDNAP) organized a fourth and fifth collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling. The task was to identify dried menstrual blood and vaginal secretion stains using specific RNA biomarkers, and additionally test 3...... housekeeping genes for their suitability as reference genes. Six menstrual blood and six vaginal secretion stains, two dilution series (1/4-1/64 pieces of a menstrual blood/vaginal swab) and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by 24 participating...... laboratories, using RNA extraction or RNA/DNA co-extraction methods. Two novel menstrual blood mRNA multiplexes were used: MMP triplex (MMP7, MMP10, MMP11) and MB triplex (MSX1, LEFTY2, SFRP4) in conjunction with a housekeeping gene triplex (B2M, UBC, UCE). Two novel mRNA multiplexes and a HBD1 singleplex were...

  20. Factors involved in patient choice of oral or vaginal treatment for vulvovaginal candidiasis

    Directory of Open Access Journals (Sweden)

    Sobel JD

    2013-12-01

    Full Text Available Jack D SobelDivision of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Vulvovaginal candidiasis (VVC is an extremely common cause of vaginal symptoms in women. Multiple antifungal products are available by either the oral or vaginal route, although no new drugs have become available for two decades. Given the therapeutic equivalence of the antimycotic agents and their routes of administration, the specific drug and formulation selected is entirely arbitrary in relation to final treatment outcome. Nevertheless, multiple factors affecting preference, both practitioner-dependent and patient-dependent, impact on selection of a specific drug and route of administration.Keywords: antifungal drugs, antimycotics, Candida vaginitis, vulvovaginal candidiasis

  1. Barriers to effective treatment of vaginal atrophy with local estrogen therapy

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    Reiter S

    2013-03-01

    Full Text Available Suzanne ReiterMid-County Health Center, Largo, FL, USAAbstract: Vaginal atrophy is a common condition among postmenopausal women, among whom many exhibit both vulvovaginal symptoms (eg, dryness, irritation, itching, and pain with intercourse and urinary symptoms (eg, increased frequency, urgency, incontinence, urinary tract infections, and dysuria. Unfortunately, few women with symptoms of vaginal atrophy report seeking treatment from a health care provider. The goal of this article is to examine reasons why patients and health care providers do not engage in discourse regarding this important topic. It is important to initiate conversations with postmenopausal women and counsel them on both why the changes occur and potential treatment options.Keywords: local estrogen therapy, vaginal atrophy, barriers, postmenopausal women

  2. Management of vaginal dryness and dyspareunia in estrogen sensitive cancer patients.

    Science.gov (United States)

    Del Pup, Lino

    2012-09-01

    Cancer patients suffer from vaginal dryness and dyspareunia earlier and longer than the general population, with more severe and distressing symptoms. Life-style advices are the first step and vaginal lubricants can be tried, but they can't completely relieve atrophic symptoms. The most effective therapy is use of vaginal estrogens, but compliance and management are particularly difficult in estrogen sensitive cancer patients because of their systemic absorption. Compliance can be improved if they are begun at a very low dose and gradually increased until the lowest effective dose is reached. Promestriene only possesses an intramucosal effect, it can be used at very low doses in cancer patients suffering from urogenital symptoms.

  3. Shigella flexneri-induced vaginitis in a prepubertal children: description of a case

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    Antonella Restelli

    2011-06-01

    Full Text Available In prepuberal girls vulvo-vaginitis are caused by germs of intestinal origin,mycetes, Gardnerella vaginalis, protozoa. Shigella is an uncommon agent able to induce valvovaginitis in children. We report the case of a 7-year-old girl with chronic vulvo-vaginitis caused by S. flexneri. Antibiotic Susceptibility Testing revealed that S. flexnery was sensible to cefotaxime, amoxicillin, imipenem, ciprofloxacin, but resistant to amikacin, cefazolin, gentamycin, ampicillin and tetracycline. A treatment with ciprofloxacin brought to a rapid resolution of all symptoms. At the follows up at 3 and 6 months the patient did not report symptoms of infection or articular cartilage abnormality; microbiological evaluations were also negative. Even if it is a single case report and other clinical trial may be performed in order to validate this hypothesis,we speculate that in patient with vulvo-vaginal infection living in environment with low hygiene care, a carefully microbiological evaluation of uncommon agents may be performed.

  4. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C

    2003-01-01

    % of the patients, and 45% were never, or only occasionally, able to complete sexual intercourse. Despite sexual dysfunction and vaginal adverse effects, 63% of those sexually active before having cancer remained sexually active after treatment, although with a considerably decreased frequency. CONCLUSIONS......: Patients who are disease free after RT for locally advanced, recurrent, or persistent cervical cancer are at high risk of experiencing persistent sexual and vaginal problems compromising their sexual activity and satisfaction.......PURPOSE: To investigate the longitudinal course of self-reported sexual function and vaginal changes in patients disease free after radiotherapy (RT) for locally advanced, recurrent, or persistent cervical cancer. MATERIALS AND METHODS: A total of 118 patients referred for RT were included...

  5. The value of the Lugol's iodine staining technique for the identification of vaginal epithelial cells.

    Science.gov (United States)

    Hausmann, R; Pregler, C; Schellmann, B

    1994-01-01

    This paper reports on the specificity of the Lugol's iodine staining technique for the detection of vaginal epithelial cells on penile swabs. Air-dried swabs taken from the glans of the penis of 153 hospital patients and from 50 healthy volunteers, whose last sexual intercourse had taken place at least 5 days previously, were stained with Lugol's solution. Glycogenated cells were found in more than 50% of the cases studied, even in healthy volunteers without urethritis. In almost all of these cases the smear contained at least a few polygonal nucleated epithelial cells showing an unequivocal positive Lugol reaction. These cells cannot be distinguished from superficial or intermediate vaginal cells, by cytomorphology or staining. Urinary tract infections had no influence on the glycogen content of male squamous epithelial cells. On the basis of these results the Lugol's method can no longer be assumed to prove the presence of vaginal cells in penile swabs.

  6. Streptococcus agalactiae vaginitis: nonhemolytic variant on the Liofilchem® Chromatic StreptoB.

    Science.gov (United States)

    Savini, Vincenzo; Marrollo, Roberta; D'Antonio, Marianna; D'Amario, Claudio; Fazii, Paolo; D'Antonio, Domenico

    2013-01-01

    Streptococcus agalactiae (group B Streptococcus, GBS) vaginal pathogenicity is not uniformly acknowledged throughout the literature; accordingly, in women, genital itching and burning, along with leukorrhea are commonly and almost exclusively referred to bacterial vaginosis, candidiasis and trichomoniasis. Conversely, GBS virulence for vagina was recognized in the past, as the organism has been observed to potentially cause local inflammation and discharge, as well as lactobacilli rarefaction. We depict here a case where a nonhemolytic (γ-hemolytic) GBS strain was found to be the etiologic agent of vaginal infection. Such uncommon S. agalactiae phenotypes are hard to be recognized and may be therefore responsible for misdiagnosing and underestimation of GBS vaginitis prevalence; here, we had the support of the Liofilchem(®) Chromatic StreptoB medium, that successfully detected such an atypical variant.

  7. Vaginal vault recurrences of endometrial cancer in non-irradiated patients

    DEFF Research Database (Denmark)

    Hardarson, Hordur Alexander; Nyhøj Heidemann, Lene; Christensen, René dePont;

    2015-01-01

    are few and limited to previously irradiated patients or patients with advanced disease. Investigation of surgical treatment for isolated vaginal vault recurrence is practically nonexistent. The aim of this study is to evaluate the efficacy of RT and ST in a non-irradiated group with recurrent endometrial......BACKGROUND: The treatment of locally recurrent endometrial cancer is based on limited evidence. The standard treatment is radiotherapy (RT) which is effective for local control and the effect has been documented in prospective studies. Investigations of surgical treatment (ST) of recurrences...... cancer limited to the vaginal vault. METHODS: Patients treated for recurrent endometrial cancer at Odense University Hospital, Denmark between 2003 and 2012 were identified, n = 118. Thirty-three patients had an isolated vaginal vault recurrence and were treated with either RT, ST or both. Re...

  8. Lactobacillus acidophilus contributes to a healthy environment for vaginal epithelial cells.

    Science.gov (United States)

    Pi, Woojin; Ryu, Jae-Sook; Roh, Jaesook

    2011-09-01

    Lactobacillus species in the female genital tract are thought to act as a barrier to infection. Several studies have demonstrated that lactobacilli can adhere to vaginal epithelial cells. However, little is known about how the adherence of lactobacilli to vaginal epithelial cells affects the acidity, cell viability, or proliferation of the lactobacilli themselves or those of vaginal epithelial cells. Lactobacillus acidophilus was co-cultured with immortalized human vaginal epithelial cells (MS74 cell line), and the growth of L. acidophilus and the acidity of the culture medium were measured. MS74 cell density and viability were also assessed by counting cell numbers and observing the cell attachment state. L. acidophilus showed exponential growth for the first 6 hr until 9 hr, and the pH was maintained close to 4.0-5.0 at 24 hr after culture, consistent with previous studies. The growth curve of L. acidophilus or the pH values were relatively unaffected by co-culture with MS74 cells, confirming that L. acidophilus maintains a low pH in the presence of MS74 cells. This co-culture model could therefore potentially be used to mimic vaginal conditions for future in vitro studies. On the other hand, MS74 cells co-cultured with L. acidophilus more firmly attached to the culture plate, and a higher number of cells were present compared to cells cultured in the absence of L. acidophilus. These results indicate that L. acidophilus increases MS74 cell proliferation and viability, suggesting that lactobacilli may contribute to the healthy environment for vaginal epithelial cells.

  9. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health

    Directory of Open Access Journals (Sweden)

    Mariya Ivanova Petrova

    2015-03-01

    Full Text Available The human body is colonized by a vast number of microorganisms collectively referred to as the human microbiota. One of the main microbiota body sites is the female genital tract, commonly dominated by Lactobacillus spp., in approximately 70% of women. Each individual species can constitute approximately 99% of the ribotypes observed in any individual woman. The most frequently isolated species are Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii and Lactobacillus iners. Residing at the port of entry of bacterial and viral pathogens, the vaginal Lactobacillus species can create a barrier against pathogen invasion since mainly products of their metabolism secreted in the cervicovaginal fluid can play an important role in the inhibition of bacterial and viral infections. Therefore, a Lactobacillus-dominated microbiota appears to be a good biomarker for a healthy vaginal ecosystem. This balance can be rapidly altered during processes such as menstruation, sexual activity, pregnancy and various infections. An abnormal vaginal microbiota is characterized by an increased diversity of microbial species, leading to a condition known as bacterial vaginosis. Information on the vaginal microbiota can be gathered from the analysis of cervicovaginal fluid, by using the Nugent scoring or the Amsel’s criteria, or at the molecular level by investigating the number and type of Lactobacillus species. However, when translating this to the clinical setting, it should be noted that the absence of a Lactobacillus-dominated microbiota does not appear to directly imply a diseased condition or dysbiosis. Nevertheless, the widely documented beneficial role of vaginal Lactobacillus species demonstrates the potential of data on the composition and activity of lactobacilli as biomarkers for vaginal health. The substantiation and further validation of such biomarkers will allow the design of better targeted probiotic strategies.

  10. Characterization of the vaginal micro- and mycobiome in asymptomatic reproductive-age Estonian women.

    Science.gov (United States)

    Drell, Tiina; Lillsaar, Triin; Tummeleht, Lea; Simm, Jaak; Aaspõllu, Anu; Väin, Edda; Saarma, Ivo; Salumets, Andres; Donders, Gilbert G G; Metsis, Madis

    2013-01-01

    The application of high-throughput sequencing methods has raised doubt in the concept of the uniform healthy vaginal microbiota consisting predominantly of lactobacilli by revealing the existence of more variable bacterial community composition. As this needs to be analyzed more extensively and there is little straightforward data regarding the vaginal mycobiome of asymptomatic women we aimed to define bacterial and fungal communities in vaginal samples from 494 asymptomatic, reproductive-age Estonian women. The composition of the vaginal microbiota was determined by amplifying bacterial 16S rRNA and fungal internal transcribed spacer-1 (ITS-1) regions and subsequently sequencing them using 454 Life Sciences pyrosequencing. We delineated five major bacterial community groups with distinctive diversity and species composition. Lactobacilli were among the most abundant bacteria in all groups, but also members of genus Gardnerella had high relative abundance in some of the groups. Microbial diversity increased with higher vaginal pH values, and was also higher when a malodorous discharge was present, indicating that some of the women who consider themselves healthy may potentially have asymptomatic bacterial vaginosis (BV). Our study is the first of its kind to analyze the mycobiome that colonizes the healthy vaginal environment using barcoded pyrosequencing technology. We observed 196 fungal operational taxonomic units (OTUs), including 16 OTUs of Candida spp., which is more diverse than previously recognized. However, assessing true fungal diversity was complicated because of the problems regarding the possible air-borne contamination and bioinformatics used for identification of fungal taxons as significant proportion of fungal sequences were assigned to unspecified OTUs.

  11. Vesico-vaginal fistula post cold cup bladder biopsy: mini review

    Directory of Open Access Journals (Sweden)

    Abigail Mawhinney

    2010-09-01

    Full Text Available Abigail Mawhinney1,*, Ammar Hameed2,*, Ali Thwaini1, Colin Mulholland11Belfast City Hospital, Urology Department, Belfast, Northern Ireland, UK; 2Addenbrookes University Hospital, Urology Department, Cambridge, UK*These authors contributed equally to this paperIntroduction: We report a case of a vesico-vaginal fistula (VVF post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade.Methods and results: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment.Conclusion: Although cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.Keywords: vesico-vaginal fistula, vaginal fistula, surgical repair of vaginal fistula, management of vaginal fistula

  12. Endometriosis-induced vaginal hyperalgesia in the rat: role of the ectopic growths and their innervation.

    Science.gov (United States)

    McAllister, Stacy L; McGinty, Kristina A; Resuehr, David; Berkley, Karen J

    2009-12-15

    Endometriosis is a painful disorder defined by extrauteral endometrial growths whose contribution to pain symptoms is poorly understood. Endometriosis is created in rats by autotransplanting on abdominal arteries pieces of either uterus (ENDO), which form cysts, or fat (shamENDO), which do not form cysts. ENDO, but not shamENDO induces vaginal hyperalgesia. We tested the hypothesis that the cysts are necessary to maintain vaginal hyperalgesia by assessing the effect of surgically removing them. Complete-cyst-removal eliminated ENDO-induced vaginal hyperalgesia up to 4 months post-operatively. Sham-cyst-removal in ENDO rats, in which cysts were not removed, or partial cyst-removal increased the ENDO-induced hyperalgesia. The decreases and increases both took 3-6 weeks to develop. Changes in ENDO-induced hyperalgesia did not occur in a control group of ENDO rats who had no surgery after ENDO. In a double-surgery control group, neither shamENDO surgery nor a subsequent sham surgery that mimicked "removal" of non-existent cysts influenced vaginal nociception. In a no-surgery control group, vaginal nociception remained stable for >6 months. The increases in ENDO-induced hyperalgesia produced by the sham-cyst-removal surgery were smaller in proestrus than in other estrous stages. During the other stages (but not during proestrus), sympathetic innervation of the cysts increased. These results suggest that maintenance of ENDO-induced vaginal hyperalgesia requires continued presence of at least some ectopic endometrial tissue, and that surgical treatment that fails to remove ectopic endometrial tissue can exacerbate the hyperalgesia, possibly due in part to an increase in the cysts' sympathetic innervation.

  13. Comparative study of sublingual and vaginal misoprostol in second trimester induced abortion

    Directory of Open Access Journals (Sweden)

    Sangeeta Raman Jogi

    2015-10-01

    Full Text Available Background: To recognize an effective Misoprostol only regime and to compare the efficacy, safety and acceptability of sublingual and vaginal Misoprostol for the termination of second trimester of pregnancy. Methods: The study was a prospective randomized trial. Women attending OPD from January2012 to December 2013, for medical abortion between gestational ages 13-20 weeks were screened, selected and divided in to two groups. Group-A received misoprostol 400 and micro;g then 200 and micro;g sublingually 3 hourly, Group-B received misoprostol 400 and micro;g then 200 and micro;g vaginally 3 hourly. They were observed for 24 hours. Main outcomes were induction-abortion interval, dose required, success rate and side effects and comfort to the route of administration. Results: Mean induction-abortion interval was 9.28 +/- 5.824 hours, 95% CI: 7.62-10.94in sublingual misoprostol group and 13.68 +/- 6.179 hours, 95% CI: 11.92-15.44 in vaginal group. Mean dose required for abortion was 948 +/- 389.264 and micro;g, 95% CI: 837.37-1058.63 in sublingual and 1248 +/- 415.142 and micro;g, 95% CI: 1,130.02-1,365.98in vaginal group. Success rate was 98% and 94%, respectively in two groups. The differences were statistically significant. Comfort to the route of administration was 90% in sublingual and 60% in vaginal group. Conclusions: Both sublingual and vaginal routes of Misoprostol are equally effective, safe, inexpensive and acceptable method. Sublingual route is better and preferred by women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1453-1459

  14. Does trocar-guided tension-free vaginal mesh (Prolift) repair provoke prolapse of the unaffected compartments?

    NARCIS (Netherlands)

    Withagen, M.I.J.; Vierhout, M.E.; Milani, A.L.

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The objective of this study was to assess the effect of the tension-free vaginal mesh (Prolift) procedure on the non-treated and initially unaffected vaginal compartments. METHODS: This prospective observational cohort study involved 150 patients who underwent a Prolift

  15. Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Thorsen, Poul; Jensen, Jørgen Skov;

    2002-01-01

    BACKGROUND: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence the...

  16. Development of long-acting bioadhesive vaginal gels of oxybutynin: formulation, in vitro and in vivo evaluations.

    Science.gov (United States)

    Tuğcu-Demiröz, Fatmanur; Acartürk, Füsun; Erdoğan, Deniz

    2013-11-30

    Overactive bladder (OAB) and vaginal dryness are common problems after menopause. Oxybutynin (OXY) is an antimuscarinic agent that has been available for more than 30 years in the treatment of OAB patients. The aim of the work reported in this paper was to develop long acting mucoadhesive gel formulations of OXY and to investigate their effects on blood levels compared to those of oral OXY immediate release tablets, in rabbits. Mucoadhesive gels were prepared with chitosan, hydroxypropyl methylcellulose (HPMC K100M) and Poloxamer 407 (Pluronic F 127). The physicopharmaceutical properties of gels were evaluated. The gel formulation which was prepared with HPMC K100M, exhibited the highest viscosity, the greatest adhesiveness, cohesiveness and mucoadhesion values. The formulation which was prepared from HPMC K100M showed suitable permeation characteristics across the vaginal mucosa. Comparative bioavailability studies were carried out on rabbits with vaginal HPMC gel, vaginal chitosan gel, vaginal OXY solution and commercially available oral Üropan tablets. It was concluded that the highest AUC and relative bioavailability values were obtained for the bioadhesive vaginal gel formulation prepared with HPMC K100M. Therefore, the mucoadhesive vaginal gels of OXY can be a promising and innovative alternative therapeutic system for the treatment of OAB. It can be safely used in cases of overactive bladder and as well as vaginal dryness after menopause.

  17. A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection

    Directory of Open Access Journals (Sweden)

    Clarke Megan A

    2012-02-01

    Full Text Available Abstract Background Vaginal pH is related to genital tract inflammation and changes in the bacterial flora, both suggested cofactors for persistence of human papillomavirus (HPV infection. To evaluate the relationship between vaginal pH and HPV, we analyzed data from our large population-based study in Guanacaste, Costa Rica. We examined vaginal pH and the risk of HPV infection, cytological abnormalities, and C. trachomatis infection. Methods Our study included 9,165 women aged 18-97 at enrollment with a total of 28,915 visits (mean length of follow-up = 3.4 years. Generalized estimating equations were used to evaluate the relationship between vaginal pH and HPV infection (both overall and single versus multiple types and low-grade squamous intraepithelial lesions (LSIL, the cytomorphic manifestation of HPV infection. The relationship between enrollment vaginal pH and C. trachomatis infection was assessed by logistic regression. Results were stratified by age at visit. Results Detection of HPV was positively associated with vaginal pH, mainly in women C. trachomatis DNA was associated with increased vaginal pH in women Conclusions Our findings suggest a possible association of the cervical microenvironment as a modifier of HPV natural history in the development of cervical precancer and cancer. Future research should include studies of vaginal pH in a more complex assessment of hormonal changes and the cervicovaginal microbiome as they relate to the natural history of cervical neoplasia.

  18. Role of Cervical Cerclage and Vaginal Progesterone in the Treatment of Cervical Incompetence with/without Preterm Birth History

    Directory of Open Access Journals (Sweden)

    Shao-Wei Wang

    2016-01-01

    Conclusions: Cervical cerclage showed more benefits in the maternal and neonatal outcomes than vaginal progesterone therapy for women with an asymptomatic short cervix and prior PTB history, while cervical cerclage and vaginal progesterone therapies showed similar effectiveness for women with an asymptomatic short cervix but without a history of PTB.

  19. Clinical application of the multi-joint testing vaginitis in diagnosis of gynecological vaginal diseases%阴道炎多联检测在妇科阴道疾病诊断中的临床应用

    Institute of Scientific and Technical Information of China (English)

    唐子平

    2011-01-01

    目的:探讨阴道炎多联检测在妇科阴道疾病的诊断中的临床应用.方法:对1516例阴道分泌物进行多联检测(pH值、过氧化氢浓度、白细胞脂酶、唾液酸苷酶、脯氨酸氨基肽酶、N-乙酰氨基葡萄糖苷酶)和用Amsel方法检测,并对其中正常阴道组、霉菌性阴道炎、滴虫性阴道炎和BV组进行对照比较.结果:根据临床表现和多联检测,BV的发病率高达27.2%,滴虫性阴道炎占12.5%,霉菌性阴道炎占9.0%.结论:利用多项目联合检测法检测阴道分泌物,能快速、简单、客观而有效的对阴道疾病进行辅助诊断.%Objective: To discuss the clinical application of the multi - joint testing vaginitis in diagnosis of gynecological vaginal diseases. Methods: More than 1516 cases of vaginal secretions of joint detection ( pH value, hydrogen peroxide concentration, white blood lipase, neuraminidase, proline aminopeptidase, gan enzyme acetyl glucosamine )and detected by Amsel and on which normal vaginal group, fungal vaginitis and trichomonas vaginitis and BV group for comparison. Results: Based on clinical manifestations and multi -joint testing, BV incidence rate as high as 27.2%, 12.5% trichomoniasis vaginitis, fungal vaginitis 9.0%. Conclusion: The use of multi - project joint detection assay of vaginal secretions can rapid,simple,objective and effective diagnosis vaginal diseases.

  20. Acute and late vaginal toxicity after adjuvant high-dose-rate vaginal brachytherapy in patients with intermediate risk endometrial cancer: is local therapy with hyaluronic acid of clinical benefit?

    Science.gov (United States)

    Delishaj, Durim; Fabrini, Maria Grazia; Gonnelli, Alessandra; Morganti, Riccardo; Perrone, Franco; Tana, Roberta; Paiar, Fabiola; Gadducci, Angiolo

    2016-01-01

    Purpose The aim of the present study was to evaluate the effectiveness of hyaluronic acid (HA) in the prevention of acute and late vaginal toxicities after high-dose-rate (HDR) vaginal brachytherapy (BT). Material and methods Between January 2011 and January 2015, we retrospectively analyzed 126 patients with endometrial cancer who underwent extrafascial hysterectomy with or without lymphadenectomy and adjuvant HDR-vaginal BT +/– adjuvant chemotherapy. The total dose prescription was 21 Gy in 3 fractions (one fraction for week). Vaginal ovules containing 5 mg of HA were given for whole duration of vaginal BT and for the two following weeks. Acute and late toxicities were evaluated according to CTCAE vs 4.02. Results According to the revised FIGO 2009 classification, most tumors were in stage IA (30.9%) and in stage IB (57.9%). Thirty-three patients (26.2%) received adjuvant chemotherapy before vaginal BT. Five-year disease-free survival (DFS) and five-year overall survival (OS) were 88% and 93%, respectively. The most common grade 1-2 acute toxicities were vaginal inflammation (18 patients, 14.3%) and dyspareunia (7 patients, 5.5%). Two patients (1.6%) had more than one toxicity. Late toxicity occurred in 20 patients (15.9%). Grade 1-2 late toxicities were fibrosis (14 patients, 11.1%) and telangiectasias (7 patients, 5.5%). Six patients (4.8%) had more than one late toxicity. No grade 3 or higher acute or late toxicities were observed. Conclusions These results appear to suggest that the local therapy with HA is of clinical benefit for intermediate risk endometrial cancer patients who receive adjuvant HDR-vaginal BT after surgery. A randomized trial comparing HA treatment vs. no local treatment in this clinical setting is warranted to further evaluate the efficacy of HA in preventing vaginal BT-related vaginal toxicity. PMID:28115957