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Anais Brasileiros de Dermatologia 2014Vulvovaginal-gingival syndrome is characterized by erosions and desquamation of the vulva, vagina, and gingiva. We reported a case of a 32-year-old woman presenting with...
Vulvovaginal-gingival syndrome is characterized by erosions and desquamation of the vulva, vagina, and gingiva. We reported a case of a 32-year-old woman presenting with an 8-year history of damage to the vulval and perianal anatomy and limitation of mouth opening. The patient's symptoms were relieved after treatment with topical tacrolimus cream.
Topics: Adult; Biopsy; Female; Gingivitis; Humans; Keratosis; Lichen Planus; Syndrome; Vulvovaginitis
PubMed: 25184936
DOI: 10.1590/abd1806-4841.20142841 -
The Journal of International Medical... Jun 2019To evaluate the acceptability, tolerability, and effects on vulvovaginitis symptoms and signs of a non-soap, herbal-based intimate solution (Zelesse®). (Observational Study)
Observational Study
OBJECTIVE
To evaluate the acceptability, tolerability, and effects on vulvovaginitis symptoms and signs of a non-soap, herbal-based intimate solution (Zelesse®).
METHODS
We conducted a prospective, observational, multicenter study including adult women with symptoms and signs of vulvovaginitis with various etiologies, including candidiasis, trichomoniasis, bacterial vaginosis, and atrophic and irritative vaginitis. The presence and intensity of signs (edema, erythema, vaginal discharge) and symptoms (pruritus) of vulvovaginitis were evaluated before and after 5-15 days of daily use of Zelesse® alone or as a coadjuvant in antimicrobial therapy. Variables following a normal distribution and categorical variables were analyzed using the Student t-test and chi-square or Fisher's exact test, respectively.
RESULTS
A total 137 women were enrolled in the study; 87 (63.5%) women received concomitant antimicrobials and 50 (36.5%) used Zelesse® only. Global symptom scores and frequency of patients with vulvovaginitis signs and symptoms, and their mean intensity, decreased after treatment in both patient groups. Vaginal pH and (in the Zelesse®-only group) vaginal flora remained unaltered. The product was safe, well tolerated, and highly accepted by patients.
CONCLUSIONS
Zelesse®, the non-soap herbal-based solution in this study, may represent a safe and effective option for symptomatic relief of vulvovaginitis.
Topics: Adult; Anti-Bacterial Agents; Female; Follow-Up Studies; Humans; Hygiene; Male; Maximum Tolerated Dose; Phytotherapy; Prognosis; Prospective Studies; Severity of Illness Index; Solutions; Spain; Vulvovaginitis
PubMed: 31088247
DOI: 10.1177/0300060519837820 -
and Cytokine Modifications during Menopause and Their Relation to Vulvar and Vulvovaginal Disorders.Journal of Menopausal Medicine Aug 2022Female sexual and reproductive health is heavily influenced by the levels and ratios of species and vaginal cytokines. Menopause marks a profound body change as it...
OBJECTIVES
Female sexual and reproductive health is heavily influenced by the levels and ratios of species and vaginal cytokines. Menopause marks a profound body change as it shifts to a natural and permanent non-reproductive state. Vulvovaginal diseases encompass a broad variety of sexual health conditions. Furthermore, both menopause and vulvovaginal diseases affect vaginal and cytokine levels. Thus, this study aimed to investigate the correlation between menopause, vulvovaginal diseases, and vaginal and cytokine levels.
METHODS
Vaginal swab samples were collected as part of a prospective data bank creation to study vaginal conditions as approved by the Institutional Review Board of Texas Tech University Health Sciences Center, Lubbock, USA. This study utilized 38 samples in this database, which were assigned to the pre-menopausal with no vulvovaginal conditions (n = 20) and post-menopausal with vulvovaginal conditions (n = 18) groups. A real-time polymerase chain reaction was conducted to determine the relative concentration of species, while cytokine analysis was performed using multiplex enzyme-linked immunosorbent assay immunoassay. The standardized mean difference, multivariate analysis of variance, and permutational unequal variance test were used for the statistical analysis.
RESULTS
Cytokines, interleukin (IL)-6, macrophage inflammatory protein-1α, IL-8, and expression were significantly elevated in the control group compared to the study group ( = 0.03 for the cytokines, = 0.0194 for ).
CONCLUSIONS
The levels of vaginal cytokine and profile were significantly different between the pre-menopausal and post-menopausal groups.
PubMed: 36070870
DOI: 10.6118/jmm.22001 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The majority of species previously categorized as Bacteroides have been reassigned into new genera. Bacteroides levii (Holdeman, Cato, and Mooretaxonomic)'s status has... (Review)
Review
The majority of species previously categorized as Bacteroides have been reassigned into new genera. Bacteroides levii (Holdeman, Cato, and Mooretaxonomic)'s status has remained uncertain. This species shares a high degree of similarity with members of the genus Porphyromonas based on biochemical, chemical, and comparative 16s rRNA sequence analysis. As a result, Bacteroides levii (Holdeman, Cato, and Moore) was reclassified as comb. now under the genus Porphyromonas.
PubMed: 38882857
DOI: 10.4103/jpbs.jpbs_1106_23 -
Journal of Xenobiotics Jul 2023Vulvovaginitis with spp. is the most common infection in women and the rate is increased during pregnancy. Antifungal prescription in pregnant women continues to...
Vulvovaginitis with spp. is the most common infection in women and the rate is increased during pregnancy. Antifungal prescription in pregnant women continues to present challenges and the decision must balance the risk of fetal toxicity with the benefits to the fetus and mother. Starting from the idea that clotrimazole is the most recommended antifungal in candidal vaginitis in pregnancy, we tested the sensitivity of different species of spp. to other azoles, polyenes, and antimetabolites. This retrospective study (January to June 2019) assessed 663 pregnant women hospitalized for various pregnancy-related symptoms in which samples of phage secretion were taken. The laboratory results confirmed 21% of cases, indicating 140 positive mycologic samples. In this study, vaginal candidiasis was mostly related to the first trimester of pregnancy (53.57%,) and less related in the last trimester (17.14%). was the most frequent isolated strain in this study, accounting for 118 cases, followed by 16 strains of and 6 cases of . The highest sensitivity for was found in azoles, mostly in miconazole (93.2%), while was completely resistant to polyene with low sensitivity in antimetabolites and even in some azoles, such as fluconazole. In our study, higher resistance rates to flucytosine were found, with and exhibiting greater resistance than .
PubMed: 37489336
DOI: 10.3390/jox13030023 -
The Cochrane Database of Systematic... Feb 2015Genital tract infection is associated with preterm birth (before 37 weeks' gestation). Screening for infections during pregnancy may therefore reduce the numbers of... (Review)
Review
BACKGROUND
Genital tract infection is associated with preterm birth (before 37 weeks' gestation). Screening for infections during pregnancy may therefore reduce the numbers of babies being born prematurely. However, screening for infections may have some adverse effects, such as increased antibiotic drug resistance and increased cost of treatment.
OBJECTIVES
To assess the effectiveness of antenatal lower genital tract infection screening and treatment programs for reducing preterm birth and subsequent morbidity.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2014), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 7) and reference lists of retrieved reports.
SELECTION CRITERIA
We included all published and unpublished randomised controlled trials in any language that evaluated any described methods of antenatal lower genital tract infection screening compared with no screening.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked for accuracy.
MAIN RESULTS
One study (4155 women at less than 20 weeks' gestation) met the inclusion criteria. The intervention group (2058 women) received infection screening and treatment for bacterial vaginosis, trichomonas vaginalis and candidiasis; the control group (2097 women) also received screening, but the results of the screening program were not revealed and women received routine antenatal care. The rate of preterm birth before 37 weeks' gestation was significantly lower in the intervention group (3% versus 5% in the control group) with a risk ratio (RR) of 0.55 (95% confidence interval (CI) 0.41 to 0.75; the evidence for this outcome was graded as of moderate quality). The incidence of preterm birth for infants with a weight equal to or below 2500 g (low birthweight) and infants with a weight equal to or below 1500 g (very low birthweight) were significantly lower in the intervention group than in the control group (RR 0.48, 95% CI 0.34 to 0.66 and RR 0.34; 95% CI 0.15 to 0.75, respectively; both graded as moderate quality evidence). Based on a subset of costs for preterm births of < 1900 g, the authors reported that for each of those preterm births averted, EUR 60,262 would be saved.
AUTHORS' CONCLUSIONS
There is evidence from one trial that infection screening and treatment programs for pregnant women before 20 weeks' gestation reduce preterm birth and preterm low birthweight. Infection screening and treatment programs are associated with cost savings when used for the prevention of preterm birth. Future trials should evaluate the effects of different types of infection screening programs.
Topics: Candidiasis, Vulvovaginal; Female; Humans; Pregnancy; Premature Birth; Trichomonas Vaginitis; Vaginosis, Bacterial
PubMed: 25922860
DOI: 10.1002/14651858.CD006178.pub3 -
Antimicrobial Agents and Chemotherapy Jun 2022Antifungal drug susceptibility tests (AST) for Candida albicans are increasingly demanded for women with refractory or recurrent vaginitis due to fluconazole...
Antifungal drug susceptibility tests (AST) for Candida albicans are increasingly demanded for women with refractory or recurrent vaginitis due to fluconazole resistance. Given reduced activity of azole drugs at pH levels found in women with vaginitis, it is proposed that AST be performed at pH 4.5, since testing at only the recommended pH 7.0 is likely to miss a significant number of clinically relevant azole-resistant C. albicans vaginal isolates.
Topics: Antifungal Agents; Azoles; Candida; Candida albicans; Candidiasis, Vulvovaginal; Drug Resistance, Fungal; Female; Fluconazole; Humans; Microbial Sensitivity Tests
PubMed: 35604210
DOI: 10.1128/aac.02366-21 -
Medicina (Kaunas, Lithuania) Jun 2021Vaginitis causes vulvovaginal symptoms, including itching, irritation, vaginal discharge, burning, or foul odor. It is one of the most common diseases encountered in... (Review)
Review
Prevalence of Pathogens and Other Microorganisms in Premenopausal and Postmenopausal Women with Vulvovaginal Symptoms: A Retrospective Study in a Single Institute in South Korea.
Vaginitis causes vulvovaginal symptoms, including itching, irritation, vaginal discharge, burning, or foul odor. It is one of the most common diseases encountered in gynecologic practice. Hypoestrogenism due to menopause has a considerable negative effect on vaginal health and leads to changes in the vaginal pH and vaginal microflora, which are related to a change in the causes and microorganisms of vaginitis. Thus the aim here was to investigate the prevalence of pathogens and other microorganisms in premenopausal and postmenopausal women with vulvovaginal symptoms, using an STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge. From January 2018 to December 2019, records of patients diagnosed with vaginitis at Changwon Gyeongsang National University Hospital were retrospectively reviewed. The premenopausal and postmenopausal subjects were categorized into Group A and Group B, respectively. and the data of symptoms, general characteristics, and results of both STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge were retrieved. On the STD 12-Multiplex real-time PCR test, was the most common microorganism in both groups. was the second most common one, followed by speceies. On the routine culture of vaginal discharge, was the most common aerobic bacterial microorganism in both groups, followed by (Group B Streptococcus, GBS). There was no significant difference between the two groups. Pathogens and other microorganisms of patients with vulvovaginal symptoms that showed a statistically significant difference between the two groups were , , , and . In this study, the prevalence of pathogens and other microorganisms in menopausal women with vulvovaginal symptoms did not show a significant difference from premenopausal women. Therefore, management strategies for patients with vulvovaginal symptoms should be developed through accurate diagnosis using appropriate diagnostic methods.
Topics: Female; Humans; Postmenopause; Prevalence; Republic of Korea; Retrospective Studies; Trichomonas Vaginitis
PubMed: 34199976
DOI: 10.3390/medicina57060577 -
Nutricion Hospitalaria Feb 2015Probiotics are used in a great number of both paediatric and adult diseases, mainly in gastrointestinal disorders, like diarrhoea. Nevertheless, their beneficial effect... (Review)
Review
Probiotics are used in a great number of both paediatric and adult diseases, mainly in gastrointestinal disorders, like diarrhoea. Nevertheless, their beneficial effect on immune alterations, such as atopic dermatitis and, more recently, in women related diseases such as vulvovaginitis and mastitis have also been observed. However, the use of probiotics is not completely implemented into the routine clinical practice for primary care physicians. There is still a great controversy with scarce scientific evidence, due to the diversity in the designs thereof which justifies the variability in the efficacy results. This outcome leads to difficulties in developing definitive treatment guidelines although there are exceptions, for example, WGO. The aim of this workshop, held at the VI Congress of the Spanish Society of Probiotics and Prebiotics is the training of primary care physicians, both paediatricians and general practitioners in the clinical applications of these nutritional preparations in different diseases: acute diarrhoea; antibiotic associated diarrhoea, necrotizing enterocolitis, employment in infant milk formulas, infant colic, irritable bowel syndrome and inflammatory bowel disease, as well as vulvovaginitis and mastitis.
Topics: Adult; Child; Humans; Infant; Infant Formula; Pediatrics; Physicians, Primary Care; Prebiotics; Primary Health Care; Probiotics
PubMed: 25659055
DOI: 10.3305/nh.2015.31.sup1.8708 -
Microbiology Spectrum Jun 2023Trichomoniasis (TV), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) are the most common causes of vaginitis. This study investigated the prevalence of...
Prevalence, Associated Factors, and Appropriateness of Empirical Treatment of Trichomoniasis, Bacterial Vaginosis, and Vulvovaginal Candidiasis among Women with Vaginitis.
Trichomoniasis (TV), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) are the most common causes of vaginitis. This study investigated the prevalence of these diagnoses, their associated factors, and the appropriateness of the empirical treatment. From March 25, 2019, to June 17, 2022, 429 women with symptoms or signs of vaginitis were enrolled in a hospital in northern Taiwan with 438 episodes of vaginitis. Vaginal swabs were collected for Gram's staining, cultures for Trichomonas vaginalis, bacteria, and yeasts, and multiplex PCR assay for TV, BV, and VVC. Their empirical treatments were recorded. Factors associated with different etiologies of vaginitis were sought in multivariable logistic regression models. The prevalence of TV, BV, and VVC were 2.1%, 22.8%, and 21.7%, respectively, while coinfections of BV and VVC, TV and BV, TV and VVC, and triple infection occurred in 5.0%, 0.2%, 0.2%, and 0.7%, respectively. Multivariable analyses revealed that having multiple sexual partners was associated with TV and BV (adjusted odds ratio [aOR] 9.756 and 3.246, respectively), while menopausal women were less likely to have VVC (aOR 0.184). Moreover, dysuria was associated with TV (aOR 4.981), vaginal itch and pelvic pain with VVC (aOR 3.223 and 0.425, respectively), and discharge pH > 4.5 with BV (aOR 1.767). Other clinical symptoms and pelvic examination features had limited value for differential diagnosis. Among the 78 empirical antifungal and metronidazole prescriptions, 55.2% were ineffective or unnecessary. Our study highlights the importance to integrate appropriate diagnostic tools into the clinical care of women with vaginitis. Vaginal complaints are widespread among women and are associated with emotional, physical, and economic burdens with challenges in their diagnosis and management. In this survey, we identified that 40% of vaginitis in Taiwan was caused by either trichomoniasis, bacterial vaginosis, vulvovaginal candidiasis, or a combination of these infections. Our data suggested that typical physical findings appeared infrequently among women with these infections and their empirical treatments were frequently inappropriate. Our findings highlighted the importance of integrating proper diagnostic tools into clinical practice to improve the diagnosis and management of vaginitis, as recommended by national and international guidelines.
Topics: Female; Humans; Vaginosis, Bacterial; Candidiasis, Vulvovaginal; Prevalence; Trichomonas Vaginitis; Trichomonas Infections
PubMed: 37052487
DOI: 10.1128/spectrum.00161-23