Efficacy and tolerability of a spray formulation containing Visnadine in women self-reporting sexual symptoms: a randomized double-blind placebo-controlled pilot study.

PURPOSE: The aim of this pilot, double-blind, randomized, placebo-controlled study, was to evaluate both the efficacy and the tolerability of a formulation for vulvar application containing Visnadine, a natural extractive substance with vasoactive properties, (ReFeel® spray, IDI Integratori Dietetici Italiani S.r.l., Italy) in women self-reporting sexual symptoms. METHODS: Sixty women (age range 18-60 years) volunteered to test the product against placebo (PL): Two puffs in the vulvar area, 10 min before sexual stimulation, for 30 days and for a minimum of six times. The main outcome measure was the improvement of the Female Sexual Function Index (FSFI) score (cut-off ≤ 26.55 for female sexual dysfunction [FSD]). Secondary outcomes were sexual satisfaction and tolerability with the product. RESULTS: PL group (n = 28) and Visnadine group (n = 30) were comparable for age, sexual function and rate of FSD at baseline (T0). After 1 month (T1), women in Visnadine group scored from 25.0 ± 3.8 to 27.9 ± 2.4 (p < 0.001), whereas no changes were evident in PL group (from 25.4 ± 5.0 to 25.6 ± 4.7). Statistically significant differences at T1 were reported in women with a positive (p < 0.001) or a negative FSD diagnosis (p < 0.01) using active treatment. Women with FSD reported significantly more improvement in satisfaction with their sexual function when treated with Visnadine spray compared to PL (p < 0.001), as well as more excitation (p < 0.001), pleasure (p < 0.001) and less time to reach orgasm (p < 0.003). No significant side effects were evident in both groups. CONCLUSIONS: On demand, 1-month use of Visnadine spray displayed positive effects on sexual function in women with and without FSD and it was well tolerated. Topical Visnadine may not only be part of multimodal strategies to manage clinically relevant sexual symptoms but also simply to help women to enhance their subjective impaired perception of sexual response.

[The Pap-test in the study of viral infections of the female genital tract]. / Il pap-test nello studio delle infezioni virali dell'apparato genitale femminile.

The authors underline a synergism of HPV + HSV and HPV + CIN that, together with general immunodeficiency and local factors are responsible for the oncogenesis of cervico carcinoma. This thesis takes on importance after literature reports of an increase of 10% in viral infections from HSV and HPV with a middle incidence of the 1-2% in all the colpocytologic examination cases not in women between 18 and 65 years. To obtain a successful preventive treatment the authors recommend a colpocytologic examination each year, possibly in association with colposcopic, histologic and molecular studies in all HPV positive cases.

[Pap-smear test today]. / Il pap-test oggi.

Remembering the publication of Papanicolau and Traut's monograph in 1943, the authors have realized the use and the spead of the Pap-Smear until the present. They have analyzed the different risks of cervical carcinoma. They think that to obtain a further reduction of the morbidity and the death-rate of such a neoplasia, it is necessary to do a pap-smear examination once a year for women with HPV infection or other risk factors. It is possible in this way, to improve results till the 90%.

[Risk factors of endometrial carcinoma]. / I fattori di rischio del carcinoma dell'endometrio.

The authors base their experience on 12 women affected by endometrial carcinoma. Problems have been diagnosed in the post-menopausal and climacterium period, considering the clinical, hormonal and lipidic profile and some tumoral markers. The most risk factors for the endometrial adenocarcinoma have been collected in the adiposity with hypertension and hyperglycemia, above all in nullipara women with late menopause and dyslipidemia.

[Use of seat belts during pregnancy]. / Sull'impiego delle cinture di sicurezza in gravidanza.

After a review of the world literature on the advantages and compulsiveness of seat belts, the authors recommend pregnant women to use them. Moreover, they invite gynaecologists and midwives to favour their use during psycho-prophylaxis courses.

[Laparoscopic total hysterectomy and its complications]. / L'intervento di laparoisterectomia totale e sue complicanze.

The Authors base their experiences on 135 total laparohysterectomy operations. Of a sample of 39 cases the postoperative lapses have shown complications with a percentage of 28.87% so divided: 25 infectious complications (18.51%); 9 thrombophlebitis (6.66%); 3 vascular lesions (2.22%); 2 intestinal lesions (1.48%). They end by saying that to have good clinical conduction of such operations it is necessary to respect the specific hygienic and preventive rules.

[The Pap test in menopause]. / Il Pap-test in menopausa.

In a study covering 156 Pap-tests in menopause, the Authors observed a reduction in infectious phlogosis, in dysplasias and neoplasias. They suggested that even during menopause in the Pap-test showed be conducted to monitor the VIN and a physiological senescence of the female genitalia.

[Preventive and therapeutic use of cefriaxon in gynecologic surgery]. / Il ceftriaxone nella profilassi e terapia della chirurgia ginecologica.

The Authors have been investigating the behaviour of ceftriaxone in gynecological surgery employing 1 g of the drug through intravenous injection an hour before the operation, after executing a cutaneous pomphus the night before. They obtained satisfactory results since out of 25 cases analyzed nowhere had they to intervene with other antibiotics. The drug, despite the 15 cases of infectious pathology observed, has been showing great tolerance and an utmost ease and usefulness of usage.

[Prophylactic and therapeutic use of ceftriaxone in cesarean section]. / Il ceftriaxone nella profilassi e terapia del taglio cesareo.

Authors did the antibiotic-prophylaxis with ceftriaxone in twenty cesarean sections (1 phial EV). Prophylaxis was sufficient in thirteen cases; on the other hand, in the remaining seven prophylaxis was followed by the three days therapy (1 phial EV). A good tolerance of the medicine was revealed in all cases. Moreover, it was tested a wide antimicrobial action with resolution of all the verified infections, except for one bacterial resistance case where some other antibiotic was used.

[Cytological study of an inflammatory type Pap-test]. / Studio citologico su un campione di pap-test di tipo infiammatorio.

The paper reports the results of the study of 900 s of which 630 were of an inflammatory type (70%). The age group most severely affected by phlogosis was that between 35-45 years old with the highest frequency in the group aged between 35-39 years old. Associated pathologies were found in 191 cases (21.2%), with bacterial infections in 101 cases (11.2%), candida in 43 cases (4.8%), T.V. in 17 cases (1.9%), viral infections in 10 cases (1.1%), CIN in 14 cases (1.5%) and malignant tumours in 2 cases (0.22%).

[Value of the Pap-test in the cervical cytological screening]. / Il valore del Pap-test nello screening citologico cervicale.

Fourteen thousand three hundred fifty six cervical smears were performed in the Obstetric and gynaecologic Department of Casorate Primo Hospital (USSL no. 77) and Oncologic Center of Milan (USSL no. 75/II) between 1-1-1987 and 30-6-1991. The incidence and mortality of uterine cervix neoplasm are discussed and the uterine cervix neoplasm are discussed and the analysis of data shows a reduction of this cancer in all countries. In italy it is estimated that the incidence is of 20.88 per 1000,000 women of all ages.

[Changes in sexual behavior of women receiving substitution therapy after surgical menopause and women in physiological menopause]. / Studio delle modificazioni della sessualità tra donne in menopausa chirurgica sottoposte a terapia sostitutiva ed in menopausa fisiologica.

We have made this study with the aim of comparing changes in sexuality between women who are in surgical menopause taking a substitutive therapy and those who are in physiological menopause. We have used a questionnaire instrument. It has been filled in by a physician during an individual conversation with the women. The results showed that sexuality valued through the parameters of satisfaction, coital frequency and desire, has been have penalized in the first group than in the second. It can be said that the trauma linked to hysterosalpingo-oophorectomy provokes alterations in sexuality which are not sufficiently counterbalanced by substitutive estrogenic therapy.

[Non-stress test. Evaluation of a new scheme for reading the results]. / Non stress test. Valutazione di un nuovo schema di lettura.

The reliability of a new Non-Stress Test reading protocol is assessed. The protocol provides for an assessment time of between 20 and 60 minutes and considers deceleration as an additional parameter to the ones commonly used. The results confirm the importance of both these factors in reducing the number of false positives.