[Comparative clinical study of a new imidazole molecule (fluconazole) and ketaconazole in the treatment of Candida albicans vulvovaginitis]. / Studio clinico comparato tra una nuova molecola imidazolica (fluconazolo) e il ketoconazolo nella terapia della vulvovaginite da Candida albicans.

A multicentre trial was carried out in Italy with the aim of comparing the efficacy, safety and tolerability of the oral administration of fluconazole with the oral administration of ketoconazole in the treatment of patients affected by Candida vulvovaginitis. A total of 174 patients with symptomatic Candida vulvovaginitis were identified both by objective examination and cell culture tests: of these 87 were treated using a single oral administration of fluconazole (150 mg) whereas the other 87 received 2 200 mg capsules of ketoconazole daily for 5 days. Tests to assess the efficacy, safety and tolerability of both treatments were carried out approximately 7 days and 5-6 weeks from the start of therapy. The results obtained showed a success rate of 92% for fluconazole-treated patients and 83% for those treated with ketoconazole. In addition to the rapid and safe efficacy of treatment, the most important findings which emerged from this study were the extreme simplicity of use, excellent patient compliance and the complete absence of collateral effects of variations in the hematochemical and urine parameters taken into consideration caused by fluconazole.

Blood pressure monitoring in diabetic pregnancy.

Hypertensive disorders which complicate 5-10% of all pregnancies are more frequent in diabetic women. We longitudinally monitored blood pressure (BP) for a 24 h period in 54 diabetic out patients, at each trimester of pregnancy, in order to observe the relationship between the blood pressure behaviour and the main clinical features of these subjects. A relationship was found between blood pressure and the diabetes type. In insulin-dependent diabetes mellitus (IDDM) women, the age of diagnosis and the diabetes duration played the major role whereas, in non insulin-dependent diabetes mellitus (NIDDM) women only the patients' age was correlated with the BP levels. Higher BP levels were found in women belonging to the White class D, and whose diabetes duration was more than 10 years. An interesting correlation was also demonstrated between BP and insulin requirement, in late pregnancy as well as the time of delivery. Early in pregnancy, BP levels, even if within normal range, were undoubtedly higher in those women who developed hypertension compared to those who continued to be normotensive. Daytime BP values were always found higher than night-time BP values but, the physiological biorhythm seemed to be altered at the end of pregnancy.

Glucose transporters (GLUT 1, GLUT 3) mRNA in human placenta of diabetic and non-diabetic pregnancies.

Glucose transporters (GLUT) catalyse the transport of glucose in many human tissues, including the placenta. On the other hand glucose concentrations can affect both glucose transport activity and level of GLUT mRNA and protein. Up to now very few studies, concerning GLUT in the placenta appeared and studies in vivo in human diabetic pregnancy are lacking. Therefore we investigated placental GLUT 1 and GLUT 3 mRNA in 10 diabetic (5 IDDM, 2 NIDDM, 3 GDM) and 9 non-diabetic women. GLUT 1 mRNA was found significantly correlated with maternal age (> 30 vs < 30 years: p < 0.025), with placental weight (> 575 vs < 575 g: p < 0.05), while GLUT 3 mRNA decreased significantly in late gestation of diabetic women (38-40 vs < 38 weeks: p < 0.025). In addition GLUT 3 was significantly lower in the diabetic than in non-diabetic women in late gestation. These preliminary results deserve to better elucidate feto-maternal carbohydrate metabolism at the placental level in normal as well as diabetic pregnancy.

Diabetes and pregnancy: prophylaxis of genital infections.

Diabetic pregnant women have many potential reasons to have genital infections such as poor metabolic control and impairement of leucocyte function. Relative immune deficiency exists in pregnancy. This study was designed to test the hypotheses that pregnant patients with insulin-dependent diabetes have a higher rate of ante partum genital infections when compared with a pair-matched control population. Two groups of pregnant women consisting of 23 patients with and 23 without diabetes mellitus, underwent colposcopy and cytology between 16th and 24th week of gestation to detect the presence of human papilloma virus (HPV), Gardnerella vaginalis, Candida albicans and aspecific infections. No significant differences were observed between the two groups.