Effectiveness of 10% povidone-iodine formulation on preoperative vaginal irrigation.

AIM: To investigate the effectiveness of 10% povidone-iodine formulation as a vaginal irrigation agent in patients undergoing hysterectomy to prevent postoperative infection. METHODS: The prevalence of postoperative infection in 277 and 132 patients who underwent preoperative vaginal cleaning with 500 mL of distilled water and 20 mL of 10% povidone-iodine solution, respectively, were compared in this retrospective study. RESULTS: Postoperative infection was observed in 15.6% of the overall patient population. The rate of postoperative infection was significantly higher in patients treated with 10% povidone-iodine formulation than in those treated with distilled water (21.4% vs 12.8%, P = 0.040). Besides the agents of vaginal irrigation, operation time, length of hospital stay and rate of intraoperative complications affected the prevalence of postoperative infection. The multivariate analysis ranked the use of 10% povidone-iodine formulation for vaginal irrigation as the second top factor contributing to postoperative infection (relative risk: 1.9 when compared to distilled water). CONCLUSION: Preoperative vaginal irrigation with 10% povidone-iodine formulation led to a significantly higher rate of postoperative infection than did preoperative vaginal irrigation with distilled water. For vaginal irrigation with povidone-iodine, different concentrations and cleaning methods should be considered in the future.

Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement: the Ohasama study.

Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85 mmHg, CBP <140/ 90 mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP > or =140/90 mmHg; MHT, HBP > or =135/85 mmHg, CBP <140/90 mmHg; sustained hypertension, HBP > or =135/85 mmHg, CBP > or =140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.

High recurrence rate of uterine fibroids on transvaginal ultrasound after abdominal myomectomy in Japanese women.

AIM: To evaluate the recurrence rate of uterine fibroids (UF) after abdominal myomectomy and the risk factors for recurrences. METHODS: In a retrospective study, transvaginal ultrasound examinations were performed in 135 women after abdominal myomectomy. The main outcome measures were cumulative UF recurrence rates after abdominal myomectomy. The Kaplan-Meier survival analysis was used to estimate the cumulative recurrence rate, and log-rank tests were applied to compare survival curves among different categorical groups of potential risk factors for recurrences. RESULTS: The cumulative UF recurrence rates at 12 and 24 months after abdominal myomectomy were 12.4 and 46.0%, respectively. Women who had a history of previous myomectomy had a higher hazard of UF recurrence than women without such a history (hazard ratio 4.1, 95% confidence interval 1.20-13.6). The women having four or more UFs had a higher hazard than those who had less than four UFs (hazard ratio 3.7, confidence interval 1.41-9.88). After adjusting these variables to each other, the hazard ratio remained similar. CONCLUSIONS: The UF recurrence rate detected by transvaginal ultrasound after abdominal myomectomy was high, but did not require any additional surgery. Physicians need to consider the timing of the myomectomy, taking into account complications of pregnancy and infertility due to UF recurrence.

Tosulfoxacin Treatment of Chlamydia Trachomatis Infection of the Uterine Cervix.

In vivo efficacy of tosufloxacin (TFLX) for treatment of Chlamydia trachomatis cervical infection in women was evaluated by enzyme immunoassay. The short term (within 31 days of treatment) response rates with a dosage of 150mg orally 3 times daily were 100% (54/54) with 14 days of treatment and 97% (38/39) with 7 days of treatment. Subjective symptoms such as lower abdominal pain, vaginal discharge, or atypical bleeding were observed in 76 (82%) of the 93 patients. After treatment, symptoms improved in 75 (99%) of 76 patients. Two of 34 patients (5.9%) showed positive results in the long interval tests (1 to 18 months after treatment). Three (2.3%) of 131 patients needed to be changed from TFLX to other drugs due to side effects (eczema, face edema, urticaria). TFLX was effective and patients showed high compliance for treatment of cervical C. trachomatis infection.