Fenticonazole nitrate for treatment of vulvovaginitis: efficacy, safety, and tolerability of 1-gram ovules, administered as ultra-short 2-day regimen.

Because of its potential as a low cost first-line monotherapy for the most common vulvovaginal infections, we evaluated fenticonazole nitrate in a prospective, open-label, multicenter pilot study with 101 sexually active women (per-protocol; 16 to 61 years of age) with vulvovaginitis involving single or mixed infections with Candida albicans, Trichomonas vaginalis, and/or Gardnerella vaginalis. Fenticonazole nitrate (1 g) was administered as vaginal ovules, once daily on days 1 and 3. Eradication (direct phase-contrast microscopy of vaginal swabs and/or microbiological culture) on day 8 was 90% (C. albicans, 26/29, p < 0.001), 70% (T. vaginalis, 7/10, p = 0.161), 67% (G. vaginalis, 22/33, p < 0.009), and 45% (mixed infection, 13/29, p = 0.001). After 28 days, relapse was 0% for candidiasis and trichomoniasis, 27% (6/22) for G. vaginalis, and 23% (3/13) for mixed infection. Overall, eradication of all offending pathogens was achieved in 67% of the total per-protocol population, with a relapse rate of only 16%. Score sums for symptoms improved from 7.0 (baseline) to 1.7 (day 8), and 0.71 (day 28), (p < 0.001). Treatment was safe and well tolerated. The results of our pilot study suggest that application of fenticonazole nitrate 1 g intravaginal ovules on 2 alternate days is a suitable first-line treatment of vulvovaginitis with acceptable broad-spectrum efficacy against the most commonly involved pathogens and with a low rate of early relapse, reserving antibiotics for patients with treatment failure or relapse of infection. Our results should encourage further examination of this approach in larger and well controlled clinical trials.

[Puerperium with short-term hospitalization]. / Puerperio de corta estancia hospitalaria.

Seventy seven cases with discharge before 12 hours post-partum and 240 cases with discharge after 24 or more hours after delivery, were evaluated at Hospital General de México, in an observational, prospective, cohort, study in low risk deliveries. Both groups were reviewed ten days after delivery. There were no different ratios for abnormal uterine hemorrhage, urinary tract infection or endometritis. Thrombophlebitis was more frequent in early discharge patients, both statistically and clinically significant (RR3.58, CI95% 1.48-8.67, P = 0.003). This finding is discussed, as well as measures to prevent it. It is concluded that early discharge programs in low risk conditions, are convenient.

[Obstetrical hysterectomy. Retrospective study over the past 3 years. General Hospital of Mexico]. / Histerectomía obstétrica. Estudio retrospectivo en los últimos tres años. Hospital General de México.

A retrospective, observational and analytical study about Obstetric-Hysterectomy on Hospital General of Mexico patients during a period of 3 years of study. The mean objective was to analyze the Hysterectomy in the pregnant puerperal stage (Obstetric-Hysterectomy), during the resolution of the problems that the pregnancy, delivery and puerperium determinate, as soon as the association of the complications during the pregnant puerperal stage that condition on the realization of this procedure, so that we can diminish the morbimortality of this procedure. We analyzed the following variables: age, ginecobstetric history, surgery indication, diagnostic omission, surgeons, surgery time, the turn when it was made, reintervention, surgery complications, the use of blood and antibiotics, days at hospital and mortality. We concluded the necessity of a national incidence, to know the most frequent indications and the morbimortality set the example to determine the diminution of the complications, the mortality and know the guides to follow in this procedure.