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1.
Am J Obstet Gynecol ; 222(2): 114-122, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31513780

RESUMO

Vaginitis is one of the most common causes of patient visits to gynecologists, primary care providers, and urgent care centers. However, many women leave without a clear diagnosis or experience recurrent symptoms despite treatment. The 3 most common etiologies of vaginitis are trichomonas, bacterial vaginosis, and vulvovaginal candidiasis, which account for an estimated 70% of cases. The remaining 30% may be related to other causes of vaginitis, including atrophic vaginitis, desquamative inflammatory vaginitis, and vaginal erosive disease. The purpose of this review is to describe the noncandidal causes of acute and recurrent vaginitis, with the goal of improving the likelihood of accurate diagnosis as well as efficient and effective therapy. We excluded candidal vaginitis from our review because there was a recently published review on this topic in the Journal. The clinical presentation and evaluation of patients with symptoms of vaginitis can be triaged into 1 of 2 diagnostic pathways: noninflammatory and inflammatory vaginitis. The most common noninflammatory cause is bacterial vaginosis. Features such as irritation, purulent discharge, and the presence of polymorphonuclear neutrophils are more suggestive of an inflammatory process. Trichomoniasis is the most common cause of inflammatory vaginitis. Other well-described forms of inflammatory vaginitis include atrophic vaginitis, desquamative inflammatory vaginitis, and erosive disease. We present a review of the pathogenesis, symptoms, examination findings, diagnostic testing, and treatment for each of these causes of noncandidal vaginitis.


Assuntos
Anti-Infecciosos/uso terapêutico , Vaginite Atrófica/diagnóstico , Candidíase Vulvovaginal/diagnóstico , Vaginite por Trichomonas/diagnóstico , Vaginose Bacteriana/diagnóstico , Administração Intravaginal , Administração Oral , Anti-Inflamatórios/uso terapêutico , Vaginite Atrófica/terapia , Clindamicina/uso terapêutico , Desidroepiandrosterona/uso terapêutico , Diagnóstico Diferencial , Terapia de Reposição de Estrogênios , Estrogênios/uso terapêutico , Feminino , Humanos , Hidrocortisona/uso terapêutico , Inflamação , Líquen Plano/diagnóstico , Líquen Plano/terapia , Metronidazol/análogos & derivados , Metronidazol/uso terapêutico , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/terapia , Penfigoide Bolhoso/diagnóstico , Penfigoide Bolhoso/terapia , Pênfigo/diagnóstico , Pênfigo/terapia , Tamoxifeno/análogos & derivados , Tamoxifeno/uso terapêutico , Tinidazol/uso terapêutico , Vaginite por Trichomonas/terapia , Vaginite/diagnóstico , Vaginite/terapia , Vaginose Bacteriana/terapia
2.
Obstet Gynecol ; 135(1): 243-245, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31856118

RESUMO

Vaginitis is defined as inflammation or infection of the vagina and is associated with a spectrum of symptoms, including vulvovaginal itching, burning, irritation, dyspareunia, "fishy" vaginal odor, and abnormal vaginal discharge. Vaginal symptoms are some of the most frequent reasons for patient visits to obstetrician-gynecologists (1) and may have important consequences in terms of discomfort and pain, days lost from school or work, sexual functioning, and self-image (2). Distinguishing vaginal from vulvar symptoms is important to direct evaluation and treatment. The purpose of this document is to provide updated evidence-based guidance for the diagnosis and treatment of the common causes of vaginitis in nonpregnant patients. Information on the treatment of vaginitis in patients with human immunodeficiency virus (HIV) is covered elsewhere (3). Guidelines are subject to change. For the most up-to-date information on vaginitis diagnosis and treatment, see the Centers for Disease Control and Prevention (CDC) Sexually Transmitted Diseases webpage, which is available at https://www.cdc.gov/std/.


Assuntos
Anti-Infecciosos/administração & dosagem , Vaginite/diagnóstico , Vaginite/terapia , Feminino , Humanos , Vaginite/microbiologia
3.
Obstet Gynecol ; 135(1): e1-e17, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31856123

RESUMO

Vaginitis is defined as inflammation or infection of the vagina and is associated with a spectrum of symptoms, including vulvovaginal itching, burning, irritation, dyspareunia, "fishy" vaginal odor, and abnormal vaginal discharge. Vaginal symptoms are some of the most frequent reasons for patient visits to obstetrician-gynecologists () and may have important consequences in terms of discomfort and pain, days lost from school or work, sexual functioning, and self-image (). Distinguishing vaginal from vulvar symptoms is important to direct evaluation and treatment. The purpose of this document is to provide updated evidence-based guidance for the diagnosis and treatment of the common causes of vaginitis in nonpregnant patients. Information on the treatment of vaginitis in patients with human immunodeficiency virus (HIV) is covered elsewhere (). Guidelines are subject to change. For the most up-to-date information on vaginitis diagnosis and treatment, see the Centers for Disease Control and Prevention (CDC) Sexually Transmitted Diseases webpage, which is available at https://www.cdc.gov/std/.


Assuntos
Anti-Infecciosos/administração & dosagem , Vaginite/diagnóstico , Vaginite/terapia , Feminino , Humanos , Vaginite/microbiologia
4.
Ann Ist Super Sanita ; 55(4): 380-385, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31850866

RESUMO

Probiotics, defined as "living microorganisms that, whether ingested in useful amount, may have beneficial effects on human body", are widely used in various products for human use, such as dietary supplements, medical devices and pharmaceutical products. The European Directive on medical devices (MDs) (DDM 93/42), also includes those MDs containing live microorganisms, particularly probiotics, that may have various destinations of use, including that of assisting the therapy of several human pathologies. In this brief note we analyzed the use of probiotics in MDs and how probiotics administration could represent one of the new frontiers of scientific research on the prevention and treatment of various diseases. We'll analyze the literature on probiotics based MDs, to review their major targets in the therapy of some of the most common human pathologies: bacterial vaginosis and vaginitis, atopic dermatitis, infantile colic, obesity, type 2 diabetes, and pharyngotonsillitis.


Assuntos
Probióticos/administração & dosagem , Vaginose Bacteriana/terapia , Administração Oral , Adolescente , Adulto , Criança , Pré-Escolar , Cólica/terapia , Dermatite Atópica , Diabetes Mellitus Tipo 2/terapia , Método Duplo-Cego , Equipamentos e Provisões/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Lactobacillus , Masculino , Obesidade/prevenção & controle , Obesidade/terapia , Faringite/terapia , Prebióticos/administração & dosagem , Prebióticos/efeitos adversos , Probióticos/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Supositórios , Simbióticos/administração & dosagem , Simbióticos/efeitos adversos , Tonsilite/terapia , Vaginite/microbiologia , Vaginite/terapia , Vaginose Bacteriana/microbiologia
6.
Public Health Nurs ; 35(6): 558-562, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30264406

RESUMO

BACKGROUND: The prevalence of North Korean female defectors is increasing in South Korea. Women who leave North Korea are exposed to sexual harassments, abuse, and other threats to their survival, which can have a devastating effect on their health. AIMS: In this study, a mobile video intervention program about selected aspects of women`s health was developed specifically for North Korean female defectors; its impact on behavioral change was evaluated. METHODS: A one group pre/posttest design was used with 61 female defectors who participated in the mobile video intervention. The program consisted of eight sessions focusing on the prevention and management of vaginitis and cervical cancer. RESULTS: The study results showed that knowledge and behavioral confidence on vaginitis and cervical cancer increased significantly among the participants following the intervention. CONCLUSIONS: This mobile video intervention program was effective in improving specific health knowledge and behavioral confidence of the participants. The program can be used to improve women`s health in this population.


Assuntos
Emigrantes e Imigrantes/educação , Neoplasias do Colo do Útero/prevenção & controle , Vaginite/prevenção & controle , Saúde da Mulher , Adulto , República Democrática Popular da Coreia , Feminino , Humanos , República da Coreia , Neoplasias do Colo do Útero/terapia , Vaginite/terapia , Adulto Jovem
7.
Medicine (Baltimore) ; 97(37): e12398, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30213012

RESUMO

BACKGROUND: We evaluated the efficacy and safety of combined high-dose interferon (IFN) and red light therapy for the treatment of subclinical and latent human papillomavirus (HPV) infections. METHODS: Ninety women diagnosed with subclinical or latent HPV infection were randomized to receive topical application of low-dose recombinant IFNα-2b (1 million IU), high-dose IFNα-2b (9 million IU), or a combination of high-dose IFNα-2b and red light therapy on the cervix and vagina. All patients received treatment once daily for 4 weeks. HPV titer was measured immediately and 4, 8, and 12 weeks after treatment to determine the rates of viral clearance and infection cure. Treatment of HPV-associated vaginitis and cervicitis was also evaluated. RESULTS: Results showed that immediately and 4, 8, and 12 weeks after treatment, the HPV clearance rates and infection cure rates were higher in the high-dose IFN and combination groups compared to the low-dose IFN group. High-dose IFN and combination therapies were significantly effective against both low-risk and high-risk HPV infections. Although the cure rates for vaginitis and cervicitis were significantly higher in the high- compared to the low-dose IFN group, rates were even higher in the combination group compared to the high-dose IFN group. Mild adverse effects were reported by a very small subset of patients (3/30) in the combination group. CONCLUSIONS: This study suggests that combination of high-dose IFN and red light therapy is safe and effective against subclinical and latent HPV infections.


Assuntos
Antivirais/administração & dosagem , Interferon-alfa/administração & dosagem , Papillomaviridae , Infecções por Papillomavirus/terapia , Fototerapia/métodos , Cervicite Uterina/terapia , Vaginite/terapia , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Interferon alfa-2 , Pessoa de Meia-Idade , Infecções por Papillomavirus/virologia , Estudos Prospectivos , Proteínas Recombinantes/administração & dosagem , Método Simples-Cego , Resultado do Tratamento , Cervicite Uterina/virologia , Vaginite/virologia , Adulto Jovem
8.
Prim Care ; 45(3): 567-586, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30115342

RESUMO

Several infections have unique consequences or considerations in pregnancy. Some common infections such as urinary tract infections, influenza, sexually transmitted diseases, and vaginitis affect pregnant women differently than the general population, can cause pregnancy complications, and require treatments that are safe in pregnancy. Infections such as hepatitis B and C and human immunodeficiency virus can be transmitted vertically and therefore management focuses on decreasing perinatal transmission. Certain infections can be transmitted in utero and cause congenital infections. Classically, these were grouped together as the TORCH infections, although now several others, including varicella virus, parvovirus, and Zika virus, have also been recognized.


Assuntos
Complicações Infecciosas na Gravidez/diagnóstico , Infecções por Chlamydia/complicações , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/terapia , Feminino , Gonorreia/complicações , Gonorreia/diagnóstico , Gonorreia/terapia , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Humanos , Transmissão Vertical de Doença Infecciosa , Influenza Humana/complicações , Influenza Humana/diagnóstico , Influenza Humana/terapia , Gravidez , Complicações Infecciosas na Gravidez/terapia , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/terapia , Toxoplasmose/complicações , Toxoplasmose/diagnóstico , Toxoplasmose/terapia , Infecções Urinárias/complicações , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Vaginite/complicações , Vaginite/diagnóstico , Vaginite/terapia , Viroses/complicações , Viroses/diagnóstico , Viroses/terapia
9.
Am Fam Physician ; 97(5): 321-329, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29671516

RESUMO

Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Bacterial vaginosis is implicated in 40% to 50% of cases when a cause is identified, with vulvovaginal candidiasis accounting for 20% to 25% and trichomoniasis for 15% to 20% of cases. Noninfectious causes, including atrophic, irritant, allergic, and inflammatory vaginitis, are less common and account for 5% to 10% of vaginitis cases. Diagnosis is made using a combination of symptoms, physical examination findings, and office-based or laboratory testing. Bacterial vaginosis is traditionally diagnosed with Amsel criteria, although Gram stain is the diagnostic standard. Newer laboratory tests that detect Gardnerella vaginalis DNA or vaginal fluid sialidase activity have similar sensitivity and specificity to Gram stain. Bacterial vaginosis is treated with oral metronidazole, intravaginal metronidazole, or intravaginal clindamycin. The diagnosis of vulvovaginal candidiasis is made using a combination of clinical signs and symptoms with potassium hydroxide microscopy; DNA probe testing is also available. Culture can be helpful for the diagnosis of complicated vulvovaginal candidiasis by identifying nonalbicans strains of Candida. Treatment of vulvovaginal candidiasis involves oral fluconazole or topical azoles, although only topical azoles are recommended during pregnancy. The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for the diagnosis of trichomoniasis in symptomatic or high-risk women. Trichomoniasis is treated with oral metronidazole or tinidazole, and patients' sex partners should be treated as well. Treatment of noninfectious vaginitis should be directed at the underlying cause. Atrophic vaginitis is treated with hormonal and nonhormonal therapies. Inflammatory vaginitis may improve with topical clindamycin as well as steroid application.


Assuntos
Anti-Infecciosos/administração & dosagem , Técnicas de Diagnóstico Obstétrico e Ginecológico , Vaginite/diagnóstico , Vaginite/terapia , Vias de Administração de Medicamentos , Feminino , Humanos
10.
Cas Lek Cesk ; 157(7): 354-357, 2018 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-30650979

RESUMO

Disorders of vulva and vagina are the most common problem in childhood in gynecological practice. As child is not the little adult, as young girl is not little woman. Childhood is characterized by changing hormone levels, which influenced hormone-dependent tissues. Etiology and diagnostics of this most common diseases are very often different of the same problem in adult woman. The most common diseases in childhood is synechia vulvae, inflammation of vulva and vagina called vulvovaginitis and skin disorders. It is very important to know everything about diagnostics and treatment to help young girls. Key words: vulvovaginitis, lichen sclerosus, synechia vulvae, child rest period, sexual development period, yeast infection.


Assuntos
Vaginite , Vulvite , Adolescente , Criança , Feminino , Humanos , Vaginite/diagnóstico , Vaginite/terapia , Vulvite/diagnóstico , Vulvite/terapia
11.
Bull Exp Biol Med ; 164(1): 75-79, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29119394

RESUMO

The effects of bone marrow multipotent mesenchymal stromal cells and their secretion products on the subpopulation composition of thymic and splenic lymphocytes were studied in female Wistar rats with experimental chronic inflammatory process in the internal genitals. Stromal cells and medium conditioned by these cells in different administration routes (intravenous or lymphotropic injection) produces different modulating effect on blood leukocyte count and on subpopulation composition of the splenic and thymic lymphocytes. The most manifest anti-inflammatory effect was observed after lymphotropic injection of multipotent mesenchymal stromal cells creating a high concentration and long persistence of the factors produced by these cells in the focus of inflammation.


Assuntos
Células-Tronco Mesenquimais/metabolismo , Baço/patologia , Timo/patologia , Vaginite/terapia , Animais , Células da Medula Óssea/metabolismo , Células Cultivadas , Feminino , Contagem de Linfócitos , Transplante de Células-Tronco Mesenquimais , Ratos Wistar , Baço/imunologia , Linfócitos T/fisiologia , Timo/imunologia , Vaginite/imunologia
12.
Obstet Gynecol Clin North Am ; 44(2): 159-177, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28499528

RESUMO

Vaginal complaints are one of the most common reasons women seek the advice of a health care provider. Uncomplicated infections such as vulvovaginal candidiasis, bacterial vaginosis, or trichomoniasis are easy to diagnose and treat. However, about 8% of patients will have a more complicated course with failure to respond to treatment or rapid recurrence of symptoms. Understanding the need for a methodical, diagnostic approach to help these women with recurrent or refractory cases of vaginal symptoms will aid the clinician achieve successful patient outcomes.


Assuntos
Vaginite , Feminino , Humanos , Vaginite/diagnóstico , Vaginite/etiologia , Vaginite/terapia
14.
Nutr. clín. diet. hosp ; 37(4): 60-68, 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-171049

RESUMO

Introducción: las infecciones vulvovaginales afectan al 75 % de las mujeres a lo largo de su vida, siendo un motivo recurrente en las consultas de ginecología y observándose generalmente un desequilibrio de la microbiota normal. Por ello, la administración de probióticos y prebióticos orales que contribuyan a la regeneración de la microbiota, parece aumentar la efectividad del tratamiento farmacológico y disminuir la tasa de recidivas. Objetivos: conocer la situación clínica actual de las infecciones vaginales y la utilización de un complemento alimenticio a base de lactobacilos (Lactobacillus crispatus LBV88, Lactobacillus rhamnosus LBV96, Lactobacillus jensenii LBV116 y Lactobacillus gasseri LBV150) y fructooligosacáridos, para el tratamiento coadyuvante de estas infecciones. Métodos: se trata de un estudio observacional de carácter retrospectivo, desarrollado en un periodo de dos años en el que participaron 186 ginecólogos, obteniendo un tamaño de muestra de n=649 casos clínicos (mujeres). Los datos se obtuvieron mediante cuestionarios validados por profesionales y los resultados fueron analizados mediante el programa informático IBM SPSS Statistic 22.0. Resultados: la mayoría de los ginecólogos (57,4 %) reciben más de 20 consultas al mes por infecciones vaginales, con una alta incidencia de recidivas (25-50 % de los casos según el 59,1 % de los expertos). La vía de elección para la administración de probióticos y prebióticos es la oral, con una media (D.T) de 6,4 (2,5) mujeres de cada 10. En los casos en los que se indicó el complemento alimenticio por vía oral, en el 41% fue como coadyuvante en el tratamiento de candidiasis, en el 19,6% como coadyuvante para el tratamiento de vaginosis, el 33,3% de los casos para la prevención de infecciones vaginales de repetición y en un 38,4% para la recuperación y mantenimiento del equilibrio de la microbiota tras procesos infecciosos, combinando la posología indicada por el fabricante y la recomendación personalizada en función de la experiencia de los ginecólogos. En cuanto a la satisfacción de las pacientes, > 90 % de las mujeres afirma que la mejoría al utilizar el complemento alimenticio es alta. Entre las características más valoradas por los ginecólogos, destaca la eficiencia con una media de 9,2 puntos, la tolerabilidad (8,8 puntos), la experiencia previa (8,5 puntos), y el perfil de probióticos utilizados (8,1 puntos). Discusión: los resultados del estudio coinciden con los datos de las sociedades científicas en cuanto a incidencia de infecciones vaginales, perfil del paciente y aparición de recidivas. Además, se refuerza la evidencia de la eficacia de los complementos alimenticios con probióticos y prebióticos como coadyuvantes para el tratamiento de estas infecciones. Aparece la vía oral como preferente para la administración de probióticos y prebióticos y se respeta la posología indicada por el fabricante del complemento en la mayoría de los casos, predominando la preferencia personal y profesional de cada ginecólogo en aquellas ocasiones en los que se indica una pauta diferente. Conclusiones: la administración por vía oral de complementos alimenticios a base de probióticos y prebióticos como coadyuvante del tratamiento de las infecciones vaginales, se muestra como una estrategia eficaz para mejorar la resolución del proceso infeccioso y prevenir la aparición de recidivas mediante la recuperación del equilibrio de la microbiota normal


Introduction: vulvovaginal infections affect 75 % of women throughout their life, being a recurrent issue in the gynecological practices and generally observing an imbalance of the normal microbiota. Thus, the administration of oral probiotics and prebiotics that contribute to regenerate the microbiota, seems to increase the effectiveness of the pharmacological treatment and decrease the recurrence rate. Objectives: knowing the current clinic situation of vaginal infections and the use of a food supplement based on lactobacilli (Lactobacillus crispatus LBV88, Lactobacillus rhamnosus LBV96, Lactobacillus jensenii LBV116 y Lactobacillus gasseri LBV150) and Fructooligosaccharides, for the adjuvant treatment of these infections. Methods: this is a retrospective observational study, developed in a two years period in which 186 gynecologists participated, obtaining a sample size of n=649 clinical cases (women). Data were collected by questionnaires validated by professionals and results were analysed by the IBM SPSS Statistic 22.0 software. Results: most gynecologists (57,4 %) received more than 20 consultations per month due to vaginal infections, with a high recurrence rate (25-50 % of the cases according to 59,1 % of specialists). The route of choice for the administration of probiotics and prebiotics is oral, with a mean (SD) of 6,4 (2,5) women out of every 10. In the cases in which oral administration was indicated for the food supplement, 41 % was as adjuvant in the treatment of candidiasis, 19,6 % as adjuvant for vaginosis treatment, 33,3 % of cases for the prevention of recurrent vaginal infections and 38,4 % for the recovery and maintenance of the microbiota balance after infectious processes, combining the dosage indicated by the manufacturer and personalized recommendations based on the experience of gynecologists. As for patient’s satisfaction, > 90 % of women confirm that the improvement when using the food complement is high. Among the characteristics most valued by gynecologists, it is highlighted efficiency with a mean of 9,2 points, tolerability (8,8 points), previous experience (8,5 points), and the probiotic profile used (8,1). Discussion: The results of the study coincide with scientific societies data regarding vaginal infections incidence, patient profile and recurrences. Besides, evidence of the efficacy of food supplements with probiotics and prebiotics as adjuvants for the treatment of these infections, is reinforced. Oral route of administration appears as a referent for the administration of probiotics and prebiotics and the dosage indicated by the manufacturer is respected in most of the cases, taking into account personal and professional preference of each gynecologist in those cases in which a different dosage is indicated. Conclusions: oral route of administration for food supplements based on probiotics and prebiotics as adjuvants for the treatment of vaginal infections, is shown as an effective strategy to improve the infectious process resolution and to prevent recurrences by recovering the balance of normal vaginal microbiota


Assuntos
Humanos , Feminino , Adulto , Probióticos/uso terapêutico , Doenças Vaginais/terapia , Vaginite/terapia , Microbiota , Inquéritos e Questionários , Estudos Retrospectivos , Vaginose Bacteriana/terapia , Candidíase/terapia
15.
J Clin Gastroenterol ; 50 Suppl 2, Proceedings from the 8th Probiotics, Prebiotics & New Foods for Microbiota and Human Health meeting held in Rome, Italy on September 13-15, 2015: S168-S170, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27741167

RESUMO

GOALS: This study was undertaken to demonstrate the ability of Lactobacillus fermentum LF5 (DSM 32277) to inhibit in vitro different Candida species and Gardnerella vaginalis to weigh its potential effectiveness even in mixed vaginal infections. BACKGROUND: A wide female population is suffering from various vulvovaginal infections. These diseases are often associated with a decrease in the concentration of Lactobacilli in the vagina. Mixed vaginal infections represent >20% of women with vulvovaginal infection. STUDY: LF5 strain was cocultured in De Man, Rogosa and Sharpe with Candida according to a 1:100 ratio in favor of the yeast. Each culture was sampled after 24 hours of incubation for the selective enumeration of the yeasts performed on yeast extract glucose chloramphenicol agar medium.The growth of Gardnerella alone (positive control) and in the presence of different concentrations of neutralized supernatants of L. fermentum LF5 ranging from 5% to 20% was quantified by means of optical density at 600 nm (OD600). RESULTS: L. fermentum LF5 demonstrated the ability to inhibit significantly the growth of the 5 species of Candida by at least 4 logarithms.Furthermore, L. fermentum LF5 showed a significant activity after both 24 and 48 hours (46% and 82% with 20% of neutralized supernatant, respectively). A significant dose-dependent growth inhibition was recorded in particular after 48 hours of incubation, even achieving a 80% inhibition of G. vaginalis growth. CONCLUSIONS: The biotherapeutic LF5 could be the only documented strain effective in mixed forms. For this purpose, a human clinical trial is in progress.


Assuntos
Candida/crescimento & desenvolvimento , Gardnerella vaginalis/crescimento & desenvolvimento , Lactobacillus fermentum , Probióticos/uso terapêutico , Vaginite/terapia , Técnicas de Cocultura , Feminino , Humanos , Vaginite/microbiologia
16.
J Microbiol Biotechnol ; 26(6): 1148-61, 2016 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-26975769

RESUMO

Lactobacilli are universally recognized as probiotics that are widely used in the adjuvant treatment of inflammatory diseases, such as vaginitis and enteritis. With the overuse of antibiotics in recent years, the lactobacilli in the human body are killed, which could disrupt the microecological balance in the human body and affect health adversely. In this work, cephalosporin-resistant Lactobacillus casei RL20 was obtained successfully from the feces of healthy volunteers, which possessed a stable genetic set. However, the shortage of lactic acid (72.0 g/l at 48 h) by fermentation did not meet the requirement for its use in medicine. To increase the production of lactic acid, the functional genes pfk and glk were introduced into the wild strain. A yield of 144.2 g/l lactic acid was obtained in the transgenic L. casei RL20-2 after fermentation for 48 h in 1 L of basic fermentation medium with an initial glucose concentration of 100 g/l and increasing antibacterial activity. These data suggested that L. casei RL20-2 that exhibited a high yield of lactic acid may be a potential probiotic to inhibit the spread of bacterial infectious diseases and may be used for vaginitis therapy.


Assuntos
Antibacterianos/metabolismo , Cefalosporinas/farmacologia , Glucoquinase/genética , Ácido Láctico/biossíntese , Lactobacillus casei/genética , Fosfofrutoquinases/genética , Probióticos , Meios de Cultura/química , Farmacorresistência Bacteriana , Fezes/microbiologia , Feminino , Fermentação , Glucoquinase/metabolismo , Glucose/farmacologia , Voluntários Saudáveis , Humanos , Ácido Láctico/metabolismo , Lactobacillus casei/efeitos dos fármacos , Lactobacillus casei/enzimologia , Microbiota , Fosfofrutoquinases/metabolismo , Probióticos/uso terapêutico , Análise Serial de Tecidos , Vaginite/terapia , Resistência beta-Lactâmica
17.
BMC Med Inform Decis Mak ; 15: 106, 2015 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-26674351

RESUMO

BACKGROUND: Syndromic management of vaginal infections is known to have poor diagnostic accuracy. Logic regression is a machine-learning procedure which allows for the identification of combinations of variables to predict an outcome, such as the presence of a vaginal infection. METHODS: We used logic regression to develop predictive models for syndromic management of vaginal infection among symptomatic, reproductive-age women in south India. We assessed the positive predictive values, negative predictive values, sensitivities and specificities of the logic regression procedure and a standard WHO algorithm against laboratory-confirmed diagnoses of two conditions: metronidazole-sensitive vaginitis [bacterial vaginosis or trichomoniasis (BV/TV)], and vulvovaginal candidiasis (VVC). RESULTS: The logic regression procedure created algorithms which had a mean positive predictive value of 61 % and negative predictive value of 80 % for management of BV/TV, and a mean positive predictive value of 26 % and negative predictive value of 98 % for management of VVC. The results using the WHO algorithm were similarly mixed. CONCLUSIONS: The logic regression procedure identified the most predictive measures for management of vaginal infections from the candidate clinical and laboratory measures. However, the procedure provided further evidence as to the limits of syndromic management for vaginal infections using currently available clinical measures.


Assuntos
Algoritmos , Aprendizado de Máquina , Modelos Teóricos , Vaginite/terapia , Adulto , Feminino , Humanos , Índia , Prognóstico , Sensibilidade e Especificidade , Síndrome
18.
Am Fam Physician ; 92(9): 778-86, 2015 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-26554471

RESUMO

The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. Noninflammatory causes of dysuria include medication use, urethral anatomic abnormalities, local trauma, and interstitial cystitis/bladder pain syndrome. An initial targeted history includes features of a local cause (e.g., vaginal or urethral irritation), risk factors for a complicated urinary tract infection (e.g., male sex, pregnancy, presence of urologic obstruction, recent procedure), and symptoms of pyelonephritis. Women with dysuria who have no complicating features can be treated for cystitis without further diagnostic evaluation. Women with vulvovaginal symptoms should be evaluated for vaginitis. Any complicating features or recurrent symptoms warrant a history, physical examination, urinalysis, and urine culture. Findings from the secondary evaluation, selected laboratory tests, and directed imaging studies enable physicians to progress through a logical evaluation and determine the cause of dysuria or make an appropriate referral.


Assuntos
Disuria/diagnóstico , Disuria/terapia , Guias de Prática Clínica como Assunto , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Vaginite/diagnóstico , Vaginite/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Educação Médica Continuada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/terapia
19.
Minerva Ginecol ; 66(5): 497-512, 2014 Oct.
Artigo em Italiano | MEDLINE | ID: mdl-25245998

RESUMO

Recurrent vaginitis and cystitis are a daily challenge for the woman and the physician. The recurrence worsens the symptoms' severity, increases comorbidities, both pelvic (provoked vestibulodynia, bladder pain syndrome, levator ani hyperactivity, introital dyspareunia, obstructive constipation, chronic pelvic pain) and cerebral (neuroinflammation and depression), increases health costs, worsens the quality of life. Antibiotics increase the risk of bacterial resistences and devastate the ecosystems: intestinal, vaginal and mucocutaneous. Pathogenic biofilms are the (still) neglected etiology of recurrences. Biofilms are structured communities of bacteria and yeasts, protected by a self-produced polymeric matrix adherent to a living or inert structures, such as medical devices. Biofims can be intra or extracellular. Pathogens live in a resting state in the deep biofilm layers as "persister cells", resistant to antibiotics and host defences and ready to re-attack the host. The paper updates the evidence on biofilms and introduces new non-antibiotic strategies of preventing and modulating recurrent vaginitis and cystitis.


Assuntos
Cistite/terapia , Qualidade de Vida , Vaginite/terapia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Biofilmes , Cistite/microbiologia , Cistite/fisiopatologia , Farmacorresistência Bacteriana , Feminino , Humanos , Recidiva , Vaginite/microbiologia , Vaginite/fisiopatologia
20.
Maturitas ; 78(2): 146-50, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24720907

RESUMO

Vaginal health, defined as the vaginal state in which the physiological condition remains stable, being protected from the onset of symptoms and facilitating a satisfying sex life, is one of the most common and less valued concerns in postmenopausal women. Many of the conditions that affect the vagina are related to its trophism and susceptibility to infection by unusual germs, which are phenomena strongly influenced by estrogen impregnation and the microbiota composition, ultimately affecting sexuality and the quality of life. An expert panel of the Spanish Menopause Society met to establish criteria for diagnosing and treating the processes that affect overall vaginal health and to decide the optimal timing and methods based on the best evidence available.


Assuntos
Pós-Menopausa , Saúde Reprodutiva , Disfunções Sexuais Fisiológicas/terapia , Vagina/patologia , Doenças Vaginais/terapia , Feminino , Humanos , Qualidade de Vida , Doenças Vaginais/diagnóstico , Vaginite/diagnóstico , Vaginite/terapia , Saúde da Mulher
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