Effect of topical oxytocin gel on vaginal mucosa in postmenopausal Egyptian women: a clinical randomized trial.

BACKGROUND: Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, particularly dyspareunia. AIM: The study aimed to investigate the effect of intravaginally applied oxytocin on expressions of vaginal atrophy. METHODS: Fifty postmenopausal women aged 47 to 66 years with vaginal atrophy participated in this double-blinded placebo-controlled study. The women were randomized to intravaginal treatment with either gel with 600 IU/mL of oxytocin (oxytocin group) or gel alone (control group) once daily for 2 weeks. The gel consisted of hypromellose, pH 3.8 (Vagovital). OUTCOMES: The color of the vaginal mucosa, the vaginal pH, and the cytology of vaginal epithelial cells were investigated before and after treatment. RESULTS: The color of the vaginal mucosa shifted from pale to red in all 25 patients treated with oxytocin but only in 4 patients in the control group (P < .001). There was a significant decrease in intravaginal pH in the oxytocin group and the control group, with the delta value being significantly greater in the oxytocin group than in the control group (P < .001). The vaginal maturation index increased significantly (P < .001) in the oxytocin group but not in the control group. CLINICAL IMPLICATIONS: Topical oxytocin gel offers an effective solution to the sexual dysfunction that is related to vaginal atrophy after menopause. STRENGTHS AND LIMITATIONS: Strengths include studying different outcomes of applying the oxytocin gel for vaginal atrophy. Limitations include the small-scale population with a relatively short duration of treatment (2 weeks). CONCLUSION: Intravaginal treatment with a gel containing 600 IU/mL of oxytocin effectively counteracts physical expressions of vaginal atrophy. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05275270; https://clinicaltrials.gov/ct2/show/NCT05275270).

The effects of intrauterine device on cervico-vaginal smears with liquid-based cytology technique: A North-Eastern Anatolia region study in Turkey.

Intrauterine device (IUD), is one of the most efficient methods of contraception. The aim of study to investigate the effects of intrauterine device in cervicovaginal smears with liquid based cytology technique in our patient population. Cervicovaginal smears of 5492 patients who sought the services of the pathology department in a sixmonth period were reviewed retrospectively. Samples were prepared with liquid based cytology technique. The patients using IUD as contraceptive method (n= 562 cases) were included in the study. The samples taken with the conventional method were excluded from the study. The results were categorized according to the Bethesda system. The age range of the patients was 18-61 years (mean age: 34.6). The most common diagnosis was "negative for intraepithelial lesion or malignancy" (97.2%). In 307 patients (54.6%) there were infection and only in 93 out of them (30.2%) a specific agent was detected. Actinomyces (11%) were recorded as the most common infectious agent, followed by Gardnerella vaginalis (2.8%) and Candida species (2.4%). There were reactive changes in 134 cases (23.8%). In 13 cases (2.3%) epithelial cell abnormalities were detected. The most common cytopathologic diagnosis was ASC-US (atypical squamous cells of undetermined significance) in patients who had epithelial cell abnormalities (2.1%). In conclusion, IUDs increase the frequency of genital infection by disrupting the genital flora. In our study the most frequent agent was Actinomyces, and this rate was higher than some studies. This high rate for Actinomyces may be associated with IUDs that are frequently used for contraception in Erzurum province with long term uses.

The colonization with Candida species is more harmful in the second trimester of pregnancy.

PURPOSE: Vaginal colonization with Candida species (spp.) during pregnancy has been associated with impaired pregnancy outcomes. There is a reduction in spontaneous preterm birth among women with recurrent asymptomatic colonization of Candida who were treated with clotrimazole. This study aimed to evaluate the impact of the trimester of vulvovaginal colonization with Candida species. METHODS: Data from all women, who were tested positive for the vaginal colonization with Candida spp. during the first or second trimester of pregnancy, and who registered for a planned birth at our tertiary referral center between 2005 and 2014 were retrospectively analyzed. Their preterm birth rate served as the primary outcome variable. Secondary outcome variables were neonatal birthweight and Apgar score. RESULTS: Overall, 1066 women were eligible for the study. In 673 women (63%), who were diagnosed with Candida spp. during the first trimester of pregnancy, the rate of preterm birth was 10% (N = 64). In 393 women (37%), who were diagnosed with candidosis during the second trimester, the preterm birth rate was 18% (N = 71; p = 0.0002). Neonates of women, who presented with vulvovaginal candidosis during the first trimester, had a mean birthweight of 3243 g, compared to 2989 g in the group with a second trimester colonization (p < 0.0001). CONCLUSION: Women who are colonized with Candida spp. during the second trimester of pregnancy have higher rates of preterm birth and lower neonatal birthweight than those who are colonized during the first trimester of their pregnancy. Screening programs for asymptomatic Candida colonization should take this information into account.

Violence against women and cervical cancer screening: a systematic review.

AIMS AND OBJECTIVES: To present a systematic review of papers published on the relationship between violence against women and cervical cancer screening. BACKGROUND: Violence against women is a serious public health problem. This phenomenon can have negative effects on victims' health and affect the frequency at which they receive cervical cancer screening. DESIGN: A systematic literature review. METHODS: This study was carried out in October 2015 with searches of the Lilacs, PubMed and Web of Science databases using the following keywords: violence, domestic violence, battered women, spouse abuse, Papanicolaou test, vaginal smears, early detection of cancer and cervix uteri. RESULTS: Eight papers published between 2002-2013 were included in this review, most of which were cross-sectional studies. Three studies found no association between victimisation and receiving Pap testing, and five studies reported an association. These contradictory results were due to higher or lower examination frequencies among the women who had experienced violence. CONCLUSION: The results of this study indicate that the association between violence against women and cervical cancer screening remains inconclusive, and they demonstrate the need for more detailed studies to help clarify this relationship. RELEVANCE TO CLINICAL PRACTICE: Professionals who aid women should be knowledgeable regarding the perception and detection of violence so that they can interrupt the cycle of aggression, which has harmful impacts on victims' health.

Vaginal fold histology reduces the variability introduced by vaginal exfoliative cytology in the classification of mouse estrous cycle stages.

Vaginal exfoliative cytology is commonly used in biomedical and toxicological research to classify the stages of the rodent estrous cycle. However, mouse vaginal exfoliative cytology is commonly used as a stand-alone tool and has not been evaluated in reference to vaginal histology and serum sex hormone levels. In this study, the direct and Giemsa-stained methods of vaginal exfoliative cytology were compared in reference to vaginal fold histology and serum sex hormone levels. Both methods predicted the estrous stages similarly with mean discordance rates of 55%, 77%, 46%, and 31%, for diestrus, proestrus, estrus, and metestrus, respectively. From these results, we conclude that vaginal exfoliative cytology may be used as a general guide to determine the desired estrous stage end point and that a definitive confirmation of the estrous stage should be obtained from evaluation of vaginal fold histology. Confirmation of the stage of the estrous cycle by vaginal fold histology will decrease the variability otherwise introduced by misclassification of estrous cycle stages with vaginal exfoliative cytology.

Agaricus Subrufescens ameliorates ovarian dysfunction and regulates altered biochemical parameters in rats with Letrozole induced polycystic ovarian syndrome.

OBJECTIVE: The objective of this study is to investigate the effects of an ethanolic extract derived from Agaricus subrufescens on rat models exhibiting Polycystic Ovarian Syndrome (PCOS) induced by Letrozole. METHODS: A total of thirty female Wistar rats were divided into five groups, each consisting of six rats. The negative control group was administered a volume of 1 mL of a 0.5% solution of carboxy methylcellulose (CMC). Letrozole (1 mg/kg) was administered to additional groups for a duration of 21 days in order to induce polycystic ovary syndrome (PCOS). Animals designated as positive controls were euthanized on the 22nd day. Both the test group and the standard group were subjected to treatment from the 22nd day to the 36th day. The experimental group was administered ethanolic extract of Agaricus subrufescens at doses of 200 mg/kg and 400 mg/kg p.o, while the control group received clomiphene citrate at a dose of 1 mg/kg. The study observed various physiological markers in individuals with polycystic ovarian disease, including estimated blood glucose levels, total cholesterol levels, triglyceride levels, and hormonal fluctuations such as increased testosterone and estrogen levels, as well as decreased progesterone levels. The presence of menstrual irregularities was confirmed through the examination of vaginal smears and histopathological changes in the ovaries. RESULTS: The consumption of Agaricus subrufescens was found to have a significant impact on various physiological parameters, including blood glucose levels, testosterone levels, anovulation, and menstrual irregularity. All therapeutic interventions significantly normalized the levels of serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT). The rats with polycystic ovary syndrome (PCOS) that were induced by Letrozole exhibited increased levels of urea and creatinine. The findings of this study indicate that the administration of Agaricus subrufescens therapy has a protective effect on renal function, as evidenced by a reduction in serum levels of urea and creatinine. In rats with polycystic ovary syndrome (PCOS) induced by Letrozole, the inhibition of hepatic synthesis, promotion of ovarian follicle immaturity, and elevation of androgen secretions result in an increase in the weight of the liver and ovaries. The weight of endocrine organs exhibited a decrease across all treatment groups. The histopathological examination of PCOS specimens revealed an increased presence of cysts and theca lutein cells. The group of rats with polycystic ovary syndrome (PCOS) that did not receive treatment exhibited a higher number of cysts compared to the groups that received treatment. CONCLUSION: This study demonstrated that the administration of Letrozole orally resulted in the development of polycystic ovarian disease. The results indicated heightened levels of blood glucose, total cholesterol, and triglycerides, as well as alterations in hormone levels such as increased testosterone and estrogen, and decreased progesterone. These hormonal changes were accompanied by menstrual irregularities, which were confirmed through the examination of vaginal smears and histopathological analysis of the ovaries in the control group with polycystic ovarian disease. The treatment groups that received Agaricus subrufescens exhibited a decrease in blood glucose, total cholesterol, and testosterone levels.

Repeated Collection of Vaginal Smear Causes Stress in Mice.

Introduction: Women are more likely to be misdiagnosed in many neuropsychiatric disorders than men. One of the possible underlying reasons for this disparity may be more frequent use of male mice than female mice in neuroscience studies. With the increasing realization of the shortcomings of this approach in understanding the neurobiological basis of these disorders, many funding agencies mandate the inclusion of both male and female subjects in study design. As the behaviors vary with the stage of the estrous cycle, the collection of vaginal smears to identify the estrous stage becomes a widely used procedure. Here we tested whether vaginal smear collection causes similar effects to that of stress by evaluating an increase in depression-like behavior and impairment in memory. Method: Vaginal smear was collected from Swiss albino mice twice a day for 10 days. In order to test depression-like behavior tail suspension, sucrose preference and splash tests were conducted. Novel object recognition and novel object location tests were performed 1 hour and 24 hours after training to evaluate short-and long-term memory respectively. Results: The female mice whose vaginal smears were collected demonstrated increased behavioral despair and anhedonia. Vaginal smear group showed deficits in both short-term and long-term memory when compared to the control group. Conclusion: Our results indicate that the collection of vaginal smear not only increased depression-like behaviors in mice, but also impaired short-term and long-term memory, indicating that the procedure of vaginal smear collection was stressful. We recommend to consider other ways of estrous cycle staging when studying behavior.

Canine Vaginal Cytology: A Revised Definition of Exfoliated Vaginal Cells.

Vaginal cytology is an important examination method in the context of gynecological disorders and cycle staging in the bitch. While collection and preparation of samples are easy, the evaluation appears to be challenging. Inconsistent definitions of cell attributes such as size, cornification and the appearance of the nucleus have been published. The aim of the project was to develop a tutorial for vaginal cell determination. To get a deeper insight into the use of cytology in practice, an online survey was distributed to veterinarians interested in small animal reproduction. Participants were asked to define eight cells and answer questions. The agreement of the 16 participants, working in eight different countries, determining the cells was poor (κ = 0.412). Eleven respondents stated that vaginal cytology has a low reliability. Nevertheless, 13 participants use this tool regularly. The tutorial was developed as a flowchart based on the survey results, scientific literature and own measurements. It guides the user systematically through the evaluation of specific cell characteristics. An evaluation of the results of five raters with difference experience levels led to a high agreement (κ = 0.858). Vaginal cytology is a useful diagnostic tool, but it seems helpful to standardize the determination of cell types.

Cytological features of a complete hydatidiform mole in a cervicovaginal smear: A case report.

Exfoliated trophoblastic cells can be seen in a cervicovaginal smear in cases of normal pregnancy or gestational trophoblastic disease (GTD) and can mimic high-grade squamous intraepithelial lesion (HSIL) or malignancy. Although they appear highly anaplastic, cytological features such as high nuclear to cytoplasmic ratio, irregular nuclear contours and scanty basophilic cytoplasm admixed with cytologically benign squamoid and endocervical cells can aid in differentiating them from malignant cells. We present a case of a 37-year-old woman with abnormal uterine bleeding for 3-months. There was no history of recent pregnancy or previous GTD. Her cervicovaginal smear showed a hypercellular smear exhibiting cytologically benign superficial and intermediate squamous cells along with clusters of benign endocervical cells with interspersed mononucleate cells. These mononucleate cells were large, with a hyperchromatic, pleomorphic nuclei, and scant basophilic cytoplasm. Cytological features were suggestive of trophoblastic cells and workup for pregnancy and GTD was advised. Her laboratory investigations showed markedly raised levels of ß human chorionic gonadotropins (ß-HCG) and ultrasound showed a uterine mass with snowstorm appearance. A uterine evacuation was performed after which histopathological examination showed microscopic features consistent with a complete hydatidiform mole. The rare presence of trophoblastic cells in a cervicovaginal smear can easily be confused with malignant cells and can be misleading to the pathologist. Trophoblastic cells should always be kept in mind when evaluating a cytology smear of a young patient irrespective of gestational status.

Direct and Indirect Measurements of Sex Hormones in Rodents During Fear Conditioning.

Fear conditioning (FC) is a widely accepted tool for the assessment of learning and memory processes in rodents related to normal and dysregulated acquired fear. The study of sex differences in fear learning and memory is vast and currently increasing. Sex hormones have proven to be crucial for fear memory formation in males and females, and several methods have been developed to assess this hormonal state in rats and mice. Herein, we explain a routine FC and extinction protocol, together with the evaluation of sex hormonal state in male and female rodents. We explain three protocols for the evaluation of this hormonal state directly from blood samples extracted during the procedure or indirectly through histological verification of the estrous cycle for females or behavioral assessment of social hierarchies in males. Although females have typically been considered to present great variability in sex hormones, it is highlighted that sex hormone assessment in males is as variable as in females and equally important for fear memory formation. The readout of these protocols has had a great impact on different fields of fear learning and memory study and appears essential when studying FC. The proven interaction with drugs involved in the modulation of these processes makes sex hormone assessment during FC a valuable tool for the development of effective treatments for fear-related disorders in men and women. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Fear conditioning and fear extinction Basic Protocol 2: Blood collection for direct measurement of sex hormone levels in fear conditioning Basic Protocol 3: Indirect measurement of sex hormones in females during fear conditioning Basic Protocol 4: Assessment of dominance status in males before a fear conditioning protocol Support Protocol: Construction of a confrontation tube.

Reproductive cycle stage assessment using vaginal cytology evaluation in African lions (Panthera leo).

Vaginal cytology evaluation is an economic, non-invasive technique for indirect monitoring of fluctuations in estrogen concentrations, and thus progression of the estrous cycle. This technique is widely used in domestic dogs for determining timing of artificial insemination. There, however, are only a few reports on the vaginal cytology of non-domestic felids, including lions. This study was conducted, therefore, to describe the vaginal epithelial changes throughout the reproductive cycle of African lions, and to investigate the efficacy of vaginal cytology assessments for predicting reproductive stages. During a 12-month period, reproductive behavioral data and vaginal swabs were collected daily from five lionesses. In total, 541 vaginal smears were evaluated for the proportion of mucosal epithelial cells, neutrophils, bacterial cells, and amount of mucous, cellular debris. One single swab with a large proportion of superficial cells, absence of neutrophils, large number of bacteria, without cellular debris was sufficient for detecting lionesses in estrus. Likewise, one cytology sample with a large proportion of parabasal and intermediate cells, few neutrophils, few bacteria, and large amount of mucous, cellular debris enabled detection of females in advanced diestrus or gestation. To distinguish lionesses in early diestrus from those in an inter-estrous period, at least two consecutive swabs were necessary for satisfactory classification. Overall, evaluation of vaginal cytology samples was an effective technique for differentiation among different stages of the reproductive cycle, confirmation of estrus, and pregnancy diagnosis in lionesses. This technique, therefore, has the potential for application in classifying different stages of the reproductive cycle in other feline species.

Regulation of estrous cycle by Cynodon dactylon in letrozole induced polycystic ovarian syndrome in Wistars albino rats.

Menstrual cycle is controlled by luteinizing hormone (LH) and follicle-stimulating hormone of anterior pituitary and regulated by gonadotropin-releasing hormone of hypothalamus. Any disturbance to this regulatory mechanism alters the pulsatile release of these hormones, especially LH; leads to polycystic ovarian syndrome (PCOS). Changes in vaginal cytology are used to interpret the changes in hormonal levels and modifications in estrous cycle. The aim of this study is to compare the pattern of vaginal cytology and body mass among PCOS rats which are treated with metformin and Cynodon dactylon. Twenty-four Wistar rats were selected and divided into four groups: control, induced, treatment, and referral. PCOS was induced in all groups except controls by giving letrozole through oral gavage for 21 days. After inducing PCOS, the referral and treatment group were treated for PCOS with metformin and C. dactylon respectively for next 21 days. Vaginal smear of all the groups were taken every day from day one and screened for estrous cycle. The body mass of the animals was measured on days 1, 21, and 42. Animals were sacrificed after 24 hours of the last dose and the reproductive organs were dissected out and weighed. Results of the study show the estrous cycle begins to revert after 1-week administration of C. dactylon; while the changes were slower in referral group. There was a rapid decrease in the body mass as well as reproductive organs among the treatment and referral group compared to that of induced and control. Finding of this study suggests that C. dactylon treats PCOS better than metformin.

Comparison of urine, self-collected vaginal swab, and cervical swab samples for detecting human papillomavirus (HPV) with Roche Cobas HPV, Anyplex II HPV, and RealTime HR-S HPV assay.

BACKGROUND: Human papillomavirus (HPV) is well established as the main cause of cervical cancer. Non-invasive self-collected urine and vaginal sampling have the potential advantage of increasing patient compliance with cervical cancer screening. METHODS: Self-collected vaginal and urine samples and clinician-collected cervical samples were collected from 101 patients, including 84 patients with high grade squamous intraepithelial lesion and 17 patients with benign ovarian disease. Each sample was evaluated with RealTime HR-S HPV, Anyplex™ II HPV, and Cobas® HPV assays. The concordance of urine and of self-collected vaginal samples with cervical samples was assessed using the kappa (k) statistic. RESULTS: In any high-risk HPV (hrHPV), the concordance of self-collected vaginal and urine samples compared to cervical samples was moderate (k 0.49-0.58) and fair to moderate (k 0.33-0.51), respectively. In HPV 16/18, the concordance of vaginal and urine samples compared to cervical samples was almost perfect (k 0.81-0.86) and moderate to substantial (k 0.59-0.63), respectively. Among the three methods for HPV detection, RealTime HR-S showed the highest concordance with vaginal (k: any hrHPV 0.58, HPV 16/18 0.86) and urine samples (k: any hrHPV 0.51, HPV 16/18 0.63) compared to cervical samples. CONCLUSION: HPV tests using self-collected vaginal samples and urine showed substantial and moderate agreement compared with cervical samples, respectively, although HPV tests using these samples were still inferior to clinician-collected cervical samples. Further research is needed on the clinical performance of HPV testing using urine and self-collected vaginal samples as the screening method.

Safety and acceptability of human papillomavirus testing of self-collected specimens: A methodologic study of the impact of collection devices and HPV assays on sensitivity for cervical cancer and high-grade lesions.

BACKGROUND: Comparative data on different self-collection methods is limited. OBJECTIVES: To assess the impact of hrHPV testing of two self-collection devices for detection of cervical carcinoma and high-grade lesions. STUDY DESIGN: Three hundred ten patients collected two cervicovaginal specimens using a brush (Evalyn®Brush) and a swab (FLOQSwabs™), and filled a questionnaire at home. Then, a physician at the clinic took a cervical specimen into PreservCyt® buffer for hrHPV testing and cytology. All specimens were tested using Anyplex™ II HPV28, Cobas® 4800 HPV Test and Xpert®HPV. RESULTS: Performance comparison included 45 cervical carcinomas and 187 patients with premalignant lesions. Compared to the physician-specimen, hrHPV testing of Evalyn®Brush showed non-inferior sensitivity for CIN3+ (relative sensitivity of Anyplex™ 0.99; Cobas® 0.96; Xpert®HPV 0.97) while hrHPV testing of FLOQSwabs™ showed inferior sensitivity (relative sensitivity of Anyplex™ 0.91; Cobas® 0.92; Xpert®HPV 0.93). Similar results were observed for invasive carcinomas albeit that FLOQSwabs™ was statistically non-inferior to the physician-specimen. Self-collection by either Evalyn®Brush or FLOQSwabs™ was more sensitive for CIN3+ than LSIL or worse cytology. Significant decrease in sensitivity for CIN3+ were observed for FLOQSwabs™ when specimens were preprocessed for hrHPV testing after 28 days. Both devices were well accepted, but patients considered Evalyn®Brush easier and more comfortable than FLOQSwabs™. CONCLUSIONS: Self-collection is comparable to current screening practice for detecting cervical carcinoma and CIN3+ but device and specimen processing effects exist. Only validated procedure including collection device, hrHPV assay and specimen preparation should be used.

Self-sampling with HPV mRNA analyses from vagina and urine compared with cervical samples.

BACKGROUND: In order to increase coverage in the organized cervical screening program, self-sampling with HPV analyses has been suggested. OBJECTIVES: The aim was to compare human papillomavirus (HPV) mRNA detection in vaginal and urine self-collected samples with clinician-taken cervical samples and the corresponding clinician-taken histological specimens. STUDY DESIGN: Self-collected vaginal, urine and clinician-taken cervical samples were analyzed from 209 women with the Aptima mRNA assay (Hologic Inc, MA, USA). Cervical cytology, colposcopy, biopsy and/or the loop electrosurgical excision procedure (LEEP) were performed in every examination. RESULTS: The sensitivity of the HPV mRNA test in detecting high-grade squamous intraepithelial lesions (HSIL)/adenocarcinoma in situ (AIS)/cancer cases was as follows: for the vaginal self-samples 85.5% (95% CI; 75.0-92.8), the urinary samples 44.8% (95% CI; 32.6-57.4), and for routine cytology 81.7% (95% CI; 70.7-89.9). For the clinician-taken cervical HPV samples the sensitivity of the HPV mRNA test in detecting HSIL/AIS/cancer was 100.0% (95% CI; 94.9-100.0). The specificity of the HPV mRNA was similar for the clinician-taken cervical HPV samples and the self-samples: 49.0% vs. 48.1%. The urinary HPV samples had a specificity of 61.9% and cytology had a specificity of 93.3%. CONCLUSION: The sensitivity of the Aptima HPV mRNA test in detecting HSIL/AIS/cancer from vaginal self-samples was similar to that of routine cytology. The Aptima HPV mRNA vaginal self-sampling analysis may serve as a complement in screening programs.

Vaginal and Urine Self-sampling Compared to Cervical Sampling for HPV-testing with the Cobas 4800 HPV Test.

BACKGROUND/AIM: To compare human papillomavirus (HPV) DNA detection in self-collected vaginal and urine samples with clinician-taken cervical samples in relation to histology. MATERIALS AND METHODS: Self-collected vaginal, urine and clinician-taken cervical samples were analyzed from 218 women with the Cobas 4800 HPV test (Roche Molecular Diagnostics). RESULTS: The sensitivity for detection of HPV in the vaginal self-sampling test was 96.4% and in urine was 83.9% relative to detection by clinician-taken cervical sample. The vaginal self-sampling and the clinician-taken HPV tests had the same sensitivity of 92.8% (95% confidence interval=86.3-96.8%) and specificity for detection of high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS). Detection in urine samples had a sensitivity of 76.3% (95% confidence interval=67.9-84.2%) for HSIL/AIS. CONCLUSION: The Cobas 4800 HPV test detects high-grade pre-cancerous cervical lesions in self-collected vaginal samples with the same high sensitivity as in clinician-taken cervical samples.

Inflammatory cells in liquid-based cytology smears classified as bacterial vaginosis.

BACKGROUND: Bacterial vaginosis (BV) remains an enigmatic question. The term "osis" instead of "itis" is used because commonly, there are no inflammatory process associated with BV. However, leukocytes are often observed in it. METHODS: In a transversal study, we evaluated 1178 cases with diagnosis of BV by liquid-based cytology (more than 20% of clue cells), attended in general gynecologic private clinic. Depending of the presence of more than five leukocytes on average per field in immersion objective (1000×), the cases were divided in two groups: few or no leukocytes (< 5 leukocytes per field) (BV) and with leukocytes (≥ 5 leukocytes per field) (BV-L). The Fisher exact and Student t tests was applied to a confidence interval of 95%. The project was approved by the Ethic Committee of Federal University of Ceará, Brazil. RESULTS: The age between the groups was the only different socio-demographic variable. The assessment of vaginal discharge aspect had no characteristic aspect. Colposcopy findings suggesting colpitis and ectopy were more frequent in the group of BV-L, 7.1% and 6.9%, respectively. The study of the microbiology demonstrated in the BV-L group, more frequently co-occurrence of Candida sp (15.1%) than in BV group (1.5%) (P < .0001). The cellular atypia was present more frequently in the BV-L (9.6%) than in BV (5.7%) (P = .0116). CONCLUSION: The presence of leukocytes in BV (or BV-L) may suggest a mixed infection, ectopy influencing the vaginal milieu and even epithelial atypia.

Birth of cloned mice from vaginal smear cells after somatic cell nuclear transfer.

Less invasive methods for donor cell collection will facilitate reproduction of wild animals using somatic-cell nuclear transfer. Stages of the estrous cycle in mice have long been studies using somatic cells that can be collected from vaginal walls using cotton tipped swabs in a relatively non-invasive manner. In this study, we examined the feasibility of these cells as sources of nuclei for somatic-cell cloning using nuclear transfer. Estrous cycles generally comprise proestrus, estrus, metestrus, and diestrus stages. In the present experiments, more than 60% of cells were nucleated in vaginal smears from all but the estrus stage. However, after somatic-cell nuclear transfer of cells from proestrus, metestrus, and diestrus stages, 66%, 50%, and 72% of cloned embryos developed to the morula/blastocyst, and cloned female mouse birth rates after embryo transfer were 1.5%, 0.3%, and 1%, respectively. These results show that noninvasively collected vaginal smears contain somatic cells that can be used to clone female mice.

Epidemiological profile and factors associated with cervicalvaginal infections in quilombola women submitted to preventive examination / Perfil epidemiológico e fatores associados às infecções cérvico-vaginais em mulheres quilombolas submetidas ao exame preventivo / Perfil epidemiológico y factores asociados a infecciones cérvico-vaginales en mujeres quilombolas sometidas a examen preventivo

Background and Objectives: reproductive tract infections are considered an important demand for women's health, due to their high prevalence in the population and the consequences they can cause, such as premature birth, infertility and cervical cancer. There are still women who do not undergo cytopathological examination, capable of preventing these infections, either due to lack of guidance or opportunity, such as quilombola women. This study aimed to identify factors associated with cervicovaginal infections in quilombola women from Feira de Santana, Bahia. Methods: a descriptive study, carried out in a transversal way and with a quantitative approach. Data collection was carried out from November 2019 to January 2020, with the application of an anamnesis form prepared by the team, with variables used in other studies, such as risk factors. Bivariate analysis was performed to obtain prevalence ratios (PR) between infections and the characteristics found. Results: a total of 82 women were studied, with an average age of 45.3 years. The main vaginal infections were caused by Gardnerella vaginalis (17.1%), Trichomonas vaginalis (8.5%), Cocci (8.5%), Candida spp. (6.2%) and Fusobacterium spp. (1.2%). In 88.2% of infected women, inflammation was present. Conclusion: the results obtained in this study showed a correlation between the inflammatory process in women and the presence of some infection. With regard to infections, there was a higher prevalence in women with low education, without a steady partner and who did not undergo regular preventive examination.(AU)

Justificativa e Objetivos: as infecções do trato reprodutivo são consideradas uma demanda importante para a saúde da mulher, devido à sua alta prevalência na população e às consequências que podem causar, como parto prematuro, infertilidade e câncer do colo do útero. Ainda há mulheres que não realizam exame citopatológico, capaz de prevenir essas infecções, seja por falta de orientação ou oportunidade, como as mulheres quilombolas. Este estudo teve como objetivo identificar fatores associados a infecções cervicovaginais em mulheres quilombolas de Feira de Santana, Bahia. Métodos: estudo descritivo, realizado de forma transversal e com abordagem quantitativa. A coleta de dados foi realizada no período de novembro de 2019 a janeiro de 2020, com a aplicação de uma ficha de anamnese elaborada pela equipe, com variáveis utilizadas em outros estudos, como fatores de risco. A análise bivariada foi realizada para obter razões de prevalência (RP) entre as infecções e as características encontradas. Resultados: foram estudadas 82 mulheres, com média de idade de 45,3 anos. As principais infecções vaginais foram causadas por Gardnerella vaginalis (17,1%), Trichomonas vaginalis (8,5%), Cocci (8,5%), Candida spp. (6,2%) e Fusobacterium spp. (1,2%). Em 88,2% das mulheres infectadas, a inflamação estava presente. Conclusão: os resultados obtidos neste estudo mostraram uma correlação entre o processo inflamatório em mulheres e a presença de alguma infecção. No que se refere às infecções, houve maior prevalência em mulheres com baixa escolaridade, sem companheiro fixo e que não realizavam exame preventivo regular.(AU)

Justificación y Objetivos: las infecciones del aparato reproductor son consideradas una demanda importante para la salud de la mujer, por su alta prevalencia en la población y las consecuencias que pueden ocasionar, como parto prematuro, infertilidad y cáncer de cuello uterino. Todavía hay mujeres que no se hacen un examen citopatológico, capaz de prevenir estas infecciones, ya sea por falta de orientación o de oportunidad, como las mujeres quilombolas. Este estudio tuvo como objetivo identificar los factores asociados a las infecciones cervicovaginales en mujeres quilombolas de Feira de Santana, Bahia. Métodos: estudio descriptivo, realizado de forma transversal y con enfoque cuantitativo. La recolección de datos se realizó de noviembre de 2019 a enero de 2020, con la aplicación de un formulario de anamnesis elaborado por el equipo, con variables utilizadas en otros estudios, como los factores de riesgo. Se realizó análisis bivariado para obtener razones de prevalencia (RP) entre las infecciones y las características encontradas. Resultados: se estudiaron un total de 82 mujeres, con una edad promedio de 45,3 años. Las principales infecciones vaginales fueron causadas por Gardnerella vaginalis (17,1%), Trichomonas vaginalis (8,5%), Cocci (8,5%), Candida spp. (6,2%) y Fusobacterium spp. (1,2%). En el 88,2% de las mujeres infectadas hubo inflamación. Conclusión: los resultados obtenidos en este estudio mostraron una correlación entre el proceso inflamatorio en la mujer y la presencia de alguna infección. En cuanto a las infecciones, hubo mayor prevalencia en mujeres con baja escolaridad, sin pareja estable y que no realizaban examen preventivo periódico.(AU)

Does speculum lubricant affect liquid-based Papanicolaou test adequacy?

BACKGROUND: There is a paucity of data on the effect of vaginal lubricants on specimen adequacy in the era of liquid-based Papanicolaou (Pap) tests. Current manufacturer recommendations advise against the use of lubricants, especially those that contain carbomers or carbopol polymers. There is, however, no conclusive evidence to support this recommendation. Moreover, the data that does exist is conflicting. METHODS: Retrospective review was performed of all liquid-based Pap tests collected between January 2010 and March 2012 by the Gynecologic Oncology division at a single hospital. Specimen adequacy was compared for vaginal and cervical specimens that were collected with and without a lubricant. Results were also compared for specimens collected with lubricants that did or did not contain carbomers. RESULTS: There was no significant difference in specimen adequacy for cervical or vaginal Pap test specimens collected with a water-soluble lubricant not containing carbomers, compared to those collected without a lubricant. There was, however, a significantly higher rate of insufficient specimens when a water-soluble lubricant containing carbomers was used. This difference was most pronounced for vaginal Pap tests (26.9% versus 1.2%, OR = 30.3, 95% CI = 16.6-55.1, P < .0001). CONCLUSIONS: Lubricants containing carbomers should be avoided when collecting liquid-based Pap tests because they can significantly decrease specimen adequacy. Lubricants that do not contain these substances do not significantly affect specimen adequacy. If there is an unusual increase in unsatisfactory Pap tests, the cytology laboratory should notify clinicians and work with them to determine the cause.