Real-world effectiveness and tolerability of Zelesse cream® for treating vulvovaginitis in adult women: an observational, prospective study

Objective To assess the efficacy, acceptability, and tolerability of a vaginal cream based on plant extracts for treating signs and symptoms of vulvovaginitis (VV) (Zelesse cream®), either as monotherapy (non-infectious VV) or adjuvant to antimicrobial therapy (infectious VV). Methods This prospective, observational, multicenter study included women who attended outpatient offices for VV. The severity of signs (vaginal discharge, erythema, and edema) and symptoms (pruritus, burning, and dysuria) was assessed before and after 15±5 days of daily treatment with Zelesse cream on a 4-point scale (18-point global score). Results The study included 58 women aged 43.0±13.2 years, including 42 who were treated with Zelesse cream only and 16 who used Zelesse cream as adjuvant to antimicrobial therapy. All participants showed significantly reduced scores and absolute prevalence of individual signs and symptoms in both groups. Similarly, the median signs/symptoms decreased by 4.0 and 8.0 points in women using Zelesse only and those using Zelesse plus antimicrobial therapy, respectively. This product was well tolerated and had high acceptability. Conclusions Zelesse cream relieves signs and symptoms of VV, either as monotherapy in non-infectious VV or as adjuvant to antimicrobial therapy in infectious VV. Future randomized, placebo-controlled trials with larger sample sizes are warranted.

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The Common Cold—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽

10.1542/peds.101.s1.181 ◽

1998 ◽

Vol 101 (Supplement_1) ◽

pp. 181-184 ◽

Cited By ~ 3

Author(s):

Nancy Rosenstein ◽

William R. Phillips ◽

Michael A. Gerber ◽

S. Michael Marcy ◽

Benjamin Schwartz ◽

...

Keyword(s):

Antimicrobial Therapy ◽

Common Cold ◽

Antimicrobial Agents ◽

Signs And Symptoms ◽

Antimicrobial Treatment ◽

Controlled Trials ◽

Nasal Discharge ◽

Treatment Changes ◽

The Common ◽

Antimicrobial Prescription

Most children will suffer between 3 and 8 colds per year, and over half of patients seen for the common cold are given an antimicrobial prescription. Unnecessary antimicrobial therapy can be avoided by recognizing the signs and symptoms that are part of the usual course of these diseases. Controlled trials of antimicrobial treatment of the common cold are reviewed. These trials consistently fail to show that treatment changes the course or outcome. Furthermore, antimicrobial therapy for patients with viral rhinosinusitis is not an effective way to prevent bacterial complications. Mucopurulent rhinitis (thick, opaque, or discolored nasal discharge) frequently accompanies the common cold and is part of the natural course of viral rhinosinusitis. It is not an indication for antimicrobial treatment unless it persists without improvement for >10 to 14 days.

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Acceptability, tolerability, and effects on symptoms and signs of vulvovaginitis of a non-soap, herbal-based intimate hygiene solution (Zelesse®)

Journal of International Medical Research ◽

10.1177/0300060519837820 ◽

2019 ◽

Vol 47 (6) ◽

pp. 2626-2636 ◽

Cited By ~ 1

Author(s):

Misericordia Guinot ◽

Jose Eliseo Blanco ◽

Juan Luis Delgado ◽

Raquel Oliva ◽

Luis Manuel San Frutos ◽

...

Keyword(s):

Symptomatic Relief ◽

Signs And Symptoms ◽

Categorical Variables ◽

Adult Women ◽

Chi Square ◽

Exact Test ◽

Before And After ◽

Effective Option ◽

Patient Groups ◽

Symptoms And Signs

Objective To evaluate the acceptability, tolerability, and effects on vulvovaginitis symptoms and signs of a non-soap, herbal-based intimate solution (Zelesse®). Methods We conducted a prospective, observational, multicenter study including adult women with symptoms and signs of vulvovaginitis with various etiologies, including candidiasis, trichomoniasis, bacterial vaginosis, and atrophic and irritative vaginitis. The presence and intensity of signs (edema, erythema, vaginal discharge) and symptoms (pruritus) of vulvovaginitis were evaluated before and after 5–15 days of daily use of Zelesse® alone or as a coadjuvant in antimicrobial therapy. Variables following a normal distribution and categorical variables were analyzed using the Student t-test and chi-square or Fisher’s exact test, respectively. Results A total 137 women were enrolled in the study; 87 (63.5%) women received concomitant antimicrobials and 50 (36.5%) used Zelesse® only. Global symptom scores and frequency of patients with vulvovaginitis signs and symptoms, and their mean intensity, decreased after treatment in both patient groups. Vaginal pH and (in the Zelesse®-only group) vaginal flora remained unaltered. The product was safe, well tolerated, and highly accepted by patients. Conclusions Zelesse®, the non-soap herbal-based solution in this study, may represent a safe and effective option for symptomatic relief of vulvovaginitis.

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216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.260 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S110-S110

Author(s):

Christina Maguire ◽

Dusten T Rose ◽

Theresa Jaso

Keyword(s):

Urinary Tract ◽

Antimicrobial Therapy ◽

Source Control ◽

Clostridioides Difficile ◽

Days Of Therapy ◽

Before And After ◽

The Difference ◽

Tract Infections ◽

Length Of Therapy ◽

The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

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Orosensory Perception of Fat/Sweet Stimuli and Appetite-Regulating Peptides before and after Sleeve Gastrectomy or Gastric Bypass in Adult Women with Obesity

Nutrients ◽

10.3390/nu13030878 ◽

2021 ◽

Vol 13 (3) ◽

pp. 878

Author(s):

Arnaud Bernard ◽

Johanne Le Beyec-Le Bihan ◽

Loredana Radoi ◽

Muriel Coupaye ◽

Ouidad Sami ◽

...

Keyword(s):

Bariatric Surgery ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Gut Hormones ◽

Sweet Taste ◽

Taste Perception ◽

Taste Sensitivity ◽

Adult Women ◽

Before And After ◽

The Impact

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.

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AB0571 IS RITUXIMAB AN ADEQUATE GLUCOCORTICOID SPARING AGENT IN IDIOPATHIC INFLAMMATORY MYOPATHIES?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4038 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1582.1-1582

Author(s):

B. H. Egeli ◽

S. Ergun ◽

Y. K. Gursoy ◽

A. Cetin ◽

S. Ugurlu

Keyword(s):

Disease Activity ◽

Alternative Treatment ◽

Statistical Power ◽

Signs And Symptoms ◽

Small Sample ◽

Idiopathic Inflammatory Myopathies ◽

Inflammatory Myopathies ◽

Treatment Methods ◽

Before And After

Background:Idiopathic inflammatory myopathies (IIM) are essentially treated aiming improvement of muscle function and extra muscular disease manifestations. The backbone of the treatment is corticosteroids enhancing the survival and patient quality of life. The lack of consensus on target-specific immunosuppressive treatment highlights the need for further studies evaluating alternative treatment methods. Rituximab is potentially a glucocorticoid-sparing agent which was reviewed in multiple studies with small sample sizes due to the rarity of the disease.Objectives:Higher statistical power can enhance the trustworthiness of alternative treatment methods yielding the main objective of this study.Methods:This retrospective study was conducted at a tertiary rheumatology center. Patients were diagnosed with an idiopathic inflammatory myopathy (dermatomyositis [DM], polymyositis [PM]) and were treated with rituximab in order to be included in this study. Clinical signs and symptoms of the presentation were noted during the first patient encounter as well as the follow-up. Parameters of disease activity including acute phase reactants, muscle enzyme levels, and disease-specific autoantibodies were analyzed.Results:The study includes 28 patients (20 DM, 8 PM). The age of diagnosis was 43.44 ± 15.77 years, follow-up duration was 60.7 ± 70.7 months. The presenting signs and symptoms of the patients are shown in Figure 1. The parameters of disease activity before and after treatment are summarized in Table 1. The mean corticosteroid dose decreased from 31.429 ±23.934 mg to 10.278 ±12.001 (p=0.001). Other treatment methods were methotrexate (n=18), Intravenous Immunoglobulin (IVIG) (n=7), and cyclophosphamide (n=2). There were not any deaths during the follow-up. Two patients were lost to follow-up.Table 1.The Parameters of Disease Activity Before and After TreatmentBefore TreatmentAfter TreatmentP ValueCPK, mean ± std (U/L)1426 ± 2049.92263.44 ± 265.630.004LDH, mean ± std (U/L)557.5 ± 365379.78 ± 192.10.03AST, mean ± std (U/L)62.52 ± 5930.16 ± 27.590.01ALT, mean ± std (U/L)56.48 ± 49.2127.64 ± 24.520.008ESR, mean ± std (mm/hour)26.38 ± 28.9820.39 ± 18.760.36CRP, mean ± std (mg/L)19.23 ± 46.1512.53 ± 26.670.5RF, mean ± std (U/mL)0 (0)N/AN/AANA, n (%)3 (10.71)N/AN/AFigure 1.The Presenting Signs and Symptoms of the PatientsConclusion:Rituximab is shown to be effective in treating myositis along with corticosteroids as well as a corticosteroid-sparing agent in retrospective studies and open-label clinical trials; however, lack of statistical power should be underlined. Long term decrease in steroid use and decrease in disease activity markers hints the effective use of rituximab as a glucocorticoid sparing agent as well as its safety with minimal side effects.Disclosure of Interests:None declared

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HPV and Cytology Testing in Women Undergoing 9-Valent HPV Opportunistic Vaccination: A Single-Cohort Follow Up Study

Vaccines ◽

10.3390/vaccines9060643 ◽

2021 ◽

Vol 9 (6) ◽

pp. 643

Author(s):

Rosa De Vincenzo ◽

Nicola Caporale ◽

Valentina Bertoldo ◽

Caterina Ricci ◽

Maria Teresa Evangelista ◽

...

Keyword(s):

Pap Smear ◽

Cox Regression ◽

Vaccine Dose ◽

Pap Smears ◽

Adult Women ◽

Sexually Active ◽

Time Intervals ◽

Dose Administration ◽

Before And After ◽

Single Cohort

Background: This study evaluates the possible effect of 9-valent (9vHPV) vaccination on the results of HPV and cytological tests in a cohort of adult women. Methods: This study is a retrospective, single-cohort, monocentric study. Sexually active women aged 14–70 years, who underwent 9vHPV vaccination, were enrolled. Dose administration dates, side effects and data on Pap smears and HPV tests performed before and after the first vaccine dose were collected. Subjects were considered “unexposed” to the vaccine for all time intervals before the first dose administration, and “exposed” to the first, second and third vaccine doses in all time intervals following each specific dose. Results: A total of 512 women underwent the first 9vHPV dose administration and were enrolled in the study. Median age at vaccination was 30.5 (14–70). Log-rank tests and Cox regression analyses showed a highly statistically significant (p < 0.0001) difference in the time to negativization after the exposure to the third vaccine dose in the 207 women starting with a Pap+ smear (HR (95% C.I.), 2.66 (1.83–3.86)) and in the 198 women starting with an HPV HR+ test (HR (95% C.I.), 7.80 (4.83–12.60)). Conclusions: 9vHPV vaccination may play a role in shortening the clearance time of HPV HR+ or Pap positivity in sexually active adult women.

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The Impact of a Single Educational Lecture on the Vaccine Confidence among Pregnant Women and Young Mothers

Vaccines ◽

10.3390/vaccines9030290 ◽

2021 ◽

Vol 9 (3) ◽

pp. 290

Author(s):

Katarzyna Tkaczyszyn ◽

Ernest Kuchar ◽

Ewa Augustynowicz ◽

Leszek Szenborn

Keyword(s):

Subjective Rating ◽

Adult Women ◽

Young Adult Women ◽

Perceived Need ◽

Comprehensive Knowledge ◽

Before And After ◽

Preventive Method ◽

Vaccine Confidence ◽

The Impact ◽

Analogue Scales

Background: We investigated the impact of a single unstructured educational lecture about vaccinations on the vaccine confidence in volunteer participants. Methods: We conducted a survey-based study during a series of open meetings related to pregnancy and parenting. Before and after the pediatrician’s lecture related to vaccinations, listeners completed the visual analogue scales (VAS, 0–15 cm), evaluating (1) self-declared knowledge on vaccinations and (2) how they perceive the safety and efficacy of this preventive method. Results: In total, 484 women aged 30 ± 4 years participated in the lecture (pregnant = 68%; ≥1 children = 56%). Participants declared to have more comprehensive knowledge on preventive vaccinations and perceived vaccines to be safer and more useful (the role for the immunity) after vs. before the lecture (median VAS: 10.4 vs. 7.2, 10.8 vs. 8.7, and 11.0 vs. 10.4 cm, all p < 0.001). Importantly, the prevalence of vaccine-related adverse events was also assessed as being higher after the lecture (median VAS: 9.9 vs. 8.0 cm, p < 0.001). The increase in self-declared knowledge on vaccinations and perceived need for vaccinations (delta VAS—VAS after minus before the lecture, expressed as % of baseline) was lower among participants who rated the lecture less vs. more useful. Importantly, both participants who liked vs. did not like the lecture comparably rated vaccines safer after vs. before the lecture (delta VAS (median, interquartile range): 16% (0–39%) vs. 18% (2–42%), p = 0.39). Conclusions: An educational lecture on vaccinations positively impacts vaccine confidence in young adult women. Irrespective of the subjective rating of the lecture, all listeners perceived vaccinations to be safer after vs. before the speech.

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The effects of aquatic therapy on mobility of individuals with neurological diseases: a systematic review

Clinical Rehabilitation ◽

10.1177/0269215514556297 ◽

2014 ◽

Vol 29 (8) ◽

pp. 741-751 ◽

Cited By ~ 54

Author(s):

Andresa R Marinho-Buzelli ◽

Alison M Bonnyman ◽

Mary C Verrier

Keyword(s):

Randomized Controlled Trials ◽

Gait Speed ◽

Neurological Diseases ◽

Dynamic Balance ◽

Experimental Studies ◽

Controlled Trials ◽

Aquatic Therapy ◽

Randomized Controlled ◽

Randomized Studies ◽

Before And After

Objective:To summarize evidence on the effects of aquatic therapy on mobility in individuals with neurological diseases.Data sources:MEDLINE, EMBASE, PsycInfo, CENTRAL, CINAHL, SPORTDiscus, PEDro, PsycBITE and OT Seeker were searched from inception to 15 September 2014. Hand-searching of reference lists was performed in the selected studies.Review methods:The search included randomized controlled trials and quasi-experimental studies that investigated the use of aquatic therapy and its effect on mobility of adults with neurological diseases. One reviewer screened titles and abstracts of retrieved studies from the search strategy. Two reviewers independently examined the full texts and conducted the study selection, data extraction and quality assessment. A narrative synthesis of data was applied to summarize information from included studies. The Downs and Black Scale was used to assess methodological quality.Results:A total of 116 articles were obtained for full text eligibility. Twenty studies met the specified inclusion criteria: four Randomized Controlled Trials (RCTs), four non-randomized studies and 12 before-and-after tests. Two RCTs (30 patients with stroke in the aquatic therapy groups), three non-randomized studies and three before-and-after studies showed “fair” evidence that aquatic therapy increases dynamic balance in participants with some neurological disorders. One RCT (seven patients with stroke in the aquatic therapy group) and two before-and-after tests (20 patients with multiple sclerosis) demonstrated “fair” evidence on improvement of gait speed after aquatic therapy.Conclusion:Our synthesis showed “fair” evidence supporting the use of aquatic therapy to improve dynamic balance and gait speed in adults with certain neurological conditions.

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An initial investigation into the effects of the equine transeva technique (pulsating current electrotherapy) on the equine Gluteus superficialis

Comparative Exercise Physiology ◽

10.3920/cep210001 ◽

2021 ◽

pp. 1-10

Author(s):

H. Knaggs ◽

G. Tabor ◽

J.M. Williams

Keyword(s):

Motor Neurons ◽

Pretreatment Condition ◽

Negative Change ◽

Temporal Variables ◽

Before And After ◽

The Right ◽

The Impact ◽

Athletic Horse ◽

Pulsating Current ◽

Larger Sample

The equine transeva technique (ETT), is a novel electrotherapy, which utilises pulsating current electrotherapy to target sensory and motor neurons. The technique may facilitate increased circulation and correction of musculoskeletal issues and injuries, such as tendon and ligament tears and muscle atrophy. Despite the importance of understanding the impact of ETT on horses, no current scientific research exists in this area. This preliminary study investigated the effects of ETT on the musculoskeletal system of the horse, specifically within the Gluteus superficialis (GS). Using surface electromyography, muscle workload was measured in 11 sound and healthy horses of varying breeds and disciplines within the inclusion criteria. Integrated electromyography (iEMG) calculated the percentage change in maximal contractions before and after ETT treatment during one minute trials at 30 s intervals. An ANCOVA determined if these constituted significant changes (Bonferroni adjusted alpha: P≤0.02). Significant differences in muscle workload were found on the left side between pre- and post-treatment readings across trials (P≤0.02), however no significant changes occurred for the right side. The majority of horses (82%; n=9) experienced bilateral changes, with 78% of these (n=7) exhibiting a negative change in muscle workload recorded from the pretreatment condition, which may indicate muscular relaxation. The results suggest ETT may have some effect on muscle workload in the athletic horse, however further research is needed to confirm the effects observed. Future studies should include randomising the side which is treated first, a larger sample size, expansion of temporal variables and consideration of a longitudinal study to determine if these trends accrue over multiple maintenance-purposed treatments.

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Short Oral Antibiotic Treatment of Osteomyelitis Questioned

Pediatrics in Review ◽

10.1542/pir.2.1.18 ◽

1980 ◽

Vol 2 (1) ◽

pp. 18-18

Keyword(s):

Antimicrobial Therapy ◽

Oral Therapy ◽

Initial Period ◽

Clinical Signs ◽

Signs And Symptoms ◽

Oral Route ◽

Antimicrobial Treatment ◽

Blood Levels ◽

Oral Antibiotic ◽

Cortical Destruction

Dr. Rothman of Haverhill, MA questioned the short duration of antimicrobial treatment and use of oral route for the patient with osteomyelitis presented by Bennett in PIR 1:153, November 1979. He noted that the traditional regimen for osteomyelitis calls for six weeks of intravenous antimicrobial therapy. Dr. Bennett quotes from Telzlaff et al (J Pediatr 92:485, 1978). In this report good results were found when antimicrobial regimens for patients with osteomyelitis and suppurative arthritis consisted of a brief initial period of parenteral therapy of only one to seven days followed by oral antimicrobial therapy begun when there was a definitive decrease in clinical signs of inflammation and continued for three weeks or longer. It is important to note that surgical drainage of pus was carried out, that antimicrobial blood levels were obtained after initiation of oral therapy to ensure adequate levels, that therapy was continued until all signs and symptoms had subsided, that there was no evidence of cortical destruction or sequestrum formation on roentgenogram, and the erythrocyte sedimentation rate was less than 20 mg/hr. When these conditions are met it is clear that oral therapy can be an adequate substitute for prolonged intravenous therapy for osteomyelitis in children.

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