scholarly journals Comparison of copper IUDs and hormonal IUDs in prevalence of Candida species in cervicovaginal smears

2022 ◽  
Vol 67 (4) ◽  
pp. 130-134
Author(s):  
Tao Wei ◽  
Hua Wang ◽  
Boyang Wen
Keyword(s):  
Candida Species ◽  
Culture Medium ◽  
Treatment Plan ◽  
Cost Effective ◽  
Fungal Species ◽  
Antifungal Drugs ◽  
Vaginal Candidiasis ◽  
Agar Culture ◽  
Vaginal Microflora

Candidal vulvovaginitis is one of the most common genital infections that different types of diagnosis are essential for a proper treatment plan. IUD is one of the most influential and long-lasting methods of contraception that can be associated with vaginal candidiasis. This study was performed to investigate the prevalence of Candida species before and three months after IUD placement in patients referred to health centers. Also, a comparison of copper IUDs and hormonal IUDs was evaluated to consider the prevalence of Candida species in cervicovaginal smears. In this regard, cervicovaginal swabs were prepared from 160 women applying for IUDs who did not show signs of vaginal infection during the vaginal examination. These people were divided into two groups of 80 cases. The first group received copper IUDs (NT Cu380, Mona Lisa®, Canada), and the second group received hormonal IUDs (Mirena, USA). They had not used antibiotics or antifungal drugs at least two weeks before and three months after IUD placement. The provided Samples were cultured in a Saburo dextrose agar medium. The milky yeast colony was transferred to chromium agar culture medium, and fungal species were differentiated by dyeing. P <0.05 was considered significant. Three months after IUD insertion, 29.57% of people who received a copper IUD were diagnosed with candidiasis. Also, different species of Candida were observed in 22.95% of people who received hormonal IUD. Because Candida albicans is found in the vaginal microflora of 30 to 80% of asymptomatic women, the decision to treat asymptomatic cases requires further study and testing. The use of Candida chromium agar differential culture medium is easy, reproducible, and cost-effective; however, in cases such as recurrent or complicated vulvovaginal candidiasis where the accurate diagnosis is essential for successful treatment, the use of sensitive and precise molecular methods such as PCR is recommended. Finally, studies with wider dimensions and longer follow-up periods are suggested to confirm and complete the present study.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Antifungal Resistance among Less Prevalent Candida Non-albicans and Other Yeasts versus Established and under Development Agents: A Literature Review

2021 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Ana Espinel-Ingroff ◽  
Emilia Cantón ◽  
Javier Pemán
Keyword(s):  
Candida Species ◽  
Resistance Mechanisms ◽  
Fungal Species ◽  
Antifungal Resistance ◽  
Antifungal Drugs ◽  
Candida Spp ◽  
In Vitro Susceptibility ◽  
Susceptibility Data ◽  
Development Agents

Fungal diseases and antifungal resistance continue to increase, including those caused by rare or emerging species. However, the majority of the published in vitro susceptibility data are for the most common fungal species. We reviewed the literature in order to pool reference minimal inhibitory concentration (MIC) data (Clinical and Laboratory Standards Institute—CLSI and European Committee on Antimicrobial Susceptibility—EUCAST) for rare/non-prevalent Candida and other yeast species. MIC results were compared with those for Candida albicans, C. glabrata, and C. krusei. Data were listed for twenty rare and emerging Candida spp., including C. auris, as well as two Cryptococcus spp., two Trichosporon spp., Saccharomyces cerevisiae and five Malassezia spp. The best detectors of antimicrobial resistance are the breakpoints, which are not available for the less common Candida species. However, epidemiological cutoff values (ECVs/ECOFFs) have been calculated using merely in vitro data for both reference methods for various non-prevalent yeasts and recently the CLSI has established ECVs for other Candida species. The ECV could identify the non-wild type (NWT or mutants) isolates with known resistance mechanisms. Utilizing these ECVs, we were able to report additional percentages of NWT, especially for non-prevalent species, by analyzing the MIC distributions in the literature. In addition, since several antifungal drugs are under development, we are listing MIC data for some of these agents.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

Microcirculation of the fingers in Raynaud’s syndrome

2005 ◽  
Vol 44 (01) ◽  
pp. 29-32 ◽  
Author(s):  
I. Garai ◽  
J. Varga ◽  
G. Szücs ◽  
Z. Galajda ◽  
C. András ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Quantitative Data ◽  
Cost Effective ◽  
Semiquantitative Analysis ◽  
Perfusion Scintigraphy ◽  
Visual Evaluation ◽  
Raynaud’S Syndrome ◽  
Raynaud's Syndrome ◽  
Primary Form

Summary Aim: We investigated the circulatory characteristics of patients suffering of primary and secondary Raynaud’s syndrome. Patients, methods: We examined 106 patients presenting with the classical symptoms of Raynaud’s syndrom (47 primary, 59 secondary) by hand perfusion scintigraphy developed by our Department of Nuclear Medicine. After visual evaluation we analyzed the images semiquantitatively, using the finger to palm ratio. We statistically compared the patients with primary and those with secondary Raynaud’s syndrome. Results: By visual evaluation we constated regional perfusion disturbances in 42 from 59 patients with secondary Raynaud’s syndrome. However, this was observed in only 3 from 47 patients with the primary form of this disease. This difference was statistically significant (p <0.001). Semiquantitative analysis showed that the finger/palm ratios (FPR) were significantly lower (p <0.05) for the patients with primary Raynaud’s syndrome. No differences in the FPR values concerning sex or right and left side. Conclusion: The hand perfusion scintigraphy with 99mTc-DTPA is a noninvasive, cost effective diagnostic tool, which objectively reflects the global and regional microcirculatory abnormalities of the hands, and provides quantitative data for follow-up.

The Chemistry of Drugs to Treat Candida albicans

2019 ◽  
Vol 19 (28) ◽  
pp. 2554-2566 ◽  
Author(s):  
Aurelio Ortiz ◽  
Estibaliz Sansinenea
Keyword(s):  
Candida Species ◽  
Antifungal Drugs ◽  
New Drugs ◽  
Drug Classes ◽  
Life Threatening ◽  
Antifungal Substances ◽  
High Level ◽  
Systemic Infections ◽  
New Compounds ◽  
Level Resistance

Background:: Candida species are in various parts of the human body as commensals. However, they can cause local mucosal infections and, sometimes, systemic infections in which Candida species can spread to all major organs and colonize them. Objective:: For the effective treatment of the mucosal infections and systemic life-threatening fungal diseases, a considerably large number of antifungal drugs have been developed and used for clinical purposes that comprise agents from four main drug classes: the polyenes, azoles, echinocandins, and antimetabolites. Method: : The synthesis of some of these drugs is available, allowing synthetic modification of the molecules to improve the biological activity against Candida species. The synthetic methodology for each compound is reviewed. Results: : The use of these compounds has caused a high-level resistance against these drugs, and therefore, new antifungal substances have been described in the last years. The organic synthesis of the known and new compounds is reported. Conclusion: : This article summarizes the chemistry of the existing agents, both the old drugs and new drugs, in the treatment of infections due to C. albicans, including the synthesis of the existing drugs.

Extended Routine Follow-up of Primary Uncomplicated Hip and Knee Arthroplasty is not Necessary

2019 ◽  
Vol 13 (1) ◽  
pp. 266-271
Author(s):  
Georgina Kakra Wartemberg ◽  
Thomas Goff ◽  
Simon Jones ◽  
James Newman
Keyword(s):  
Aseptic Loosening ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Cost Effective ◽  
Face To Face ◽  
Primary Surgery ◽  
Effective System ◽  
Knee Revision Surgery ◽  
Knee Revision

Aims: To create a more effective system to identify patients in need of revision surgery. Background: There are over 160,000 total hip and knee replacements performed per year in England and Wales. Currently, most trusts review patients for up to 10 years or more. When we consider the cost of prolonged reviews, we cannot justify the expenditure within a limited budget. Study Design & Methods: We reviewed all patients' notes that underwent primary hip and knee revision surgery at our institution, noting age, gender, symptoms at presentation, referral source, details of the surgery, reason for revision and follow up history from primary surgery. Results: There were 145 revision arthroplasties (60 THR and 85 TKR) that met our inclusion criteria. Within the hip arthroplasty group, indications for revision included aseptic loosening (37), dislocation (10), and infection (3), periprosthetic fracture, acetabular liner wear and implant failure. All thirty-seven patients with aseptic loosening presented with pain. Twenty-five were referred from general practice with new symptoms. The remaining were clinic follow-ups. The most common reason for knee revision was aseptic loosening (37), followed by infection (21) and then progressive osteoarthritis (8). Most were referred from GP as a new referral or were clinic follow-ups. All patients were symptomatic. Conclusion: All the patients that underwent revision arthroplasty were symptomatic. Rather than yearly follow up, we recommend a cost-effective system. We are implementing a 'non face-to-face' system. Patients would be directly sent a questionnaire and x-ray form. The radiographs and forms will be reviewed by an experienced arthroplasty surgeon. The concerning cases will be seen urgently in a face-to-face clinic.

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