scholarly journals Problematic issues of diagnosis and treatment of vulvovaginitis of mixed bacterial-candidiasis etiology

2021 ◽  
pp. 43-46
Author(s):  
О.V. Kravchenko
Keyword(s):  
Clinical Symptoms ◽  
Laboratory Research ◽  
Vaginal Mucosa ◽  
Vaginal Gel ◽  
Drug Of Choice ◽  
Before And After ◽  
Therapy Effectiveness ◽  
Rapid Restoration ◽  
Antiseptic Agent ◽  
Fungal Associations

The aim of the study is to evaluate the effectiveness of modern antiseptic agent Gynodek in the treatment of mixed bacterial-candidiasis vulvovaginitis.Materials and methods. There were 67 patients with bacterial-candidiasis vulvovaginitis under observation. The diagnosis of candidiasis infection was verified according to the data of clinical and laboratory research methods. Patients received vaginal gel Gynodek 5 ml once a day for 7 days. The effectiveness of treatment was assessed according to the data of the clinical examination before treatment and on the 7th day of observation, and according to the laboratory (bacterioscopic, bacteriological) data before and after treatment. Complete clinical and bacterial debridement was criteria of the treatment effectiveness.Results and discussion. The clinical picture of bacterial-fungal vulvovaginitis was characterized by a decrease in the number and severity of symptoms such as hyperemia and edema of the mucous membrane, discharge from the genital tract was not typical.There were no complaints in 95.5% of the examined women after end of therapy, there were no objective symptoms in all women on the 7th day of treatment. Bacteriological examination after 2 weeks confirmed the therapy effectiveness in 86.6% of women. Peptostreptococcus spp. after treatment sowed at significant concentrations 106–107 CFU/ml only in 1.5% of patients, Streptococcus spp. in 8.9% of women, Candida albicans in 13.4%. Lactobacilli in the amount of 107 CFU/ml were in 86.6% of patients, which indicates a rapid restoration of normal vaginal microflora.Conclusions. Bacterial-fungal associations of microorganisms in the vaginal biotope lead to a complex clinical symptoms, which makes it difficult to make a timely diagnosis. Gynodek vaginal gel is highly effective against gram-positive, gram-negative and fungal microflora, which makes it the drug of choice in the treatment of bacterial-candidiasis vulvovaginitis. Gynodek creates a comfortable pH, promotes the rapid restoration of own lactoflora, and increases the functional activity of the vaginal mucosa epithelium, which ensures the prevention of vaginal infection recurrence.

scholarly journals TO010A NEW IMMUN-TOXICOLOGICAL TEST TO DETECT POLYSULFONE HYPERSENSITIVITY IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Joachim Beige ◽  
Ralph Wendt ◽  
Despina Rüssmann ◽  
Karl-Peter Ringel
Keyword(s):  
False Negative ◽  
False Negative Rate ◽  
Lymphocyte Transformation ◽  
Clinical Problem ◽  
Lymphocyte Transformation Test ◽  
Laboratory Research ◽  
Humoral Immune ◽  
Before And After ◽  
Positive Results

Abstract Background and Aims Incompatibility of dialysis procedure due to hypersensitivity against dialyzer material which currently is mainly based on polysulfone and derivatives can not be assessed by routine laboratory tests. Although the frequency of such symptoms is suspected to be low (below 2%) such resembles an important clinical problem because dialysis procedures are frequently accompanied by symptoms of non-tolerability with reasons not being entirely clear while circulatory reasons are suspected to play a major role. Method To enlighten the role of polysulfone hypersensitivity, we adapted known standardized material immune-toxicological tests (lymphocyte transformation test, basophil degranulation test) to the specific conditions of dialysis and polysulfone material sensitivity. We developed a method of polysulfone micronisation and measured humoral immune response of isolated patient´s lymphocytes when incubated with polysulfone dispersion. Results 39 samples from 103 patients with suspected polysulfone hypersensitivity showed positive results for type 1 (n=19), type 4 (n=18) or both type (n=2) reactions. There were no significant differences in the level of stimulation measured for DI, SI and lymphogenesis before and after dialysis (average delta -0.4; -0.28; - 1.74, p = 0.71; 0.34; 0.37) and with different dialyzer materials (Tab. 1). Patients with pos. type 4 results (LTT and lymphogenesis) showed highly correlated results in either LTT or lymphogenesis test (Fig. 1, R=0.87, p<0.0001). 8 out of 8 samples from patients with repeated test on different PS showed positive results on either PS. One patient tested positive on PS showed no hypersensitivity with another non-PS (PMMA) material. Conclusion This is the first methodological report showing plausible in-vitro results of patients samples concerning polysulfone intolerance. On the first superficial view, a “false-negative” rate of 60% looks rather disappointing, because all samples derived from patients with suspicion of PS hypersensitivity. However, due to the clinical variability of intolerance symptoms and the high prevalence of any problems after HD initiation, mainly of circulatory origin after initiating extracorporeal circuit, this rate may obviously express the true frequency of isolated PS material hypersensitivity in suspected patients. Alternative pathophysiological pathways of material sensitivity like complement activation, remain to be elucidated and incorporated into a comprehensive future testing panel. Further clinical and laboratory research is needed to define true polysulfone hypersensitivity and to enlighten the field of hypothetic subclinical material incompatibility in patients with impaired dialysis tolerability.

scholarly journals Therapeutic Use of Cerebellar Intermittent Theta Burst Stimulation (iTBS) in a Sardinian Family Affected by Spinocerebellar Ataxia 38 (SCA 38)

2021 ◽  
Author(s):  
Angela Sanna ◽  
Paolo Follesa ◽  
Paolo Tacconi ◽  
Mariangela Serra ◽  
Maria Giuseppina Pisu ◽  
...  
Keyword(s):  
Spinocerebellar Ataxia ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Therapeutic Use ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Motor Cortex Excitability ◽  
Before And After ◽  
Theta Burst ◽  
Serum Bdnf

AbstractSpinocerebellar ataxia 38 (SCA 38) is an autosomal dominant disorder caused by conventional mutations in the ELOVL5 gene which encodes an enzyme involved in the synthesis of very long fatty acids, with a specific expression in cerebellar Purkinje cells. Three Italian families carrying the mutation, one of which is of Sardinian descent, have been identified and characterized. One session of cerebellar intermittent theta burst stimulation (iTBS) was applied to 6 affected members of the Sardinian family to probe motor cortex excitability measured by motor-evoked potentials (MEPs). Afterwards, patients were exposed to ten sessions of cerebellar real and sham iTBS in a cross-over study and clinical symptoms were evaluated before and after treatment by Modified International Cooperative Ataxia Rating Scale (MICARS). Moreover, serum BDNF levels were evaluated before and after real and sham cerebellar iTBS and the role of BDNF Val66Met polymorphism in influencing iTBS effect was explored. Present data show that one session of cerebellar iTBS was able to increase MEPs in all tested patients, suggesting an enhancement of the cerebello-thalamo-cortical pathway in SCA 38. MICARS scores were reduced after ten sessions of real cerebellar iTBS showing an improvement in clinical symptoms. Finally, although serum BDNF levels were not affected by cerebellar iTBS when considering all samples, segregating for genotype a difference was found between Val66Val and Val66Met carriers. These preliminary data suggest a potential therapeutic use of cerebellar iTBS in improving motor symptoms of SCA38.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals Perturbations in Eosinophil Homeostasis following Treatment of Lymphatic Filariasis

2000 ◽  
Vol 68 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Ramya Gopinath ◽  
L. E. Hanna ◽  
V. Kumaraswami ◽  
V. Perumal ◽  
V. Kavitha ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Wuchereria Bancrofti ◽  
Activation Markers ◽  
Interleukin 5 ◽  
Hla Dr ◽  
Before And After ◽  
Early Peak ◽  
Eosinophil Activation ◽  
Later Phase ◽  
Second Peak

ABSTRACT Treatment of patients with patent Wuchereria bancroftiinfection results in an acute clinical reaction and peripheral eosinophilia. To investigate the dynamics of the eosinophil response, changes in eosinophil activation and degranulation and plasma levels of eosinophil-active chemokines and cytokines were studied in 15 microfilaremic individuals in south India by sequential blood sampling before and after administration of 300 mg of diethylcarbamazine (DEC). Clinical symptoms occurred within 24 h. Plasma interleukin-5 (IL-5) and RANTES levels peaked 1 to 2 days posttreatment, preceding a peak peripheral eosinophil count at day 4. Major basic protein secretion from eosinophils paralleled IL-5 secretion, while levels of eosinophil-derived neurotoxin peaked at day 13 after treatment. Expression of the activation markers HLA-DR and CD25 on eosinophils rose markedly immediately after treatment, while expression of VLA-4 and α4β7 showed an early peak within 24 h and a second peak at day 13. Thus, the posttreatment reactions seen in filarial infections can be divided into an early phase with killing of microfilariae, clinical symptomatology, increases in plasma IL-5 and RANTES levels, and eosinophil activation and degranulation and a later phase with expression of surface integrins on eosinophils, recruitment of eosinophils from the bone marrow to tissues, and clearance of parasite antigen.

scholarly journals Kinetic Analysis of Mouse Brain Proteome Alterations Following Chikungunya Virus Infection before and after Appearance of Clinical Symptoms

PLoS ONE ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. e91397 ◽  
Author(s):  
Christophe Fraisier ◽  
Penelope Koraka ◽  
Maya Belghazi ◽  
Mahfoud Bakli ◽  
Samuel Granjeaud ◽  
...  
Keyword(s):  
Virus Infection ◽  
Kinetic Analysis ◽  
Mouse Brain ◽  
Chikungunya Virus ◽  
Clinical Symptoms ◽  
Before And After ◽  
Brain Proteome

The Keloid Intervention Benefit Inventory 21: A New Assessment Tool for the Quality of Life of Patients with Auricular Keloids

2021 ◽  
Author(s):  
Daniel Häussler ◽  
Stefanie Hüttemann ◽  
Christel Weiß ◽  
Nicole Karoline Rotter ◽  
Haneen Sadick
Keyword(s):  
Quality Of Life ◽  
Internal Consistency ◽  
Social Impact ◽  
Assessment Tool ◽  
Clinical Symptoms ◽  
Physical Symptoms ◽  
Medical Intervention ◽  
Medical Interventions ◽  
Before And After

Abstract Purpose The assessment of the quality of life (QoL) of patients with chronic diseases before and after medical interventions has gained increasing importance in recent decades. Particularly for patients with visible keloid scars in the head and neck region, standardized measurement tools are either absent or have been shown to be insufficient. The aim of the present study was to create a new standardized questionnaire that is specific to auricular keloid patients and reflects their clinical symptoms and QoL. Methods The Keloid Intervention Benefit Inventory 21 (KIBI-21) questionnaire was developed in two stages. First, a group of experts identified a pool of 26 questions and modified and supplemented the items through a comparison with existing QoL assessments so that they related to keloid-specific clinical symptoms and the QoL of patients with auricular keloids before and after a medical intervention. This questionnaire was distributed to 27 outpatients who had undergone medical interventions for visible auricular keloids. Second, a sequential statistical analysis was conducted. This included a single-item assessment and reduction, analysis for internal consistency, construct validity, and divergence validity as well as a factor analysis. The analyses were performed for the entire questionnaire and for the items in the subcategories General Health, Physical Symptoms, Self-Esteem, and Social Impact. Results The final version of this newly validated and standardized KIBI questionnaire consisted of 21 items, of which each item was assigned to only one subscale. The questionnaire showed a Cronbach's α of 0.84 with a good internal consistency. In the item correlation validity, strong associations were found in all subscales, except for the Social Impact Subscale. Conclusion The keloid-specific QoL questionnaire KIBI-21 proved to be a reliable and reproducible instrument to assess the QoL and clinical symptoms in patients suffering from auricular keloids before and after a medical treatment.

scholarly journals ASMANEX TWISTHALER - THE DRUG OF CHOICE AMONG INHALED CORTICOSTEROIDS

2013 ◽  
Vol 10 (6) ◽  
pp. 51-57
Author(s):  
T V Latysheva ◽  
E A Latysheva ◽  
O V Shubina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Control Methods ◽  
Efficacy And Safety ◽  
Prior Therapy ◽  
Asthma Symptoms ◽  
Drug Of Choice ◽  
Systemic Corticosteroids ◽  
Before And After ◽  
Baseline Therapy

Goals. To reveal the clinical efficacy and safety of Asmanex in patients with moderate and severe bronchial asthma (BA), treated with inhaled and/or systemic glucocorticosteroids (GCS), depending on the severity and level of control. Methods. 40 patients (age 18 to 65 years) were treated with Asmanex with equivalent to prior therapy with inhaled corticosteroids (ICS) doses or in combination with systemic corticosteroids prior therapy (without increasing the dose of systemic corticosteroids) for 3 months. Efficacy was assessed before and after the treatment on a background of Asmanex treatment by the need of additional using of agonists of β 2-adrenoreceptors, severity of daytime and nighttime asthma symptoms, dynamics of spirometry parameters. The efficacy of Asmanex was compared with the original baseline therapy of other inhaled corticosteroids at equivalent doses using the new delivery system.

scholarly journals Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases

2020 ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

Lipid Profiles in Lyme Borreliosis: A Potential Role for Apheresis?

2019 ◽  
Vol 51 (05) ◽  
pp. 326-329 ◽  
Author(s):  
Richard Straube ◽  
Karin Voit-Bak ◽  
A. Gor ◽  
Til Steinmeier ◽  
George P. Chrousos ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Membrane Filtration ◽  
Clinical Symptoms ◽  
Causal Relation ◽  
Pilot Trial ◽  
Lipid Profiles ◽  
Common Causes ◽  
Before And After ◽  
History Of ◽  
Lipids And Lipoproteins

AbstractDyslipidemia and dyslipoproteinemia are common causes of metabolic and cardiovascular diseases. On the other hand, intracellular bacteria, such as Borrelia burgdorferi, utilize host lipids to survive and disseminate within the host. Recent data suggest that elevated lipids are a contributing factor to the maintenance and severity of Lyme disease and its complications. Here we review and discuss the role of lipids in Borreliosis and report on a pilot trial to examine the potential roles of circulating lipids and lipoproteins in patients with Borrelia infection. In this analysis we assessed the clinical and lipid profiles of 519 patients (319 women, 200 men) with a proven history of Lyme disease, before and after an extracorporeal double membrane filtration. Lipid profiles pre- and post-apheresis were analyzed in conjunction with clinical symptoms and parameters of inflammation. Circulating cholesterol, triglycerides, LDL, LP(a), and other inflammatory lipids were significantly reduced after the apheresis, while symptoms of the disorder and bioindexes of inflammation such as CRP improved. Further studies should be initiated to investigate the possibly causal relation between Lyme disease and circulating lipids and to design appropriate therapeutic strategies.

On the pharmacological effects of two lidocaine concentrations tested on spontaneous and evoked pain in human painful neuroma: A new clinical model of neuropathic pain

2013 ◽  
Vol 4 (4) ◽  
pp. 258
Author(s):  
Adriana Miclescu ◽  
Björn Hägglöf ◽  
Martin Schmelz ◽  
Torsten Gordh
Keyword(s):  
Neuropathic Pain ◽  
Clinical Symptoms ◽  
Control Level ◽  
New Drugs ◽  
Spontaneous Pain ◽  
Double Blind ◽  
Clinical Model ◽  
Analgesic Effects ◽  
Proposed Model ◽  
Before And After

AbstractAimsSpontaneous and evoked pains are key symptoms of patients with neuropathic pain and there is a current discussion on the predictive value of evoked pain read outs for the reduction of spontaneous pain. Here we describe a new clinical model of neuropathic pain that may be useful for evaluation of new drugs. We also report the effects of lidocaine in this model as reference values.MethodsIn a randomized double-blind experiment, the analgesic effects of local lidocaine were investigated separately for spontaneous pain and for stimulus-evoked allodynia and hyperalgesia in sixteen patients with painful neuromas after traumatic nerve injuries in the upper extremities. The patterns of sensory changes were compared before and after treatment with lidocaine (0.1% or 0.5%, 1 ml), with 1–2 weeks interval, injected close to the neuroma. Spontaneous and evoked pains were assessed using a visual analogue scale (VAS) and quantitative/qualitative sensory testing.ResultsLidocaine dose-dependently reduced spontaneous and evoked pain scores by more than 90% with maximum effects between 1 and 5 min for evoked pain and between 3 and 15 min for spontaneous pain. While evoked pain normalized rapidly reaching about 50% of the control level 20 minutes after the injection spontaneous pain levels were lower than 25% at this time. Moreover, in 4 patients the reduction of ongoing pain lasted 24 h whereas evoked pain had returned to baseline levels in all the patients after 1 h.ConclusionDifferential analgesic effects of local lidocaine on spontaneous and evoked pain suggest that different mechanism underlie these two key clinical symptoms. Thus, clinical trials assessing localized traumatic neuropathic pain should investigate both aspects of pain separately with the proposed model allowing testing of new drugs systemically or locally administered.

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