Difficulties in therapy of aerobic vaginitis and ways to overcome them

Pathological discharge from the genital tract and other signs of discomfort of the external genitalia are a common cause of a visit to the gynecologist. The cause of these disorders in most cases is vulvovaginal infection, accompanied (vaginitis) or not accompanied (vaginosis) by leukocyte reaction. Methods for treating vulvovaginal infection are predominantly local therapy or systemic agents with highly selective antimicrobial activity. Since a significant part of the vaginitis is of mixed polymicrobial origin, treatment should be complex, which determines the possibility of prescribing topical medicines containing several components of a wide spectrum of action. At the same time, the complexity of diagnosis and the time spent on it allow one to talk about the advisability of empirical therapy of vulvovaginitis, accompanied by severe clinical symptoms.

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A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302011000800013 ◽

2011 ◽

Vol 55 (8) ◽

pp. 590-598 ◽

Cited By ~ 11

Author(s):

Paulina M. Merino ◽

Ethel Codner ◽

Fernando Cassorla

Keyword(s):

Polycystic Ovarian Syndrome ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Rational Approach ◽

Adult Women ◽

Ovulatory Dysfunction ◽

Ovarian Morphology ◽

Key Factor ◽

Symptoms And Signs ◽

Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a lifelong disorder characterized by hyperandrogenism and ovulatory dysfunction, with a wide spectrum of clinical symptoms and signs. Three different sets of diagnostic criteria have been established in order to define this disease in adult women, but there is controversy regarding the use of these criteria in adolescence. During puberty, the adult criteria for ovulatory dysfunction does not seem applicable, because an irregular menstrual pattern and a decreased ovulatory rate is a physiologic event during this period of life. Also, a higher prevalence of polycystic ovarian morphology (PCOM) may be observed during this period, so PCOM is not a useful criterion to define PCOS in young women. These findings suggest that a key factor to diagnose to PCOS during adolescence is hyperandrogenism. In addition, since PCOM is not clearly associated with hyperandrogenism during this period of life, the term "polycystic ovarian syndrome" during adolescence creates confusion and may be misleading.

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Surgical diseases of the female genital tract 2. Vagina and external genitalia

In Practice ◽

10.1136/inp.c4571 ◽

2010 ◽

Vol 32 (8) ◽

pp. 362-369 ◽

Cited By ~ 1

Author(s):

Mickey Tivers ◽

Stephen Baines

Keyword(s):

Genital Tract ◽

Female Genital Tract ◽

External Genitalia ◽

Female Genital

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Multiple causes for rhinolithiasis

Rhinology Journal ◽

10.4193/rhino13.153 ◽

2014 ◽

Vol 52 (2) ◽

pp. 183-186

Author(s):

T. Send ◽

M. Jakob ◽

K.W.G. Eichhorn

Keyword(s):

Nasal Cavity ◽

Foreign Bodies ◽

Clinical Symptoms ◽

Pathological Findings ◽

Common Cause ◽

Clinical Pattern ◽

Ectopic Tooth ◽

Low Incidence ◽

Iatrogenic Origin ◽

Endotracheal Anesthesia

Background: Rhinoliths are rare affections of the main nasal cavity and the paranasal sinuses. Initially, as a result of their low incidence, they are often incorrectly classified as calcified tumors in clinical examination. Methodology: We have identified three cases in our patient population and evaluated the clinical symptoms as well as the pathological findings and the causes of the disease. Results: Due to their extension and the respective clinical pattern, all masses were surgically removed under endotracheal anesthesia. The histopathological findings comprised an ectopic tooth, a vegetable (most likely a leaf from the garden) as well as a textile foreign body (probably of iatrogenic origin). Conclusion: Undiscovered foreign bodies of the main nasal cavity are a common cause for the formation of rhinoliths. We have also displayed the respective incidence and the therapeutic options.

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Pregnancy against the background of bacterial vaginosis: modern ways of solving the problem

HEALTH OF WOMAN ◽

10.15574/hw.2020.153.23 ◽

2018 ◽

pp. 23-30

Author(s):

O.V. Gorbunova ◽

◽

N.P. Goncharuk ◽

H.V. Zarichanska ◽

N.A. Ermolovich ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Local Therapy ◽

Perinatal Complications ◽

Aerobic Vaginitis ◽

Vaginal Microflora ◽

Keywords Screening ◽

High Concentrations ◽

Combined Drugs ◽

Selection Of

Pregnancy against the background of bacterial vaginosis is accompanied by a high risk of obstetric and perinatal complications. Therefore, bacterial vaginosis must be treated in pregnant women. Screening and therapy are performed at the beginning of the II or III trimester of pregnancy. The survival of colonies of pathogenic microorganisms in biofilms is significantly increased, so they can remain viable even at high concentrations of antiseptic. The main advantage of using local combined antiseptic agents is the ability to achieve the maximum concentration of the antibiotic exactly in the place of the greatest accumulation of pathogens with the ability to influence biofilms. The objective: was to compare the efficacy and safety of various regimens of therapy with topical combined drugs (Lynda and Meratin Combi) in pregnant women with bacterial vaginosis. Materials and methods. The biocenosis of the vagina was investigated in 351 pregnant women in the II trimester. The diagnosis of bacterial vaginosis was established if the patient had any three of the Amsel criteria. Results. Microbiological screening of the vaginal biocenosis in the II trimester of pregnancy showed that normocenosis among the surveyed was 18.5%; bacterial vaginosis – 31.6%; vulvovaginal candidiasis – 26.5%; aerobic vaginitis – 22.8%, trichomonas vaginitis – 0.6%. Against the background of bacterial vaginosis, the threat of miscarriage, placental dysfunction occurred 6 times more often, anemia and preeclampsia three times more often, gestational pyelonephritis twice more often than in healthy pregnant women. In most patients, the sensitivity of the vaginal microflora to metronidazole and ornidazole is the same, but depends on the dose of the antiseptic, the sensitivity to miconazole was almost twice as high as to nystatin. This confirms the need for a differentiated selection of antiseptics for local therapy of bacterial vaginosis during pregnancy. Conclusion. A more rapid dynamics of the disappearance of the main symptoms of bacterial vaginosis and the normalization of the pH of the vaginal secretion were noted after the use of the drug Limenda. In order to prevent relapse of the disease, it is necessary to carry out the second stage of treatment with probiotics to restore its own lactoflora. Keywords: screening of vaginal biocenosis in the II trimester of pregnancy; complications of pregnancy against the background of bacterial vaginosis; treating bacterial vaginosis during pregnancy; biofilms; sensitivity of the vaginal microflora to antiseptics; topical treatment of bacterial vaginosis; Limenda; Meratin Kombi.

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Photo gallery of onychodystrophies

Russian Journal of Skin and Venereal Diseases ◽

10.17816/dv48900 ◽

2020 ◽

Vol 23 (3) ◽

pp. 194-196

Author(s):

Ivan S. Maksimov

Keyword(s):

Fungal Infection ◽

Clinical Symptoms ◽

Everyday Practice ◽

Common Cause ◽

Dermatological Diseases ◽

Nail Changes ◽

Clinical Pictures

Onychodystrophies are various pathological processes in the nail apparatus of infectious and non-infectious nature, related to changes in its morphology. The most common cause of nail changes is a fungal infection. However, onychodystrophy can be a manifestation of dermatological diseases, trauma, medication, systemic and tumor processes. Since the clinical symptoms of onychodystrophies are unspecific, sometimes it can cause difficulties in making a diagnosis. This photo gallery presents clinical pictures of diseases that a physician may encounter in everyday practice.

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Can Stereotactic Body Radiotherapy Effectively Treat Hepatocellular Carcinoma?

Journal of Clinical Oncology ◽

10.1200/jco.2015.64.8097 ◽

2016 ◽

Vol 34 (5) ◽

pp. 404-408 ◽

Cited By ~ 14

Author(s):

Aisling Barry ◽

Jennifer J. Knox ◽

Alice C. Wei ◽

Laura A. Dawson

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Function ◽

Group Performance ◽

Clinical Symptoms ◽

Wedge Resection ◽

Family Doctor ◽

Eastern Cooperative Oncology Group ◽

Local Therapy ◽

Fluid Restriction ◽

Liver Mass

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 78-year-old woman with a past medical history of hepatitis C virus (HCV) presented on routine examination to her family doctor with abnormal liver function tests. She was referred for liver ultrasound, which detected a liver mass. Multiphasic magnetic resonance imaging (MRI) diagnosed liver cirrhosis and a segment 7/8 lesion measuring 4 cm, suspicious for a hepatocellular carcinoma (HCC), without evidence of portal hypertension. Child-Pugh (CP) score (ranging from 5 to 15) is a clinically relevant measure of synthetic liver function, based on international normalized ratio and albumin and bilirubin levels, as well as presence or absence of ascites and encephalopathy. A score of A5 or 6 is associated with better postoperative survival compared with CP B7 to 9 or CP C10 to 15, in which surgery is contraindicated. Her CP score was A6, based on a low albumin of 34 g/L. Platelets were slightly depressed at 121,000 μL, and alpha-fetoprotein level was 89 μg/L. She had not received treatment of her HCV because of her age and low viral load. She does not drink alcohol. Clinically the patient had an Eastern Cooperative Oncology Group performance status (PS) of 1, no stigmata of chronic liver disease, and no ascites or encephalopathy or other associated clinical symptoms. An HCC multidisciplinary cancer conference recommended surgical resection. The patient was taken to the operating room for a planned liver nonanatomic wedge resection. At the time of laparotomy, extensive cirrhosis was found and resection was abandoned because of the high risk of liver failure. A biopsy was not obtained, as the tumor had classic arterial enhancement and washout on venous and delayed-phase computed tomography (CT) imaging, which is diagnostic for HCC. After laparotomy, the patient developed liver insufficiency manifested by new ascites and peripheral edema, treated with diuretics, a low-salt diet, and fluid restriction. She was discharged home after a week and referred for a radiation oncology opinion. Three months after laparotomy, her liver function had recovered, with resolution of her ascites and PS of 2. It was decided to proceed with nonsurgical local therapy to the liver mass with curative intent.

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Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment

Cancer Control ◽

10.1177/1073274818778256 ◽

2018 ◽

Vol 25 (1) ◽

pp. 107327481877825 ◽

Cited By ~ 21

Author(s):

Luis Miguel Juárez-Salcedo ◽

Lubomir Sokol ◽

Julio C. Chavez ◽

Samir Dalia

Keyword(s):

Malt Lymphoma ◽

Clinical Presentation ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Gastric Lymphoma ◽

B Cell Lymphoma ◽

Low Grade ◽

Predisposing Factor ◽

Primary Gastric Lymphoma ◽

Non Hodgkin Lymphoma

Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma and represents a wide spectrum of disease, ranging from indolent low-grade marginal zone lymphoma or mucosa-associated lymphoid tissue (MALT) lymphoma to aggressive diffuse large B-cell lymphoma. The PGL is a relatively rare cancer and easily misdiagnosed due to its unspecific symptoms of the digestive tract. The medical literature and ongoing clinical trials were reviewed on the clinical presentation, diagnosis, prognosis, prevention, and treatment of PGL. Primary gastric lymphoma is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis. Chronic gastritis secondary to Helicobacter pylori ( H pylori) infection has been considered a major predisposing factor for MALT lymphoma. Magnetic resonance imaging and endoscopic ultrasonography have helped in staging of these cancers. The clinical course and prognosis of this disease are dependent on histopathological subtype and stage at the time of diagnosis. A global therapeutic approach to the cure of PGL has completely changed over the past 10 years, including innovative and conservative options to reduce treatment toxicity. Due to the rarity of PGL, many aspects of this neoplasm are still controversial. The incidence of this disease is increasing, making it necessary for clinicians to understand the clinical symptoms, workup, and treatment of these lymphomas.

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The efficacy and safety of using the topical medicine with combined action in patients with opportunistic vaginal infections

GYNECOLOGY ◽

10.26442/20795696.2020.5.200397 ◽

2020 ◽

Vol 22 (5) ◽

pp. 22-26

Author(s):

Vera N. Prilepskaya ◽

Giuldana R. Bairamova ◽

Elena A. Mezhevitinova ◽

Andrei E. Donnikov ◽

Dmitry Yu. Trofimov ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Genital Tract ◽

Clinical Signs ◽

Vulvovaginal Candidiasis ◽

Long Term Results ◽

Vaginal Infections ◽

Aerobic Vaginitis ◽

Laboratory Parameters ◽

Recommended Treatment ◽

Gynecological Examination

Relevance.Infections of the lower genital tract are one of the most common reasons for women to visit a gynecologist. According to various authors, among all vulvovaginitis, the highest percentage of patients visiting a doctor is bacterial vaginosis (2050%), vulvovaginal candidiasis (1739%), trichomoniasis (10%) and other genital infections (10%). In the management of patients with infectious processes of the genitals, the choice of the method of therapy is of great importance, which allows not only to influence the microbes-associates, detected in high concentrations in the womans vagina during the initial episode of the disease, but also to prevent the development of relapses. Aim.To evaluate the clinical and laboratory efficacy, adherence and long-term results of benzydamine use in patients with vulvovaginal candidiasis, aerobic vaginitis and bacterial vaginosis Materials and methods.The study included 31 women aged 18 to 49 years, who complained of abundant discharge from the genital tract, itching, burning, dyspareunia. A comprehensive clinical and laboratory examination was carried out, including the collection of anamnestic data, general and special gynecological examination, microscopy of vaginal smears, KOH test, determination of the pH of the vaginal environment, assessment of vaginal microbiocenosis by quantitative PCR in real time. All patients were prescribed benzydamine hydrochloride, which was used as monotherapy in the form of a vaginal solution according to the recommended treatment regimen specified in the instructions for medical use of the drug TantumRosa 1 (irrigation 2 times a day for 10 days). Results.In 1219 days after beginning treatment, 25 (80.6%) of 31 patients with laboratory signs of vaginal microflora alterations showed restoration of the normal vaginal biocenosis laboratory parameters. Of them, 8 patients initially had dysbiosis, 12 patients yeast-like fungi, 4 patients aerobic vaginitis and 1 patient a combination of dysbiosis and fungi. Herewith, all patients also noted clinical signs of improvement. In 1219 days after beginning treatment, 6 (1.4%) of 31 patients with laboratory signs of vaginal biocenosis alterations had unsatisfactory laboratory parameters; that is vaginal biocenosis alterations (a decrease in Lactobacillus spp. percentage). At the same time, there were no clinical signs of pronounced inflammation such as pathological discharge, hyperemia, vaginal swelling. Conclusion.Benzydamine hydrochloride can be widely used in gynecological practice due to its combined effects on inflammation of the vagina, good clinical and microbiological results. It is important to note that additional therapy with drugs which contain lactobacilli is required only in 19.4% of cases. The clinical and laboratory effectiveness of benzydamine hydrochloride (TantumRosa) was 96.8%, since the relapse rate after 3060 days of the study did not exceed 3.2%.

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Otorhinolaryngological manifestations of COVID-19

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0014.8514 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Jarosław Wysocki

Keyword(s):

Respiratory Tract ◽

Distress Syndrome ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Multiple Organ ◽

Upper Respiratory Tract ◽

Equilibrium System ◽

Similar Frequency ◽

Upper Respiratory ◽

Loss Of Strength

COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard

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