scholarly journals Combined drugs in local therapy of infectious vulvovaginitis are a priority area of ​​today

2021 ◽  
Vol 4 ◽  
pp. 83-92
Author(s):  
V.I. Mamchur ◽  
S.M. Dronov
Keyword(s):  
Inflammatory Diseases ◽  
Local Treatment ◽  
Local Therapy ◽  
Aerobic Vaginitis ◽  
Old Patients ◽  
Normative Documents ◽  
Treatment Regimens ◽  
Genital Area ◽  
Number Of Patients ◽  
Combined Drugs

One of the key and strategically important problems of modern gynecology both around the world and in Ukraine is infectious and inflammatory diseases (IVD) of the lower genital tract: according to various estimates, back in the 90s of the last century, this diagnosis was made in about 40 % of patients in gynecological hospitals. Over the first decade of the 21st century, the incidence rate of genital IVI increased 1.4 times in 18–24-year-old patients, and 1.8 times in 25–29-year-old patients. At the same time, the costs of diagnostics and treatment have increased, which reach 50-60% of all costs for the provision of gynecological care to the population.In the structure of gynecological morbidity, the indicator of the number of patients with infectious and inflammatory diseases of the genital area continues to occupy a leading position in terms of frequency in the population, amounting to 60.4-65.0%, however, information from different authors regarding their true prevalence is very contradictory. So, according to the materials of the 33rd European Congress of the International Union against for Sexually Transmitted Infections (IUSTI-Europe), bacterial vaginosis (BV) occurs in 12-80% of women, vulvovaginal candidiasis – VVC (at least one episode in life) - in 75%, aerobic vaginitis (AV) – in 15-25% [8]. According to other authors, the prevalence of BV is 24-30%, VVC – 9.7-11.7%, nonspecific (aerobic) vaginitis – 5.0-23.7%.Combined drugs Neo-Penotran® Forte and Gainomax have a high safety profile, which is due to the unique features of the pharmacokinetics and pharmacodynamics of their components. This determines the advantages in the speed of bactericidal action over other antibacterial and antimycotic agents. These drugs are highly effective in the local treatment of BV and vulvovaginal infections, reaching 98.5% in some nosologies.The effectiveness and safety of the use of Neo-Penotran® Forte and Gainomax in the treatment of infections of the female genital area served as the basis for their inclusion in standard treatment regimens according to indications, and their use is regulated by the normative documents of the Ministry of Health of Ukraine.

Use of a drug containing ornidazole-neomycin–prednisolone–econazole for the empirical treatment of vaginal infections

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 28-32
Author(s):  
Valerii G. Volkov ◽  
Tatyana V. Zakharova
Keyword(s):  
Inflammatory Diseases ◽  
Local Treatment ◽  
Empirical Treatment ◽  
New Combination ◽  
Microbiological Analysis ◽  
Vaginal Infections ◽  
Aerobic Vaginitis ◽  
Burning Pain ◽  
Lower Genital Tract ◽  
Unpleasant Smell

Relevance. Empirical treatment of vaginitis is indicated due to its polymicrobial etiology and limited microbiological analysis. The aim of the study was to study the combination of ornidazoleneomycinprednisoloneeconazole (ONPE, Elzhina) as a first-line drug for local treatment of patients with various forms of non-specific vaginitis. Materials and methods. The study included 55 non-pregnant women aged 18 to 50 years (381.5 years) who had clinical and laboratory signs of acute vaginitis. Results. All patients at the initial treatment complained of pathological discharge, 47 (85.5%) noted itching, burning, pain in the genital area of various degrees of severity, 17 (30.9%) discomfort when urinating, 9 (16.4%) unpleasant smell, 8 (14.5%) dyspareunia, 4 (2.2%) complained of sensations of a foreign body in the vagina. The clinical and laboratory effectiveness of treatment was 89.1% (49). In 6 (10.9%) patients, clinical improvement was noted, with the remaining laboratory signs of aerobic vaginitis. Conclusion. The new combination of ornidazoleneomycinprednisoloneeconazole (ONPE, Elzhina ) has a good efficacy and safety profile and can be used to initiate empirical treatment of non-specific inflammatory diseases of the lower genital tract.

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

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.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Opportunities for treating opportunistic vaginal infections during pregnancy

GYNECOLOGY ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 11-15 ◽  
Author(s):  
T E Karapetyan ◽  
V V Muravieva ◽  
A S Ankirskaya ◽  
L A Lyubasovskaya ◽  
T V Priputnevich
Keyword(s):  
Positive Result ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Premature Birth ◽  
Local Treatment ◽  
Vaginal Infections ◽  
Aerobic Vaginitis ◽  
Early Gestation ◽  
Early Stages ◽  
Intrauterine Infections

The aim of the study was to evaluate the effectiveness of treatment of women with opportunistic vaginal infections during pregnancy. Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed. Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections - in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.

scholarly journals Durable Continuous-Flow Mechanical Circulatory Support: State of the Art

Hearts ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 127-138
Author(s):  
Antonio Loforte ◽  
Luca Botta ◽  
Silvia Boschi ◽  
Gregorio Gliozzi ◽  
Giulio Giovanni Cavalli ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Continuous Flow ◽  
Mechanical Circulatory Support ◽  
State Of The Art ◽  
Ease Of Use ◽  
Circulatory Support ◽  
Pulse Modulation ◽  
Ventricular Assist ◽  
Old Patients ◽  
Number Of Patients

Implantable mechanical circulatory support (MCS) systems for ventricular assist device (VAD) therapy have emerged as an important strategy due to a shortage of donor organs for heart transplantation. A growing number of patients are receiving permanent assist devices, while fewer are undergoing heart transplantation (Htx). Continuous-flow (CF) pumps, as devices that can be permanently implanted, show promise for the treatment of both young and old patients with heart failure (HF). Further improvement of these devices will decrease adverse events, enable pulse modulation of continuous blood flow, and improve automatic remote monitoring. Ease of use for patients could also be improved. We herein report on the current state of the art regarding implantable CF pumps for use as MCS systems in the treatment of advanced refractory HF.

scholarly journals Urgency treatment profile of 0 to 15 year-old children assisted at urgency dental service from Bauru Dental School, University of São Paulo

2005 ◽  
Vol 13 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Vivien Thiemy Sakai ◽  
Ana Carolina Magalhães ◽  
Juliano Pelim Pessan ◽  
Salete Moura Bonifácio da Silva ◽  
Maria Aparecida de Andrade Moreira Machado
Keyword(s):  
Root Resorption ◽  
Sao Paulo ◽  
Dental Service ◽  
Dental School ◽  
São Paulo ◽  
Old Patients ◽  
Number Of Patients ◽  
Treatment Data ◽  
Caries Lesions ◽  
Treatment Profile

Dental recordings of 0 to 15-year-old patients assisted at Urgency Dental Service (UDS) from Bauru Dental School, University of São Paulo, in 2001 and 2002, were assessed in order to quantify the number of patients that used the service, to determine attendance patterns, and to record the frequency of different types of dental emergencies and their performed treatment. Data were plotted and submitted to a descriptive statistical analysis. Among the total of patients attended at UDS (6020), 1166 (19.37%) were children, with mean age of 9.24 years. Trauma was the cause for 199 (17.06%) of the recorded urgency visits. It occurred more frequently in children between 0 and 3 years of age (34.42%), and between 7 and 12 years of age (18.12%). The main treatments performed were temporary restoration (33.33%) for coronal fracture, and orientation (24.44%) for luxation. Nontraumatic events were the etiology for 967 (82.92%) of the total urgency diagnosis. The most commonly found nontraumatic diagnosis was dental caries lesions (61.75%), followed by problems of eruption or root resorption (14.27%) and bone or soft tissue lesions (6.51%), among others (17.47%). The most frequent treatments performed for caries lesions were: excavation and temporary restoration (39.39%) when there was no abscess, and coronal opening and dressing (40.95%) for caries lesions with abscess. There was an increasing trend in caries lesions prevalence according to the rising of the age, in contrast to trauma prevalence. Treatment for both situations was done according to the indicated protocol for each case.

Biologics in Microangiopathic Wounds

2018 ◽  
Vol 17 (4) ◽  
pp. 205-213
Author(s):  
Massimo Papi ◽  
Claudia Papi
Keyword(s):  
Inflammatory Diseases ◽  
Platelet Rich Plasma ◽  
Connective Tissue Diseases ◽  
Local Therapy ◽  
Biologic Agents ◽  
Biologic Drugs ◽  
New Class ◽  
Skin Ulcers ◽  
Inflammatory Processes ◽  
Inflammatory Molecules

In the last decades the possibility to diagnose a skin ulcer has greatly improved. We learnt that a consistent percentage of nonhealing ulcers may be caused by a microangiopathic disorder that has not been properly investigated and cured. Pathogenetically, we can distinguish 2 main groups: (1) ulcers due to inflammatory microangiopathy, mainly including cutaneous small and medium vessel vasculitis, pyoderma gangrenosum, and connective tissue diseases, and (2) ulcers due to occlusive microangiopathy. The group of microangiopathic occlusive ulcers is more heterogeneous and includes different disorders ranging from livedo vasculopathy to calciphylaxis, hydroxyurea-induced ulcers, antiphospholipid antibodies ulcers, and various other types. These conditions can induce thromboses or anatomo-functional occlusion of cutaneous microvessels. Despite different physiopathologic mechanisms, the ulcer resulting from a primitive microangiopathy may receive basic treatments that are in the complex similar to other pathogenetically different wounds, including MOIST-based local therapy and elastic compression when it is not contraindicated. Persistent inflammatory processes are increasingly demonstrated as responsible for the chronicity of many skin ulcers. New data concerning the biological phases of wound healing and the molecules that play crucial roles in this process suggested the use of new specific therapies. Some of them such as growth factors and platelet-rich plasma are prevalently used as topical biologic agents with variable benefits. In recent years, a new class of systemic anti-inflammatory molecules, better known as biologic drugs, have been introduced in the cure of chronic inflammatory diseases that can induce microangiopathic injuries and ulcerative complication. They enlarged the therapeutic options in case of nonresponder microangiopathic ulcers and could represent a future model of “pathogenetically based” therapy of skin ulcers.

scholarly journals Difficulties in therapy of aerobic vaginitis and ways to overcome them

2021 ◽  
Vol 4 ◽  
pp. 30-35
Author(s):  
I.V. Kuznetsova
Keyword(s):  
Genital Tract ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Local Therapy ◽  
External Genitalia ◽  
Empirical Therapy ◽  
Aerobic Vaginitis ◽  
Common Cause ◽  
Selective Antimicrobial Activity ◽  
Systemic Agents

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.

OS06.2A Local immunotherapy of glioblastoma via AAV-mediated gene transfer of checkpoint inhibitors in combination with CAR-NK cells

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii8-ii9
Author(s):  
M I Strecker ◽  
K Wlotzka ◽  
F Strassheimer ◽  
J Reul ◽  
P N Harter ◽  
...  
Keyword(s):  
Side Effects ◽  
Tumor Cell ◽  
Nk Cells ◽  
Cellular Response ◽  
Checkpoint Inhibitors ◽  
Local Treatment ◽  
Local Therapy ◽  
Target Cells ◽  
Dependent Manner ◽  
Local Immunotherapy

Abstract BACKGROUND Glioblastoma (GB) is the most common primary brain tumor which is characterized by low immunogenicity of tumor cells and prevalent immunosuppression in the tumor microenvironment (TME). Since expression of PD-L1 on GB cells has been described, immunotherapy with checkpoint inhibitors (CIs) may be a promising approach for GB treatment. However, systemic administration of CIs bears the risk of autoimmune-like side effects, while the intratumoral drug concentration reached may not be sufficient. METHODS We studied delivery of CIs through targeted Adeno-associated viral vectors (AAVs) encoding an anti PD-1 immunoadhesin (aPD-1) as a novel approach towards local immunotherapy in the syngeneic GL261-HER2 glioma model. Tumor cell-specific delivery was achieved by targeting HER2 via a specific designed ankyrin repeat protein (DARPin). We investigated the effects of this strategy alone and in combination with local injection of HER2-specific CAR-NK cells (NK-92/5.28.z), which have already shown efficacy in preclinical GB models and are currently under investigation in the CAR2BRAIN phase I clinical trial. Furthermore, aPD-1 functionality and cellular response to viral transduction as well as compatibility of both therapy approaches has been evaluated in various in vitro models. RESULTS HER2-AAV transduction efficacy of GB cells correlated with HER2 expression level, while target cells did not show anti-viral responses upon transduction. After transduction with aPD-1 HER2-AAVs, aPD-1 immunoadhesin was secreted in a time-dependent manner, bound its target on PD-1-expressing cells and was able to re-activate T-cells due to PD-1 blockade. AAV-transduction did not interfere with CAR-NK cell mediated tumor cell lysis. Biodistribution studies in mice revealed the presence of aPD-1 up to 10 days after a single HER2-AAV injection. In subcutaneous GL261-HER2 tumors, local treatment with HER2-AAVaPD-1 or HER2-AAVIgG-Fc+ NK-92/5.28.z therapy had no significant effect, whereas combination therapy profoundly delayed tumor growth. CONCLUSIONS Local therapy with aPD-1 encoding HER2-AAVs in combination with NK-92/5.28.z cells is a promising novel strategy for GB immunotherapy with the potential to enhance efficacy and reduce side effects.

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