THE NEGATIVE IMPACT OF ALIMENTARY OBESITY ON THE STATE OF LOCAL IMMUNITY OF THE VAGINAL MUCOSA AND THE EFFECTIVENESS OF THE THERAPY OF BACTERIAL VAGINOSIS

Проведен анализ результатов стандартного лечения бактериального вагиноза у 143 больных с учетом наличия у них алиментарного ожирения. Все женщины, принимавшие участие в нашем исследовании, дали письменное информированное согласие на участие в нем. Лечение БВ проводилось по общепринятой методике метронидазолом и клиндамицином. В зависимости от наличия алиментарного ожирения больных бактериальным вагинозом разделили на 2 группы. В I группу вошли 97 без алиментарного ожирения. Во II группе у 46 больных отмечалось увеличение массы тела, соответствующее алиментарному ожирению II степени. Исследования проводили до начала лечения и через 14 суток после его завершения. Сравнительный анализ результатов лечения БВ в исследуемых группах показал, что на фоне АО II степени отмечались достоверно более выраженные увеличение количества «ключевых клеток» (P<0,05) и смещение pH в щелочную сторону (P<0,05) во II группе. При этом эффективность лечения у больных II группы, где отмечалось алиментарное ожирение II степени была достоверно меньше, чем в I (P<0,05), что свидетельствовало о негативном влиянии алиментарного ожирения на состояние локального иммунитета слизистой оболочки влагалища и результативность проводимой терапии бактериального вагиноза. The results of standard treatment of bacterial vaginosis in 143 patients were analyzed, taking into account the presence of alimentary obesity in them. All the women who took part in our study gave written informed consent to participate in it.BV was treated according to the generally accepted method with metronidazole and clindamycin. Depending on the presence of alimentary obesity, patients with bacterial vaginosis were divided into 2 groups. Group I included 97 people without alimentary obesity. In group II, 46 patients had an increase in body weight corresponding to alimentary obesity of the II degree. Studies were conducted before the start of treatment and 14 days after its completion. A comparative analysis of the results of BV treatment in the study groups showed that against the background of grade II AO, there was a significantly more pronounced increase in the number of "key cells" (P<0.05) and a pH shift to the alkaline side (P<0.05) in group II. At the same time, the effectiveness of treatment in group II patients with grade II alimentary obesity was significantly less than in group I (P<0.05), which indicated a negative effect of alimentary obesity on the state of local immunity of the vaginal mucosa and the effectiveness of the therapy of bacterial vaginosis.

Changes in the Oral Cavity in Menopausal Women—A Narrative Review

Oral health awareness during the menopausal period is essential to minimize the inevitable inconveniences which may occur due to hormonal changes. The decrease in estrogen hormone concentration impacts the oral mucosa in a similar way to the vaginal mucosa due to the presence of estrogen receptors in both of these structures. An estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries, causing a change in pain tolerance and problems in the use of removable prosthetic restorations. Mucosal epithelium during the menopausal period is more vulnerable to infections, candidiasis, burning mouth syndrome, oral lichen planus (OLP), or idiopathic neuropathy. Moreover, salivary glands are also hormone-dependent which leads to changes in saliva secretion and its consistency. In consequence, it may affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease in menopausal women. Due to the large variety of complaints and symptoms occurring in the oral cavity, menopausal women constitute a significant group of patients who should receive special preventive and therapeutic care from doctors and dentists in this particular period.

Efek Kefir Terhadap Kadar Superokdidase Dismutase, Malondialdehyde Pada Mencit Balb/C Diinduksi Streptococcus Agalactiae

Streptococcus agalactiae are pathogenic bacteria which cause vaginal infection. Vaginal and cervical infections in pregnant women can reduce elasticity of the membranes that cause premature rupture of membranes. This can also impact to neonatal morbidity and mortality in first week of birth. Kefir is known as a probiotic that can act as an immunomodulator. The role of kefir is believed to improve the immune system. The role of kefir in preventing infection is still rarely studied, especially as an immunomodulator and in reducing the number of pathogenic bacteria.This study aimed to evaluate superoxide dismutase (SOD) level, Malondialdehyde (MDA) level, and the population of the colonization Streptococcus agalactiae in BALB-C mice fed kefir. This study was true experimental with post test only control group design. Sample was BALB-C mice induced by Streptococcus agalactiae. SOD and MDA level was examined by enzyme-linked immunosorbent assay (ELISA) and Streptococcus agalactiae identification by colony count. The results of the one-way ANOVA analysis showed there was no significant differences between all groups for SOD levels (P 0.393). In the level of MDA there was also no difference between all groups (P 0.204). Whereas in the number of Streptococcus agalactiae colonies there was a significant difference (P 0.000) with the smallest number of colonies found at dose of 0.5 ml / day. Conclusion: kefir as a probiotic drink did not affect to the SOD and MDA level of BALB/ C mice induced by Streptococcus agalactiae, but kefir affected to number of Streptococcus agalactiae colonies. Further research needs to show the relation of kefir as probiotics with proinflammatory and other anti-inflammatory parameters such as interleukin and immunological vaginal mucosa.

Conducting genetic interaction analysis with CRISPR-Cas9-based strategies in Candida albicans

Candida albicans is an opportunistic fungal pathogen found in the oral mucosa, the gut, the vaginal mucosa, and humans' skin. While C. albicans can cause superficial infections, severe invasive infections can occur in immunocompromised individuals. Understanding the survival mechanisms and pathogenesis of C. albicans is critical for novel antifungal drug discovery. Determining the relationships between different genes can create a genetic interaction map, which can identify complementary gene sets, central to C. albicans survival, as potential drug targets in combination therapy. A genetic approach using the CRISPR-Cas9-based genome editing platform will focus on genetic interaction analysis of C. albicans stress response genes. The ultimate goal is to create a stress response gene deletion library to study its pathogen survival role. This library of single and double stress response gene mutants will be screened under diverse growth conditions to assess their relative fitness. Genetic interaction analysis will help map out epistatic interactions between fungal genes involved in growth, survival, and pathogenesis and uncover putative targets for combination antifungal therapy based on negative or synthetic lethal genetic interactions.

Assessment of Sensitivity and Profitability of an Intravaginal Sensor for Remote Calving Prediction in Dairy Cattle

One critical point of dairy farm management is calving and neonatal first care. Timely calving assistance is associated with the reduction of calf mortality and postpartum uterine disease, and with improved fertility in dairy cattle. This study aimed to evaluate the performance and profitability of an intravaginal sensor for the prediction of stage II of labor in dairy farms, thus allowing proper calving assistance. Seventy-three late-gestating Italian Holstein cows were submitted to the insertion of an intravaginal device, equipped with light and temperature sensors, connected with a Central Unit for the commutation of a radio-signal into a cell phone alert. The remote calving alarm correctly identified the beginning of the expulsive phase of labor in 86.3% of the monitored cows. The mean interval from alarm to complete expulsion of the fetus was 71.56 ± 52.98 min, with a greater range in cows with dystocia (p = 0.012). The sensor worked correctly in both cold and warm weather conditions, and during day- or night-time. The intravaginal probe was well tolerated, as any cow showed lesions to the vaginal mucosa after calving. Using sex-sorted semen in heifers and beef bull semen in cows at their last lactation, the economic estimation performed through PrecisionTree™ software led to an income improvement of 119 € and 123 €/monitored delivery in primiparous and pluriparous cows, respectively. Remote calving alarm devices are key components of “precision farming” management and proven to improve animal welfare, to reduce calf losses and to increase farm incomes.

Lactobacillus iners Cell-Free Supernatant Enhances Biofilm Formation and Hyphal/Pseudohyphal Growth by Candida albicans Vaginal Isolates

Candida albicans is a commensal fungus of the vaginal mucosa and the principal etiological agent of vaginal candidiasis. Vaginal dysbiosis has been reported during vulvovaginal candidiasis (VVC), with a progressive decrease in Lactobacillus crispatus population and an increase in L. iners population. To date, the role of L. iners in VVC pathogenesis remains scarcely explored. Herein we investigated the in vitro effect of L. iners cell-free supernatant (CFS) on the ability of C. albicans to form biofilms. Biomass and metabolic activity were measured by crystal violet and XTT assays. Further, light microscopy was performed to determine the effect of L. iners CFS on biofilm cellular morphology. We found that L. iners CFS induced a significant increase in biofilm formation by C. albicans clinical isolates which were categorized as moderate or weak biofilm producers. This effect was associated with an enhancement of hyphal/pseudohyphal growth, and the expression levels of HWP1 and ECE1, which are typical hyphae-associated genes, were upregulated. Overall, these results suggest that L. iners contributes to the pathogenesis of VVC and highlight the complexity of the interaction between C. albicans and vaginal lactobacilli. Understanding these interactions could prove essential for the development of new strategies for treating VVC.

Possibilities of using neodymium laser to improve the condition of vaginal mucosa in women of various ages with initial stages of genital prolapse

Genital prolapse is a sort of epidemic and is registered today in 30% to 56% of women of both reproductive and menopausal ages. Until now, the initial stages of prolapse were not taken into account; as a rule, the correction began immediately with surgical treatment, the results of which were not always satisfactory, and the recurrence rate with plastic correction with one’s own tissues ranged from 37 to 45%. One of the main manifestations of prolapse of the vaginal walls, especially n perimenopause, is vulvovaginal mucosal atrophy, which directly depends on the pH in the vagina. The study is devoted to the analysis of the effectiveness of using neodymium laser to improve the condition of the vaginal mucosa in women of different age groups with initial degrees of genital prolapse. Purpose: scientific substantiation of using neodymium laser in patients of different age groups with grade I–II cysto-rectocele. Material and research methods. Studies were carried out in 69 women aged 31 to 52 years with cysto-rectocele of grade I–II (ICD-10 code N81.6), with the duration of the disease from 4 to 15 years. All patients, depending on their age and the method of treatment used, were divided into 2 groups comparable in terms of clinical and functional characteristics — the main and control groups, each of which had 2 subgroups. In the main group: subgroup 1 included 27 patients of reproductive age with grade I–II cysto-rectocele, who underwent a neodymium laser course with Magic Gyno, consisting of 3 intravaginal procedures with an interval of 28 days; subgroup 2 included 22 patients of perimenopausal and menopausal age with grade I–II cysto-rectocele, who underwent a course of 3 intravaginal procedures with Magic Gyno neodymium laser with an interval of 28 days. The control group included 20 patients with grade I–II cysto-rectocele, who underwent a special complex of exercise therapy; depending on their age, they were also divided into two subgroups: 1 (10 patients) — of reproductive age, 2 (10 patients) — of perimenopausal and menopausal age. The results obtained indicate a pronounced effect of the course application of intravaginal exposure by a neodymium laser on the state of the vulvovaginal mucosa in patients with grade I–II cysto-rectocele, of both reproductive and, most importantly, peri-menopausal age, which was manifested in the normalization of the pH of vaginal discharge and elimination of signs of atrophy of the mucous membrane of the vulva and vagina and was confirmed by the data of pH-metry and the Vaginal Health Index Score. Conclusion. The course use of a neodymium laser in patients of different age groups with grade I–II cysto-rectocele contributes to the formation of a pronounced tropho-stimulating effect, which is manifested in the normalization of the pH of the vaginal discharge and the elimination of signs of atrophy of the mucous membrane of the vulva and vagina.

The renaissance of barrier contraception (based on the data from an international clinical trial)

Background. In recent years, interest in the use of barrier methods of contraception has increased, since many women prefer them in connection with the change in the epidemiological situation associated with COVID-19, with contraindications to other methods of contraception, as well as with irregular sex life and casual sexual intercourse. In addition, these methods of contraception are preferred for breastfeeding mothers and pre- and postmenopausal women. Studies of the efficacy of spermicidal agents in late reproductive age women have not previously been carried out, although their use in this population is of particular interest, since these agents do not have a systemic effect and, if used correctly, can prevent unwanted pregnancies. The article presents data from an international French-Russian study of the efficacy of spermicides containing benzalkonium chloride in late reproductive age women (over 40 years). The study was carried out on the basis of 7 private offices of obstetricians and gynecologists in France and 6 obstetric and gynecological clinics in Russia. Aim. Assessment of the contraceptive efficacy, safety and acceptability of a cream containing benzalkonium chloride in women over 40 years of age. Materials and methods. The study included non-pregnant women aged 40 and over who had at least 1 menstrual period in the past 3 months and who would like to use spermicides as contraception for at least 6 months. After a 6-month period of mandatory use of spermicide, patients could, if desired, continue to use it for the next 6 months. All women were given Pharmatex (1.2%), a vaginal cream containing benzalkonium chloride (1.2 g per 100 g of cream) as the active ingredient, 1 standard dose before each intercourse. The primary endpoint was the Pearl Index. The acceptability of the method after each use of the cream, the moisturizing effect, and the woman's and researcher's overall satisfaction with this method of contraception were also assessed. Safety was assessed using adverse event monitoring. Results. An analysis of efficacy of the study drug showed that during study, pregnancy did not occur in any of the women. Pearl Index for 12 months was 0. Over the mandatory 6-month period, the use of Pharmatex cream was assessed by patients as acceptable (to some extent acceptable, acceptable, completely acceptable) in 98% of sexual intercourse, and over the 12-month period in 98.6% of intercourse. The moisturizing effect of the cream was noted by 96.1% of women. In 6 months of the use of Pharmatex cream, overall satisfaction was rated as quite good, good, or very good by 99.3% of patients and in 12 months by 100% of patients. Adverse events were noted only in 0.5% of cases. Most of these events were assessed as unrelated to the study drug. Conclusion. The use of a benzalkonium chloride spermicidal cream can be considered an effective and acceptable method of contraception for women over the age of 40. It is well tolerated, has a moisturizing effect on the vaginal mucosa, and meets the needs and lifestyle of women. The contraceptive with benzalkonium chloride has a favorable safety profile: it does not adversely affect the normal flora of the vagina, can be used during breastfeeding, since it does not penetrate into the vascular bed and doesnt have systemic effects.

Current opportunities for treatment and prevention of recurrent vulvovaginitis in reproductive aged women

Vulvovaginal candidiasis is an urgent medical and social problem, a common reason for women to see a doctor. This disease occurs in women of different ages, which leads to a significant decrease in the quality of life, and to more serious complications in some cases (genitourinary system diseases, miscarriage, vaginal stenosis, etc.).Research objective. Comprehensive assessment of the effectiveness of treatment and prevention of recurrent vulvovaginal candidiasis (RVVC) with Candivac (contains inactivated microorganisms in the form of frozen lyophilized 4 original strains, which are the most common causative agents of vaginal candidiasis).Materials and methods. 76 women of reproductive age with RVVC were examined and randomized into 2 groups: the main group consisted of 40 patients who received anti-candidiasis therapy with fluconazole and Candivac; the control group included 36 women who received only the standard fluconazole antifungal regimen. The duration of observation was 12 months.Criteria for evaluating treatment efficacy were no/reduction of clinical symptoms and changes in the vaginal mucosa, positive dynamics of laboratory tests (with control after 3 and 12 months) from the start of treatment. Results. Clinical efficacy of treatment (regression of complaints and normalization of objective data) in two groups was observed in the majority of patients. At the same time, clinical efficiency in the main group was 87% and exceeded that in the comparison group (63%), which was accompanied by the normalization of the vaginal microbiocenosis. However, after complex therapy with Candivac a more reliable result was observed, which was accompanied by a significant decrease in the frequency of disease recurrence.Conclusions. Study showed that Candivac in combination with antifungal therapy and probiotic promotes the elimination of systemic inflammation and the rapid return of normal intravaginal microflora, and reduces the number of RVVC recurrences.

Recurrent bacterial vaginosis: possible ways of correction

Research objective: to increase the effectiveness of bacterial vaginosis (BV) treatment in women of reproductive age.Materials and methods. The study involved 64 women of reproductive age with BV. After a course of local antibiotic therapy participants were divided into 2 groups: patients of group I were not prescribed local remedies to restore the vaginal microflora, patients of group II were prescribed vaginal prebiotic suppositories Folial № 10. No additional drugs were used in subgroups IA and IIA, while oral probiotic Maxibalance was prescribed in subgroups IB and IIB. The effectiveness of BV treatment was evaluated at the first, third and sixth months of the observation period according to the results of clinical examination and vaginal pH evaluation by litmus strips.Results. The course of BV in subgroup IA was characterized by prevailing number of relapses and their early appearance. 1 case of BV recurrence was found among patients of subgroup IA at the 1st month of follow-up, 6 and 8 BV episodes were found at 3 and 6 months of follow-up respectively. Sequential treatment with antibiotics and oral probiotics (subgroup IIB) was associated with the onset of 3 BV relapses on 4–5 months from baseline. Local prebiotic (subgroup IIA) after the vaginal sanation was associated with BV reoccurrence in only one patient at the end of the study. No relapses of BV were detected in subgroup IIB during the study.Conclusions. Permanent imbalance of vaginal normocenosis creates optimal conditions for chronic and recurrent diseases of dysbiosis nature, especially BV. Despite the sensitivity of the anaerobic flora to the recommended antibacterial medications, their use as monotherapy in BV treatment is often insufficient. The results of the study demonstrate a significant anti-relapse efficiency of consecutive treatment by antibacterial drugs and a complex of probiotic + prebiotic. This effect is probably based on the restoration of vaginal immunity and metabolism by stable colonization of the vaginal mucosa with live lactobacilli of eubiotic origin.