Vulvovaginitis
Trichomonas
Vaginal Discharge
Candida
Trichomonas vaginalis
Nitriles
Triazoles
Aromatase Inhibitors
Antineoplastic Agents, Hormonal
Tamoxifen
Postmenopause
Detection of the human 70-kD and 60-kD heat shock proteins in the vagina: relation to microbial flora, vaginal pH, and method of contraception. (1/43)
The expression of the 60-kD and 70-kD heat shock proteins (hsp60 and hsp70) in the vaginas of 43 asymptomatic women of reproductive age with or without a history of recurrent vulvovaginitis (RVV) were compared. Vaginal wash samples were obtained and assayed by enzyme-linked immunosorbent assay (ELISA) for human hsp60 and hsp70. Heat shock protein 70 was not detected in any of the 19 women with no history of RVV, and hsp60 was present in only one woman in this group. In contrast, in the RVV group, 11 (45.8%) were hsp60-positive and eight (33.3%) were hsp70-positive. The presence of either heat shock protein in the vagina was associated with an elevated vaginal pH (>4.5). Bacterial vaginosis or Candida was identified in some of the asymptomatic subjects; their occurrence was significantly higher in women with vaginal hsp70 than in women with no heat shock proteins. Oral contraceptives were used by 35.7% of subjects who were negative for vaginal heat shock proteins, as opposed to only 12.5% of women who were positive for hsp70 and 8.3% who were positive for hsp60. Expression of heat shock proteins in the vagina may indicate an altered vaginal environment and a susceptibility to vulvovaginal symptoms. (+info)Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract. (2/43)
AIM: To clarify the contribution of clinical and environmental factors and infection to the aetiology of vulvovaginitis in premenarchal girls, and to determine clinical indicators of an infectious cause. DESIGN: It was necessary first to define normal vaginal flora. Cases were 50 premenarchal girls > 2 years old with symptoms of vulvovaginitis; 50 controls were recruited from girls in the same age group undergoing minor or elective surgery. RESULTS: Interview questionnaire showed no difference between cases and controls in regards to hygiene practices, exposure to specific irritants, or history of possible sexual abuse. Normal vaginal flora was similar to that described in previous studies, with the exception of organisms likely to be associated with sexual activity. 80% of cases had no evidence of an infectious cause. In the 10 cases in whom an infectious cause was found, there was significantly more visible discharge and distinct redness of the genital area on examination compared with other cases. CONCLUSIONS: The findings suggest that vulvovaginitis in this age group is not usually infectious or necessarily related to poor hygiene, specific irritants or sexual abuse, although any of these can present with genital irritation. The possibility of sexual abuse should always be considered when a child presents with genital symptoms, but our data indicate it is not a common contributing factor. Infection is generally associated with vaginal discharge and moderate or severe inflammation. (+info)Semiquantitative bacterial observations with group B streptococcal vulvovaginitis. (3/43)
OBJECTIVE: Group B streptococcal (GBS) vulvovaginitis is a poorly-delineated clinical entity. The purpose of this study is to report semiquantitative data from four cases of GBS vulvovaginitis and to comment on their significance in terms of the in vitro inhibitory capabilities of GBS. METHODOLOGY: Four patients whose clinical presentations were consistent with GBS vulvovaginitis, from whom GBS was isolated and for whom semi-quantitative as well as qualitative microbiologic data existed, were identified. RESULTS: To produce vulvovaginitis, GBS must be at a high multiplicity (10(8) CFU/g of vaginal fluid). Single coisolates were identified in three of the four cases (two cases of Escherichia coli and one case of Staphylococcus aureus). Group B streptococcus does not inhibit either of these bacteria in vitro. CONCLUSION: When the growth requirements for the demonstration of in vitro inhibition for GBS or lack thereof are met in vivo, the in vivo observations are consistent with those projected from the in vitro data. (+info)Effects of minocycline and tetracycline on the vaginal yeast flora. (4/43)
Two groups of women with non-specific genital infection were treated for two weeks with tetracycline 250 mg six-hourly and minocycline 100 mg twice daily respectively. Cultures for yeasts were performed before treatment and at the end of the first and second weeks. Before treatment yeasts, mostly Candida albicans, were recovered from 13% of the women. After one and two weeks' treatment yeasts were isolated from 22 and 29% of women treated with tetracycline, and from 19 and 29% of women treated with minocycline. It is concluded that despite inhibition of the growth of yeasts shown by minocycline in vitro, there is no evidence of any significant difference between the actions of tetracycline and minocycline on the vaginal yeast flora. (+info)Diagnosis of vaginitis. (5/43)
Vaginitis is the most common gynecologic diagnosis in the primary care setting. In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. Vaginitis develops when the vaginal flora has been altered by introduction of a pathogen or by changes in the vaginal environment that allow pathogens to proliferate. The evaluation of vaginitis requires a directed history and physical examination, with focus on the site of involvement and the characteristics of the vaginal discharge. The laboratory evaluation includes microscopic examination of a saline wet-mount preparation and a potassium hydroxide preparation, a litmus test for the pH of vaginal secretions and a "whiff" test. Metronidazole is the primary treatment for bacterial vaginosis and trichomoniasis. Topical antifungal agents are the first-line treatments for candidal vaginitis. (+info)Microbial flora of the lower genital tract during pregnancy: relationship to morbidity. (6/43)
Nineteen genera and groups of micro-organisms were isolated from the lower genital tract of 280 women at their first antenatal visit. Chlamydia, viruses, and T-strain mycoplasmas were not sought, and only routine methods of anaerobic culture were used. Growth was recorded as scanty, moderate or heavy. The population studied was grouped according to age, parity, gestational stage at booking, presence and degree of severity of lower genital tract morbidity, past history of vulvovaginitis, and suspicion of lower genital tract morbidity as evidenced by a request for a report on the microbiological findings. The frequency of isolation of the various microbes in health and in disease is given. The grading of Gram-stained smears bore no relation to the isolation rates of lactobacilli, but there was a significant increase (p less than 0-001) in the isolation rates of each of the following: Mycoplasma hominis, Bacteroides spp., Trichomonas vaginalis, Gram-variable cocco-bacilli, and anaerobic streptococci in those patients with smears in which lactobacilli were adjudged to be absent. The isolation of faecal streptococci was increased (p less than 0-001) in women aged more than 34 years. Escherichia coli (p less than 0-05) and anaerobic and microaerophilic streptococci (p less than 0-02) were isolated more frequently from those booking after the 25th week of pregnancy. The incidence of M. hominis (p less than 0-02) and of anaerobic streptococci (p less than 0-05) increased between the first and third trimesters. No significance positive correlations were established between the isolation rates of the various microbes and objective assessment of lower genital tract morbidity or the demonstration of pus cells, but lactobacilli were isolated less frequently (p less than 0-01) from those with morbidity. The isolation of Candida albicans (p less than 0-02), T. vaginalis (p less than 0-05), and M. hominis (p less than 0.05) was increased in patients in whom vulvovaginitis was suspected, and that of T. vaginalis (p less than 0-05) was increased in those with a past history of vulvovaginitis. The study indicates that, other than the pathogens T. vaginalis and C. albicans, only M. Hominis could be suspected, on statistical grounds, of being associated with disease of the lower genital tract during early pregnancy. (+info)Value of Candida polymerase chain reaction and vaginal cytokine analysis for the differential diagnosis of women with recurrent vulvovaginitis. (7/43)
OBJECTIVES: Recurrent vulvovaginitis remains difficult to diagnose accurately and to treat. The present investigation evaluated the utility of testing vaginal specimens from women with symptomatic recurrent vulvovaginitis for Candida species by polymerase chain reaction (PCR) and for cytokine responses. METHODS: Sixty-one consecutive symptomatic women with pruritus, erythema, and/or a thick white discharge and a history of recurrent vulvovaginitis and 31 asymptomatic women with no such history were studied. Vaginal swabs were tested for Candida species by PCR, for the antiinflammatory cytokine interleukin (IL)-10, and for the proinflammatory cytokine IL-12. RESULTS: C. albicans was detected in 19 (31.1%) of the patients as well as in three (9.7%) controls (P = 0.03). Both IL-10 (31.1% vs. 0%) and IL-12 (42.6% vs. 6.5%) were also more prevalent in the recurrent vulvovaginitis patients (P < 0.001). However, there was no relation between the presence or absence of Candida and either cytokine. Detection of IL-12 in 14 women indicated the stimulation of a vaginal cell-mediated immune response possibly from an infectious agent. The presence of only IL-10 in six patients indicated a suppression of vaginal cell-mediated immunity and was consistent with a possible allergic etiology. The absence of both IL-10 and IL-12 in other patients, similar to that found in healthy controls, suggested a noninfectious, nonallergic etiology of their symptoms. CONCLUSION: Many women with recurrent vulvovaginitis are not infected with Candida. Testing for Candida should be required in this population. Treatment with only anti-Candida medication will clearly be inadequate for the majority of women with this condition. (+info)Attendance by older patients at a genitourinary medicine clinic. (8/43)
OBJECTIVES: To determine how patients aged 50 and above had been referred to a department of genitourinary medicine (GUM), why they had attended, their sexual histories, and what diagnoses were made. To identify any special sexual health needs in this group of patients. METHODS: A case note review was undertaken of all patients aged 50 and over attending the Portsmouth GUM department over a 3 month period. RESULTS: There was a marked difference in reason for attendance between men and women in this older age group. Men were more likely to attend for a sexual health screen, often with minimal or no symptoms, following an extramarital or casual liaison. Women more commonly had symptoms causing difficulties with sexual intercourse with their regular partner. CONCLUSIONS: Older people present to GUM departments with a wide range of sexually associated problems. The diagnostic and management expertise available in GUM departments makes them ideal providers of sexual health care for this as well as younger age groups. (+info)Vulvovaginitis is a medical term that refers to inflammation of the vulva and vagina. It is often characterized by symptoms such as itching, burning, redness, swelling, discomfort, pain, and abnormal vaginal discharge. The condition can be caused by various factors, including infections (such as bacterial vaginosis, yeast infections, or sexually transmitted infections), irritants (like chemicals found in soaps, douches, or sanitary products), allergies, or hormonal changes.
The symptoms of vulvovaginitis can vary depending on the cause and severity of the inflammation. In some cases, it may resolve on its own or with simple home remedies, while in other cases, medical treatment may be necessary to clear up any underlying infection or address any specific causes of the inflammation.
If you are experiencing symptoms of vulvovaginitis, it is important to speak with a healthcare provider for an accurate diagnosis and appropriate treatment plan.
Vulvovaginal candidiasis is a medical condition that refers to an infection in the vagina and vulva caused by Candida fungus, most commonly Candida albicans. This type of infection is also commonly known as a yeast infection. The symptoms of vulvovaginal candidiasis can include itching, redness, swelling, pain, and soreness in the affected area, as well as thick, white vaginal discharge that may resemble cottage cheese. In some cases, there may also be burning during urination or sexual intercourse. Vulvovaginal candidiasis is a common condition that affects many women at some point in their lives, and it can be treated with antifungal medications.
Oxyuriasis is a parasitic infection caused by the intestinal roundworm, Enterobius vermicularis (also known as the pinworm or threadworm). The infection is most commonly found in school-aged children.
The life cycle of this worm begins when an infected person passes microscopic eggs through their stool. These eggs can then be ingested unknowingly, often by touching the mouth with contaminated hands. Once inside the body, the larvae hatch and migrate to the small intestine, where they mature into adult worms. The female adults then move to the large intestine (colon), particularly the cecum, where they lay their eggs on the perianal skin, usually at night. This causes intense itching, which leads to scratching and further spread of the eggs through self-infection or transmission to others.
Symptoms of oxyuriasis include perianal itching, restless sleep (due to anal itching), irritability, and, in some cases, abdominal pain. The diagnosis is usually confirmed by identifying pinworm eggs using the "scotch tape test," where a piece of cellophane tape is pressed against the anus first thing in the morning and then examined under a microscope for the presence of eggs.
Treatment typically involves administering anti-parasitic medications, such as albendazole or mebendazole, to both the infected person and their close contacts to break the transmission cycle. Good hygiene practices, including regular handwashing and frequent nail trimming, are essential in preventing reinfection and spreading the infection to others.
Trichomonas is a genus of protozoan parasites that are commonly found in the human body, particularly in the urogenital tract. The most well-known species is Trichomonas vaginalis, which is responsible for the sexually transmitted infection known as trichomoniasis. This infection can cause various symptoms in both men and women, including vaginitis, urethritis, and pelvic inflammatory disease.
T. vaginalis is a pear-shaped flagellate protozoan that measures around 10 to 20 micrometers in length. It has four flagella at the anterior end and an undulating membrane along one side of its body, which helps it move through its environment. The parasite can attach itself to host cells using a specialized structure called an adhesion zone.
Trichomonas species are typically transmitted through sexual contact, although they can also be spread through the sharing of contaminated towels or clothing. Infection with T. vaginalis can increase the risk of acquiring other sexually transmitted infections, such as HIV and human papillomavirus (HPV).
Diagnosis of trichomoniasis typically involves the detection of T. vaginalis in a sample of vaginal or urethral discharge. Treatment usually involves the administration of antibiotics, such as metronidazole or tinidazole, which are effective at killing the parasite and curing the infection.
Vaginal discharge refers to the fluid that comes out of the vagina on a regular basis. It's a normal and healthy process for the body to keep the vagina clean and maintain its pH balance. The amount, color, and consistency of vaginal discharge can vary throughout a woman's menstrual cycle and can also be influenced by various factors such as pregnancy, sexual arousal, and infections.
Normal vaginal discharge is typically clear or white and may have a mild odor. However, if the discharge changes in color, consistency, or smell, or if it's accompanied by symptoms such as itching, burning, or pain, it could be a sign of an infection or other medical condition that requires treatment.
It is important to note that while vaginal discharge is a normal bodily function, any abnormal changes should be evaluated by a healthcare professional to ensure appropriate diagnosis and treatment.
The vagina is the canal that joins the cervix (the lower part of the uterus) to the outside of the body. It also is known as the birth canal because babies pass through it during childbirth. The vagina is where sexual intercourse occurs and where menstrual blood exits the body. It has a flexible wall that can expand and retract. During sexual arousal, the vaginal walls swell with blood to become more elastic in order to accommodate penetration.
It's important to note that sometimes people use the term "vagina" to refer to the entire female genital area, including the external structures like the labia and clitoris. But technically, these are considered part of the vulva, not the vagina.
'Candida' is a type of fungus (a form of yeast) that is commonly found on the skin and inside the body, including in the mouth, throat, gut, and vagina, in small amounts. It is a part of the normal microbiota and usually does not cause any problems. However, an overgrowth of Candida can lead to infections known as candidiasis or thrush. Common sites for these infections include the skin, mouth, throat, and genital areas. Some factors that can contribute to Candida overgrowth are a weakened immune system, certain medications (such as antibiotics and corticosteroids), diabetes, pregnancy, poor oral hygiene, and wearing damp or tight-fitting clothing. Common symptoms of candidiasis include itching, redness, pain, and discharge. Treatment typically involves antifungal medication, either topical or oral, depending on the site and severity of the infection.
Trichomonas vaginalis is a species of protozoan parasite that causes the sexually transmitted infection known as trichomoniasis. It primarily infects the urogenital tract, with women being more frequently affected than men. The parasite exists as a motile, pear-shaped trophozoite, measuring about 10-20 micrometers in size.
T. vaginalis infection can lead to various symptoms, including vaginal discharge with an unpleasant odor, itching, and irritation in women, while men may experience urethral discharge or discomfort during urination. However, up to 50% of infected individuals might not develop any noticeable symptoms, making the infection challenging to recognize and treat without medical testing.
Diagnosis typically involves microscopic examination of vaginal secretions or urine samples, although nucleic acid amplification tests (NAATs) are becoming more common due to their higher sensitivity and specificity. Treatment usually consists of oral metronidazole or tinidazole, which are antibiotics that target the parasite's ability to reproduce. It is essential to treat both partners simultaneously to prevent reinfection and ensure successful eradication of the parasite.
Nitriles, in a medical context, refer to a class of organic compounds that contain a cyano group (-CN) bonded to a carbon atom. They are widely used in the chemical industry and can be found in various materials, including certain plastics and rubber products.
In some cases, nitriles can pose health risks if ingested, inhaled, or come into contact with the skin. Short-term exposure to high levels of nitriles can cause irritation to the eyes, nose, throat, and respiratory tract. Prolonged or repeated exposure may lead to more severe health effects, such as damage to the nervous system, liver, and kidneys.
However, it's worth noting that the medical use of nitriles is not very common. Some nitrile gloves are used in healthcare settings due to their resistance to many chemicals and because they can provide a better barrier against infectious materials compared to latex or vinyl gloves. But beyond this application, nitriles themselves are not typically used as medications or therapeutic agents.
Triazoles are a class of antifungal medications that have broad-spectrum activity against various fungi, including yeasts, molds, and dermatophytes. They work by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes, leading to increased permeability and disruption of fungal growth. Triazoles are commonly used in both systemic and topical formulations for the treatment of various fungal infections, such as candidiasis, aspergillosis, cryptococcosis, and dermatophytoses. Some examples of triazole antifungals include fluconazole, itraconazole, voriconazole, and posaconazole.
Aromatase inhibitors (AIs) are a class of drugs that are primarily used in the treatment of hormone-sensitive breast cancer in postmenopausal women. They work by inhibiting the enzyme aromatase, which is responsible for converting androgens into estrogens. By blocking this conversion, AIs decrease the amount of estrogen in the body, thereby depriving hormone-sensitive breast cancer cells of the estrogen they need to grow and multiply.
There are three main types of aromatase inhibitors:
1. Letrozole (Femara) - a non-steroidal AI that is taken orally once a day.
2. Anastrozole (Arimidex) - another non-steroidal AI that is also taken orally once a day.
3. Exemestane (Aromasin) - a steroidal AI that is taken orally once a day.
In addition to their use in breast cancer treatment, AIs are also sometimes used off-label for the treatment of estrogen-dependent conditions such as endometriosis and uterine fibroids. However, it's important to note that the use of aromatase inhibitors can have significant side effects, including hot flashes, joint pain, and bone loss, so they should only be used under the close supervision of a healthcare provider.
Antineoplastic agents, hormonal, are a class of drugs used to treat cancers that are sensitive to hormones. These agents work by interfering with the production or action of hormones in the body. They can be used to slow down or stop the growth of cancer cells and may also help to relieve symptoms caused by the spread of cancer.
Hormonal therapies can work in one of two ways: they can either block the production of hormones or prevent their action on cancer cells. For example, some hormonal therapies work by blocking the action of estrogen or testosterone, which are hormones that can stimulate the growth of certain types of cancer cells.
Examples of hormonal agents used to treat cancer include:
* Aromatase inhibitors (such as letrozole, anastrozole, and exemestane), which block the production of estrogen in postmenopausal women
* Selective estrogen receptor modulators (such as tamoxifen and raloxifene), which block the action of estrogen on cancer cells
* Luteinizing hormone-releasing hormone agonists (such as leuprolide, goserelin, and triptorelin), which block the production of testosterone in men
* Antiandrogens (such as bicalutamide, flutamide, and enzalutamide), which block the action of testosterone on cancer cells
Hormonal therapies are often used in combination with other treatments, such as surgery or radiation therapy. They may be used to shrink tumors before surgery, to kill any remaining cancer cells after surgery, or to help control the spread of cancer that cannot be removed by surgery. Hormonal therapies can also be used to relieve symptoms and improve quality of life in people with advanced cancer.
It's important to note that hormonal therapies are not effective for all types of cancer. They are most commonly used to treat breast, prostate, and endometrial cancers, which are known to be sensitive to hormones. Hormonal therapies may also be used to treat other types of cancer in certain situations.
Like all medications, hormonal therapies can have side effects. These can vary depending on the specific drug and the individual person. Common side effects of hormonal therapies include hot flashes, fatigue, mood changes, and sexual dysfunction. Some hormonal therapies can also cause more serious side effects, such as an increased risk of osteoporosis or blood clots. It's important to discuss the potential risks and benefits of hormonal therapy with a healthcare provider before starting treatment.
Tamoxifen is a selective estrogen receptor modulator (SERM) medication that is primarily used in the treatment and prevention of breast cancer. It works by blocking the action of estrogen in the body, particularly in breast tissue. This can help to stop or slow the growth of hormone-sensitive tumors.
Tamoxifen has been approved by the U.S. Food and Drug Administration (FDA) for use in both men and women. It is often used as a part of adjuvant therapy, which is treatment given after surgery to reduce the risk of cancer recurrence. Tamoxifen may also be used to treat metastatic breast cancer that has spread to other parts of the body.
Common side effects of tamoxifen include hot flashes, vaginal discharge, and changes in mood or vision. Less commonly, tamoxifen can increase the risk of blood clots, stroke, and endometrial cancer (cancer of the lining of the uterus). However, for many women with breast cancer, the benefits of taking tamoxifen outweigh the risks.
It's important to note that while tamoxifen can be an effective treatment option for some types of breast cancer, it is not appropriate for all patients. A healthcare professional will consider a variety of factors when determining whether tamoxifen is the right choice for an individual patient.
Postmenopause is a stage in a woman's life that follows 12 months after her last menstrual period (menopause) has occurred. During this stage, the ovaries no longer release eggs and produce lower levels of estrogen and progesterone hormones. The reduced levels of these hormones can lead to various physical changes and symptoms, such as hot flashes, vaginal dryness, and mood changes. Postmenopause is also associated with an increased risk of certain health conditions, including osteoporosis and heart disease. It's important for women in postmenopause to maintain a healthy lifestyle, including regular exercise, a balanced diet, and routine medical check-ups to monitor their overall health and manage any potential risks.
Breast neoplasms refer to abnormal growths in the breast tissue that can be benign or malignant. Benign breast neoplasms are non-cancerous tumors or growths, while malignant breast neoplasms are cancerous tumors that can invade surrounding tissues and spread to other parts of the body.
Breast neoplasms can arise from different types of cells in the breast, including milk ducts, milk sacs (lobules), or connective tissue. The most common type of breast cancer is ductal carcinoma, which starts in the milk ducts and can spread to other parts of the breast and nearby structures.
Breast neoplasms are usually detected through screening methods such as mammography, ultrasound, or MRI, or through self-examination or clinical examination. Treatment options for breast neoplasms depend on several factors, including the type and stage of the tumor, the patient's age and overall health, and personal preferences. Treatment may include surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy.
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