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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trichomonas vaginalis is a flagellate protozoon which in women commonly causes vaginal itching; burning, and a frothy, offensive and seropurulent yellowish discharge. Incidence of infection in women varies from 13 to 60%, and is highest during pregnancy because of excess estrogens and in women with poor hygiene or with vaginitis. In men, the incidence ranges from 9 to 37% of persons with urethral discharge. This study presents the results of the use of a single dose treatment of Trichomonas vaginitis with 2.0 gm Tinidazole. 350 women with vaginal discharge from the Gynecology Dept. of Cairo University hospitals were studied. Microscopic study of the discharge revealed T. vaginalis in 103 cases (aged 17 to 48 years). Majority of the clinical complaints (pruritus vulvae; soreness; sense of fullness in vagina and dysuria) disappeared in all cases after administration of 2.0 gm single dose of Tinidazole. Discharge; dyspareunia and soreness or pain at vulval interoitus disappeared in about 2/3 of cases; improved in about 1/4 and persisted in less than 8% (failure in these cases was attributed to other causes such as cervical erosion; bacterial infections; hormonal or other pathologic lesions in the internal genitalia). Mild gastrointestinal reaction (nausea and vomiting) were observed in 5 cases and transient urticaria in 1 case.
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PMID:Treatment of Trichomonas vaginitis with a single dose of tinidazole. 123 91

A study was carried out on 200 patients divided in two groups of 100, labeled 1 and 2. They underwent vaginal secretion tests by the direct method in order to assess its appropriateness for Gardnerella vaginalis presumptive diagnosis. This study was related with patients' symptoms, such as leukorrhea and fetidity prevailing in Group 1 and lower abdomen pain prevailing in Group 2, as well as the proportions of germs isolated and the association with this symptom for defining the microorganism role in the occurrence of so-called unspecific vaginitis; Group 1 had 100% of positive plates and Group 2 had 55%, who were given adequate treatment for the couple with further confirmation of the results which were effective in 96.7% of the cases. No relation could be seen between IUD and the presence of germ, since it is likely that its existence was not taken into account on inserting IUD.
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PMID:[The use of the direct method for the diagnosis of Gardnerella vaginalis vaginitis]. 129 10

The Norplant System consists of 6 capsules each containing 36 mg of crystal line levonorgestrel (LNG), for a total dose of 216 mg LNG. The capsules are inserted subdermally in the mid-upper arm, and LNG diffuses continuously through the capsule walls for 5 years. In the United States the Norplant System was approved in December 1990. The initial rate of hormone delivery is about 85 mcg/day, then decreases over the next 9 months to 5 mcg/day, and over the ensuing 9 months to 35 mcg/day. Thereafter, the diffusion rate levels off for the next 3.5 years, averaging around 30-35 mcg/day. Removal results in a drop in the plasma concentration of levonorgestrel to below contraceptive levels within 24 hours and below the detectable limit of .1 pg/ml at 96 hours. Preliminarily data from 402 users over 5 years show improvements of Norplant produced better efficacy in all weight classes and a lowered cumulative rate of 1.1 pregnancies of 100 users. The pregnancy rate for the first year of use is 02., better than for oral contraceptives. Side effects include headache, nervousness, nausea, dizziness, dermatitis, acne, change of appetite, breast tenderness, minimal weight gain, some change in hair distribution, and adnexal enlargement. Adverse reactions include breast discharge, possible cervicitis, musculoskeletal pain, abdominal discomfort, leukorrhea, and vaginitis. More than the usual number of bleeding days occurred in slightly more than one fourth of the patients, prolonged bleeding in 27.6% spotting in 17.1% and amenorrhea in 9.4% of patients. Hyperlipidemic users should be observed for possible low-density lipoprotein elevations. The cumulative discontinuation rate for pregnancy was 3.9 per 100 users; for bleeding irregularities the rate was 25.1 per 100 users, and for other medical results it was about 22.4 per 100 users. Personal reasons for discontinuation accounted for 38.7 per 100 users, equivalent to a cumulative continuation rate of about 30 per 100 users over the 5-year duration.
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PMID:The NORPLANT system of contraception. 168 4

Urinary tract infections are among the most common bacterial infections. To provide appropriate and cost-effective treatment, physicians need to stratify patients with urinary complaints into uncomplicated or complicated categories. This can be accomplished by the history, presenting symptoms, risk factors, and physical examination. Complicated urinary tract infections occur in patients with a history of recurrent infections, signs or symptoms of upper tract disease, or coexisting conditions such as pregnancy, immunosuppression, or structural anomalies of the urinary tract. Uncomplicated urinary tract infections occur in otherwise healthy women who have a history of lower tract symptoms of short duration. Symptoms of urinary tract infection include some combination of dysuria, frequency, urgency, hematuria, and suprapubic pain. An uncomplicated urinary tract infection is not accompanied by fever or flank pain. The microbiology of uncomplicated urinary tract infection is predictable, with Escherichia coli and other Enterobacteriaceae, Staphylococcus saprophyticus, and Enterococcus causing more than 90% of urinary tract infections. A history, brief physical examination, and urinalysis are all that is necessary to diagnose a urinary tract infection. Some of the specialized dipsticks and rapid screens are as accurate as microscopic examination in detecting urine white cells. A presumptive diagnosis can be made when a patient has clinical symptoms and some combination of pyuria, hematuria, or bacteriuria. Urine cultures are unnecessary in uncomplicated urinary tract infections and add substantially to the cost of therapy. Pitfalls in the diagnosis include other entities causing dysuria, such as vaginitis, vulvar lesions, physical or chemical irritants, and sexually transmitted diseases. Appropriate therapy requires selection of a drug and determination of the length of treatment. A minor infection should be treated with easy, safe, cost-effective therapy. For urinary tract infections, there are too many antibiotic options, ranging from a single, parenteral dose to a 14-day course of oral medication. Early optimism about single-dose oral therapy has been replaced by evidence suggesting that 3 days of therapy is probably the best. This will eradicate simple urinary tract infections in virtually all patients and decrease the incidence of relapse, whereas patients who are treatment failures usually have occult upper tract infection. Drug choices for short-course therapy include representatives from the penicillin, sulfa, and quinolone families. Selection of a specific drug requires consideration of costs, allergies, side effects, and spectrum of activity. A knowledge of local microbial sensitivity profiles and individual patient tolerance is helpful in guiding the clinician to the appropriate therapeutic regimen.
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PMID:New directions in the diagnosis and therapy of urinary tract infections. 203 19

Estimates were carried out on the clinical and bacteriological efficacy of an intramuscular combination of sulbactam/ampicillin, together with an assessment of its tolerability and safety in the treatment of gynaecological and obstetric infections. A total of 30 women with pelvic inflammatory disease, wound infections, vaginitis and puerperal sepsis received an intramuscular combination of sulbactam/ampicillin in a total daily dose of 1.5 g for between 3 and 7 days. Clinical cure and improvement were achieved in 27 (90%) cases but there was no response in three (10%) cases. No side-effects were seen in 29 (97%) cases, whereas tolerable local injection site pain was reported in one case. The safety of the sulbactam/ampicillin antibiotic combination was evident in all the cases studied, as there was no significant difference between the means of laboratory tests before and after therapy of blood and renal measures.
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PMID:Intramuscular sulbactam/ampicillin combination therapy in gynaecological and obstetric bacterial infections. 206 Jun 93

Data concerning 604 girls up 18 year old were analysed. On the basis clinical symptoms and results of culture of various biological materials on selected media--the monofocal Trichomonas infection concerning the most often vulva and vagina, rarely urethra or other regions of urinary organ as well as the multifocal Trichomonas infection, particularly complicated by mycosis were proved. It was found the convergence statistically significant (P less than or equal to 0.5) of the invasion of T. vaginalis with some symptoms of inflammation of genital and urinary organs; the highest values of Pearson-Bravais coefficient was obtained in Trichomonas infection of genital organs and vaginal discharges, pain of vulva and vagina, the picture of colpitis maculosa, but in the multifocal one also with itching and pain in urethra and dysuria. T. vaginalis without symptoms occurred very seldom in the girls.
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PMID:[Analysis of the relations between selected symptoms of inflammation of the genital and urinary organs and invasion of Trichomonas vaginalis]. 213 96

The traditional criterion of 10(5) colony-forming units (CFU) per milliliter of urine to diagnose urinary tract infection was based on studies of pregnant and nonpregnant women with asymptomatic bacteriuria or acute pyelonephritis. Recent studies of symptomatic women revealed that urine cultures in approximately one third of those with confirmed urinary tract infections grew only 10(2) to 10(4) CFU/mL. The major causes of acute dysuria among such women are urinary tract infection, sexually transmitted disease, and vaginitis. In most instances, it is possible to make the diagnosis based on clinical features. The major features of urinary tract infection are internal dysuria; frequency, urgency, and voiding of small volumes; abrupt onset; suprapubic pain; presence of pyuria. Presence of hematuria which occurs in about 50 percent of patients strongly suggests bacterial cystitis. Three to seven days of empiric antimicrobial therapy is indicated for these patients, with selection of a first-line antimicrobial agent that offers efficacy against Escherichia coli or Staphylococcus saprophyticus; reasonable cost; few side effects. Ampicillin is not recommended. Indications for culture include uncertain clinical features; history of previous infection within the past three weeks; duration of symptoms of more than seven days; recent hospitalization or catheterization; pregnancy; diabetes. To maximize the sensitivity and specificity of the urine culture in acutely symptomatic women, it is necessary to request the laboratory to report 10(2) to 10(4) CFU/mL.
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PMID:Protocol for diagnosis of urinary tract infection: reconsidering the criterion for significant bacteriuria. 304 81

Data were collected on 750 patients over a 6-month period at a Troop Medical Clinic in the US in an effort to identify gynecological problems of soldiers and to gain insight into the most effective ways to handle the needs of female soldiers. All female soldiers belonging to the Nurse Practitioner Gynecological Satellite Clinic at Ft. Campbell, Kentucky, who had a gynecological need were seen by the nurse practitioner. Previously, most had been referred to the gynecological clinic in the hospital. The data included age, current contraception, chief complaint, and diagnosis. 72% of the patients in garrison and in the field were under age 25; 47% of all clients used no contraception. All women using no contraceptive measures were queried as to their reasons for non-use. Very few were sexually active; very few were actively seeking pregnancy. Most gave vague reasons for their non-use of contraception. Routine pelvic examinations accounted for 34% of the gynecological visits to the Troop Medical Clinic (TMC). A diagnosis of no pathology was obtained in 43% of the TMC visits and 5% of the field visits. The leading gynecological pathology was vaginitis (including sexually transmitted diseases), which was diagnosed in 30% of the TMC visits and 36% of the field visits. Urinary tract infection was another frequent diagnosis, especially in the field. Oral contraceptive (OC) side effects, functional pain, and pregnancy were other common diagnoses. Diagnoses requiring further workup by a physician represented only 9% of the TMC visits and 19% of the field visits. Physician referrals included suspected diagnoses such as pelvic inflammatory disease, ectopic pregnancy, and ovarian cysts -- all problems that are not within the realm of nurse practitioner management. The data suggest that most gynecological conditions are manageable in the TMC or in the field given that the few necessary gynecological supplies and pharmaceuticals are made available and the health care provider is familiar with gynecological management.
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PMID:Chief complaints, contraceptive use and diagnoses of female soldiers in ambulatory GYN clinic. 310 20

Chronic vaginitis is the most common vaginal disorder. Dogs with vaginitis show no signs of systemic illness but often lick at the vulva and have purulent or hemorrhagic vaginal discharges. Vaginitis is most commonly secondary to a noninfectious inciting factor such as congenital vaginal anomalies, clitoral hypertrophy, foreign bodies, trauma to the vaginal mucosa, or vaginal tumors. Inspection of the caudal vagina and vestibule both visually and digitally will often reveal the source of vaginal irritation. Vaginal cytology is used to establish the stage of the estrous cycle as well as distinguish uterine from vaginal sources of discharge. Vaginal cultures are used to establish the predominant offending organism associated with vaginal discharges and may be used as a guide for selection of a therapeutic agent. Vaginitis is best managed by removing the inciting cause and treating the area locally with antiseptic douches. Congenital malformations at the vestibulovaginal or vestibulovulvar junction may prevent normal intromission. Affected bitches may be reluctant to breed naturally because of pain. Such defects are detected best by digital examination. Congenital vaginal defects may be corrected by digital or surgical means. Prolapse of tissue through the lips of the vulva may be caused by clitoral hypertrophy, vaginal hyperplasia, or vaginal tumors. Enlargement of clitoral tissue is the result of endogenous or exogenous sources of androgens. Treatment of this condition includes removal of the androgen source and/or surgical removal of clitoral tissue. Vaginal hyperplasia is detected during proestrus or estrus of young bitches. Hyperplastic tissue will regress during diestrus. Tissue that is excessively traumatized and/or prolapse of the entire vaginal circumference may be removed surgically. Ovariohysterectomy may be used to prevent recurrence. Vaginal tumors are detected most often in older intact bitches. Such tumors are generally of smooth muscle or fibrous tissue origin and benign. Surgical excision of the tumor combined with ovariohysterectomy is usually curative.
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PMID:Vaginal disorders. 348 58

The antiinflammatory effect of benzydamine compared with a placebo in a randomized study is reported in the treatment of trichomonas- and candida-induced vaginitis. The reduction of inflammation and its clinical manifestations was determined and statistically analysed, demonstrating that benzydamine has a definite effect on the early reduction of functional pain and symptoms.
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PMID:Clinical evaluation of benzydamine for treatment of vaginitis: results of a randomized study with emphasis on functional symptoms. 361 May 13


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