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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Candida parapsilosis was isolated from the vaginas of several nonpregnant, nondiabetic, mostly premenopausal outpatients who presented the characteristic signs and symptoms of a frank vulvovaginal candidiasis (heavy discharge with cottage cheese appearance and intense itching, with or without vulvar erythema and dyspareunia). All isolates conformed morphologically, biochemically, and serologically to the standard description of the species. They showed high acid proteinase-secretory activity in vitro and were appreciably pathogenic for cyclophosphamide-immunodepressed mice. Some isolates were also tested for their vaginopathic potential in ovariectomized rats under estradiol administration. In all cases, the rat vagina was colonized by C. parapsilosis to an extent and duration not different from those caused by a vaginopathic isolate of Candida albicans. Periodic acid-Schiff-stained vaginal smears taken at intervals during rat experimental infection showed C. parapsilosis yeasts adhering to exfoliated epithelial cells of rat vagina. Overall, these results emphasize the proteolytic and pathogenic potential of C. parapsilosis and suggest that this fungus may be an agent of clinical vaginitis.
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PMID:Isolation, acid proteinase secretion, and experimental pathogenicity of Candida parapsilosis from outpatients with vaginitis. 268 Dec 58

Trichomonas vaginalis was detected by culture or wet-mount examination in 118 (15%) of 779 randomly selected women attending a sexually transmitted disease clinic. Vaginal trichomoniasis was significantly associated with symptoms of yellow discharge, abnormal vaginal odor, and vulvar itching and with signs of colpitis macularis ("strawberry cervix"), purulent vaginal discharge, and vaginal and vulvar erythema. A logistic regression model was used to adjust for coinfections, as well as for demographic, behavioral, and other possible confounding variables. Trichomonas vaginalis remained significantly associated with symptoms of yellow vaginal discharge (odds ratio [OR] = 2.4) and vulvar itching (OR = 3.0) and with signs of colpitis macularis (OR = 241), purulent vaginal discharge (OR = 8.0), vulvar erythema (OR = 2.5), and vaginal erythema (OR = 4.3). The sensitivity of symptoms and signs associated with trichomoniasis was relatively low. Nevertheless, clinical manifestations can be used to identify those patients for whom a wet-mount examination would likely have high yield. Careful clinical examination and selective use of wet-mount examination together with wider use of more sensitive tests for subclinical infection, such as culture or direct immunofluorescent staining of vaginal fluid, could lead to improved detection and control of this infection.
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PMID:Clinical manifestations of vaginal trichomoniasis. 278 46

Approximately 90 per cent of all the vaginitides are caused by bacterial vaginosis, candidiasis, or trichomoniasis. Bacterial vaginosis is the most frequent, causing approximately 50 per cent of vaginal infections. As described by Amsel and colleagues, three of four findings indicate bacterial vaginosis: amine odor, pH greater than 4.5, clue cells, and a thin homogeneous discharge. Because G. vaginalis colonizes the vagina, treatment should not be instituted in an asymptomatic woman on the basis of a positive culture. For symptomatic patients, oral metronidazole 500 mg twice daily for 7 days is the treatment currently recommended. Vulvovaginal pruritus should be equated with candidiasis until proven otherwise. Mycelia or spores on 10 per cent KOH preparation are diagnostic of candidiasis in the presence of symptoms. Imidazole creams or suppositories are the treatment of choice. Trichomoniasis is characterized by malodor and mild pruritus. Demonstration of trichomonads on saline preparation or a positive culture provides the diagnosis. A single 2 gm dose of oral metronidazole is the initial treatment. Recurrences should provoke inquiry regarding predisposing factors and investigation of sexual partners. Vaginitis can recur, but if approached properly, these recurrences can be minimized, allowing the patient to proceed with daily life in comfort.
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PMID:Vaginitis: a common malady. 305 61

Of 277 non-pregnant women, 67 (24%) harboured Candida albicans in the genital tract. Of 56 women yielding C albicans who had no other infection diagnosed, 14 were symptomless and 10 had no clinical signs of vulval redness, vaginitis, or discharge. Symptoms and signs tended to be more severe in women with higher yeast counts. Of 22 women with moderate or severe symptoms (pruritus with or without discharge) and signs, 15 had yeast counts of more than 10(3) colony forming units (cfu)/ml, whereas six of nine women with no symptoms or signs had counts of fewer than 10(3) cfu/ml.
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PMID:Vaginal candidosis: relation between yeast counts and symptoms and clinical signs in non-pregnant women. 306 Apr 23

The effects of Hachimijiogan, a Chinese medicine, were studied in patients with senile colpitis. Eighty-eight postmenopausal patients, aged 42-76 years, were treated. Hachimijiogan was effective in 65 of 66 cases with abnormal discharge, 10 of 11 with pruritus vaginae and 60 of 62 with subepithelial hemorrhage. Overall more than ninety per cent of the patients responded well. The serum FSH, E1 and E2 levels were not statistically changed in this treatment. The vaginal Pap smear showed a significant decrease in parabasal type cells and an increase in intermediate type cells (p less than 0.01). Radioimmunoassay of E1, E2, E3, testosterone, FSH, LH and prolactin in Hachimijiogan were below the levels of sensitivity. These data suggest that Hachimijiogan is effective for senile colpitis and patients with senile colpitis associated with estrogen dependent tumors could be safely treated by Hachimijiogan.
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PMID:[Hachimijiogan having no estrogenic activity is effective for senile colpitis]. 312 78

We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively. Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients. Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings. C. trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05). Isolation of C. albicans was significantly associated with vulvar pruritus (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001). G. vaginalis and M. hominis are significantly associated with bacterial vaginosis (P less than 0.001). This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).
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PMID:Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology. 313 8

Among 106 women harbouring yeasts in the vagina and with other causes of genital pathology excluded, there was a statistically significant association between numbers of yeasts recovered semi-quantitatively from vaginal swabs and symptoms of pruritus and signs of abnormal vaginal discharge but no association between yeast numbers and other individual symptoms or signs of vaginal candidosis, including patients' own subjective assessment of abnormal vaginal discharge. The presence of yeasts detectable by direct microscopic examination was statistically associated with pruritus, discharge and vaginitis. There was no relationship between numbers of vaginal yeasts and histories of antibiotic or oral contraceptive usage or the stage of the menstrual cycle. Distributions of Candida species and Candida albicans biotypes were not statistically related to any symptoms, signs or other factors. The results of this study suggest that vaginal pathology caused by Candida species may be related to the quantity of the fungus in the vagina and that only pruritus and objectively assessed vaginal discharge are firm clinical indicators of Candida infection.
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PMID:Candida concentrations in the vagina and their association with signs and symptoms of vaginal candidosis. 323 47

A review of the new concepts of the anatomy of the anal sphincter mechanism and the physiology of defecation is presented. The external sphincter is a triple-loop system; each loop can function as a separate sphincter through voluntary inhibition action and mechanical compression. Stress defecation resulting from internal sphincter damage is described. A new technique for repair of rectal incontinence is presented, which depends on inducing continence not only by mechanical compression, but also by voluntary inhibition. The mechanism of defecation and rectal continence is described and four types of incontinence presented. Also, the mechanism of both the levator dysfunction syndrome and prolapse is demonstrated and a technique of repair is presented. The study defines two types of rectal anomalies; suprahiatal and infrahiatal. The role of the embryonic anorectal sinus, anorectal band, and epithelial debris in the genesis of perirectal suppuration, chronic anal fissure, pruritus ani, and hemorrhoids is described. The communicating veins, identified between the hemorrhoidal and vesical plexuses, offer an explanation for the vague pathologic aspects of recurrent bacteriuria, urethral discharge, cervicitis, and vaginitis, and provide a proper line for their treatment. They also serve to perform a new radiographic technique--anal cystography--and to administer drugs, including chemotherapeutics, in the treatment of pelvic malignancies.
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PMID:A concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. 331 51

The role of the man in the etiology of recurrent vaginitis was examined in three women who reported an association between coitus and the initiation of clinical symptoms. The patients' disorders consisted of vaginal pruritus, burning, a white discharge, and painful coitus. Vaginal pH in each case was 4.5. Microscopic examination of wet mounts of vaginal secretion had no clue cells and no organisms other than lactobacillus. One culture was positive for Candida albicans; however, successful treatment of the C. albicans vaginitis did not eliminate the patient's symptoms. Semen samples from the patients' partners were negative for C. albicans. One of the seminal fluids had highly elevated concentrations of total IgE. The other two semen samples contained IgE antibodies that were reactive with a particulate fraction of vaginal fluids obtained from their wives. In contrast, vaginal fluids from the patients were all negative for IgE antibodies to their partner's semen. Use of a condom during coitus ended the recurring cycles of vaginitis in all three women. Vaginitis may be induced by an allergic reaction initiated by the transfer from men to women during coitus of IgE antibodies reactive either to antigens of the female genital tract or components of semen. Men allergic to female vaginal secretions, to vaginal microbes or their products, or to semen represent a previously unrecognized noninfectious vector for this disorder.
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PMID:Recurrent vaginitis as a result of sexual transmission of IgE antibodies. 251 24

The symptoms, signs, and laboratory findings for 69 women who were seen at a sexually transmitted disease (STD) clinic and who had acute urinary tract infection (UTI) were compared with those for women who had vaginitis, gonorrhea, or chlamydial infection. Escherichia coli and Staphylococcus saprophyticus were the two most common causes of acute cystitis in this population and accounted for 62 (90%) of 69 infections. Forty-three percent of the women had positive tests for antibody-coated bacteria (ACB), an observation implying renal infection although symptoms of upper tract infection were infrequent. Frequency, urgency, dysuria, and suprapubic tenderness were significantly associated with cystitis, whereas vaginal discharge and vulvar itching were associated with vaginitis. There was, however, considerable overlap in symptoms among the four groups of women, and their accurate differentiation required objective information based upon pelvic examination, examination of vaginal fluid, and urinalysis. In the absence of vaginitis on wet mount and mucopurulent cervicitis on examination, pyuria, as determined by examination of centrifuged urine, had an 88% sensitivity, 76% specificity, 61% positive predictive value, and 93% negative predictive value for acute UTI. Because of the high prevalence of positive ACB tests and the possibility that infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae may be mistaken for cystitis, we prefer a five- to seven-day course of antibiotics over single-dose therapy for treatment of patients with possible UTI in the setting of an STD clinic.
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PMID:Urinary tract infection among women attending a clinic for sexually transmitted diseases. 654 11


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