Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial vaginosis (BV), candidiasis, and trichomoniasis account for more than 90% of vaginal infections. BV typically is associated with a decrease in commensal, protective lactobacilli and a proliferation of other flora. Mobiluncus is pathognomonic but found in only 20% of cases. Presence of 3 of 4 criteria indicates BV: a homogenous noninflammatory discharge (not many WBCs); pH >4.5; clue cells (bacteria attached to borders of epithelial cells, > 20 % of epithelial cells); and a positive whiff test. New intravaginal BV preparations cause less-adverse systemic effects than oral regimens. Trichomonas vaginalis, a protozoan, appears to be sexually transmitted and causes up to 25% of vaginitis cases. Diagnosis is made by observation of a foul, frothy discharge; pH >4.5 (present in 70% of cases); punctate cervical microhemorrhages (25% of cases); and motile trichomonads on wet mount (50%-75% of cases). Recommended treatment is a single 2g dose of oral metronidazole. Treatment failure is usually due to nontreatment of the male partner. Candidiasis typically presents as a thick, "curdled" white discharge or vulvar pruritus, with a hyperemic vagina and an erythematous and/or excoriated vulva. Vaginal pH is usually in the normal range of 3.8-4.2 in uncomplicated candidiasis. Microscopic examination of the discharge reveals hyphae or budding yeast in 50%-70% of cases. While the most common offender is Candida albicans, Candida tropicalis and Candida glabrata have become increasingly prevalent. Approximately 15% of C albicans organisms are resistant to clotrimazole and miconazole. Recurrent infections may be treated with fluconazole 150mg weekly for up to 12 consecutive weeks.
 ...
PMID:Practical Guide to Diagnosing and Treating Vaginitis. 974 76

This study examines the relationship between a history of induced abortion and current or previous sexually transmitted diseases (STDs) and other gynecologic symptoms. Study participants consisted of a cohort of women attending 2 family planning and 1 youth clinic; 192 were admitted with history of induced abortion and 804 women served as controls. A structured interview to obtain data on previous genital infections and gynecologic symptoms was conducted and gynecologic examination was performed. Various types of STDs and gynecologic symptoms were diagnosed including chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacterial vaginosis. The study found a high frequency of gynecologic symptoms in women with history of induced abortion such as abnormal vaginal discharges, pruritus, genital malodor, deep dyspareunia and urinary symptoms. Moreover, a history of gonorrhea, genital chlamydial infection, genital warts, and genital herpes were 1.5-5 times more common among women who experienced induced abortion. As a consequence of the 3-fold increase in the history of STDs, the study found a 4-fold increase of a history of pelvic inflammatory disease in women with induced abortion history. Considering these findings, women attending clinics for induced abortions could be a good target population for STD information programs and campaigns.
 ...
PMID:Sexually transmitted diseases and gynecologic symptoms and signs in women with a history of induced abortion. 1022 85

Vaginitis resulting from bacterial, fungal, or protozoal infections can be associated with altered vaginal discharge, odor, pruritus, vulvovaginal irritation, dysuria, or dyspareunia, depending on the type of infection. Bacterial vaginosis, which is primarily characterized by a malodorous discharge, is common in women with multiple sex partners and is caused by the overgrowth of several facultative and anaerobic bacterial species. Vulvovaginal candidiasis is characterized by pruritus and a cottage cheese-like discharge. Vaginal trichomoniasis, a sexually transmitted disease caused by an anaerobic protozoan parasite, is associated with a copious yellow or green, sometimes frothy, discharge. Differential diagnosis of these infections requires a thorough history, vulvovaginal examination, and simple laboratory tests, including microscopy of the vaginal discharge. The information obtained from this workup should enable an accurate diagnosis. Topical or oral metronidazole is the treatment of choice for bacterial vaginosis; terconazole, or other antifungals, for vulvovaginal candidiasis; and oral metronidazole for trichomoniasis.
 ...
PMID:Treating vaginitis. 1054 57

According to World Health Organization estimates, there are 333 million new cases of sexually transmitted diseases (STDs) each year. The total number of reproductive tract infections (RTIs) is even higher since these infections may have few visible symptoms, especially in women. Left untreated, however, RTIs can lead to infertility. Common symptoms include: unusually thick or foul-smelling vaginal or urethral discharge, genital sores, anal sores, genital itching, pain when urinating and during sexual intercourse, painful swelling in the lymph glands or groin, and lower abdominal pain. The open sores associated with STDs such as syphilis, chancroid, and genital herpes greatly increase the risk of HIV transmission, as may STDs such as gonorrhea that are associated with urethral or vaginal discharge. To facilitate the prompt diagnosis and treatment of RTIs, this article briefly describes the diagnosis and long-term effects of gonorrhea, syphilis, chancroid, chlamydia, pelvic inflammatory disease, genital herpes, genital warts, candida, and bacterial vaginosis.
 ...
PMID:Common infections. 1234 38

This randomised, double-blind, multicentric clinical study compared the efficacy and tolerability of the two vaginal antiseptics, 10 mg dequalinium chloride (CAS 522-51-0, Fluomycin N) and 200 mg povidone iodine (CAS 25655-41-8), in a parallel-group design. A total of 180 patients with vaginal infections of varying etiology participated in this study (bacterial vaginosis, fluor vaginalis, vulvo-vaginal candidiasis, trichomoniasis). Patients were randomly allocated to one of the two treatment groups and were treated once per day for 6 days. Control examinations took place 5 to 7 days after the end of treatment, and 3 to 4 weeks after the first control examination. The total symptoms score, a summary score for the clinical symptoms, discharge, burning, pruritus, redness of vulva/vagina, was defined as primary efficacy parameter. The treatments at the first control examination were compared in the full analysis set using the Wilcoxon-Mann-Whitney U-test, 2-sided, thereby proving equivalence of both treatments at the 5% level. Both treatments strongly improved the symptoms of vaginal infections both on short-term and long-term follow-up. Descriptive analysis of the secondary parameters, vaginal pH, degree of purity of the vaginal flora, and number of lactobacilli in the wet mounts, supported the comparable efficacy of both therapies to restore the vaginal milieu. Analysis of the diagnostic subgroups indicated that irrespective of the diagnosis, both treatments improved the efficacy criteria as observed for the entire population. The global assessment of the therapeutic efficacy by investigators and patients supported the results of the efficacy analysis with good to very good ratings in 70-90% of the cases. A good tolerability of both preparations was observed in this study with a low number of adverse events in the test group (5.8%).
 ...
PMID:Local treatment of vaginal infections of varying etiology with dequalinium chloride or povidone iodine. A randomised, double-blind, active-controlled, multicentric clinical study. 1240 87

Vaginal infections, during reproductive period are frequent and although not life treating, they can affect their normal functions. They can also affect women's fertility as well as the course of pregnancy. The outcome of pregnancy can be endangered due to the possibility of infection of newborn while passing trough birth canal of the infected mother. As statistically shown, bacterial vaginosis is considerably more often found with the patients having precancerous changes on cervix, or diagnosed cancer of cervix, comparing with women with healthy cervix. It can also cause the appearance of postoperative pelvic cellulitis after hysterectomy. On the other side, the presence of S. agalactiae in vaginal secretion may cause very serious and lethal infections of the newborn such as meningitis, pneumonia and sepsis. As for protozoa T. vaginalis it has been shown that it could cause reduced fertility ability and that during pregnancy it could damage fetal membranes and bring to its premature rupture and premature birth. There is also increased risk of cervix cancer. During reproductive period of women especially if risk factors are existing such as hormone therapy, diabetes mellitus type 1 and applications of wide range antibiotics, vaginal fungal infections caused by Candida can frequently appear. These infection apart from the discomfort like itch and affluent secretion they can also mean diagnostic and therapeutical problem. Regular microbiological test of women are highly recommended during reproductive period as standard for bacterial vaginosis, fungal and trichomonas infections. If those results appear negative, further microbiological tests are necessary. Such tests which are more elaborate, more timely and more expensive are referring to tests on chlamydia, microplasma and some viruses that can also be the cause of vaginal secretion disbalance in women during reproductive period.
 ...
PMID:[Importance of microbiologic examination of vaginal secretions in the reproductive period]. 1522 66

Common infectious forms of vaginitis include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Vaginitis also can occur because of atrophic changes. Bacterial vaginosis is caused by proliferation of Gardnerella vaginalis, Mycoplasma hominis, and anaerobes. The diagnosis is based primarily on the Amsel criteria (milky discharge, pH greater than 4.5, positive whiff test, clue cells in a wet-mount preparation). The standard treatment is oral metronidazole in a dosage of 500 mg twice daily for seven days. Vulvovaginal candidiasis can be difficult to diagnose because characteristic signs and symptoms (thick, white discharge, dysuria, vulvovaginal pruritus and swelling) are not specific for the infection. Diagnosis should rely on microscopic examination of a sample from the lateral vaginal wall (10 to 20 percent potassium hydroxide preparation). Cultures are helpful in women with recurrent or complicated vulvovaginal candidiasis, because species other than Candida albicans (e.g., Candida glabrata, Candida tropicalis) may be present. Topical azole and oral fluconazole are equally efficacious in the management of uncomplicated vulvovaginal candidiasis, but a more extensive regimen may be required for complicated infections. Trichomoniasis may cause a foul-smelling, frothy discharge and, in most affected women, vaginal inflammatory changes. Culture and DNA probe testing are useful in diagnosing the infection; examinations of wet-mount preparations have a high false-negative rate. The standard treatment for trichomoniasis is a single 2-g oral dose of metronidazole. Atrophic vaginitis results from estrogen deficiency. Treatment with topical estrogen is effective.
 ...
PMID:Management of vaginitis. 1560 61

The objective of this study was to estimate prevalence and risk factors of reproductive tract infections (RTIs) among women in Haiphong, Vietnam. In October 1998, 197 women aged 18-49 were recruited into a community-based, cross-sectional study. Of the 197 women, 95 (49.5%) were diagnosed with > or = 1 endogenous reproductive tract infections (RTI) and 7 (3.6%) with > or = 1 sexually transmitted disease (STD). In three separate multivariate analyses, age <30 years (OR = 2.5; 95% CI = 1.1, 5.8), residential mobility (OR = 2.3; 95% CI = 1.1, 4.9), self reported genital itch/discharge (OR = 2.1; 95% CI = 1.1, 4.1), and reported belief that RTI symptoms were shameful (OR = 2.5; 95% CI = 1.2, 5.0) were associated with bacterial vaginosis (BV); low education was associated with candida (OR = 2.6; 95% CI = 1.0, 6.7); > or = 1 abortion was associated with > or = 1 STD (OR = 9.2; 95% CI = 1.1, 427). The prevalence of STDs was low but the prevalence of endogenous infections was high. Abortion is a proxy for other factors, such as high risk sexual behavior in either the woman or her partner. Given the low prevalence STD in this area of Vietnam, clinical case management of women presenting with RTI symptoms should focus on treatment of the more common endogenous infections, candida and BV.
 ...
PMID:Prevalence and risk factors for reproductive tract infections among women in rural Vietnam. 1677 Dec 33

Trichomoniasis is a common but less well known sexually transmitted infection affecting men and women. In men it is often asymptomatic and goes undetected. In women it can produce a profuse, frothy, unpleasant-smelling vaginal discharge with pruritus and soreness which is sometimes confused with vulvo-vaginal candidiasis (thrush) and bacterial vaginosis. Women often mistakenly treat themselves for thrush with no result. Diagnosis is by laboratory culture and treatment is with metronidazole. Partner notification and treatment should be undertaken. Trichomoniasis often coexists with chlamydia and gonorrhoea. It can have consequences for reproduction, including low birth weight and preterm labour, and has been found to be a co-factor in the transmission of HIV. It is therefore mandatory to ensure prompt and appropriate treatment for all patients diagnosed with trichomoniasis.
 ...
PMID:Dealing with trichomoniasis. 1713 77

Fenticonazole is an imidazole derivative with a broad spectrum of antimycotic activity against dermatophytes and yeasts in in vitro and clinical studies. Fenticonazole exerts its unique antimycotic mechanism of action in the following three ways: (i) inhibition of the secretion of protease acid by Candida albicans; (ii) damage to the cytoplasmic membrane; and (iii) by blocking cytochrome oxidases and peroxidises. Fenticonazole has also been shown to exhibit antibacterial action, with a spectrum of activity that includes bacteria commonly associated with superinfected fungal skin and vaginal infections, and antiparasitic action against the protozoan Trichomonas vaginalis. Therefore, fenticonazole may be an ideal topical alternative to multi-agent treatment of mixed infections involving mycotic, bacterial, dermatophyte and/or Trichomonas spp.Open-label clinical studies show that fenticonazole, in different pharmaceutical preparations administered once or twice daily, is effective in the treatment of superficial mycoses of the skin. In particular, fenticonazole is very effective (often with 100% of patients achieving a negative mycological assay) in pityriasis versicolor and candidiasis. For example, a large (n = 760) study showed fenticonazole 2% cream, spray or powder to be associated with a mycological response in 100% of patients with pityriasis versicolor, 96.3% of those with tinea infections and 95.2% of patients with Candida infections. Comparative clinical studies show fenticonazole once or twice daily to be at least as effective as six different topical antimycotics (miconazole, clotrimazole, econazole, bifonazole, naftifine and cyclopyroxolamine) in the treatment of superficial mycoses of the skin. Intravaginal administration of fenticonazole is associated with a high rate of microbiological efficacy in patients with vaginal candidiasis, trichomoniasis, mixed infection and bacterial vaginosis. Intravaginal fenticonazole is at least as effective as clotrimazole and shows similar efficacy to miconazole in patients with vaginal candidiasis. Fenticonazole has a rapid onset of action and clinical efficacy is generally observed within days of commencing treatment.Topical fenticonazole is very well tolerated; adverse events are generally mild to moderate in severity and transient. The most frequent adverse events are burning sensation/cutaneous irritation and itch when applied to the skin. In a large, open-label study in superficial mycoses of the skin, the incidence of adverse events was <5% and these were rarely responsible for treatment discontinuation. Burning sensation is the most common adverse event seen with fenticonazole when administered intravaginally. However, this symptom of vaginal fungal infection was often present in patients prior to drug administration.Given the rising incidence of superficial fungal, and possibly mixed, infections, topical fenticonazole represents an important part of the topical antimycotic armamentarium.
 ...
PMID:Topical fenticonazole in dermatology and gynaecology: current role in therapy. 1884 6


<< Previous 1 2 3 4 5 Next >>