Symptoms associated with vaginal colonization with yeast

We correlated vulvovaginal symptoms with vaginal cultures for yeast in healthy female college students. Yeasts were isolated from 42 (29.2%) of 144 women. Only four (22%) of 18 women with positive fungal cultures had fungal elements visualized microscopically in vaginal material suspended in 10% potassium hydroxide (potassium hydroxide wet preparations). Symptoms, mainly vulvovaginal itching and irritation, were reported by 28 (67%) of 42 women whose cultures contained yeast and by 22 (22%) of 102 women who were not colonized by yeast (p less than 0.01). We conclude that vaginal colonization by yeasts is commonly associated with vulvovaginal symptoms, often in the absence of positive potassium hydroxide wet preparation results. These data suggest that vaginal specimens from women who have vulvovaginal symptoms and negative potassium hydroxide wet preparation results should be cultured for fungi before the diagnosis of fungal vulvovaginitis is excluded.     

Immune function in patients with ovarian carcinoma treated with irradiation or with cytostatics

The immunocompetence of 25 patients with ovarian cancer was followed up during and after radiation or chemotherapy, by using the number of lymphocytes, E-rosette-forming cells, and mitogen responses as parameters. In comparison with chemotherapy, the irradiation caused a profound and permanent immunosuppression. In patients treated with chemotherapy, the number of E-rosette-forming cells and the mitogen responses were fewer in the patients who developed recurrence or dissemination.     

Magnesium intoxication in women with preeclampsia with severe features treated with magnesium sulfate

ABSTRACT

Objective

To evaluate the maternal-neonatal outcome in magnesium (Mg)-intoxicated women with preeclampsia with severe features (PESF) treated with magnesium sulfate (MgSO₄).     

Factors associated with postpartum hemorrhage with vaginal birth

A case-control study was performed to study risk factors for postpartum hemorrhage. Cases of hemorrhage were defined by a hematocrit decrease of 10 points or more between admission and post-delivery or by the need for red-cell transfusion. Patients with antenatal bleeding were excluded. Among 9598 vaginal deliveries, postpartum hemorrhage occurred in 374 cases (3.9%). Three controls were matched to each case and multiple logistic regression was used to control for covariance among predictor variables. Factors having a significant association with hemorrhage were prolonged third stage of labor (adjusted odds ratio 7.56), preeclampsia (odds ratio 5.02), mediolateral episiotomy (4.67), previous postpartum hemorrhage (3.55), twins (3.31), arrest of descent (2.91), soft-tissue lacerations (2.05), augmented labor (1.66), forceps or vacuum delivery (1.66), Asian (1.73) or Hispanic (1.66) ethnicity, midline episiotomy (1.58), and nulliparity (1.45). These data may help predict postpartum hemorrhage and may be useful in counseling patients about the advisability of home delivery, intravenous access in labor, or autologous blood donation.     

重组人干扰素α-2b凝胶治疗慢性宫颈炎疗效观察

目的探讨重组人干扰素α-2b凝胶(商品名:尤靖安)治疗慢性宫颈炎的临床疗效。方法采用多中心、随机双盲、平行安慰剂对照的临床试验方法,选择2004-09-20-2005-09-10由6个试验中心共录入250例慢性宫颈炎患者,随机分为两组。治疗组:125例,采用尤靖安治疗;对照组:125例,采用凝胶基质治疗。隔日用药1次,10次为1疗程。于治疗后连续3次月经干净后的第3～7天进行疗效评价。结果纳入疗效分析240例(治疗组120例,对照组120例);通过统计分析,治疗组和对照组各时间点宫颈糜烂(现已改称宫颈柱状上皮异位)面积的减小值绝对值、相对于基线的变化百分率(%)间统计学差异有显著性意义(P=0·001);人乳头瘤病毒(HPV)阳性患者各时间点糜烂面积相对于基线的变化的绝对值和好转百分率差异有显著性意义(P<0·05),尤靖安组总有效率为84·87%,明显高于对照组的62·07%(P<0·05)。结论重组人干扰素α-2b凝胶治疗慢性宫颈炎疗效肯定,耐受性好,安全性高。     

Immature teratoma with gliomatosis peritonei associated with pregnancy

Immature teratoma is a malignant form of teratoma that contains immature structures resembling those of the embryo. It is rare and accounts for less than 1% of all ovarian cancers. It occurs most frequently in young women but it is very rarely reported in association with pregnancy.     

Priapus is Happier with Venus than with Bacchus

IntroductionThe relationship between alcohol consumption and erectile function is still not completely clarified.AimAims of the present study are to explore a number of biological and clinical correlates of alcohol consumption in a sample of men consulting for sexual dysfunction, and to verify possible associations with the incidence of major adverse cardiovascular events (MACEs).MethodsA consecutive series of 1956 (mean age 55 ± 11.9 years old) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of the previous sample (N = 1687) was enrolled in a longitudinal study.Main Outcome MeasuresDifferent clinical, biochemical, instrumental (penile Doppler ultrasound [PCDU]), and intrapsychic (Middlesex Hospital Questionnaire [MHQ]) were evaluated. We considered alcohol abuse more than three drinks per day.ResultsAmong the patients studied 81% reported no or mild (<4 drinks/day) alcohol consumption whereas 14.3% and 3.9% declared a moderate (4–6 drinks/day) or severe (>6 drinks/day) alcohol abuse, respectively. After adjustment for confounders, both moderate or severe alcohol abuse was associated with low perceived partner's sexual desire, worse couple relationship, and smoking abuse. Furthermore, moderate and severe alcohol abuse was associated with low prolactin and thyroid-stimulating hormone levels, as well as an increase in triglycerides and total cholesterol levels. Penile blood flow was reduced in moderate and severe alcohol drinkers even after adjustment for confounders. In the longitudinal study, after adjusting for confounding factors, any kind of alcohol abuse was independently associated with a higher incidence of MACE (hazard ratio = 2.043 [1.059–3.943]; P < 0.0001).ConclusionsOur findings demonstrate that, in subjects consulting for erectile dysfunction, severe alcohol consumption is associated with a worse sexual function and a higher incidence of MACE. Boddi V, Corona G, Monami M, Fisher AD, Bandini E, Melani C, Balzi D, Sforza A, Patussi V, Forti G, Mannucci E, and Maggi M. Priapus is happier with Venus than with Bacchus. J Sex Med 2010;7:2831–2841.     

Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy

Objective

Since the Group Européen de Curiethérapie and the European Society for Radiotherapy and Oncology (GEC–ESTRO) published recommendations for 3D MRI-based image-guided adaptive brachytherapy (IGBT) in the treatment of cervical cancer, many institutions have implemented this technique and favourable results were documented. We investigated if introduction of IGBT in our centre indeed improved treatment outcomes and reduced toxicity compared to conventional brachytherapy (CBT).

Methods

A retrospective analysis was done of outcomes of patients with stage IB-IVA cervical cancer treated with primary radiation therapy with curative intent between 2000 and 2012. Outcome measures were overall and disease-free survival, pelvic control, distant metastasis and treatment related adverse events (AE).

Results

126 patients were analysed; 43 had been treated with CBT between 2000–2007, and 83 with IGBT between 2007–2012. External beam radiation (mean; 46.6 Gy) was combined with concurrent weekly cisplatin (51.6%), or hyperthermia (24.6%); radiation alone was used in 23.8%. Median follow-up was 121.8 months for CBT patients, vs. 42.3 months for IGBT. Complete remission was achieved in 83.7% of patients in the CBT group and in 98.8% of IGBT patients (p < 0.01). Overall survival at 3 years was 51% and 86%, respectively (p = 0.001). Pelvic recurrence was found in 32% vs. 7% (p < 0.001). Most patients had low grade adverse events. High grade (3–4) AE occurred in 15.4% vs. 8.4% at 3 years (p = 0.06).

Conclusion

Introduction of IGBT for cervical cancer has led to significantly increased 3-year locoregional control and survival rates, whilst reducing late morbidity.     

Treatment with teriparatide in a patient with pregnancy-associated osteoporosis

Introduction.?The decrease of BMD during a physiological pregnancy can in rare cases be intensified and lead to dramatic microarchitectural changes, which causes an increase incidence of fractures, preferably at the spine. This dramatic clinical picture is called pregnancy-associated osteoporosis.

Case history.?We present the case of a 40-year-old woman (gravida IV, para II) with acute back pain right after delivery due to four fractures of the spine. The diagnosis was confirmed by dual-energy X-ray absorptiometry measurement result (T-score??4.1 SD (0.598?g/cm²) at the lumbar spine (L1–L4), T-score??1.5 SD (0.759?g/cm²) at the total hip). Due to the severity of symptoms, a therapy with teriparatide (20?mg daily) was started for a period of 18 months.

Results.?After end of therapy, the T-score had significantly increased at the lumbar spine as well as at the hip (T-score of??2.1 (0.813?g/cm²) and??0.6 (0.864?g/cm²), respectively. The relative increase of BMD at the spine and total hip was 36% and 13.8%, respectively.

Discussion.?Our report demonstrates the successful use of teriparatide underlined by the increase of bone mineral density and the improvement of clinical symptoms in a case of severe pregnancy-associated osteoporosis for the first time.     

Factors associated with cytoreducibility among women with ovarian carcinoma

OBJECTIVES: The aim of the current study is to investigate the clinical and molecular factors associated with cytoreduction among women with advanced stage epithelial ovarian carcinoma EOC. METHODS: Seventy-two women with FIGO stage III and IV EOC or primary peritoneal carcinoma (PPC) underwent similar attempt at surgical cytoreduction, mostly by the same surgeon. The histologic material of these patients was reviewed and the histologic subtype and grade were assigned. Immunohistochemical tests were performed for expression of molecular regulators of apoptosis (p53, p21, Bcl(2), Bcl(x), Bax) and chemoresistance (PGP, MRP, LRP, GST). The following factors were assessed for their association with complete (no residual tumor) and optimal (residual tumor < 1 cm) cytoreduction: type of carcinoma (EOC versus PPC), stage, CA-125 values, ascites, histology, tumor grade, and p53, p21, Bcl(2), Bcl(x), Bax, PGP, MRP, LRP, GST expression using the odds ratio and associated 95% confidence intervals. Significant univariate odds ratios were assessed jointly in a multivariate logistic regression model. Receiver operating characteristic curve analysis was performed to determine the CA-125 level with the maximal cytoreduction prognostic power. RESULTS: Twenty-three (31.9%) women had no residual tumor, 35 (48.6%) had 1 cm. Factors with significant univariate associations with complete cytoreduction included stage, CA-125 level, ascites, histology, and p53. p53 expression was the only factor which remained significant in the multivariate analysis (odds ratio 7.2, 95% CI 1.5, 34.9). A preoperative CA-125 value of 相似文献