The Experts below are selected from a list of 276 Experts worldwide ranked by ideXlab platform
Paulo César Giraldo - One of the best experts on this subject based on the ideXlab platform.
-
Hygienic and sexual habits of women with recurrent Vulvovaginitis
2020Co-Authors: Cordeiro Sn, Egberto Ribeiro Turato, Vicentini Rm, Ana Katherine Gonçalves, Paulo César GiraldoAbstract:Episodes of Vulvovaginitis are quite definitely one of the most common gynecological complaints that lead women to consult a gynecologist. The reasons for frequent recurrences have not been clearly established. Identify the hygienic and sexual factors that can be associated to the recurrence of Vulvovaginitis. Fifty-one women presenting a microbiological diagnosis of recurrent Vulvovaginitis and 61 women with no complaint were studied. This study was carried out at the department of Gynecology the State University of Campinas (UNICAMP SP. Brazil). After informed consent all the patients were submitted to a structured interview regarding their habit hygiene and sexual behavior. The analysis of the results to test the association between the groups and the independent variables related to habits hygienic and sexual factors was carried out by odds ratio (confidence interval of 95%). The analyses point out that white women OR 3.03 e Confidence Interval of 95% (1.25 a 7.33) and those that use condoms OR 2.44 and Confidence Interval of 95% (0.47 to 12.63) presented more associations to recurrent Vulvovaginitis. Contraries the use of deposit medroxiprogesterona OR 0.05 e Confidence Interval of 95% (0.01 a 0.50) and amenorreia OR 799 and Confidence Interval of 95% (1.73 a 36.87) were more associated to the control group. On the other hand all other variables studded have not shown any association with recurrent Vulvovaginitis. Despite the weak association found it seems that hygiene clothing and sexual behavior did not influence the risk of recurrent Vulvovaginitis. The set of hygienic and sexual factors does not seem to have favoured recurrent Vulvovaginitis in the group of women studied. (authors)
-
value of candida polymerase chain reaction and vaginal cytokine analysis for the differential diagnosis of women with recurrent Vulvovaginitis
Infectious Diseases in Obstetrics & Gynecology, 2000Co-Authors: Stephanie Weissenbacher, Paulo César Giraldo, Steven S Witkin, Vera Tolbert, Iara M Linhares, Andrea Haas, Rainer E Weissenbacher, William J LedgerAbstract: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.
-
vaginal heat shock protein expression in symptom free women with a history of recurrent Vulvovaginitis
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Paulo César Giraldo, A Neuer, Irina Korneeva, Ayrton Ribeirofilho, Jose Antonio Simoes, Steven S WitkinAbstract:Abstract Objectives: The cause of recurrent Vulvovaginitis remains unexplained in most cases. Heat shock protein synthesis is induced under conditions of stress; its presence in vaginal samples from women who were between episodes of recurrent Vulvovaginitis thus might reflect a persistent perturbation in the local milieu. Study Design: We undertook an evaluation by means of enzyme-linked immunosorbent assay of 60-kd heat shock protein and inducible 70-kd heat shock protein expressions in vaginal wash samples from 24 symptom-free women with a history of recurrent Vulvovaginitis and 19 matched control subjects. The samples were also tested for Candida albicans , Chlamydia trachomatis , Ureaplasma urealyticum , Mycoplasma hominis, and human papillomavirus by polymerase chain reaction; for bacterial vaginosis by clinical and microbiologic evaluation; and for interleukin 10, interleukin 1, interleukin 8, RANTES, and eotaxin by enzyme-linked immunosorbent assay. Results: The presence of 60-kd heat shock protein was detected in 11 women with recurrent Vulvovaginitis (45.8%) and 1 control subject (5.3%, P = .005). Similarly, 70-kd heat shock protein was present in 8 patients with recurrent Vulvovaginitis (33.3%) and no control subjects ( P = .005). The presence of 60-kd heat shock protein and the presence of 70-kd heat shock protein were correlated with each other ( P = .02), as were both 60-kd heat shock protein ( P = .006) and 70-kd heat shock protein ( P = .01) correlated with IL-10. There was no relation between the presence of 60-kd heat shock protein or 70-kd heat shock protein and detection of IL-1, IL-8, or any microorganism. Conclusion: The expression of heat shock proteins and IL-10 in the vaginas of women with a history of recurrent Vulvovaginitis but not in the vaginas of control subjects suggests the existence of differences in the vaginal milieu between the 2 groups, even when both are without vaginal symptoms. (Am J Obstet Gynecol 1999;180:524-9.)
Dragan Bogdanovic - One of the best experts on this subject based on the ideXlab platform.
-
streptococcus pyogenes as the cause of Vulvovaginitis and balanitis in children
Pediatrics International, 2017Co-Authors: Gordana Randjelovic, Vesna Mladenovic, Suzana Otasevic, Snežana Mladenovicantic, Radmila Radovanovicvelickovic, Marina Randjelovic, Dragan BogdanovicAbstract:Background Streptococcus pyogenes (group A Streptococcus) is the etiological agent of perineal infection in children, consisting of perianal infection, Vulvovaginitis and balanitis. If it is not properly diagnosed and treated, it can persist for many months and can cause severe complications. Furthermore, treatment with penicillin can be followed by failures and recurrences. Methods We report here the prevalence of S. pyogenes isolates in genital tract specimens from girls (n = 1692) with symptoms of Vulvovaginitis and from boys (n = 52) with balanitis in the municipality of Nis, Southeast-Serbia (the Western Balkans) in a 10 year period, and the seasonal distribution, patient age and sensitivity to bacitracin and antimicrobial drugs used in the treatment of streptococcal infection. Results Streptococcal Vulvovaginitis was diagnosed in 2.30% of examinees. Of those cases, 64.10% were detected from April to September, and it was most common (71.79%) in girls aged 3–7 years. Streptococcal balanitis was diagnosed in two instances: in a 4-year-old boy and in a 7-year-old boy. S. pyogenes strains resistant to bacitracin were identified in five girls. Two isolates with M phenotype and five isolates with cMLSB phenotype were identified. Conclusions Streptococcal Vulvovaginitis was diagnosed less often in the present study, but it was still far more common than streptococcal balanitis in childhood. Bacitracin resistance of S. pyogenes strains should be taken into account in routine microbiological identification, and the detection of S. pyogenes isolates resistant to erythromycin requires surveillance in the present geographical territory.
-
microbiological aspects of Vulvovaginitis in prepubertal girls
European Journal of Pediatrics, 2012Co-Authors: Gordana Ranđelovic, Vesna Mladenovic, Ljiljana Ristic, Suzana Otasevic, Sofija Brankovic, Snežana Mladenovicantic, Milena Bogdanovic, Dragan BogdanovicAbstract:This study aimed to establish the vaginal introitus microbial flora in girls with and without symptoms of Vulvovaginitis, and to present the distribution of isolated microorganisms by age groups in girls with Vulvovaginitis. We enrolled 500 girls with Vulvovaginitis symptoms, aged 2–12 years, referred by their pediatricians for microbiological examination of the vaginal introitus swabs, and 30 age-matched asymptomatic girls. Similar microbial flora was isolated in both groups, but the symptomatic girls had significantly more common positive microbiological findings compared to controls (p < 0.001). In symptomatic girls, the following pathogenic bacteria were isolated: Streptococcus pyogenes (4.2%), Haemophilus influenzae (0.4%), and Staphylococcus aureus (5.8%). Bacteria of fecal origin were found in vaginal introitus swabs in 33.8% of cases, most commonly Proteus mirabilis (14.4%), Enterococcus faecalis (12.2%), and Escherichia coli (7.0%). The finding of fecal flora was more common compared to controls, reaching a statistical significance (p < 0.05), as well as in girls aged up to 6 years (p < 0.001). Candida species were found in 2.4% of girls with Vulvovaginitis symptoms. Conclusion: The microbial ecosystem in girls with clinical signs of Vulvovaginitis is complex and variable, and the presence of a microorganism does not necessarily imply that it is the cause of infection. The diagnosis of Vulvovaginitis in prepubertal girls requires a complex and comprehensive approach, and microbiological findings should be interpreted in the context of clinical findings.
G. R. G. Monif - One of the best experts on this subject based on the ideXlab platform.
-
Semiquantitative Bacterial Observations With Group B Streptococcal Vulvovaginitis
Infectious Diseases in Obstetrics and Gynecology, 1999Co-Authors: G. R. G. MonifAbstract: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
-
semiquantitative bacterial observations with group b streptococcal Vulvovaginitis
Infectious Diseases in Obstetrics & Gynecology, 1999Co-Authors: G. R. G. MonifAbstract: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.
Steven S Witkin - One of the best experts on this subject based on the ideXlab platform.
-
value of candida polymerase chain reaction and vaginal cytokine analysis for the differential diagnosis of women with recurrent Vulvovaginitis
Infectious Diseases in Obstetrics & Gynecology, 2000Co-Authors: Stephanie Weissenbacher, Paulo César Giraldo, Steven S Witkin, Vera Tolbert, Iara M Linhares, Andrea Haas, Rainer E Weissenbacher, William J LedgerAbstract: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.
-
vaginal heat shock protein expression in symptom free women with a history of recurrent Vulvovaginitis
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Paulo César Giraldo, A Neuer, Irina Korneeva, Ayrton Ribeirofilho, Jose Antonio Simoes, Steven S WitkinAbstract:Abstract Objectives: The cause of recurrent Vulvovaginitis remains unexplained in most cases. Heat shock protein synthesis is induced under conditions of stress; its presence in vaginal samples from women who were between episodes of recurrent Vulvovaginitis thus might reflect a persistent perturbation in the local milieu. Study Design: We undertook an evaluation by means of enzyme-linked immunosorbent assay of 60-kd heat shock protein and inducible 70-kd heat shock protein expressions in vaginal wash samples from 24 symptom-free women with a history of recurrent Vulvovaginitis and 19 matched control subjects. The samples were also tested for Candida albicans , Chlamydia trachomatis , Ureaplasma urealyticum , Mycoplasma hominis, and human papillomavirus by polymerase chain reaction; for bacterial vaginosis by clinical and microbiologic evaluation; and for interleukin 10, interleukin 1, interleukin 8, RANTES, and eotaxin by enzyme-linked immunosorbent assay. Results: The presence of 60-kd heat shock protein was detected in 11 women with recurrent Vulvovaginitis (45.8%) and 1 control subject (5.3%, P = .005). Similarly, 70-kd heat shock protein was present in 8 patients with recurrent Vulvovaginitis (33.3%) and no control subjects ( P = .005). The presence of 60-kd heat shock protein and the presence of 70-kd heat shock protein were correlated with each other ( P = .02), as were both 60-kd heat shock protein ( P = .006) and 70-kd heat shock protein ( P = .01) correlated with IL-10. There was no relation between the presence of 60-kd heat shock protein or 70-kd heat shock protein and detection of IL-1, IL-8, or any microorganism. Conclusion: The expression of heat shock proteins and IL-10 in the vaginas of women with a history of recurrent Vulvovaginitis but not in the vaginas of control subjects suggests the existence of differences in the vaginal milieu between the 2 groups, even when both are without vaginal symptoms. (Am J Obstet Gynecol 1999;180:524-9.)
Rupert Jones - One of the best experts on this subject based on the ideXlab platform.
-
childhood Vulvovaginitis and vaginal discharge in general practice
Family Practice, 1996Co-Authors: Rupert JonesAbstract:Results. Non-specific Vulvovaginitis with mixed bacterial flora, associated with poor hygiene and atrophic vaginal mucosa, was the commonest cause; specific bacteria were found in 10 out of 42 cases, including six of Streptococcus pyogenes. No Candida was isolated. Treatment with topical oestrogen cream was effective only with mixed infection, oral antibiotics were effective in both mixed and single organisms. No evidence of sexual abuse nor foreign body was found. Conclusion. Childhood Vulvovaginitis is not uncommon in general practice, is usually associated with mixed growth of faecal organisms, and is seldom due to serious causes such as sexual abuse or foreign body.
