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Alison J Huang, Deborah Grady
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March 19, 2018: JAMA Internal Medicine
Caroline M Mitchell, Susan D Reed, Susan Diem, Joseph C Larson, Katherine M Newton, Kristine E Ensrud, Andrea Z LaCroix, Bette Caan, Katherine A Guthrie
Importance: Nearly half of postmenopausal women report bothersome vulvovaginal symptoms, but few data support the efficacy of 2 commonly recommended treatments. Objective: To compare the efficacy of a low-dose vaginal estradiol tablet and a vaginal moisturizer, each vs placebo, for treatment of moderate-to-severe postmenopausal vulvovaginal symptoms. Design, Setting, and Participants: This 12-week multicenter randomized clinical trial enrolled postmenopausal women with moderate to severe symptoms of vulvovaginal itching, pain, dryness, irritation, or pain with penetration...
March 19, 2018: JAMA Internal Medicine
Nafiseh Saghafi, Maryam Karjalian, Masumeh Ghazanfarpour, Imaneh Khorsand, Hassan Rakhshandeh, Masumeh Mirteimouri, Masoudeh Babakhanian, Talat Khadivzadeh, Mohammad Javad Najafzadeh, Ahmad Ghorbani, Leila Pourali, Sara Bahman
The goal of this study was to compare the effect of Anethum graveolens (dill) vaginal suppositories and 100 mg clotrimazole vaginal tablets on vulvovaginal Candidiasis. This study was a single centre, single-blind, randomised, placebo-controlled trial, in which 60 women with microbiology-confirmed vulvovaginal candidiasis were randomly assigned to dill and clotrimazole groups. At the end of the study, the estimated prevalence of leucorrhoea, burning, and itching was 23%, 23% and 20% in dill users, respectively...
March 19, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
S Palacios, R E Nappi, N Bruyniks, M Particco, N Panay
OBJECTIVES: The primary objective of the European Vulvovaginal Epidemiological Survey (EVES) was to assess, at a country level, the prevalence of postmenopausal women with vulvovaginal atrophy (VVA) confirmed by gynecological clinical assessment among all postmenopausal women attending menopause centers. METHOD: Women aged 45-75 years old with their last menstrual period more than 12 months before and who attended menopause or gynecology centers were included...
March 19, 2018: Climacteric: the Journal of the International Menopause Society
Siew Mei Samantha Ng, Jia Mao Yap, Qiu Ying Lau, Fui Mee Ng, Esther Hong Qian Ong, Timothy Barkham, Jeanette Woon Pei Teo, Mohammad Alfatah, Kiat Whye Kong, Shawn Hoon, Prakash Arumugam, Jeffrey Hill, Cheng San Brian Chia
Vulvovaginal candidiasis (VVC) is a genital fungal infection afflicting approximately 75% of women globally and is primarily caused by the yeast Candida albicans. The extensive use of fluconazole, the first-line antifungal drug of choice, has led to the emergence of fluconazole-resistant C. albicans, creating a global clinical concern. This, coupled to the lack of new antifungal drugs entering the market over the past decade, has made it imperative for the introduction of new antifungal drug classes. Peptides with antifungal properties are deemed potential drug candidates due to their rapid membrane-disrupting mechanism of action...
March 9, 2018: European Journal of Medicinal Chemistry
O Sy, K Diongue, C B Ahmed, O Ba, F C Moulay, B Lo, D Ndiaye
AIM: To determine the prevalence and the associated risk factors of vulvovaginal candidiasis in pregnant women in Mauritania. PATIENTS AND METHOD: The study was carried out at the laboratory of the Mère et Enfant Center in Nouakchott, from November 1, 2016 to February 5, 2017. It concerned all pregnant women in the third trimester that came to the natal consultation at the gynecology service. These women must have given their informed consent in written form. After completing the survey to collect epidemiological and clinical data, a sample was collected to perform fresh direct examination and culture on Sabouraud-Chloramphenicol media...
March 13, 2018: Journal de Mycologie Médicale
Flavia De Bernardis, Sofia Graziani, Flavio Tirelli, Stavroula Antonopoulou
Vulvovaginal candidiasis is a common mucosal infection affecting a large proportion of women with some of them affected by recurrent often intractable forms of the disease. Thus, there is an increasing interest in understanding the pathogenesis of this disease. The aim of our work was to characterize, in animal models of vaginal candidiasis, the components of the host-fungus interaction at the mucosal level.The evidence of an immune response in the vaginal compartment was very encouraging to identify the proper targets for new strategies for vaccination or immunotherapy of vaginal candidiasis...
April 1, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Natalie O Rosen, Amy Muise, Emily A Impett, Isabelle Delisle, Mary Lou Baxter, Sophie Bergeron
Background: Vulvodynia is an idiopathic vulvovaginal pain condition that has significant sexual and relational consequences. Most women with vulvodynia continue to have intercourse, possibly because of a desire to approach positive outcomes (e.g., intimacy) and avoid negative outcomes (e.g., partner disappointment). Purpose: This study examined daily associations between approach and avoidance sexual goals and women's pain during intercourse and couples' sexual and relational well-being, as well as the mediating role of sexual cues...
February 17, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
James J Leyden, Vilma Sniukiene, David R Berk, Alexandre Kaoukhov
BACKGROUND: There is a need for new oral antibiotics for acne with improved safety profiles and targeted antibacterial spectra. Sarecycline is a novel, tetracycline-class antibiotic specifically designed for acne, offering a narrow spectrum of activity compared with currently available tetracyclines, including less activity against enteric Gram-negative bacteria. This phase 2 study evaluated the efficacy and safety of three doses of sarecycline for moderate to severe facial acne vulgaris...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Stephen R Brand, Thorsten P Degenhardt, Karen Person, Jack D Sobel, Paul Nyirjesy, Robert J Schotzinger, Amir Tavakkol
BACKGROUND: Lanosterol demethylase (CYP51), is an enzyme essential for fungal growth, and catalyzes an early step in the biosynthetic pathway of ergosterol, a sterol required for fungal cell membrane formation and integrity. CYP51 is the molecular target of the class of drugs referred to as 'azole antifungals.' VT-1161 is a novel, oral, selective inhibitor of fungal CYP51, and is being developed for the treatment of recurrent vulvovaginal candidiasis. OBJECTIVE: We evaluated the efficacy and safety of 4 dosing regimens of oral VT-1161 compared to placebo in women with recurrent vulvovaginal candidiasis, defined as at least 3 symptomatic episodes of acute vulvovaginal candidiasis within a 12-month period...
March 10, 2018: American Journal of Obstetrics and Gynecology
Sanata Bamba, Adama Zida, Ibrahim Sangaré, Mamoudou Cissé, David W Denning, Christophe Hennequin
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the national demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0...
March 11, 2018: Journal of Fungi (Basel, Switzerland)
Xiao-Yu Yu, Fei Fu, Wen-Na Kong, Qian-Kun Xuan, Dong-Hua Wen, Xiao-Qing Chen, Yong-Ming He, Li-Hua He, Jian Guo, Ai-Ping Zhou, Yang-Hong Xi, Li-Jun Ni, Yu-Feng Yao, Wen-Juan Wu
Streptococcus agalactiae and Candida albicans often co-colonize the female genital tract, and under certain conditions induce mucosal inflammation. The role of the interaction between the two organisms in candidal vaginitis is not known. In this study, we found that co-infection with S. agalactiae significantly attenuated the hyphal development of C. albicans , and that EFG1 -Hwp1 signal pathway of C. albicans was involved in this process. In a mouse model of vulvovaginal candidiasis (VVC), the fungal burden and the levels of pro-inflammatory cytokines, IL-1β, IL-6 and TNF-α showed a increase on co-infection with S...
2018: Frontiers in Microbiology
Michael Gold, Anneke Andriessen, Alexandros Bader, Red Alinsod, Elizabeth Shane French, Nathan Guerette, Yegor Kolodchenko, Michael Krychman, Susan Murrmann, Julene Samuels
INTRODUCTION: The use of energy-based devices for the treatment of vaginal laxity, orgasmic dysfunction, and stress incontinence, such as minimally ablative fractional laser and radiofrequency, is gaining momentum. This review aims to answer clinical questions on the application of energy-based devices for feminine genital rejuvenation. METHODS: The target group includes physicians involved in esthetic medicine and feminine genital rejuvenation. A literature review was conducted on technologies in use for feminine rejuvenation to explore their safety, efficacy, tolerability, patient satisfaction, and clinical usability...
March 10, 2018: Journal of Cosmetic Dermatology
Vadim M Kemaykin, Nariman B Tabinbaev, Mahira S Khudaibergenova, Anastasia A Olifirovich, Layzzat M Abdrakhmanova, David W Denning, Nikolai Klimko
Our work aimed to generate a preliminary estimation of severe and chronic fungal diseases in the Republic of Kazakhstan with a model proposed by LIFE (Leading International Fungal Education). Calculations were carried out on data from 2015. Published results of studies of mycoses in Kazakhstan were identified; in the absence of national data from the scientific literature, the frequency of life-threatening and serious mycoses in defined groups of patients at risk from other countries were taken into account...
March 8, 2018: Journal of Fungi (Basel, Switzerland)
Lígia de Souza Fernandes, Yuri Martins Amorim, Elton Libério da Silva, Samuel Calixto Silva, Alécia Junia Aparecida Santos, Franciele Natália Peixoto, Luara Moniele Neves Pires, Raquel Yumi Sakamoto, Flávia do Carmo Horta Pinto, Maria Virgínia Costa Scarpa, Marcelo Gonzaga de Freitas Araújo
Owing to the growing resistance among isolates of Candida species to usual antifungal agents and the well-known therapeutic potential of curcumin, the purpose of this study was to develop and validate a vaginal formulation containing this substance and to evaluating its effectiveness in the treatment of experimental vulvovaginal candidiasis METHODS: Curcumin was incorporated in a vaginal cream in three concentrations (0.01, 0.1 and 1.0%). The different concentrations of the cream and its controls were intravaginally administered in an immunosuppressed rat model to evaluate the efficacy in the treatment of experimental vulvovaginal candidiasis...
March 8, 2018: Mycoses
Sharon Daniel, Reut Rotem, Gideon Koren, Eitan Lunenfeld, Amalia Levy
BACKGROUND: Spontaneous abortions are the most common complication of pregnancy. Clotrimazole and miconazole are widely used vaginal-anti-mycotic agents used for the treatment of vulvovaginal candidiasis. A previous study has suggested an increased risk of miscarriage associated with these azoles, which may lead health professionals to refrain from their use even if clinically indicated. The aim of the current study was to assess the risk for spontaneous abortions following first trimester exposure to vaginal-anti-mycotics...
March 3, 2018: American Journal of Obstetrics and Gynecology
Daniel Brustolin Ludwig, Luciana Erzinger Alves de Camargo, Najeh Maissar Khalil, Marcos Ereno Auler, Rubiana Mara Mainardes
Amphotericin B (AmB) is one of the most used drugs for the treatment of systemic fungal infections; however, the treatment causes several toxic manifestations, including nephrotoxicity and hemolytic anemia. Chitosan-coated poly(lactide-co-glycolide) (PLGA) nanoparticles containing AmB were developed with the aim to decrease AmB toxicity and propose the oral route for AmB delivery. In this work, the antifungal efficacy of chitosan-coated PLGA nanoparticles containing AmB was evaluated in 20 strains of fungus isolates from patients with vulvovaginal candidiasis (01 Candida glabrata and 03 Candida albicans), bloodstream infections (04 C...
March 1, 2018: Mycopathologia
Mihai Mareș, Valentina Ruxandra Moroti-Constantinescu, David W Denning
OBJECTIVE: To estimate for the first time the burden of fungal infections in Romania. METHODS: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were used in the present study. When no data were available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters...
March 1, 2018: Journal of Fungi (Basel, Switzerland)
Rogelio de J Treviño-Rangel, José F Espinosa-Pérez, Hiram Villanueva-Lozano, Alexandra M Montoya, Angel Andrade, Alexandro Bonifaz, Gloria M González
Candida bracarensis is an emerging cryptic species within the Candida glabrata clade. To date, little is known about its epidemiology, virulence, and antifungal susceptibility. This study documents the occurrence of C. bracarensis for the first time in Mexico and focuses on its in vitro production of hydrolytic enzymes, as well as antifungal susceptibility to echinocandins. This strain was isolated from a vaginal swab of a female with vulvovaginal candidosis; exhibited a very strong activity of aspartyl proteinase, phospholipase, and hemolysin; and was susceptible to caspofungin, anidulafungin, and micafungin (MIC = 0...
February 27, 2018: Folia Microbiologica
Novera G Chughtai, Raheela Mohsin Rizvi
The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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