Effect of fluconazole capsules combine with Zhibai dihuangwan on serum IL-10, TNF-α and clinical effect on trichomonas vaginitis patients / 中国生化药物杂志

Objective To investigate the fluconazole capsule combined with Zhibaidihuangwan on Trichomonas vaginitis patients on serum IL-10,TNF-α and clinical effect.Methods 78 cases of trichomonas vaginitis patients were collected in our hospital,randomly divided into two groups: experimental group and control group,with 39 cases in each.After admission,the patients in the control group received fluconazole 0.2g,onetimes aday; patients in the experimental group on the basis of the control group given Zhibai dihuangwan eight pills/time,threetimes a day,continuous treatment for fourweeks.Observation and comparison of two groups of patients before and after treatment of interleukin-10(IL-10),tumor necrosis factor alpha(TNF-α),the patient's vaginal health score and the level of clinical efficacy.Results compared with before treatment,IL-10,TNF-α levels were decreased after treatment of the two groups,the difference is statistically significant(P<0.05); Compared with the control group,IL-10,TNF-α is low of patients in the experimental group,the difference has statistical significance(P< 0.05);Compared with before treatment,the patients in the two groups of vagina health score were significantly increased after treatment,the difference is statistically significant(P<0.05); Compared with the control group,the vagina health score is higher in experimental group patients,the difference is statistically significant(P< 0.05); Compared with the control group,the the total efficiency is higher of patients in the experimental group,the difference is statistically significant(P<0.05).Conclusion fluconazole capsule combined with Zhibaidihuangwan can reduce trichomonad vaginitis patients serum IL-10,TNF-α levels,improve clinical symptoms,clinical curative effect is better.

Secreção vaginal anormal: Sensibilidade, especificidade e concordância entre o diagnóstico clínico e citológico / Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis

OBJETIVOS: Estimar a prevalência da vaginose bacteriana (VB), candidíase e tricomoníase e comparar os achados do exame físico da secreção vaginal com o diagnóstico microbiológico, obtido pelo estudo citológico do esfregaço vaginal, pelo do método de Papanicolaou. MÉTODOS: Estudo de corte transversal que incluiu 302 mulheres com idade entre 20 a 87 anos, submetidas à entrevista e exame ginecológico para avaliação da secreção vaginal e coleta de esfregaço citológico, no período de junho de 2012 a maio de 2013. Para avaliar a acurácia das características da secreção vaginal em relação ao diagnóstico microbiológico do esfregaço citológico foi empregado as análises de sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN), com seus respectivos IC95%. Para avaliar o grau de concordância entre as características clínicas da secreção vaginal e os achados microbiológicos no exame citológico, foi aplicado o índice kappa (k). RESULTADOS: A prevalência da VB, candidíase e tricomoníase foi de 25,5, 9,3 e 2,0%, respectivamente. A sensibilidade, especificidade, valor o VPP e o VPN das características clínicas da secreção vaginal para o diagnóstico citológico de VB foram de 74, 78,6, 54,3, e 89,9%, respectivamente. A sensibilidade, a especificidade, o VPP e o VPN das características clínicas da secreção vaginal para o diagnóstico citológico de candidíase foram de 46,4, 86,2, 25,5 e de 94%, respectivamente. O grau de concordância entre a avaliação clínica da secreção vaginal e o diagnóstico microbiológico de VB, candidíase e tricomoníase, avaliados pelo índice kappa foi de 0,47, 0,23 e 0,28, respectivamente. CONCLUSÃO: A causa mais frequente de secreção vaginal anormal foi VB. A avaliação clínica da secreção vaginal apresentou sensibilidade, VPP e grau de concordância moderado a fraco, comparado ao diagnóstico microbiológico, o que indica a necessidade de avaliação complementar do achado clínico de secreção vaginal anormal. .

PURPOSE: To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear using the Papanicolaou method. METHODS: A cross-sectional study of 302 women aged 20 to 87 years, interviewed and submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value (NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was 0.47, 0.23 and 0.28, respectively. CONCLUSION The most common cause of abnormal vaginal secretion was BV. The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis, indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion. .

Comparison of the clinical effect of ornidazole and metronidazole in the treatment of trichomonal vaginitis / 中国基层医药

Objective To observe and compare the clinical efficacy of ornidazole and metronidazole in the treatment of trichomonal vaginitis.Methods We selected 64 patients with trichomonal vaginitis who were treated in our hospiatl from January 201 3 to December 201 4,and they were divided into the observation group and the control group,each group had 32 cases.The observation group was treated with ornidazole,while the control group was treated with metronidazole.The clinical efficacy,yellow leucorrhea,frequent urination,and other clinical symptoms and adverse reactions of the two groups were compared.Results The total effective rate of the ornidazole group was 96.875%,which of the metronidazole group was 81 .75%.The ornidazole group was significantly better than the met-ronidazole group,and there was significant difference (χ2 =6.869,P 0.05).After treatment,the clinical symptoms incindence:yellow leucorrhea,frequent urination,etc of the ornidazole group was significantly lower than those of the metronidazole group,and there were significant differences (χ2 =6.594,8.256,6.783,6.469,all P <0.05 ).The incidence of adverse reaction of the ornidazole group was significantly lower than that of the metronidazole group,and there was significant difference (χ2 =8.325,P <0.05).Conclusion The clinical efficacy of ornidazole for the treament of trichomonas vaginitis was significantly better than metronidazole,and the clinical symptoms improved more significantly, it has higher safety and worthy of clinical application.

Tricomoniasis: una visión amplia / Trichomoniasis: a wide-scope view

La tricomoniasis es responsable hasta del 30% de las infecciones de transmisión sexual no virales. La mayor frecuencia es en mujeres de 16 a 35 años. Puede ser asintomática, lo que facilita su transmisión. El agente etiológico es el protozoo Trichomonas vaginalis, transmitido casi siempre por contacto sexual. Se presenta una revisión que incluye los siguientes aspectos: epidemiología, taxonomía, fisiopatología, hábitat y ciclo de vida, sintomatología y complicaciones, métodos diagnósticos, tratamiento y relación entre Trichomonas vaginalis, VIH, virus del papiloma humano y Mycoplasma hominis.

Worldwide, trichomoniasis is the most widespread non-viral sexually transmitted infection; it causes up to 30% of such infections. The highest incidence occurs among women 16 to 35 years old. It may be asymptomatic, which facilitates transmission. Its etiologic agent is the protozoan parasite Trichomonas vaginalis, usually transmitted by sexual contact. This review includes the following aspects: epidemiology, taxonomy, physiopathology, habitat and life cycle, symptomatology, diagnostic methods, treatment, and relationship with VIH, PVH and Mycoplasma hominis infections.

Diagnostic values of vaginitis five of the joint inspection kit combined with microscopic examination for vaginal disease / 国际检验医学杂志

Objective To investigate the diagnostic values of vaginitis five of the joint inspection kit combined with microscopic examination for common vaginal disease.Methods The vaginal secretions samples from 4 114 outpatients were tested with LTS-V400 vaginitis five of the joint inspection kit and microscopic examination.The examination results of age groups were analyzed and compared.Results In all 4 114 cases of samples,the positive rate of trichomonad(1.95%)was significantly lower than that of fun-gi(4.74%),P 40-50-age group,which were 1.95%,6.10%,14.15%,10.24% and 46.34%,respectively. The positive rates of H2 O2 ,pH >4.5 and pH 50 age group,which were 85.43%,86.09%,and 0.66%,respectively.The positive rates of trichomonad,SNA,LE,H2 O2 ,pH>4.5 and pH<3.8 were statistically different a-mong the age groups(P <0.05 ).Conclusion Vaginitis five of the joint inspection kit combined with microscopic examination is suitable for the diagnosis of trichomonas vaginitis,mouldsex vaginitis,and bacterial vaginal disease .

Prevalência e fatores de risco independentes à tricomoníase em mulheres assistidas na atenção básica / Prevalence and independent risk factors for trichomoniasis in women receiving primary health care

OBJETIVO: Avaliar a prevalência e os fatores associados à tricomoníase em mulheres assistidas na atenção primária. MÉTODOS: Foi desenvolvido um estudo transversal envolvendo uma amostra 314 prontuários, aleatoriamente selecionados por um processo de amostragem sistemática, entre as mulheres atendidas em serviços de atenção básica à saúde. Foram analisadas variáveis socioeconômicas, demográficas e clínicas. RESULTADOS: A prevalência de Trichomonas vaginalis foi de 10,5%, sendo que 35% das mulheres analisadas residiam na zona rural. A análise de regressão logística ajustada mostrou como preditores independentes para a presença da tricomoníase: a elevada pressão arterial, odor vaginal desagradável e dispareunia. CONCLUSÃO: A aplicabilidade prática dos resultados refere-se a subsídios para o planejamento de novas ações de enfermagem para a prevenção e redução da prevalência da tricomoníase em mulheres.

OBJECTIVE: Evaluate the prevalence and factors associated with trichomoniasis in women receiving primary health care. METHODS: A cross-sectional study was developed, involving a sample of 314 medical records, randomly selected through a process of systematic sampling, among women receiving primary health care services. The socioeconomic, demographic and clinical variables were examined. RESULTS: The prevalence of Trichomonas vaginalis was 10.5%, and 35% of the women studied lived in rural areas. The adjusted logistic regression analysis showed that the independent predictors of the presence of trichomoniasis were: high blood pressure, unpleasant vaginal odor and dyspareunia. CONCLUSION: In terms of practical applicability, the results can provide information for planning new nursing initiatives to prevent and reduce the prevalence of trichomoniasis in women.

Clinical characteristics of aerobic vaginitis and its mixed infectious / 中华妇产科杂志

Objective To investigate clinical characteristics of aerobic vaginitis AV) and its mixed infections for diagnosis efficiently. Methods From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV) , vulvovaginal candidiasis (VVC), trichemonal vaginitis (TV) , and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. Results Among 516cases, AV cases were found in 14. 7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30% , 13/44) , and mixed with TV (25% , 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4. 5 (84% , 27/32). Vaginal cleanliness mainly was grade Ⅲ - V (88% , 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. Conclusions Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV.

A Case of Neonatal Trichomonas Vaginitis / 대한주산의학회잡지

Trichomonas vaginitis is a sexually transmitted disease by Trichomonas vaginalis infection especially in adults that is significantly associated with preterm delivery, premature rupture of membrane and low-birth-weight neonates. Although neonatal infection is rare, a vertical transmission might substantially occur by direct contact of protozoal infection. The reported clinical manifestation of trichomoniasis is purulent vaginal discharge in only severely infected neonates. I experienced a case of virulent neonatal Trichomonas vaginitis which was confirmed by vaginal wet mount examination in a neonate born full-term, complaining of excessive purulent vaginal discharge, with no perinatal complication of premature rupture of membrane or low-birth-weight. The patient had complete resolution of symptom after the administration of metronidazole, thus I report this case along with a brief review of literatures.

Updated treatment of vaginitis / 대한산부인과학회지

Three common vaginal infections are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonas vaginitis (TV). However their symptoms and signs are similar and atypical and other non-infectious vaginal inflammations will be the causes of identical symptoms. Hence accurate diagnosis is the first step in management of vaginitis and then appropriate therapy should be conducted. Metronidazole is the drug of choice for the treatment of BV and TV. Topical or oral azole antifungal regimens are highly effective in reliving symptoms of VVC. Physicians who treat the woman having vaginitis should consider the fact that the disease may be chronic, frequent and recurrent due to antibiotics abuse and over the counter antimycotic agents. Also predisposing factors must be removed before medical therapy.

Clinical Observation of 3 Metronidazol Therapeutic Regimens for Trichomonas Vaginitis / 中国药房

OBJECTIVE:To investigate observation of three metronidazol combined with drug for vaginal local application on trichomnas vaginitis. METHODS:195 patients with trichomonas vaginitis were randomly divided into three groups. They were treated with drug for vaginal local application plus single dose or multiple dose of metronidazol(p.o) ,respectively. Then their curative effects were compared. RESULTS:In single large dose of metronidazol group remission rate,cure rate and total effective rate were higher than in multiple low dose group in the first and the second day. Significant difference was noted between the two groups(P0.05) . CONCLUSION:The curative effect of single large dose of metronidazol was better than the multiple low dose. The therapeutic effect of single dose of metronidazol(1.6 g) is similar to single dose(2.0 g) .