Infecciones cervicovaginales en exudados vaginales / Cervicovaginal infections in vaginal exudates

Introducción: Se desconocen las características de las infecciones cervicovaginales, diagnosticadas mediante el exudado vaginal, sobre todo en mujeres cubanas de mediana edad. En otras etapas del ciclo vital femenino, sí se han realizado estos estudios. Esta información es importante, fundamentalmente para realizar acciones de promoción de salud. Objetivo: Determinar las características de las infecciones cervicovaginales más frecuentes diagnosticadas mediante el exudado vaginal. Método: Se realizó un estudio transversal en 1118 mujeres. Se recogió la edad (agrupada en 20 - 44 años y 45 y más años), los resultados del exudado vaginal, la percepción de secreción vaginal o la ausencia de esta (asintomáticas) y los microorganismos identificados en el exudado. Resultados: El 49,9 por ciento de exudados vaginales fueron positivos a vaginosis bacteriana, Cándidas albicans, Trichomonas vaginalis y desequilibro en la ecología vaginal. El 45 por ciento de las pacientes no tenían secreción vaginal, es decir, estaban asintomáticas. Conclusión: Las infecciones cervicovaginales se caracterizaron por ser de elevada frecuencia, usualmente asintomáticas, con predominio de vaginosis bacteriana, candidiasis y trichomoniasis(AU)

ABSTRACT Introduction: The characteristics of cervicovaginal infections diagnosed by vaginal exudate are unknown, especially in middle-aged Cuban women. At other stages of the female life cycle, these studies have been done. Due to the importance of this information, to carry out health promotion actions, this research was carried out. Objective: To determine the characteristics of the most frequent cervicovaginal infections diagnosed by vaginal exudate. Method: A cross-sectional study was conducted in 1118 women. Age (grouped into 20-44 years and 45 and over), the results of positive vaginal discharge, the perception of presence or not of vaginal discharge (asymptomatic) and the microorganisms identified in the discharge were collected. Results: 49.9 percent of vaginal exudates were positive for bacterial vaginosis, Candidas albicans, Trichomonas vaginalis and imbalance in vaginal ecology. 45 percent of the patients had no vaginal discharge, that is, they were asymptomatic. Conclusion: Cervicovaginal infections were characterized by being of high frequency, usually asymptomatic, with prevalence of bacterial vaginosis, candidiasis and trichomoniasis(AU)

Eosinofilia no sangue periférico de mulheres com candidiase vaginal recorrente / Eosinophilia in peripheral blood of women with recurrent vaginal candidiasis

OBJETIVO: Quantificar o número de células de defesa e os níveis de imunoglobulina E (IgE) no sangue periférico em amostra de mulheres com candidíase vaginal recorrente. MÉTODOS: Estudo de corte transversal com 60 mulheres, 40 com candidíase vulvovaginal e 20 do grupo controle (sem doença). As células de defesa foram identificadas utilizando um sistema de impedância combinada com a citometria de fluxo, os níveis de IgE total e específica foram medidos por meio de técnicas de quimiluminescência, o teste de Mann-Whitney foi utilizado para variáveis nominais e do teste de Spearman para correlações das concentrações de IgE e de eosinófilos no sangue periférico. RESULTADOS: O número de eosinófilos no sangue periférico de pacientes com candidíase vulvovaginal, 302,60 (±253,07), foi significativamente maior do que o grupo controle, 175,75 (±109,24) (p=0,037). Os níveis séricos de IgE total e específica foram semelhantes em ambos os grupos de mulheres com e sem candidíase vulvovaginal recorrente (p=0,361). Entretanto, observou-se uma correlação positiva moderada entre eosinofilia e níveis de IgE total no sangue periférico de mulheres com candidíase vaginal recorrente (r=0,25). CONCLUSÃO: Mulheres com candidíase vaginal recorrente parecem ter maior concentração de eosinófilos no sangue periférico que as assintomáticas.

PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.

Vulvovaginites: estudo das variaçoes de pH vaginal e microflora associada / Vulvovaginitis: vaginal pH changes and associated microflora

PURPOSE: To establish a correlation between pH vaginal and the microflora associated in carriers of vulvovaginites. METHODS: In the present study, the cytopathological examination and the vaginal flow in a group of 65 sexually active women had been carried through, 20 and 72 years, taken care of in the Laboratório de Citologia Clínica do Departamento de Análises Clínicas e Toxicológicas da Universidade Federal do Rio Grande do Norte, for determination of microorganisms in cervicovaginal sample and of pH in the vaginal flow. RESULTS: Associating pH vaginal with the presence of vulvovaginitis, it was evidenced that the Candida sp. occurred more frequently in pH 4.0, Trichomonas vaginalis in pH 6.0, Gardnerella vaginalis in pH 5.0, coconuts in pH 5.0, bacilli in pH 4.0 and cocos/bacilos in pH 6.0. It was observed that all the patients had presented at least one type of ethiological agent of vulvovaginiti and an associated microflora. CONCLUSION: The joint accomplishment of the cytological examinations and the determination of pH revealed important for directing the microflora associated with the vulvovaginiti, suggesting, of this form, that pH vaginal plays preponderant role how much to the presence of the infectious agents in the vaginal ecosystem.

Prevalence, species distribution and antifungal sensitivity of vaginal yeasts in infertile women.

A total of 326 high vaginal swabs from infertile women attending the Institute of Reproductive Medicine were cultured from June 1999 to May 2000. Candida species was isolated from 42(12.88%) patients. Candida albicans (40.47%) followed by Candida glabrata (38.09%) were the most common isolates. Other species included Candida tropicalis (14.28%) and Candida krusei (7.14%). All isolates were tested for sensitivity by disc diffusion method on Yeast Nitrogen Agar base towards four antifungals. Seven (16.7%) candida strains showed resistance to Fluconazole and 19(45.23%) of the strains showed resistance to Itraconazole, and 4(9.5%) strains showed resistance to Nystatin. There was no resistance to Amphotericin B. Of the 7 strains resistant to Fluconazole, 3 were Candida krusei, 3 were Candida glabrata and 1 was Candida tropicalis.

The prevalence of Chlamydia trachomatis infection in rural Thai women.

A cross sectional study was designed to investigate the prevalence of Chlamydia trachomatis among different groups of rural women in the northeast Thailand. The presence of chlamydial antigens in endocervical swabs was detected by ELISA. The prevalences of Chlamydia trachomatis were 6.8% (31/485), 5.2% (24/466) and 6.7% (12/179) in women attending antenatal, postpartum and family planning clinics respectively. The average prevalences of C. trachomatis among hospital-based and community-based women were 6.1% (67/1,103) and 3.6% (15/411) respectively. In addition, the prevalences of some pathogens including Candida albicans, Trichomonas vaginalis, Treponema pallidum and Neisseria gonorrhoea among hospital-based and community-based women were 14.2, 2.8, 0.7, 0.2 and 10.9, 5.1, 2.7, 0.0% respectively. It was concluded that C. trachomatis was a problem of woman's reproductive health.

Cytodiagnosis of discharge per vaginum.

Simple, rapid, inexpensive methods such as pH determination, wet mount, KOH mount, amine test, Gram staining of vaginal discharge were undertaken prior to Pap stained smears of 158 patients of leucorrhoea. We were able to detect non-specific vaginitis (44.30%), Trichomoniasis (16.45%), Candida vaginitis (9.49%), gonococcal vaginitis (0.63%) and senile vaginitis (12 cases). No specific pathology was shown in 26 cases. 1.69% of the cases were of cervical erosion and 3.79% cases suggestive of squamous malignancy.

Relaçäo sexual; Principal fator desencadeante na candidíase vaginal de repetiçäo: Estudo do tempo decorrente entre o início da atividade sexual regular e a candidíase de repetiçäo / Sexual intercourse; The main triggering factor in recurrent vaginal candidiasis: Study of the period of time arisen between the beginning of the regular sexual activity and the recurrent candidiasis

Um estudo retrospectivo foi realizado, analisando a história de 211 pacientes portadoras de candidíase vaginal de repetição e constatou que 139 (65,8 por cento) desenvolveram a doença após o início da atividade sexual genital regular, e que a relação sexual é o mais freqüente fator desencadeante das crises. De acordo com o programa de informática Epi-info, o estudo constatou também que uma mediana de quatro anos foi o intervalo de tempo decorrente entre o início da atividade sexual genital e o início da doença. Isto faz pensar na possibilidade de um período de sensibilização, facilitado pelo trauma da mucosa vaginal e pelo efeito imunodepressor do sêmen

Estudo da associaçäo entre a candidíase vaginal de repetiçäo e a rinite alérgica / Study of association between recurrent vaginal candidiasis and allergic rhinitis

Um crescente número de pacientes do sexo feminino têm procurado o auxílio dos alergistas em busca de diagnóstico e tratamento para uma patologia que se mantém rebelde a tratamentos insistentes e diversos: a candidíase vaginal de repetiçäo. Säo mulheres sadias que näo apresentam diabetes ou imunodeficiências, näo usam corticosteróides ou antibióticos cronicamente e em sua maioria já näo usam contreceptivos orais. Concomitantemente têm sintomas nasais alérgicos como queixa freqüente. O objetivo deste estudo tranversal foi comprovar a associaçäo entre a candidíase vaginal de repetiçäo e a rinite alérgica, estudando 95 mulheres portadoras de candidíase e 100 controles femininos de igual faixa etária que na mesma época procuraram o consultório de Alergia por outras queixas. Comparou-se a frequüencia diagnosticada de doenças alérgicas nos dois grupos e concluiu-se que no grupo portador de condidiase a incidência de rinite alérgica foi de 71 por cento, enquanto no grupo-controle a incidência de rinite alérgica foi de 42 por cento. Esta diferença foi considerada estatisticamente significativa de acordo com o programa de informática Epi-Info. Outra conclusäo foi a baixa freqüência observada da associaçäo entre a candidíase de repetiçäo e a asma brônquica em mulheres alérgicas, sugerindo desta forma a existência de uma possível síndrome nasal-vaginal alérgica, que ainda näo pode ser explicada à luz dos conhecimentos existentes

Immunological profile of women suffering from recurrent candidal vaginitis

The pathogenesis of recurrent vaginal c and idosis in women with no predisposing factors is still poorly understood. Twenty women [20-45 years] suffering from this syndrome and 22 healthy females [control group] were included in this study. There was a decrease in the percentage of total T-cells in 65% of the patients and a decrease in the percentage of phagocytes in 80% of them, with a statistically significant decrease in their mean percentages compared to the controls. On assessing the T-cell function by the macrophage migration inhibition test, no significant difference between patients and controls was found on using the phytohemagglutinin as a mitogen. While a significant defect was found in the T-cell function among the patients compared to the controls when C and ida albicans antigen was used. The percentage of B-cells and T-helper, T-suppressor and TH:TS ratio were found not to be different when the patients and controls were compared

Tratamiento de candidiasis vaginal crónica recurrente con crema vaginal de Tioconazol al 2 por ciento / Treatment with 2 por ciento tioconazol vaginal cream in chronic recurrent vaginal candidiasis

27 pacientes con candiasis vaginal de tipo crónica recurrente fueron tratadas intravaginalmente durante 3 dias con Tioconazol en crema vaginal al 2 por ciento. En este grupo se logró la negativización microbiológica en 74.1 por ciento de los casos en la evaluación a corto plazo y en 63 por ciento de los casos en la de largo plazo; ninguna paciente se perdió hasta los 35 días post tratamiento. De las 17 pacientes con cultivos negativos hasta los 35 días de seguimiento post-tratamiento, que fueron re-evaluadas entre los 60 a 80 días después de completado el tratamiento, dos pacientes se perdieron y 12/15 (80 por ciento) continuaron siendo microbiológicamente negativas. En consecuencia, es nuestra impresión que los tres casos que se positivaron deben ser considerados como reinfecciones. Desde el punto de vista clínico y de las pacientes, los síntomas y signos revirtieron rápidamente, principalmente durante los primeros 5 días después de iniciado el tratamiento. Cuando los síntomas reaparecen, lo más probable es que la infección esté recurriendo o las pacientes se hayan reinfectado. La tolerancia deberá ser considerada como notablemente buena, no se detectaron efectos indeseables