Therapeutic value of trichloroacetic acid in the treatment of isolated genital warts on the external female genitalia.

OBJECTIVE: To evaluate the value of 85% trichloroacetic acid (TCA) in the treatment of human papillomavirus (HPV)-associated genital warts of the external genitalia and to detect the recurrence rate and side effects of this therapeutic regimen. STUDY DESIGN: All patients with a suspected HPV-related papillary vulvar lesion after initial examination underwent vulvoscopic evaluation with a magnification of 8-20x using acetic acid and toluidine blue. Under local anesthesia, biopsies were taken from acuminate or papillary warts for histopathologic confirmation and from suspicious areas to exclude preinvasive or invasive diseases. Following histopathologic diagnosis, patients were treated with 85% TCA. RESULTS: Overall, 51 patients with isolated vulvar and/or perianal genital warts were included. Of those patients, 11 (21.5%) had acuminate and 40 (78.5%) had papular genital warts. All the women had lesions of the labia minora. The other localizations were as follows: labia majora, 18 (35.3%); lateral vulva, 5 (9.8%); clitoris, 9 (17.6%); fourchette, 16 (31.3%); and perianal area, 7 (13.7%). All lesions were successfully treated by the end of the treatment period (median, 4; range 2-5). None of the patients had recurrence or new lesions during the 6-month follow-up period. In the second 6 months, 9 patients (17.6%) were diagnosed with recurrent lesions. Although all the patients experienced transient burning pain during therapy, none of them discontinued the therapy. Ulceration was observed in 8 patients (15.6%). Of those patients only 3 had permanent scarring (5.8%). CONCLUSION: We recommend the use of TCA in patients with external genital warts, especially for mild to moderate cases. It is associated with a high success rate and low morbidity if sufficient care is taken during application.

The mean platelet volume in gestational diabetes.

OBJECTIVE: To compare the platelet count and mean platelet volume (MPV) values of pregnancies diagnosed with gestational diabetes with those of healthy pregnancies. MATERIAL-METHOD: Between June 2003 and September 2004, 100 healthy pregnancies and 100 pregnancies with gestational diabetes were studied at Gazi University, Department of Obstetrics and Gynecology. RESULTS: While no statistically significant difference was observed in the platelet count between the two groups, the MPV of the gestational diabetes group (9.4 +/- 1.6 fl) was evaluated to be significantly higher than the MPV of the healthy pregnancy group (8.3 +/- 1.1 fl). Additionally, when linear regression analysis was performed an inverse relationship was observed between platelet number and MPV. CONCLUSION: There is a need for further research focusing on the platelet function in the observation and treatment of gestational diabetes, which can pose the risk of developing Type 2 diabetes for the mother and has negative consequences for the fetus.

Susceptibility to some antifungal drugs of vaginal lactobacilli isolated from healthy women.

Samples were taken from the lateral vaginal wall of 19 healthy women. Lactobacilli were isolated from ten of these women. Fifty-eight Lactobacillus isolates were identified as L. gasseri, L. vaginalis, L. acidophilus, L. delbrueckii spp. lactis, L. crispatus, L. plantarum, L. cellobiosus, L. jensenii, L. salivarius, L. curvatus, L. brevis and L. oris. The inhibitory effect of isoconazole and oxiconazole in 0.2, 0.1 and 0.05 microg/ml concentrations on 58 Lactobacillus spp. and Candida albicans (AJD 180) were investigated, using an agar diffusion method. Although both antifungal drugs showed a large inhibitory effect on C. albicans, oxiconazole had a very low inhibitory effect on Lactobacillus isolates. The natural resistance of lactobacilli to anti-fungal drugs may enable the development of an antifungal drug(s)/ probiotic combination for antifungal activity and lactobacilli replacement therapy.