A randomized, comparative study of a single oral dose of fluconazole versus a single topical dose of clotrimazole in the treatment of vaginal candidosis among general practitioners and gynaecologists.

OBJECTIVES: To compare efficacy, acceptability and patient preference of a single oral dose of fluconazole with a single intravaginal dose of 500 mg clotrimazole (medication groups) in women with vaginal candidosis visiting gynaecologists or general practitioners (study groups). DESIGN: A comparative, randomized multicenter study. EVENTS: Baseline visit and treatment, short-term follow-up after 1 week and long-term follow-up after 4 weeks. At each visit, symptoms were graded and cultures were obtained. RESULTS: Symptomatic and mycological efficacy did not differ statistical significant in the medication groups or study groups. A complicated history regarding vaginal candidosis was more often found among gynaecologists, yielding poorer results of treatment. Patients preferred oral treatment over intra-vaginal treatment. CONCLUSIONS: No differences were found in the clinical and mycological efficacy of both drugs. Clinical results were related to parameters originating from the patients history, resulting in less favourable results in the study group of gynaecologists.

Melatonin and melatonin-progestin combinations alter pituitary-ovarian function in women and can inhibit ovulation.

Although melatonin (MEL) controls seasonal reproductive cyclicity in some mammalian species, its role in women is controversial. In this study data are presented related to the influence of MEL or MEL-progestin combinations on the pituitary-ovarian axis and ovulation in 32 women. MEL was administered in a dosage of 300 mg to 12 women for 4 months [to 8 women daily (days 1-30) and to 4 women on days 5-17 of the cycle]. MEL was also combined with the synthetic progestin norethisterone (NET) in an attempt to evaluate MEL's effect on a partially suppressed pituitary-ovarian axis. In 16 women, 4 combinations were tested on 4 women each on days 1-21: dosages of 300 mg MEL/0.75 mg NET, 75 mg MEL/0.75 mg NET, 7.5 mg MEL/0.75 mg NET, and 75 mg MEL/0.30 mg NET. In addition, 2 women were medicated with 300 mg MEL alone, and 2 were medicated with 300 mg MEL/0.15 mg NET on days 1-21 for 2 months. During the study, LH, FSH, estradiol (E2), and progesterone (P4) blood levels were determined at regular intervals. After a period of 4 months, daily administration of 300 mg MEL (days 1-30) caused significantly decreased mean LH levels compared to those in 8 nonmedicated controls (P less than 0.001). Also compared to nonmedicated control data, a significant inhibition of P4 in the first and fourth medication months (P less than 0.001) was observed. LH and E2 inhibition reached significance in the fourth medication month (P less than 0.005). Also, the treatments of 300 mg MEL (days 5-17) and 75 mg MEL combined with 0.3 mg NET caused a significant decrease in LH, E2, and P4 levels compared to those in the nonmedicated control group in the first and fourth medication months (P less than 0.05). The data further suggest an additive or synergistic effect between MEL and NET. The medications did not alter sleep-wake rhythms and were not complicated by any side-effects. The presented data suggest that MEL and MEL/NET combinations inhibit ovarian function in women, and that MEL/NET combinations can emerge as effective oral contraceptives.

Is serum beta 2 microglobulin a useful marker in patients with breast cancer?

In a study of 19 patients with breast cancer serum beta 2 microglobulin (beta 2 mu) was evaluated as a tumour marker. Serum beta 2 mu did not correlate with tumour stage, survival time, or histological differentiation grade. Nor did a change of serum beta 2 mu reflect a change of tumour mass. Additionally, serum beta 2 mu lacks specificity and sensitivity, as only 21% of our patients had an increased serum beta 2 mu.

Comparison of photographic (multiple-exposure photography) and conventional evaluation of ejaculates for fertility prognosis.

Semen obtained from 191 men visiting our infertility clinic was studied by MEP and conventional methods. With MEP, sperm count, percentage of motility, sperm velocity, straight line approach, and speed constancy were determined. Two years afterward 49 of the men appeared to have fertilized their partners. Between the fertile and infertile men, no differences in motility values determined by MEP could be detected. The only differences observed existed in sperm count and duration of infertility.

Motility and morphology of human spermatozoa in split ejaculates.

Sperm concentration and four motility characteristics (per cent motile spermatozoa, average velocity, average straight line approach and average speed constancy) were determined in three fractions of human split ejaculated from healthy volunteers. A semi-automatic analysis technique was used to determine sperm parameters from multiple exposure photographs (MEP). Sperm concentration and percentage motility were significantly higher in the first fraction as compared to the third fraction of split ejaculates. The average spermatozoal velocity, average speed constancy and average straight line approach were the same in all fractions. Differences in the percentage of motile spermatozoa were also found after collection of split ejaculates in culture medium. This phenomenon may have been caused by differences in sperm morphology. Significantly more normal spermatozoa were present in the first fractions of 19 split ejaculates as compared to the last fractions.