Dequalinium chloride use in adult Spanish women with bacterial vaginosis: an observational study.

Bacterial vaginosis (BV) represents the most frequent vaginal infection in women of childbearing age. The aim of this study was to characterise episodes of BV among adult Spanish women and their management with dequalinium chloride (DQC). Data from 573 DQC-treated BV adult women was obtained on medical records and questionnaires. The study shows that 20.6% had presented vaginal infections previously. Comorbid candidosis was significantly associated to other symptoms, such as pruritus or leucorrhoea. Most patients (64.3%) indicated a moderate-strong impact of the BV episode on their sexual life. After treatment, 84.8% of patients reported no BV symptoms. Patients were given instructions to prevent relapses. Most patients (83.1%) rated DQC as 'satisfactory' or 'very/extremely satisfactory' regarding symptom relief, prevention or treatment of the episode of BV. In conclusion, this study provides a better understanding of BV episodes and the impact of the treatment with DQC in real clinical practice in Spanish patients.IMPACT STATEMENTWhat is already known on this subject? Bacterial vaginosis (BV) is the most commonly reported vaginal infection among women of childbearing age. Despite the availability of antibiotic medications for the treatment of BV, management of this condition remains challenging. In fact, recurrence of BV has been reported for up to 50% of cases. However, antiseptic agents are considered an effective option for BV treatment.What the results of this study add? The study provides a better understanding of the prevalent symptomatology and the impact on quality of life of women with BV. Moreover, it has been observed that antiseptic dequalinium chloride (DQC) efficiently reduces symptoms and improves quality of life of the patients during episodes of BV.What the implications are of these findings for clinical practice and/or further research? In the context of the World Health Organisation recommendations on the rational use of antibiotics, we believe that the use of DQC may be a good alternative to antibiotics as a therapy for BV.

Epidemiology of uterine myomas and clinical practice in Spain: An observational study.

OBJECTIVE: Characterization of the clinical features of symptomatic uterine myomas in Spanish women visiting the gynaecologist, including impact on quality of life and possible risk factors, description of main therapeutic approaches, and evaluation of symptom and quality of life progression 6 months after inclusion in the study. STUDY DESIGN: This was an observational, epidemiological, non-interventional, multicentre study performed between June 2015 and March 2016. Data were collected at baseline and follow-up visits 6 months apart from women with a diagnosis of uterine myomas and visiting a participating gynaecologist in outpatient units of private clinics or public hospitals in Spain. Data consisted of a gynaecological clinical inspection, an interview with open questions to the patients, and self-administered generic questionnaires. The main outcome measures were socio-demographic data, clinical history, myoma clinical features, symptomatology, data on surgical choices, patient satisfaction, and risk factors associated to myomas. RESULTS: Data were collected from 569 patients (1,022 myomas) at 56 hospitals and private gynaecological offices in Spain. Most patients (85%) presented between 1 and 3 myomas, predominantly intramural and subserosal. Most common symptoms reported heavy menstrual bleeding and pelvic pain, and the mean (±SD) symptom severity score in the UFS-QoL questionnaire (range 0-100) was 50.89 ±â€¯20.85. Up to 60.5% of patients had an indication of surgery (55.8% myomectomies, 40.4% hysterectomies) to treat their uterine myomas and 39.5% followed other therapies, mainly pharmacological. After six months of treatment, all patients had experienced significant reduction in symptoms and improvement of quality of life. CONCLUSIONS: The most frequent symptoms reported by women diagnosed with uterine myomas were heavy menstrual bleeding, pelvic or abdominal pain and dysmenorrhea; QoL was impaired reflecting high symptom distress. We found that surgery was the main therapeutic approach to manage uterine myomas in Spain. Both surgical and non-surgical treatments achieve relevant improvements in symptom severity and quality of life.

Risk assessment in submarine outfall projects: the case of Portugal.

Submarine outfalls need to be evaluated as part of an integrated environmental protection system for coastal areas. Although outfalls are tight with the diversity of economic activities along a densely populated coastline being effluent treatment and effluent reuse a sign of economic prosperity, precautions must be taken in the construction of these structures. They must be designed so as to have the least possible impact on the environment and at the same time be economically viable. This paper outlines the initial phases of a risk assessment procedure for submarine outfall projects. This approach includes a cost-benefit analysis in which risks are systematically minimized or eliminated. The methods used in this study also allow for randomness and uncertainty. The input for the analysis is a wide range of information and data concerning the failure probability of outfalls and the consequences of an operational stoppage or failure. As part of this risk assessment, target design levels of reliability, functionality, and operationality were defined for the outfalls. These levels were based on an inventory of risks associated with such construction projects, and thus afforded the possibility of identifying possible failure modes. This assessment procedure was then applied to four case studies in Portugal. The results obtained were the values concerning the useful life of the outfalls at the four sites and their joint probability of failure against the principal failure modes assigned to ultimate and serviceability limit states. Also defined were the minimum operationality of these outfalls, the average number of admissible technical breakdowns, and the maximum allowed duration of a stoppage mode. It was found that these values were in consonance with the nature of the effluent (tourist-related, industrial, or mixed) as well as its importance for the local economy. Even more important, this risk assessment procedure was able to measure the impact of the outfalls on human health and the environment.