- Efficacy and safety of combined high-dose interferon and red light therapy for the treatment of human papillomavirus and associated vaginitis and cervicitis: A prospective and randomized clinical study. [Randomized Controlled Trial]
- MMedicine (Baltimore) 2018; 97(37):e12398
- CONCLUSIONS: This study suggests that combination of high-dose IFN and red light therapy is safe and effective against subclinical and latent HPV infections.
- Comparative risk of genital infections associated with SGLT2 inhibitors: A real-world retrospective cohort study. [Journal Article]
- DODiabetes Obes Metab 2018 Sep 12
- It is unclear the extent to which Sodium-glucose co-transporter 2 (SGLT2) inhibitors increase the risk of genital infections in routine clinical care against other antidiabetic medications, or whethe...
It is unclear the extent to which Sodium-glucose co-transporter 2 (SGLT2) inhibitors increase the risk of genital infections in routine clinical care against other antidiabetic medications, or whether the increased risk is consistent across gender or age subgroups, within individual SGLT2 agents, or it is more pronounced at a particular time after treatment initiation. We conducted a retrospective cohort study in two US commercial claims databases (2013-2017). In the primary analysis, a 1:1 propensity-score matched cohorts of female and male with type-2 diabetes mellitus initiating a SGLT2 inhibitor vs DPP-4 inhibitors was created. The outcome was a composite of genital candidal infections, vaginitis or vulvovaginitis in females, and genital candidal infections, balanitis, balanoposthitis, phimosis or paraphimosis in males. Among a propensity-score matched cohorts of 129,994 females and 156,074 males, the adjusted Hazard Ratio and excess-risk per 1,000 person years for SGLT2 v DPP-4 inhibitors was 2.81 (95% CI, 2.64, 2.99) and 87.4 (95% CI, 79.1, 96.2) respectively for females, and was 2.68 (95% CI, 2.31, 3.11and 11.9 (95% CI, 9.3-15.0) for males. Findings were similar in the SGLT2 inhibitor vs GLP1 agonist comparison, more pronounced in the subgroup of patients aged ≥60 (HR, 4.45 (95% CI, 3.83-5.17) in females and 3.30 (95% CI, 2.56-4.25) in males), and no meaningful difference across individual SGLT2 inhibitors was identified. This increase in risk was evident in the first month of treatment initiation and remained elevated throughout the course of therapy. SGLT2 inhibitors were associated with an approximately three-fold increase in risk of genital infections This article is protected by copyright. All rights reserved.
- Characterization of beta-tubulin DNA sequences within Candida parapsilosis complex. [Journal Article]
- CMCurr Med Mycol 2018; 4(1):24-29
- CONCLUSIONS: Our data provided the basis for further discoveries of the relationship between the species belonging to C. parapsilosis complex. Furthermore, the findigns of the prsent study revealed the efficiency of beta-tubulin DNA sequence data in the identification and taxonomy of C. parapsilosis and other pathogenic yeasts.
- Chronic vulvovaginitis caused by Candida dubliniensis in an immunologically competent adult female. [Journal Article]
- IJInt J STD AIDS 2018 Aug 31; :956462418792113
- Candida, a commensal dimorphic fungus, is the most common microorganism that causes opportunistic fungal infections worldwide. It can cause diseases ranging from superficial mucosal infections to dis...
Candida, a commensal dimorphic fungus, is the most common microorganism that causes opportunistic fungal infections worldwide. It can cause diseases ranging from superficial mucosal infections to disseminated, systemic life-threatening infections. Among Candida species, Candida albicans is the most common infectious agent. Nowadays, non- albicans Candida species are also emerging as significant pathogens. Candida dubliniensis has been implicated as a causative agent of oral candidiasis in HIV-infected individuals but has also been recovered from HIV non-infected individuals with oral candidiasis and rarely from the genital tract of women with vaginitis. Such cases have been under-reported due to phenotypic resemblance to C. albicans. The majority of C. dubliniensis clinical isolates tested to date have been susceptible to fluconazole, but they tend to develop resistance rapidly. Here, we report a case of chronic vulvovaginitis due to C. dubliniensis not responding to standard doses of fluconazole.
- Diagnosis and Treatment of Genitourinary Syndrome of Menopause. [Journal Article]
- NWNurs Womens Health 2018 Aug 28
- Genitourinary syndrome of menopause (GSM), formerly referred to as vulvovaginal atrophy or atrophic vaginitis, is a common chronic condition that requires a collaborative treatment plan between a hea...
Genitourinary syndrome of menopause (GSM), formerly referred to as vulvovaginal atrophy or atrophic vaginitis, is a common chronic condition that requires a collaborative treatment plan between a health care provider and a woman to relieve symptoms and improve quality of life. Many women are not aware that symptoms can be controlled with treatment. Current treatment options approved for GSM include vaginal moisturizers, lubricants, and hormones. For women with GSM symptoms that are unresponsive to nonhormonal therapy, low-dose vaginal estrogen therapy is the preferred pharmacologic treatment. Clinicians should be trained to routinely ask appropriate questions during the history to elicit sufficient information to assess for GSM. Physical examination findings may further confirm suspicion of GSM.
- Candida parapsilosis Vaginal Infection-a New Site of Azole Drug Resistance. [Review]
- CICurr Infect Dis Rep 2018 Aug 27; 20(11):43
- CONCLUSIONS: Clinicians are required to determine a causal relationship between vaginal isolates of C. parapsilosis before prescribing antifungal agents, recognizing the possibility of fluconazole resistance to explain refractory symptomatology.
- Association of gestational diabetes mellitus and abnormal vaginal flora with adverse pregnancy outcomes. [Journal Article]
- MMedicine (Baltimore) 2018; 97(34):e11891
- Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. This study aimed to examine the association between GDM and abnormal vaginal flora, and the association between abno...
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. This study aimed to examine the association between GDM and abnormal vaginal flora, and the association between abnormal vaginal flora and adverse pregnancy outcomes.This was a prospective study of pregnant women who visited Xuanwu Hospital of the Capital Medical University (Beijing, China) between February and October 2015. All women were screened for GDM according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations. Vaginal secretions were sampled at 28 to 30 and 37 to 40 weeks. Microorganisms were examined.The women were 28.3 ± 2.6 years and their body mass index was 22.8 ± 1.4 kg/m. GDM was associated with higher frequencies of vulvovaginal candidiasis (22.6% vs 9.7%, P < .001), premature rupture of membranes (PROM) (22.6% vs 11.5%, P = .004), premature delivery (16.1% vs 5.5%, P = .02), chorioamnionitis/puerperal infection (19.4% vs 4.5%, P < .001), macrosomia (9.7% vs 4.0%, P = .04), neonatal hypoglycemia (5.4% vs 1.0%, P = .02), and neonatal referral (15.1% vs 6.5%, P = .008). Among healthy women, abnormal flora was associated with PROM (19.4% vs 7.5%, P = .02) and chorioamnionitis/puerperal infection (11.9% vs 0.8%, P < .001). Among women with GDM, abnormal flora was associated with PROM (32.1% vs 10.0%, P < .001), premature delivery (17.7% vs 6.3%, P = .04), and chorioamnionitis/puerperal infection (32.8% vs 2.5%, P < .001).The vaginal infection rate was higher in patients with GDM compared with healthy pregnant women. GDM and abnormal vaginal flora were both associated with adverse pregnancy outcomes. The vaginal Lactobacillus species were different between the 2 groups, which could contribute to the adverse outcomes.
- Incidence and risk of vaginal candidiasis associated with SGLT2 inhibitors in real-world practice for women with type 2 diabetes. [Journal Article]
- JDJ Diabetes Investig 2018 Aug 23
- CONCLUSIONS: The rates of developing positive colonization and symptomatic vaginitis after starting SGLT2 inhibitors appear to be higher in real-world practice than the rates of 31% and 5-10% in clinical trials, respectively. Risk factors of vaginal Candida colonization may be different before and after taking SGLT2 inhibitors. This article is protected by copyright. All rights reserved.
- Factors in the HIV risk environment associated with bacterial vaginosis among HIV-negative female sex workers who inject drugs in the Mexico-United States border region. [Journal Article]
- BPBMC Public Health 2018 Aug 20; 18(1):1032
- CONCLUSIONS: Our findings suggest that FSW-PWIDs' risk of BV may be shaped by the microphysical HIV risk environment. Addressing components of the physical risk environment, including interventions to reduce gender-based violence, may alleviate the burden of BV and subsequent susceptibility to HIV/STIs among FSW-PWIDs in the Mexico/US border region.
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- Infections During Pregnancy. [Review]
- PCPrim Care 2018; 45(3):567-586
- Several infections have unique consequences or considerations in pregnancy. Some common infections such as urinary tract infections, influenza, sexually transmitted diseases, and vaginitis affect pre...
Several infections have unique consequences or considerations in pregnancy. Some common infections such as urinary tract infections, influenza, sexually transmitted diseases, and vaginitis affect pregnant women differently than the general population, can cause pregnancy complications, and require treatments that are safe in pregnancy. Infections such as hepatitis B and C and human immunodeficiency virus can be transmitted vertically and therefore management focuses on decreasing perinatal transmission. Certain infections can be transmitted in utero and cause congenital infections. Classically, these were grouped together as the TORCH infections, although now several others, including varicella virus, parvovirus, and Zika virus, have also been recognized.