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At least 577 records · Page 32Linked to original sources
PubMed1986

Systemic absorption of miconazole from the vagina.

The serum concentrations of miconazole were measured in 11 healthy adult females for 72 hours following a single 1200 mg vaginal pessary. The mean peak serum miconazole concentration was 10.4 micrograms/l and the mean elimination half life was 56.8 h. The mean area under the serum concentration time curve was 967 micrograms/l.h. The calculated mean systemic bioavailability of the vaginal pessary was 1.4%. There was large intersubject variation in serum miconazole pharmacokinetics. This formulation may provide effective single dose treatment for vaginal candidosis.

Absorption↗
PubMed1992

Pattern of gonadotropin-releasing hormone (GnRH)-like stimuli sufficient to induce follicular growth and ovulation in ewes passively immunized against GnRH.

The pattern of GnRH-like stimuli capable of inducing follicular growth, ovulation, and luteal function was evaluated in ewes passively immunized against GnRH. The estrous cycles of 30 regularly cyclic sheep were synchronized using vaginal pessaries impregnated with a synthetic progestogen. Animals were passively immunized against GnRH (groups 2-5, n = 6) or the carrier protein, keyhole limpet hemocyanin (KLH; group 1, n = 6), at the time of pessary removal (PR). Circhoral delivery of saline (groups 1, 2, and 5) or low amplitude GnRH agonist (des-Gly10 GnRH ethylamide [100 ng/hourly pulse]; groups 3 and 4) was initiated at PR and continued for 3 (groups 4 and 5) or 12 days (groups 1-3). In groups 4 and 5, the amplitude of the GnRH-like stimulus was increased to 800 ng/hourly pulse (stimulus-shift) during the 24-h period beginning 72 h after PR. The amplitude of the hourly stimulus was adjusted to 100 ng/pulse 96 h after PR and continued at that level to Day 12. The endocrine changes associated with follicle growth and maturation (serum concentrations of estradiol [E2] above 10 pg/ml), ovulation (surge-like secretion of LH and FSH), and normal luteal function (serum concentrations of progesterone [P] above 2 ng/ml) were evident in ewes passively immunized against KLH (group 1). In this group, the preovulatory surge of gonadotropins was noted 48.7 +/- 1.2 h after PR. These endocrine events were blocked by passive immunization against GnRH (group 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Effects of passive immunization against inhibin-peptide on secretion of follicle-stimulating hormone and ovulation rate in ewes carrying the Booroola fecundity gene.

Objectives of the study were to determine whether 1) inhibin negative feedback regulation of FSH secretion is diminished in ewes carrying a copy of the Booroola fecundity (FecB) gene and 2) differential FSH secretion is obligatory for expression of gene-specific differences in ovulation rate (OR). The approach was to compare FSH and ovulatory responses to passive immunoneutralization of inhibin in ewes with and without a copy of the FecB gene. Twenty-eight 2- to 3-yr-old ewes were assigned within genotype to antibody (alpha-IF-Ab) or control groups. Genotypes consisted of 3/4 Rambouillet x 1/4 Booroola ewes with one copy of the FecB gene (FecB+; 57 kg) and 3/4 Rambouillet x 1/4 Booroola ewes without the FecB gene (++; 59 kg). Estrus was synchronized during the breeding season using progesterone-releasing pessaries (CIDR-G). Pessaries were removed at 0 h. A single injection of alpha-IF-Ab or control solution was given at -48 h. Alpha-IF-Ab had been developed against a synthetic inhibin fragment matching the N-terminal region of ovine inhibin's alpha subunit. For injection, alpha-IF-Ab had been precipitated from ovine immune sera and concentrated. Blood samples were collected at 6-h intervals from -48 to 48 h, and laparoscopy was performed 14 days after CIDR-G withdrawal. All ewes exhibited estrus and ovulated. Genotype and alpha-IF-Ab treatment were without effect on intervals to estrus. Both factors affected OR (p < or = 0.001). Mean OR in control ++ and FecB+ ewes were 1.6 and 2.7, respectively; mean OR in alpha-IF-Ab-treated ++ and FecB+ ewes were 2.5 and 4.6, respectively. Following injection of alpha-IF-Ab, FSH concentrations increased within 6 h, peaked 12-18 h later, and then declined. Magnitude of FSH increases was similar in ++ and FecB+ ewes (70% and 85% over control values, respectively). Results demonstrate that 1) inhibin negative feedback regulation of FSH secretion is not a site of FecB gene action and 2) the mechanism by which the FecB gene increases OR does not necessarily involve increased FSH secretion during the period of preovulatory follicular development.

Animals↗
PubMed1987

4-bromo-7-hydroxyindan oxime--a new potent spermicidal agent.

The spermicidal effect of eleven chelating agents with a ring structure was evaluated using human spermatozoa. All were potent spermicides in vitro. 4-Bromo-7-hydroxyindan oxime (S-11) was the most potent and its lowest effective concentration for immobilizing sperm within 20 sec was 0.02 mg/ml; its toxicity was also the lowest of the compounds tested with an acute LD50 of 2936 mg/kg. In rabbits, S-11 caused no local irritation to the conjunctiva or quadriceps femoris muscle at a concentration of 0.02 mg/ml. Heart, liver, kidney, spleen, lung and vagina showed no pathological changes when vaginal pessaries containing 1 or 10 mg of S-11 were administered daily, six times a week for 90 days. When vaginal pessaries of 8 or 40 mg S-11 were administered on days 7-15 after mating, no significant abnormality in general appearance, in the viscera or bone development of foetuses were found.

Animals↗
PubMed1984

The effect of exogenous hormones on the resistance of the early pregnant human cervix.

The force required to dilate the cervix to a diameter of 8 mm (cervical resistance index) has been measured in 355 patients undergoing suction termination in the first trimester of pregnancy. The cervical resistance index (CRI) was significantly lower in multigravid patients compared with primigravid patients. Prior treatment with prostaglandin E2 pessaries produced a consistent reduction in CRI in multigravidae but not in primigravidae. The effect of the prostaglandin was more pronounced on the compliance of the cervical tissue than on the diameter of the cervical canal. Treatment with pessaries of oestradiol, progesterone and medroxy-progesterone acetate produced no changes in the CRI.

Cervix Uteri↗
PubMed1990

Pretreatment with mifepristone (RU 486) reduces interval between prostaglandin administration and expulsion in second trimester abortion.

The effect of pretreatment with mifepristone on prostaglandin-induced abortion was investigated in a double-blind randomized trial involving 100 women in the second trimester of pregnancy. The women were randomly allocated to receive either 600 mg oral mifepristone or placebo tablets 36 h before the administration of gemeprost pessaries. The median interval between administration of prostaglandin and abortion was significantly shorter in the mifepristone group (6.8 h) compared with the placebo group (15.8 h). The women pretreated with mifepristone required significantly fewer gemeprost pessaries to induce abortion and experienced significantly less pain than the women who had received placebo.

Abortifacient Agents↗
PubMed2000

Polyherbal formulations with wide spectrum antimicrobial activity against reproductive tract infections and sexually transmitted pathogens.

PROBLEM: Recent reports indicate high incidence of genital infections, most of which are sexually transmitted. Although specific drugs and antibiotics are available for some, a safe spermicidal formulation with wide spectrum antimicrobial action would be a desirable addition to the presently available spermicides. METHODS: Formulations at different dilutions were tested in culture systems on standard strains and clinical isolates including some isolates resistant to drugs. The effect on (HSV)-2 and Chlamydia trachomatis was determined in vivo in progestin sensitized mice. The effect on HIV-1 was investigated in two standardized systems. RESULTS: Polyherbal cream inhibited the growth in culture of clinical isolates of Candida albicans, Candida krusei and Candida tropicalis. Both the polyherbal cream and the Praneem polyherbal pessary inhibited urinary tract Escherichia coli (including multidrug resistant strains), and Neisseria gonorrhoeae (including 2 strains resistant to penicillin). Both formulations manifested virucidal activity against HIV-1 at >2 and 50% dilutions (in two different test systems) on contact for 1-2 min. Intravaginal inoculation of the cream and the pessary suspensions before inoculation of the pathogen prevented lesions and vaginal transmission of HSV-2 and C. trachomatis in progestin sensitized mice. CONCLUSIONS: Polyherbal formulations have wide spectrum antibacterial, antifungal and antiviral effect against the tested sexually transmitted pathogens.

Animals↗
PubMed1985

Efficacy of econazole ('Gyno-Pevaryl' 150) in vaginal candidosis during pregnancy.

An open, multi-centre study was carried out in 117 pregnant women presenting with vaginal candidosis to assess the effectiveness of econazole in providing mycological control and symptom relief, and in preventing, as far as possible, the risk of contamination of the newborn: nearly 50% of the patients were in the last month of pregnancy. Patients received a single course of econazole given as 1 vaginal pessary (150 mg) on 3 consecutive days. Clinical and mycological assessments were made 1 week after the end of treatment and again at delivery, unless it happened before the first control visit. The infants were investigated at birth and 1 week afterwards. An 80% mycological cure rate was obtained and there was complete or marked relief of symptoms in the majority of patients after treatment. Twenty patients received further antimycotic treatment before delivery either because of failure (13) or relapse (7) after the single course of econazole. The relapse rate was 13.3%. No congenital abnormality was observed in the neonates and only 1 infant, born to a mother who was positive for Candida at the time of delivery, developed oral candidosis. Local tolerance of the vaginal pessaries was good and there were no reports of side-effects.

Adolescent↗
PubMed2005

Management of metronidazole-resistant Trichomonas vaginalis--a new approach.

Metronidazole-resistant trichomoniasis is an infrequent but challenging problem with no universally successful treatment. Since 1994, we have been using a combination regimen consisting of high-dose tinidazole plus a broad-spectrum antibiotic, i.e. doxycycline or ampicillin, and clotrimazole pessaries, for 7--14 days in this condition. A retrospective case review identified 11 cases of resistant trichomonas between 1994 and 2002. In the absence of resistance testing, resistance was defined clinically. Nine of the 11 patients were cured; one patient did not attend follow-up. In the women who attended for follow-up, the cure rate was 90%. We have found the combination of tinidazole, a broad-spectrum antibiotic, and clotrimazole pessaries to be a tolerable and effective treatment for metronidazole-resistant Trichomonas vaginalis. Although a variety of total doses of tinidazole were used in our patients, based on our findings, and those of others, we would recommend giving tinidazole 2 g twice daily for 14 days (total dose 56 g).

Ampicillin↗
PubMed1989

Fertilization and ovum recovery rates in superovulated ewes following cervical insemination or laparoscopic intrauterine insemination at different times after progestagen withdrawal and in one or both uterine horns.

In Exp. 1, 40 ewes were used in a 2 x 2 factorial design to investigate the effects of intrauterine versus cervical insemination and superovulation using pig FSH or PMSG and GnRH on egg recovery and fertilization rate. Cervical inseminations were carried out at 48 and 60 h (N = 20 ewes) and intrauterine insemination at 52 h (N = 20 ewes) after progestagen pessary withdrawal. Eggs were recovered on Day 3 of the oestrous cycle. Ovulation, egg recovery and fertilization rates were independent of the type of superovulatory hormone used. Fertilization rate was high irrespective of insemination site but intrauterine insemination at 52 h was associated with a significant (P less than 0.01) decrease in egg recovery of over 40% compared with cervically inseminated ewes. In Exp. 2 ewes were inseminated at 36 (N = 5), 48 (N = 6) or 60 (N = 6) h after pessary withdrawal to determine the optimum intrauterine insemination time to maximize both fertilization rate and egg recovery. Egg recovery per ewe flushed was 23, 59 and 67% after intrauterine insemination at 36, 48 and 60 h respectively. Correspondingly, 0, 85 and 100% of the eggs recovered were fertilized. The results of Exps 1 and 2 suggest that when intrauterine insemination occurs before or during ovulation it interferes with oocyte collection by the fimbria. In Exp. 3 egg recovery and fertilization rates were determined after cervical insemination at 48 and 60 h (N = 8) or intrauterine insemination at 48 (N = 9) or 60 (N = 8) h after progestagen withdrawal. Ewes in the last two groups were subdivided and inseminated unilaterally or bilaterally. Egg recovery was high after cervical insemination (95%) but only 36% of these eggs were fertilized. Unilateral intrauterine insemination was as effective as bilateral in ensuring high fertilization rates (100 versus 97%). Intrauterine insemination at 48 h compared with 60 h resulted in a significantly lower (P less than 0.05) percentage of eggs recovered (42 versus 90% respectively). However, reducing the degree of interference by adopting unilateral rather than bilateral insemination did not alleviate the detrimental effects of the 48-h insemination time on egg recovery. From these results we advocate the adoption of intrauterine insemination at 60 h after progestagen withdrawal to maximize fertilization rate and egg recovery in superovulated ewes.

Animals↗
PubMed1994

Changes in progesterone secretion following treatment with transforming growth factor alpha (TGF-alpha) during the follicular phase of the sheep oestrous cycle.

The effects of transforming growth factor alpha (TGF-alpha) on ovarian steroid secretion were investigated. Three crossbred ewes synchronized for oestrus with ovarian autotransplants were infused with TGF-alpha (30 micrograms in 12 h) via the ovarian artery for 12 h before withdrawal of progestagen pessary. Three ewes were used as controls. Jugular and ovarian venous blood samples were taken at intervals of 10 min at two stages during the follicular phase (21-27 h and 38-42 h after pessary withdrawal) and every 2 h from 44 to 86 h. Plasma LH and FSH concentrations, and ovarian secretion rates of inhibin, androstenedione, oestradiol and progesterone were determined using radioimmunoassays. LH pulse amplitude increased in ewes treated with TGF-alpha in the early follicular phase (0.92 +/- 0.25 micrograms l-1 in controls versus 3.10 +/- 0.35 micrograms l-1 in TGF-alpha treated ewes; P < 0.05) and remained high in the late follicular phase. Plasma FSH concentrations were high during the follicular phase in ewes treated with TGF-alpha (P < 0.05). The infusion of TGF-alpha had no significant effect on the ovarian rate of secretion of androstenedione and, although the secretion rates of oestradiol and inhibin were consistently lower in TGF-alpha-infused ewes, the differences were not significant. The ratio of secretion of androstenedione to oestradiol was greater during the follicular phase in TGF-alpha-treated ewes (P < 0.05), suggesting that the efficiency of aromatization had been impaired.(ABSTRACT TRUNCATED AT 250 WORDS)

Androstenedione↗
PubMed2000

Chronic vaginal candidiasis. Management in the postmenopausal patient.

Vulvovaginal candidiasis (VVC) is a cause of significant morbidity in many women of a childbearing age worldwide. There is a paucity of literature on the prevalence of this condition in postmenopausal women, although it is believed to be uncommon because of the estrogen dependence of VVC. Postmenopausal women who have underlying risk factors for VVC (e.g. hormone replacement therapy, uncontrolled diabetes mellitus, immunosuppression caused by medication or disease) may be at risk of chronic or recurrent VVC. However, as in younger women, it is likely that, even after exhaustive investigations, no cause will be found in a significant number of patients. The investigation and treatment of VVC in older women should be the same as that undertaken in younger women. Both topical and oral preparations are available, but oral regimens are perhaps more acceptable because of the ease of administration and avoidance of potentially messy creams and suppositories. Ketoconazole at a dosage of 400 mg daily for 14 days can be used to achieve clinical remission of symptoms and negative fungal cultures. Induction treatment should be followed by maintenance therapy for 6 months with ketoconazole 100 mg daily, itraconazole 50 to 100 mg daily or fluconazole 100 mg weekly or 150 mg monthly. Short courses of topical therapy, e.g. 500 mg clotrimazole pessaries as a single weekly dose for 6 months or 100mg miconazole pessaries twice weekly for 3 months, followed by once weekly for 3 months may also be used.

Candidiasis, Vulvovaginal↗
PubMed1986

Determinants of estrous behavior in lactating Holstein cows.

The objective was to determine factors that affect the expression of estrus. Thirteen lactating Holstein cows were ovariectomized about 4 to 6 wk postpartum and then challenged repeatedly with progesterone and estradiol benzoate to induce estrus six times during the postpartum period. Each challenge included 5 d when the cow was primed with progesterone through insertion of a progesterone-impregnated, foam rubber pessary. Estradiol benzoate (1 mg) was injected intramuscularly 36 h after removal of the pessary. Groups of two to three cows each began the experiment at 3-mo intervals to avoid confounding treated simultaneously. Observations for estrous behavior were at 8-h intervals following each challenge. A minimum of three sexually active cows were always observed together to avoid differences in estrous behavior caused by having too few sexually active animals in the group. Observations for estrous behavior were at 8-h intervals following each challenge. During each observation, cows were observed for 30 min on dirt and for 30 min on concrete. Standing behavior was not influenced by postpartum interval, season of year, or milk yield. Mounting behavior increased from the first to the sixth postpartum challenge, but it was not affected by season of year or milk yield. Duration of estrus, mounting activity, and standing activity were greater on dirt than on concrete. These results indicate that the surface on which cows were observed had a profound effect on sexual behavior; however, postpartum interval, season of year, and milk yield were of minor importance.

Animals↗
PubMed2000

Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse.

PURPOSE: We determined the indications for anti-incontinence surgery in continent women undergoing surgical repair of severe urogenital prolapse. MATERIALS AND METHODS: We prospectively evaluated 24 continent women referred for evaluation of severe urogenital prolapse. All patients underwent a meticulous clinical evaluation, including a complete history and physical examination, urinary questionnaire, voiding diary, pad test, cotton swab test, video urodynamics and cystoscopy. The urodynamic evaluation was repeated with prolapse repositioning by a fitted vaginal pessary. Surgical intervention was tailored according to urodynamic findings. RESULTS: Reduction of prolpase with a pessary unmasked sphincteric incontinence in 14 women (58%). Ten women with no urodynamic evidence of sphincteric incontinence underwent anterior colporrhaphy and no additional anti-incontinence procedure was performed. Mean followup was 44 months (range 12 to 96). None had postoperative stress incontinence but 1 (10%) had a recurrent grade 2 cystocele. The 14 remaining women with sphincteric incontinence after prolapse reduction underwent anterior colporrhaphy with a pubovaginal sling procedure. Mean followup in these cases was 47 months (range 12 to 108). In 2 patients (14%) stress incontinence developed postoperatively and 1 (7%) had a recurrent grade 3 cystocele. The incidence of urge incontinence did not appear to be significantly influenced by either surgical intervention. Overall 12 patients had preoperative urge incontinence, of whom 9 (75%) had persistent urge incontinence postoperatively. In another woman new onset urge incontinence developed. CONCLUSIONS: Preoperative urodynamic evaluation with and without prolapse reduction is essential for making the correct diagnosis of masked stress incontinence in women with urogenital prolapse. The decision to perform a concomitant prophylactic anti-incontinence procedure should be tailored to individual urodynamic findings. Larger series and longer followup are needed to establish the most effective preventive procedure for this troublesome clinical problem.

Aged↗
PubMed2000

[Severe cardiovascular complications relating to Gemeprost therapy].

The use of gemeprost vaginal pessaries is generally thought to be a method with little complications used for cervical softening within the first two trimesters of pregnancy. Though in our hospital two cases presented with severe cardiovascular reactions, to be attributed to the effect of prostaglandins. The first patient experienced a severe cardiogenic shock due to vasospasm several hours after primary administration of gemeprost vaginal pessaries and a cerebral stroke some hours later. The second patient suffered of a myocardial infarction ensuing from coronary spasm.

Abortifacient Agents, Nonsteroidal↗
PubMed2001

[Ovarian abscess due to Actinomyces sp. in absence of an intrauterine contraceptive device].

The disease caused by Actinomyces spp. is often of difficult diagnosis. Actinomyces spp. are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. IUD and pessaries facilitate the access of the microorganisms to the pelvis. We report an unusual case of ovarian infection by Actinomyces sp. in a 41 year-old female without IUD, admitted at the Institute in November 1998, with persistent fever. She had had an early menopause 3 years before, and had received hormonal replacement therapy. Usual and unusual infections were discarded by microbiological and serologic studies. Abdominal ultrasonography showed a slight left pyelocalycial dilatation and a simple cyst in the left ovary; heart ultrasonography was normal. Gynecological examination showed an enlarged uterus, similar to an 8 week pregnancy, painless, and fixed anexial masses. The transvaginal ultrasonography showed uterine myomas, one of them of 42 mm in the isthmus region, large ovaries, cystic, with acoustic shadows, and the left one with a septum. The preoperative diagnosis was infected bilateral cystic teratoma. The procedure was an exploratory laparotomy, followed by a bilateral salpingo-oophorectomy. The specimen studies showed an endometrioma with calcium deposits in the wall of the right ovary, and an abscess in the left ovary, also with calcification of the wall. The sample from the left abscess developed Actinomyces sp. After surgery, and treatment with penicillin, the fever disappeared. It is important to remark that the ovarian infection by Actinomyces sp. can also occur in patients without an IUD or a pessary; it might cause anexial images that can be interpreted as a tumour, inducing to erroneous diagnosis and treatment.

Abscess↗
PubMed2003

Uterine cervical elongation and prolapse during pregnancy: an old unsolved problem.

Prolapse with elongation of the cervix is a rare complication of pregnancy. Prolapse that existed before onset of pregnancy will usually resolve spontaneously by the end of the second trimester, without further complications. A pessary can be used to protect the cervix. Prolapse that develops during pregnancy is usually first noted in the third trimester, and management consists of bed rest in a slight Trendelenburg position. In these cases, pessaries will probably not remain in place or prevent preterm labor. Patient discomfort, urinary tract infection, acute urinary retention, premature labor, and prenatal loss are still major complications, and prolapse usually persists or recurs after labor. Treatment depends on the severity of the condition and the patient's preference.

Female↗