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PubMed1994

Vaccination against bovine herpes mammillitis virus infections in guinea pigs.

Bovine herpes mammillitis virus or bovine herpesvirus type 2 (BHV-2) causes ulcerative lesions on the teats and udders of infected cows. Since no commercial vaccine is available for this disease, we investigated certain experimental BHV-2 vaccines against this virus in infected guinea pigs. Vaginally infected guinea pigs get severe, self-limiting vaginal infections characterized by erythema and swelling and the production of measurable vaginal virus titers. Two vaccine approaches were investigated: vaccination with wild-type (WT) virus by the subcutaneous route, and vaccination either subcutaneously or intravaginally with a thymidine kinase (TK) deficient (TK-) virus. The TK- strain was prepared by passage of BHV-2 in the presence of the potent TK-dependent antiviral agent 1-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)-5-methyluracil (FMAU). The antiviral activity of FMAU against the virus in plaque reduction assays changed from 0.05 to 2 microM at the same time that the TK activity of the mutant virus decrease to 7% of WT virus TK activity. Subcutaneous vaccination of guinea pigs with WT and TK- viruses did not induce vaginal infection. Primary vaginal infection (vaccination) with the TK- virus led to greatly reduced lesion severity compared to vaginal infection with the WT virus. However, the amount of vaginal virus titers recovered during these primary infections was similar for both TK- and WT viruses, indicating that both viruses had equal infecting potential. Thirty days after vaccination the animals were re-infected intravaginally with WT virus. The vaccinated animals showed dramatically reduced lesion severity and low recoverable virus titers compared to age-matched nonvaccinated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravaginal↗
PubMed1990

Effect of virus dose and nonoxynol-9 on the genital transmission of SIV in rhesus macaques.

One inoculation of cell-free SIVmac (50 TCID50) caused persistent viremia in nine of 13 female rhesus macaques inoculated intravaginally. Persistent viremia was produced in two of four male rhesus macaques by twice placing cell-free SIVMAC (50 TCID50) onto the skin and urethral os of the penis. Placing a spermicide containing nonoxynol-9 into the vaginal canal prior to repeated intravaginal inoculations of SIV prevented transmission of the virus in three of six female rhesus macaques.

Administration, Intravaginal↗
PubMed2005

The effect of intravaginal applied gonadotropin-releasing hormone agonist on different oestrous parameters and reproductive performance in post weaned sows.

In a Hungarian large breeding unit, 481 weaned sows were assigned to three groups and were treated as follows. Sows in Group 1 (Control, n=161) were artificially inseminated (3.01 +/- 0.4 times) during their standing reflex; sows in Group 2 (n=160) were artificially inseminated 3 times at 12-hour intervals, independent of detection of oestrus and immediately after administration of a GnRH-agonist at 96 hours postweaning; and sows in Group 3 (n=160) were artificially inseminated 3 times at 12-hour intervals, beginning at their standing reflex after administration of a GnRH-agonist. Pre-trial daily average lactational feed intake, average daily feed intake from weaning to oestrus, oestrus within 6 days of weaning (%), ovulation within 6 days of weaning (%), wean-to-oestrus interval (h), duration of oestrus (h), follicle size (mm), interval from oestrus to ovulation (h), subsequent day 24 pregnancy rate (%), farrowing rate (%) and total number of pigs born were evaluated. Pre-trial average daily voluntary lactational feed intake was 7.1 +/- 0.5 kg in Group 1, 7.2 +/- 0.4 kg in Group 2, and 7.3 +/- 0.7 kg in Group 3 (P > 0.05). Average voluntary daily feed intake from weaning-to-oestrus was 4.3 +/- 0.9 kg in Group 1, 4.2 +/- 0.8 kg in Group 2, and 4.1 +/- 0.5 kg in Group 3 (P > 0.05). Oestrus was detected within 6 days of weaning in 143 (88.8%) sows in Group 1, 143 (89.4%) sows in Group 2, and in 142 (88.8%) sows in Group 3. Follicle size did not differ (P > 0.05) among the groups. In Group 1, 83.2%, in Group 2, 90.6%, and in Group 3,91.3% of the sows ovulated within 6 days of weaning (P < 0.05), but there were no significant (P > 0.05) differences in 24 Day pregnancy rates (81.4%; 91.3%; and 92.5%). Farrowing rates were in Group 1, 84.5%, in Group 2, 91.3%, in Group 3, 91.9% (P > 0.05). Wean-to-oestrus interval was 115.5 h in Group 1, 114.9 h in Group 2, and 115.7 h in Group 3 (P > 0.05). Duration of oestrus was significantly shorter in Group 2 (41.9 h) and Group 3 (42.1 h) than in Group 1 (68.3 h) (P < 0.001). Similarly, the interval from oestrus to ovulation was significantly different (P < 0.01) between the groups (Group 1, 49.0 h Group 2, 32.0 h, and Group 3, 31.1 h). Sows in Group 2 (12.7) and Group 3 (12.6) had a significantly higher (P < 0.01) number of pigs born than sows in Group 1 (n = 10.9). The interval between oestrus and ovulation was highly and positively correlated (r = 0.83) with the duration of oestrus.

Administration, Intravaginal↗
PubMed2005

Functional and histological effects of intravaginal electrical stimulation on the pelvic muscles: a study in the rat.

We studied functional and histological effects of electrical stimulation (ES) on pelvic muscles of the rat. With intravaginal electrodes, the musculus pubococcygeus and musculus iliococcygeus in the awake animal were stimulated three times 6 min per day with 5 min of rest in between, 5 days per week, 7 consecutive weeks with a biphasic rectangular symmetrical current of 25 Hz, 400-mus pulse duration, on/off time of 5/10 and with an amplitude of 2-4 mA. A "sham group" received the same handling but no stimulation. Contraction measured with intra-rectal pressure during stimulation increased more in the stimulated than in the sham group, but did not reach statistical significance probably due to low power. The 2A fast fibres increased with 14% in the musculus iliococcygeus and with 6% in the musculus pubococcygeus. Type 1 slow fibres did not change. Increased capillary density was found after stimulation. Repeated intravaginal ES has mainly an influence on the fast fibres in the pelvic muscles. To influence slow fibres, another stimulation program or current parameters would seem necessary.

Adenosine Triphosphatases↗
PubMed1991

Long-term treatment of atrophic vaginitis with low-dose oestradiol vaginal tablets.

Fifty-one post-menopausal women suffering from symptoms of oestrogen deficiency-derived atrophic vaginitis were treated intravaginally with two therapeutic regimens based on doses of 25 micrograms 17 beta-oestradiol (E2) in an open, controlled study. All the patients received treatment daily for 2 weeks by way of induction therapy. They were then randomly allocated to either once-weekly (17 patients) or twice-weekly (34 patients) vaginal administration for a further 50 weeks as maintenance treatment. Endometrial histopathology was evaluated before and after 1 year of treatment. The effects on symptoms and oestrogen/gonadotrophin levels were determined before and after 2, 12, 24, 36 and 52 weeks of therapy. Nine women continued twice-weekly treatment for a further year, meaning that they underwent treatment for a total period of 2 years. Endometrial biopsies were obtained after 2 years of treatment. All the pretreatment endometrial biopsies indicated an atrophic endometrium. One patient out of the 14 who completed 1 year of therapy in the group treated once weekly showed weak proliferation of the endometrium, while the other 13 had an atrophic endometrium. In the group treated twice weekly, 2 out of the 31 patients who completed the study showed weak proliferation of the endometrium. The other 29 had an atrophic endometrium. All 9 women who received treatment for 2 years had an atrophic endometrium at the end of the treatment period. The twice-weekly dosage regimen gave complete relief of symptoms in almost all patients, whereas the majority of the patients in the group treated once weekly still had mild symptoms. No adverse effects were reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravaginal↗
PubMed2005

Supplementing previously treated anestrous dairy cows with progesterone does not increase first-service conception rate.

The objective of this study was to investigate the effect of supplementing previously treated anovulatory anestrous (AA) dairy cows with progesterone delivered intra-vaginally for 7 days, commencing 4 or 5 days after insemination, on first-service conception rate. A clinical trial, involving 990 AA dairy cows in 14 dairy herds, was conducted during the 2002/2003 breeding season. On Day -8, all cows were treated with a progesterone-containing intravaginal device (Cue-Mate). The devices were removed on Day -2; on Day -1, all cows were given 1mg of estradiol benzoate im. Cows in the control group (n = 499) received no further treatments. Cows in the treatment group (n = 491) that had been inseminated on Day 0 or 1 had a new device inserted (on Day 4 or 5), with removal of the device after 7 days. First-service conception rates for the control and treatment groups were not different (35.0% versus 36.7% respectively; P = 0.41). Furthermore, there was no difference in conception rates between cows that had devices inserted on Day 4 or 5 (31.3% versus 37.2% respectively; P = 0.45). In conclusion, supplementation of previously treated AA dairy cows with an intravaginal progesterone-releasing device for 7 days (commencing 4 or 5 days after insemination) did not significantly improve first-service conception rate.

Administration, Intravaginal↗
PubMed1997

A placebo-controlled, double-blind prospective study in healthy female volunteers of dextrin sulphate gel: a novel potential intravaginal virucide.

A double-blind, placebo-controlled study was designed to evaluate the safety and tolerability of intravaginal dextrin sulphate (D2S) gel to assess its preliminary suitability as a potential vaginal virucide. Tolerability was assessed by questionnaire and patient interview. Colposcopy with vaginal biopsy was performed to assess the macroscopic and microscopic evidence of inflammation. The potential impact of the gel on normal vaginal flora was examined by quantitative lactobacilli culture with assessment of the ratio of peroxide to nonperoxide-producing organisms. Colposcopy revealed mild erythema in five of 24 subjects receiving active gel and in none of the 12 placebo recipients, but histology in all subjects revealed no evidence of inflammation. No impact on vaginal lactobacilli was found. We conclude that D2S gel is safe and well tolerated intravaginally at the dosing schedule used in this study.

Administration, Intravaginal↗
PubMed1995

Intravaginal misoprostol for termination of midtrimester pregnancy.

Misoprostol seems to be a drug with many potential uses apart from the treatment of gastric and duodenal ulcers. The oral tablet appears to be effective for termination of midtrimester pregnancy when administered intravaginally. Further research should be carried out to determine its full range of action in order that the drug can be utilized to its maximum potential.

Abortion, Induced↗
PubMed2000

Simian immunodeficiency virus rapidly penetrates the cervicovaginal mucosa after intravaginal inoculation and infects intraepithelial dendritic cells.

Despite recent insights into mucosal human immunodeficiency virus (HIV) transmission, the route used by primate lentiviruses to traverse the stratified squamous epithelium of mucosal surfaces remains undefined. To determine if dendritic cells (DC) are used by primate lentiviruses to traverse the epithelial barrier of the genital tract, rhesus macaques were intravaginally exposed to cell-free simian immunodeficiency virus SIVmac251. We examined formalin-fixed tissues and HLA-DR(+)-enriched cell suspensions to identify the cells containing SIV RNA in the genital tract and draining lymph nodes within the first 24 h of infection. Using SIV-specific fluorescent in situ hybridization combined with immunofluorescent antibody labeling of lineage-specific cell markers, numerous SIV RNA(+) DC were documented in cell suspensions from the vaginal epithelium 18 h after vaginal inoculation. In addition, we determined the minimum time that the SIV inoculum must remain in contact with the genital mucosa for the virus to move from the vaginal lumen into the mucosa. We now show that SIV enters the vaginal mucosa within 60 min of intravaginal exposure, infecting primarily intraepithelial DC and that SIV-infected cells are located in draining lymph nodes within 18 h of intravaginal SIV exposure. The speed with which primate lentiviruses penetrate mucosal surfaces, infect DC, and disseminate to draining lymph nodes poses a serious challenge to HIV vaccine development.

Administration, Intravaginal↗
PubMed2000

Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening.

OBJECTIVE: To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture. STUDY DESIGN: We performed a two-year retrospective chart review to determine the incidence of uterine rupture in patients with a previous cesarean delivery undergoing cervical ripening or the induction of labor. RESULTS: Uterine dehiscence occurred in 1 and uterine rupture occurred in 3 of 48 women with a prior cesarean delivery treated with 50 micrograms doses of intravaginal misoprostol for cervical ripening. Uterine rupture was found in 1 of 89 women who had an oxytocin infusion for induction of labor and none of the 24 patients who received intravaginal prostaglandin E2 placed for cervical ripening. CONCLUSION: Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.

Administration, Intravaginal↗
PubMed2001

Efficacy of clindamycin vaginal ovule (3-day treatment) vs. clindamycin vaginal cream (7-day treatment) in bacterial vaginosis.

OBJECTIVE: To compare the efficacy and safety of a 3-day regimen of clindamycin vaginal ovules with a 7-day regimen of clindamycin vaginal cream for the treatment of bacterial vaginosis (BV). METHODS: Women with a clinical diagnosis of BV were treated with a 3-day course of clindamycin ovules or a 7-day course of clindamycin cream administered intravaginally. Three hundred and eighty-four patients received study drug and were included in the evaluable patient population (ovule group, n = 204; cream group, n = 180). Assessments included pelvic examination and diagnostic testing. Primary efficacy endpoints were a resolution of two of three diagnostic criteria at the first follow-up visit and three of three diagnostic criteria at the second. RESULTS: Cure rates in the evaluable patient population were similar between treatment groups: 53.7% (109/204) for the ovule group and 47.8% (85/180) for the cream group (p = 0.2471, 95% CI -4.1-16.0%). The most commonly reported medical event, vulvovaginal pruritus, had similar incidence in both treatment groups. CONCLUSIONS: A 3-day course of clindamycin vaginal ovules is as effective and well-tolerated as a 7-day course of clindamycin vaginal cream in the treatment of BV.

Administration, Intravaginal↗
PubMed2002

Intravaginal 400 microg misoprostol for pregnancy termination in cases of blighted ovum: a randomised controlled trial.

OBJECTIVE: To investigate the effectiveness and side effects of intravaginal misoprostol 400 micrograms compared with a placebo for facilitating complete abortion in cases of blighted ovum. DESIGN: A prospective randomised placebo-controlled trial. SETTING: Rajavithi Hospital, Thailand between 1 July 1998 and 31 January 1999. SAMPLE: Fifty-four pregnant women with gestations of up to 12 weeks whose diagnosis of blighted ovum had been made by transvaginal ultrasound. METHODS: The patients were assigned randomly into two equal groups; the study group received two tablets of vaginal misoprostol (200 micrograms/tablet), and the control group received two tablets of a vaginal placebo. RESULTS: The complete abortion rate was significantly higher in the women receiving misoprostol (63%) compared with those receiving the placebo (18.5%) (p < 0.05). Lower abdominal pain (74.1%) and fever (14.8%) were significantly higher in the study group than in the placebo group (22.2%) and (0%) respectively, (p < 0.05). CONCLUSION: Intravaginal 400 microg misoprostol is significantly more effective for termination of blighted ovum than placebo, but lower abdominal pain and fever are signifcantly higher in the misoprostol group.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

[Induction of labor by misoprostol, an analog of PGE1. A prospective study of 200 cases].

We carried out a prospective study of 200 pregnant women who required induction of labor at full term, at the Lalla Meryem maternity unit of the Ibn Rochd University Hospital, Casablanca, between January 1st 1996 and June 30th 1997. The aim of this study was to evaluate the efficacy, tolerance and acceptance of misoprostol (Cytotec) as a drug for inducing labor in unfavorable conditions (Bishop < 5). Misoprostol (a PGE1 analog) was administered to the women via the vagina, with a dose of 1/4 tb (50 mg) given every 6 hours, and a maximum of 3 doses (150 mg). If labor had not begun 18 h after the start of the protocol, misoprostol induction was considered to have failed. We found that misoprostol failed to induce labor in 5% of cases, Syntocinon was required in 40% of cases and the interval between misoprostol insertion and vaginal delivery was 13.3 + 11.1 h. The rate of delivery by cesarean section was 22% and the mean amount of misoprostol required was 1.3 doses (66 mg). The mean cost of labor induction was 0.6 FF, the frequency of uterine hyperstimulation was 3.5% and maternal, fetal and neonatal tolerance was good. Our results confirm that intravaginal misoprostol is very effective and well tolerated for the induction of labor in pregnant women at full term, in unfavorable obstetric conditions.

Administration, Intravaginal↗
PubMed2001

Preinduction cervical ripening. A randomized trial of intravaginal misoprostol alone vs. a combination of transcervical Foley balloon and intravaginal misoprostol.

OBJECTIVE: To determine if the addition of a mechanical ripening agent (transcervical Foley balloon) to a pharmacologic agent (intravaginal misoprostol) improves the efficiency of preinduction cervical ripening. STUDY DESIGN: Singleton patients with an indication for delivery, unfavorable cervix (Bishop score < or = 5) and no contraindication to labor were randomly assigned to two groups: misoprostol alone (25 micrograms intravaginally every 3 hours for no more than 12 hr) or combination therapy (25-French transcervical Foley balloon inflated to 50 mL of sterile water with identical intravaginal misoprostol dosing). All patients received a history and physical examination (including Bishop score), preripening ultrasound, electronic fetal heart rate and contraction monitoring (to rule out spontaneous labor and document fetal well-being). Multiple variables of perinatal outcome were analyzed, including the main outcome variables of ripening-to-delivery time and cesarean section rate. RESULTS: During August 1998 to August 1999, 81 patients were randomized, 40 to misoprostol alone and 41 to combination therapy. There were no differences between the groups with respect to maternal demographics, preripening Bishop score, maternal complications, intrapartum intervention or neonatal outcome. The misoprostol group spent longer periods of time in active labor, and there was a trend for the combination group to require oxytocin for longer intervals. These findings did not significantly affect the total ripening-to-delivery time or cesarean section rate which were similar for both groups. CONCLUSION: The addition of mechanical ripening with a transcervical Foley balloon to intravaginal misoprostol did not improve the efficiency of preinduction cervical ripening. Mechanical and pharmacologic cervical ripening agents appear to act independently rather than synergistically.

Administration, Intravaginal↗
PubMed2003

Luteal activity at the onset of a timed insemination protocol affects reproductive outcome in early postpartum dairy cows.

This study was designed to compare two timed insemination protocols, in which progesterone, GnRH and PGF2alpha were combined, with the Ovsynch protocol in presynchronized, early postpartum dairy cows. Reproductive performance was also evaluated according to whether cows showed high or low plasma progesterone concentration, at the onset of treatment. One hundred and six early postpartum dairy cows were presynchronized with two cloprostenol treatments given 14 days apart, and then assigned to one of the three treatment groups. Treatments for the synchronization of estrus in all three groups started 7 days after the second cloprostenol injection, which was considered Day 0 of the actual treatment regime. Cows in the control group (Ovsynch, n=30) were treated with GnRH on Day 0, PGF2alpha on Day 7, and were given a second dose of GnRH 32 h later. Cows in group PRID (n=45) were fitted with a progesterone releasing intravaginal device (PRID) for 9 days, and were given GnRH at the time of PRID insertion and PGF2alpha on Day 7. In group PRID/GnRH (n=31), cows received the same treatment as in the PRID group, but were given an additional GnRH injection 36 h after PRID removal. Cows were inseminated 16-20 h after the administration of the second GnRH dose in the Ovsynch group, and 56 h after PRID removal in the PRID and PRID/GnRH groups. Ovulation rate was determined on Day 11 postinsemination by detecting the presence of a corpus luteum in the ovaries. Lactation number, milk production, body condition at the onset of treatment and treatment regime were included as potential factors influencing ovulation and pregnancy after synchronization. Logistic regression analysis for cows with high and low progesterone concentration on treatment Day 0 revealed that none of the factors included in the models, except the interaction between progesterone and treatment regime, influenced the risk of ovulation and pregnancy significantly. In cows with high progesterone concentration at treatment onset, Ovsynch treatment resulted in a significantly improved pregnancy rate over values obtained following PRID or PRID/GnRH treatment. In cows with low progesterone concentration, PRID or PRID/GnRH treatment led to markedly increased ovulation and pregnancy rates with respect to Ovsynch treatment. These findings suggest the importance of establishing ovarian status in early postpartum dairy cows before starting a timed AI protocol, in terms of luteal activity assessed by blood progesterone.

Administration, Intravaginal↗
PubMed1989

Treatment of bacterial vaginosis with intravaginal sponges containing metronidazole.

A small clinical trial evaluated the safety and effectiveness of intravaginal sponges containing metronidazole for the treatment of bacterial vaginosis (BV). Twenty women were treated with sponges containing 250 mg metronidazole (two sponges per day for two days), and 32 were treated with sponges containing 1,000 mg metronidazole (one sponge per day for three days). After four weeks there was a significantly higher cure rate (P less than .10) for women using the higher-dose sponge (88.0% vs. 57.1%). Although not significantly different (P greater than .10), the rates of side effects and complications were somewhat more frequent for women using the higher-dose sponge. Additional clinical trials are being conducted to further evaluate the 1,000-mg-metronidazole sponge for the treatment of BV.

Administration, Intravaginal↗
PubMedDate not supplied

Efficacy of intravaginal misoprostol in second-trimester pregnancy termination: a randomized controlled trial.

A prospective randomized, double-blind, controlled clinical trial to compare the clinical efficacy and side effects of intravaginal misoprostol with the traditional prostaglandin, gemeprost, in second-trimester pregnancy interruption was conducted. A sample size of 100 women was calculated to demonstrate that misoprostol was as effective as gemeprost in achieving delivery within 24 hours (alpha = 0.1, 80% power). Women were recruited with fetal death in utero, severe fetal anomaly, or psychosocial pregnancy termination between 14 and 28 weeks gestation and randomized to receive either 1 mg gemeprost 3 hourly for 5 doses, or 200 mcg misoprostol 6 hourly for 4 doses, intravaginally. The therapeutic regimens were repeated if undelivered by 24 hours. Those undelivered after 48 hours received an extra-amniotic PGF2 alpha infusion. The median gestation at recruitment was identical: gemeprost 19 weeks (IQ 17-22 weeks) vs. misoprostol 19 weeks (IQ 17-21 weeks), P = 0.887. Delivery within 24 hours occurred in 75.1% of women receiving gemeprost and 74.9% receiving misoprostol (P = 1.0). The median time from prostaglandin commencement to delivery was similar: gemeprost 13.7 hours (IQ 9.0-23.5 hours) vs. misoprostol 16.9 hours (IQ 10.3-23.5 hours), P = 0.769. A significant reduction in the incidence of vomiting in women randomized to misoprostol occurred (34% vs. 13.2%, P = 0.017). There was no significant difference in the incidence of maternal fever > 37.5 degrees C, nausea, diarrhea, or placental retention. A 200-fold pharmaceutical cost advantage was observed with the use of misoprostol compared with gemeprost. Intravaginal misoprostol performs as effectively as gemeprost in achieving delivery in the second trimester without increase in adverse effects and displaying a significant cost advantage.

Abortifacient Agents, Nonsteroidal↗