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PubMed1981

[Clinical experience with cefotiam in the field of pediatrics (author's transl)].

A clinical study on cefotiam (CTM) was performed in the field of pediatric infection, and the following results were obtained: The number of cases studied were six including 2 cases of U.T.I., 1 case of vaginitis and vulvitis, 1 cervical lymphadenitis, 1 absence of thigh and coxitis. Clinical responses to CTM were excellent in 3 cases, good in 1 cases but there was 1 exception who dropped out because of concurrent use of other antibiotics. As for bacteriological responses, CTM eliminated the pathogens E. coli and P. mirabilis from U.T.I., Staph. epidermidis and P. morganii, from vaginitis and vulvitis, H influenzae and Str. pneumoniae from cervical lymphadenitis and Staph. aureus from abscess of thigh. No side effect was observed except 1 case who showed an elevation of GOT, GPT and LDH. It is uncertain, however, wether this abnormality was resulted from the use of CTM or not, because the other antibiotics were used also.

Age Factors↗
PubMed1995

Radiation recall reaction to idarubicin resulting in vaginal necrosis.

Radiation recall reactions are uncommon delayed tissue reactions seen in previously irradiated sites following treatment with cytotoxic agents. We evaluated a 64-year-old who developed two episodes of acute vulvitis and vaginal necrosis after receiving idarubicin therapy for acute myelogenous leukemia. Three years earlier she had undergone successful radiotherapeutic treatment of a stage I squamous cell carcinoma of the vagina. Her symptoms and examination findings resolved with local therapy and discontinuation of idarubicin. Recall reactions have been associated with the antitumor antibiotics actinomycin D and doxorubicin and, more recently, the mitotic inhibitors vinblastine and Taxol. The mechanism of this phenomenon is poorly understood but may be related to sequential stem cell injury or depletion. Because physical and biopsy findings are nonspecific, the diagnosis must be suspected on the basis of the patient's history and the location of the reaction within the prior treatment field.

Carcinoma, Squamous Cell↗
PubMed1982

India ink immune method for the study of antibody-coated urinary bacteria.

The sediments of 373 urines were studied for antibody-coated bacteria by the India ink immune method. Positive results were obtained in 14.7 per cent of upper urinary tract infections, 18.9 per c nt of lower urinary tract infections, 29 per cent of bacteriuria, and 15.2 per cent in healthy girls. Since antibody-coated bacteria could find their way into negative urines only by contamination, 296 vulvar secretions were also examined. Positive results were obtained in 15.5 per cent of girls with urinary tract infections, 63.9 per cent of those with vulvitis and 24.1 per cent in girls with no infection. It is concluded from the results that the presence or absence of antibody-coated bacteria in the urine is unrelated to the site of urinary infection.

Antibody-Coated Bacteria Test, Urinary↗
PubMed2000

Cicatrizing conjunctivitis associated with paraneoplastic lichen planus.

PURPOSE: To report two cases of cicatrizing conjunctivitis associated with paraneoplastic lichen planus. METHODS: Case reports. RESULTS: Two patients were examined because of redness and discomfort in both eyes. A 63-year-old woman with follicular, small-cleaved cell lymphoma had cicatrizing conjunctivitis, stomatitis, vulvitis, and skin lesions. A 25-year-old man with malignant thymoma had cicatrizing conjunctivitis, erosive stomatitis, and penile papules. Histopathologic studies of conjunctiva and skin biopsy specimens in the first patient and labial biopsy specimens in the second revealed lichen planus. CONCLUSION: Paraneoplastic lichen planus is a possible cause of cicatrizing conjunctivitis associated with inflammatory skin and mucous membrane disease.

Adult↗
PubMed2000

Detection of Ureaplasma diversum in cattle using a newly developed PCR-based detection assay.

Ureaplasma diversum has been associated with different clinical manifestations including bovine vulvitis, endometritis, salpingitis, spontaneous abortion and infertility. Because the isolation of this ureaplasma from clinical samples is difficult, there is a need for improved detection methods. We developed a PCR assay based on amplification of a region of the gene encoding 16S rRNA. The specificity of the amplification was verified by sequence analysis. Female bovine vaginal swabs (n=168) were collected and the presence of U. diversum evaluated by both culture methods and by the PCR assay. Culture was positive for 60 samples (35.7%), and PCR-specific amplification was obtained for 89 samples (52.9%). These results indicated a high prevalence of U. diversum in the selected animals and the higher sensitivity of this PCR assay as compared to culture.

Animals↗
PubMed2002

[Genital infections in prepubertal girls].

Vulvitis and vulvovaginitis are the most common gynecologic complaint in prepubertal girls. The frequently observed therapeutic failures are due mainly to lack of knowledge of the characteristics of this age group, of age and development in appropriate diagnostic procedures and of therapeutic measures similar to those in the adult female patient. Prepubertal girls are anatomically, physiologically and behaviorally at relative risk for vulvovaginitis. Symptoms include pruritus, genital pain, "vulvar dysuria" and discharge. History taking and a general pediatric examination are mandatory, thereafter an age appropriate careful anogenital examination should follow. It requires time, patience and knowledge of the different non traumatizing examination techniques. The findings in girls with vulvovaginitis are variable and erythema, excoriations and discharge can be found. The genital inspection and the use of microscopy and microbiologic studies are helpful in planning an appropriate therapy. The majority of vulvovaginal infections in children are nonspecific but they can also be caused by specific organisms and are mostly bacterial. Yeast infections are not found in otherwise healthy prepubertal girls. The therapeutic approach consists of improved anogenital hygiene, sitz/tub baths and use of non irritating soaps. However if an abnormal population of bacteria is present antimicrobial therapy should be considered. Reassurance and a review of preventive methods are crucial in the management of girls with vulvovaginitis.

Bacterial Infections↗
PubMed1998

Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1.

To examine associations between method of contraception, sexually transmitted diseases (STDs), and incident human immunodeficiency virus type 1 (HIV-1) infection, a prospective observational cohort study was done among female sex workers attending a municipal STD clinic in Mombasa, Kenya. Demographic and behavioral factors significantly associated with HIV-1 infection included type of workplace, condom use, and parity. In multivariate models, vulvitis, genital ulcer disease, vaginal discharge, and Candida vaginitis were significantly associated with HIV-1 seroconversion. Women who used depo medroxyprogesterone acetate (DMPA) had an increased incidence of HIV-1 infection (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.4-3.4). In a multivariate model controlling for demographic and exposure variables and biologic covariates, the adjusted HR for HIV-1 infection among DMPA users was 2.0 (CI, 1.3-3.1). There was a trend for an association between use of high-dose oral contraceptive pills and HIV-1 acquisition (HR, 2.6; CI, 0.8-8.5).

Behavior↗
PubMed1996

The commonest causes of symptomatic vulvar disease: a dermatologist's perspective.

A prospective study of 141 consecutive adult patients with chronic vulvar symptoms referred to a dermatologist was carried out to determine the commonest conditions seen. Eighty-nine per cent of patients underwent vulvar biopsy. The commonest cause of chronic vulvar symptoms in this group of patients was dermatitis, seen in 54% of patients. The other commonly seen conditions were lichen sclerosus (13%), chronic vulvovaginal candidiasis (10%), dysaesthetic vulvodynia (9%) and psoriasis (5%). Although 38% of patients had previously been diagnosed as suffering from human papillomavirus (HPV) vulvitis, histopathological evidence of HPV was seen in only 5%. All cases showing HPV also demonstrated spongiotic dermatitis on biopsy. In this study group, a majority (overall 72%) of patients with a chronic vulvar complaint had a corticosteroid responsive dermatosis rather than a gynaecological condition. The patients with HPV on biopsy also responded to topical corticosteroids, and it was concluded that their symptoms may have been due to dermatitis unrelated to the presence of HPV. In such patients, the assumption that 'subclinical HPV' is a cause of symptoms and the practice of focusing medical and particularly surgical treatment on eradication of the virus may be inappropriate. A review of the commonest vulvar conditions seen by the author is presented.

Adult↗
PubMed1995

Audit of 114 non-neoplastic vulvar biopsies.

OBJECTIVE: The purpose of this study was to show the benefits and limitations of vulvar biopsy in the setting of a multidisciplinary clinic specialising in non-neoplastic diseases of the vagina and vulva. DESIGN: One hundred and fourteen vulvar biopsies were reviewed and classified according to the classification of the International Society for the Study of Vulvar Diseases. RESULTS: The histological diagnoses were lichen sclerosus 25%, lichen simplex chronicus 35%, non-erosive inflammatory dermatoses comprising psoriasis, spongiotic dermatitis, dermatophytosis and psoriasiform dermatitis 13%, erosive vulvitis and lichen planus 9%, nonspecific inflammation 6%, miscellaneous 9% and normal 4%. CONCLUSIONS: Biopsies in cases of lichen sclerosus were useful for confirmation of clinical diagnosis and to exclude early invasive malignancy. In lichen simplex chronicus, biopsies helped exclude an underlying dermatosis requiring specific treatment. Psoriasis, spongiotic dermatitis, dermatophytosis and excoriated lichen simplex chronicus posed a common clinical differential diagnosis of the reddened vulva. The eroded vulva often proved a diagnostic problem clinically and histologically. The clinical syndrome of vestibulitis did not have a specific histological picture, and biopsies showed nonspecific inflammation, mild hyperplasia or were normal. No case of squamous cell hyperplasia was diagnosed and the place of this diagnosis in the ISSVD classification needs review.

Adolescent↗
PubMed1969

Prevalence of symptomless urinary tract disease in Birmingham schoolchildren. I. Pyuria and bacteriuria.

In a pilot project 2,122 schoolchildren were screened for symptomless urinary tract disease by the examination of midstream urine specimens. These were tested for albumin, blood, and glucose with Labstix commercial strips, together with microscopy for abnormal cellular excretion.One case of renal glycosuria was found but none of previously undiagnosed diabetes mellitus. Out of 1,096 boys, 11 (1%) had pyuria-a leucocyte count greater than 10/cu.mm.-but only four showed abnormal counts on retesting. None had urinary tract infection.Out of 1,026 girls, 96 (9.3%) had pyuria initially but 35 were normal on retesting. Of the remaining 61 girls, 59 attended the outpatients department for further investigation, and in 30 vulvitis appeared to be the sole cause. Ten were proved to have significant bacteriuria and six of them showed radiological abnormalities.It is suggested that careful long-term studies are needed to study the economics and the implications of screening on a national scale.

Adolescent↗
PubMed1974

Gynaecological abnormalities found at a cytology clinic.

A survey was made of abnormalities found on pelvic examination of 2,656 women who attended for cervical smears in the three years 1967-9. Eight women had malignant cells in their smears, and 68 women pelvic tumours, four of them malignant. Severe vulvitis was common in women over 46. Many of the women who had non-malignant conditions were treated though they had no complaints. They were among the most appreciative and subsequently sought out the clinic staff to thank them. It is important that a full examination should be made by an experienced gynaecologist.

Adult↗
PubMed1979

Granulomatous inflammation of the vulva and penis--a genital counterpart to cheilitis granulomatosa.

3 patients are described, in whom chronic swelling of the external genitals occurred after recurrent infections. The histological findings were identical to those seen in cheilitis granulomatosa, the dermal component of Melkersson-Rosenthal syndrome. The authors suppose that the disease of the 3 patients is a genital counterpart to cheilitis granulomatosa, and the name vulvitis or posthitis granulomatosa is suggested.

Adult↗
PubMed1989

Papilloma virus infection of the vulva.

Analyses of the possible presence of human papilloma virus (HPV) DNA were performed on 84 biopsies from 50 women with clinically and histopathologically suspected HPV infection of the vulva. The colposcopic criteria for inclusion in the study were: acetowhite flat lesions with or without fissures and/or diffuse hyperplastic mucosa with a granulated or filamental surface. Directed biopsies for histopathology and DNA hybridization (dot-blot and Southern-blot) were taken. All women had histopathological evidence of HPV infection. Twelve women had cervical and/or vulvar neoplasia. HPV DNA could be demonstrated in the vulvar biopsies from 24 women; 13 women had HPV 16, 3 had HPV 18, HPV 31 and HPV 33, respectively. In addition, 10 biopsies contained HPV DNA of unknown types. Fifty-five percent of granulated and filamental lesions and 43% of flat lesions with or without fissures were positive for HPV DNA. 34 women had one or more of the following symptoms: itching, burning, dyspareunia, discharge, fissures, dryness and dysuria. Papillomavirus vulvitis is a sexually transmitted disease which may cause recalcitrant symptoms and/or concomitant neoplasia. It is thus important to recognize the different symptoms and signs of this disease.

Adult↗
PubMed2002

Clinical trial comparing the activity and efficacy of ibuprofen isobutanolammonium vs Benzydamine hydrochloride, applied as vaginal irrigations, in patients with vaginitis.

This study was conducted on 30 female patients (average age: 40.5 +/- 11 years, age range 19-65), affected by vulval and/or vaginal phlogosis with a prevalence of uterine fibromyomatosis and metrorrhagia of a varied nature. Sixteen patients were affected with vulvitis and 14 with vulvovaginitis. Fifteen patients were assigned to the treatment with Ibuprofen isobutanolammonium and 15 to the treatment with Benzydamine hydrochloride. Both the subjective symptoms (burning and itching) and the objective symptoms (erythema, oedema, exudation) showed a marked reduction as early as the third day of treatment and the comparison between the score at the start of treatment and on day three of the treatment was highly significant in both study groups (p < 0.01). This improvement was, however, more marked in the group of patients treated with ibuprofen isobutanolammonium, where a more rapid reduction of both the subjective and objective symptoms was observed on the third day. This trend, although not as marked as on the third day, was confirmed at the end of the study, on the seventh day.

Adult↗
PubMed1992

Local antiphlogistic treatment with Apulein cream.

The effectivity of two topical steroids, Apulein cream and Hydrocortisone ointment, was compared in women suffering from vulvitis and other superficial inflammations. The basic properties of budesonide and data from references have been discussed. In the examined cases Apulein cream proved to be a more effective and more rapidly acting antiphlogistic as compared to Hydrocortisone ointment. The adjuvant and symptomatic role of corticosteroid therapy and the importance of adequate target-specific treatment in cases of infection is emphasized.

Administration, Topical↗
PubMed1978

[Examination of the vulva of small girls. A too often neglected examination].

After a description of the methods of examination of the vulva, the authors discuss the most important findings. Among the organic diseases, are congenital abnormalities, vulvar coalescence, imperforate hymen, polyps, cysts and above all, trauma. Among the infections, one may note vulvitis or vulvovaginitis but also inclusions, of the clitoridian smaegma, and meatitis. Among the functional disorders, examination of the vulva is necessary for precocius puberty, amenorrhoea, and late puberty. Finally, it permits one to solve a certain number of false problems ; it is however often neglected and should form part of all complete pediatric examinations.

Amenorrhea↗
PubMed1990

[Triapten ointment in the treatment of herpes genitalis in the female].

We report about the therapy of Herpes simplex infections. We applied triapten ointment topically in 166 women with relapse illnesses. In cases with early application we cured 80 per cent of vulvitis herpetica. In 17 per cent we observed side effects we tried to clarify the reasons.

Antiviral Agents↗
PubMed1990

[Infectious genital diseases and their significance in the development of cervix cancer and its precancerous conditions].

Basis of this trial are examinations of 100 Patients with colposcopic and/or cytologic suspicion for precancerous or early stages of cancer of the uterine Cervix and of 100 patients in the same age with normal cervical findings. Infections conditions vulvitis and condylomata acuminata could be found twice frequent in the cervical group in the control one. Significant differences could be calculated between the two groups with regard to bacterial infections of the vagina (60/22), bacterial vaginosis (54/38) and trichomoniasis (35/22). Sexual transmitted diseased are risk factors in the development of cervical cancer. Patients with those infections have to be supervised exactly.

Cell Transformation, Neoplastic↗