@article {3596, title = {Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study.}, journal = {Eur J Obstet Gynecol Reprod Biol}, volume = {182}, year = {2014}, month = {2014 Nov}, pages = {136-9}, abstract = {

BACKGROUND: Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC). Although the pathogenesis of VVC remains a controversial issue, disruption of the balance between the vaginal microbiota may facilitate overgrowth by Candida. Some probiotic bacterial strains can suppress Candida albicans; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the adhesion of C. albicans.

OBJECTIVE: To evaluate the effect of the application of Lactobacillus plantarum P17630 in restoring the vaginal microbiota and prevention of relapses among women with acute VVC undergoing conventional (azole) local and main therapy.

METHODS: Retrospective comparative study. We recruited 89 women with a diagnosis of VVC, who were placed into two groups on the basis of reported treatment. The control group was treated with a daily dose of 2\% clotrimazole vaginal cream at bedtime for 3 days, followed by vaginal application of a capsule containing lubricant once a day for 6 days and then once a week for another 4 weeks. The probiotic group was treated with the same azole-based protocol but followed by vaginal application of a capsule containing Lactobacillus plantarum P17630 (>10$_{8}$ CFU) once a day for 6 days and then once a week for another 4 weeks beginning the day following clotrimazole discontinuation. Clinical and diagnostic patterns were monitored for three months of follow-up.

RESULTS: At the end of study the probiotic-treated women showed a statistically significant increase in Lactobacillus values "+++" (80\% versus 40\%, p<0.001) and a better subjective resolution of symptoms such as vaginal discomfort described as burning or itching (90\% versus 67.5\%, p<0.03). Among controls there was a non-significant increase at 3 months of recurrence of infection, but a significant increase of women with value of pH=5 or >5.

CONCLUSION: Although the results of different studies are controversial, most have suggested use of probiotics in the prevention or treatment of VVC, and no adverse effects have been reported. Our data with L. plantarum P17630 (Gyno-Canesflor - Bayer) confirm the role of this specific strain as a potential empirical preventive agent for reducing vaginal discomfort after conventional treatment of acute VVC and shifting the vaginal milieu toward a predominance of lactobacilli with an improvement of the vaginal pH value.

}, keywords = {Administration, Intravaginal, Adolescent, Adult, Antifungal Agents, Candidiasis, Vulvovaginal, Clotrimazole, Female, Humans, Lactobacillus plantarum, Microbiota, Middle Aged, Probiotics, Recurrence, Retrospective Studies, Secondary Prevention, Vagina, Vaginal Creams, Foams, and Jellies, Young Adult}, issn = {1872-7654}, doi = {10.1016/j.ejogrb.2014.09.018}, author = {De Seta, F and Parazzini, F and De Leo, R and Banco, R and Maso, G P and De Santo, D and Sartore, A and Stabile, G and Inglese, S and Tonon, M and Restaino, S} } @article {1978, title = {Pelvic inflammatory disease (PID) from Chlamydia trachomatis versus PID from Neisseria gonorrhea: from clinical suspicion to therapy.}, journal = {G Ital Dermatol Venereol}, volume = {147}, year = {2012}, month = {2012 Oct}, pages = {423-30}, abstract = {

Pelvic inflammatory disease (PID) is the most significant complication of sexually transmitted infections in childbearing-age women and it represents an important public health problem because of its long-term sequelae (chronic pelvic pain, tubal infertility, ectopic pregnancy). Prior to the mid 1970s PID was considered a monoetiologic infection, due primarily to Neisseria gonorrhea. Now it is well documented as a polymicrobial process, with a great number of microrganisms involved. In addition to Neisseria gonorrhea and Chlamydia trachomatis, other vaginal microrganisms (anaerobes, Gardnerella vaginalis, Haemophilus influenzae, enteric Gram negative rods, Streptococco agalactie, Mycoplasma genitalium) also have been associated with PID. There is a wide variation in PID clinical features; the type and severity of symptoms vary by microbiologic etiology. Women who have chlamydial PID seem more likely than women who have gonococcal PID to be asymptomatic. Since clinical diagnosis is imprecise, the suspicion of PID should be confirmed by genital assessment for signs of inflammation or infection, blood test and imaging evaluation. Laparoscopic approach is considered the gold standard. According to the polymicrobial etiology of PID, antibiotic treatment must provide broad spectrum coverage of likely pathogens. Early administration of antibiotics is necessary to reduce the risk of long-term sequelae.

}, keywords = {Chlamydia Infections, Chlamydia trachomatis, Female, Gonorrhea, Humans, Neisseria gonorrhoeae, Pelvic Inflammatory Disease}, issn = {0392-0488}, author = {De Seta, F and Banco, R and Turrisi, A and Airoud, M and De Leo, R and Stabile, G and Ceccarello, M and Restaino, S and De Santo, D} } @article {1938, title = {Role of high molecular weight hyaluronic acid in postmenopausal vaginal discomfort.}, journal = {Minerva Ginecol}, volume = {64}, year = {2012}, month = {2012 Aug}, pages = {321-9}, abstract = {

AIM: Aim of the present study was to quantify the intensity of vulvovaginal symptoms before and after treatment with high molecular weight hyaluronic acid (HA), to test the tolerability and safety of the product, to evaluate the effect on the quality of life and the compliance to the treatment.

METHODS: This was a double-blind randomized placebo-controlled study. In seven months we enrolled 36 post-menopausal women, equally distributed in placebo and active group. The evaluation was based on at least three atrophy-related signs and on the patient reported symptoms. After the written informed consent, the participants were instructed to apply the gel (drug or placebo) daily. Three days after the end of the treatment the patients received a final examination to evaluate the progress of symptoms, the presence of any adverse events and their correlation with the treatment.

RESULTS: Self-evaluation scales and investigator evaluation showed that the vaginal dryness was significantly reduced both in placebo and in the active group; however, high molecular weight HA was the only active treatment in reducing significantly itching and burning (P<0.02 and <0.04 respectively). Both treatments significantly reduced vaginal atrophy (P<0.001), erythema (P<0.01 placebo and P<0.001 HA) and vaginal dryness (P<0.001), but HA treatment was significantly more effective on the first two symptoms. Both treatments were very well tolerated and compliance of the treatment was very high.

CONCLUSION: High molecular weight HA could be effective in subjective and objective improvement of postmenopausal vaginal atrophy providing a good compliance. No adverse events occurred during the entire period of the study.

}, keywords = {Atrophy, Double-Blind Method, Female, Humans, Hyaluronic Acid, Middle Aged, Molecular Weight, Postmenopause, Vagina, Vaginal Diseases}, issn = {0026-4784}, author = {Grimaldi, E F and Restaino, S and Inglese, S and Foltran, L and Sorz, A and Di Lorenzo, G and Guaschino, S} }