@article {3597, title = {Can Lactobacillus fermentum LF10 and Lactobacillus acidophilus LA02 in a slow-release vaginal product be useful for prevention of recurrent vulvovaginal candidiasis?: A clinical study.}, journal = {J Clin Gastroenterol}, volume = {48 Suppl 1}, year = {2014}, month = {2014 Nov-Dec}, pages = {S102-5}, abstract = {

OBJECTIVE: To assess the effectiveness of the association of 2 specific strains, Lactobacillus fermentum LF10 (DSM 19187) and Lactobacillus acidophilus LA02 (DSM 21717), specifically formulated in slow-release effervescent tablets, in patients with recurrent vulvovaginal candidiasis.

STUDY DESIGN: The study was a clinical trial of 58 women diagnosed with recurrent VVC (>=4 culture-confirmed episodes in a 12-mo period). All patients were given 200 mg of fluconazole orally as an induction dose for 3 alternate days during the first treatment week. Afterward, the patients were given a new product formulated in slow-release vaginal tablets containing at least 0.4 billion live cells of each of lactobacillus L. fermentum LF10 and L. acidophilus LA02 (first phase of the prophylactic period), on alternate days for 10 consecutive nights. Patients who were still free of symptoms were given 1 vaginal tablet every week for the next 10 weeks (second phase of the prophylactic period). Patients asymptomatic after the total duration of the observation phase (7 mo) were considered as responders.

RESULTS: During the second 10-week prophylactic phase, 49 of 57 (86.0\%) patients remained free of clinical recurrence, whereas symptomatic VVC occurred in 8 patients (14.0\%). During the 7-month follow-up, 42 patients of 49 (85.7\%) were symptom free at the end of the protocol, whereas clinical recurrences occurred in 7 women (14.3\%). Overall, 42 of 58 women enrolled in the study (72.4\%) experienced no clinical recurrence throughout the 7-month observation phase (responders).

CONCLUSIONS: This study strengthens the evidence supporting the use of specific lactobacilli with well-demonstrated activities associated with the creation and maintenance of a vaginal biofilm that hinders the persistence of an infection caused by Candida.

}, keywords = {Administration, Intravaginal, Adult, Biofilms, Candidiasis, Vulvovaginal, Delayed-Action Preparations, Female, Humans, Italy, Lactobacillus acidophilus, Lactobacillus fermentum, Middle Aged, Probiotics, Recurrence, Tablets, Time Factors, Treatment Outcome, Vagina, Vulva, Young Adult}, issn = {1539-2031}, doi = {10.1097/MCG.0000000000000225}, author = {Murina, Filippo and Graziottin, Alessandra and Vicariotto, Franco and De Seta, Francesco} } @article {1946, title = {The clinical interpretation and significance of electronic fetal heart rate patterns 2 h before delivery: an institutional observational study.}, journal = {Arch Gynecol Obstet}, volume = {286}, year = {2012}, month = {2012 Nov}, pages = {1153-9}, abstract = {

PURPOSE: To evaluate the clinical significance of intrapartum fetal heart rate (FHR) monitoring in low-risk pregnancies according to guidelines and specific patterns.

METHODS: An obstetrician, blinded to neonatal outcome, retrospectively reviewed 198 low-risk cases that underwent continuous electronic fetal monitoring (EFM) during the last 2 h before delivery. The tracings were interpreted as normal, suspicious or pathological, according to specific guidelines of EFM and by grouping the different FHR patterns considering baseline, variability, presence of decelerations and bradycardia. The EFM groups and the different FHR-subgroups were associated with neonatal acid base status at birth, as well as the short-term neonatal composite outcome. Comparisons between groups were performed with Kruskal-Wallis test. Differences among categorical variables were evaluated using Fisher{\textquoteright}s exact test. Significance was set at p < 0.05 level.

RESULTS: Significant differences were found for mean pH values in the three EFM groups, with a significant trend from "normal" [pH 7.25, 95 \% confidence interval (CI) 7.28-7.32] to "pathological" tracings (pH 7.20, 95 \% CI 7.17-7.13). Also the rates of adverse composite neonatal outcome were statistically different between the two groups (p < 0.005). Among the different FHR patterns, tracings with atypical variable decelerations and severe bradycardia were more frequently associated with adverse neonatal composite outcome (11.1 and 26.7 \%, respectively). However, statistically significant differences were only observed between the subgroups with normal tracings and bradycardia.

CONCLUSIONS: In low-risk pregnancies, there is a significant association between neonatal outcome and EFM classification. However, within abnormal tracings, neonatal outcome might differ according to specific FHR pattern.

}, keywords = {Acidosis, Bradycardia, Female, Fetal Blood, Fetal Monitoring, Heart Rate, Fetal, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Labor, Obstetric, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Retrospective Studies, Single-Blind Method, Statistics, Nonparametric, Time Factors}, issn = {1432-0711}, doi = {10.1007/s00404-012-2446-8}, author = {Maso, Gianpaolo and Businelli, Caterina and Piccoli, Monica and Montico, Marcella and De Seta, Francesco and Sartore, Andrea and Alberico, Salvatore} }