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Recurrent Vulvovaginal Candidiasis (recurrent + vulvovaginal_candidiasis)
Selected AbstractsComprehensive review of conventional and non-conventional methods of management of recurrent vulvovaginal candidiasisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2007Cathy WATSON Abstract Recurrent vulvovaginal candidiasis (VVC) is a condition what causes women a great deal of discomfort, inconvenience, and sometimes has psychological sequelae.1 This condition is notoriously difficult to manage. Conventional management is generally favoured by medical practitioners. Some practitioners prefer not to offer other options because of significant possible side-effects and the lack of research supporting alternative treatments. There are many studies and much available information surrounding uncomplicated VVC, including two systematic reviews.2,3 In the area of recurrent VVC however, quality conclusive studies are scarce, and recurrent VVC is featured infrequently in randomised controlled trials (RCTs). Systematic reviews that strongly support a particular pharmacological method of conventional management of recurrent VVC over another are absent from medical literature. Recommendations are largely formed on the basis of scanty RCTs and expert opinion. There is even less conclusive evidence in the area of alternative therapies; yet despite this, anecdotally many practitioners (both alternative and mainstream) continue to advocate certain treatments in the absence of any reliable cure that can be confidently prescribed. As the use of methods other than mainstream medicine becomes more widespread, it is important to be aware of both conventional and non-conventional management of recurrent vulvovaginal candidiasis. Practitioners need to ascertain their patient's preference and treatment history. It is difficult to find comprehensive literature assessing both approaches. Giving women the most up-to-date and relevant information, and different management options, is essential in allowing them to make informed decisions. This review critically assesses both mainstream and less conventional approaches in the management of recurrent VVC. [source] Symptomatic candidiasis: Using self sampled vaginal smears to establish the presence of Candida, lactobacilli, and Gardnerella vaginalisDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2007M. K. Engberts M.D. Abstract In a prospective cohort study, 10 symptomatic women with recurrent vulvovaginal candidiasis were taught how to prepare vaginal smears of their own vaginal fluids on days 7, 14, 21, and 28. The 40 smears were stained with the PAS-method and examined by three different cytopathologists for presence of Candida. Thereafter, the smears were restained with Giemsa-stain to determine presence of lactobacilli, Gardnerella vaginalis ("clue cells") and neutrophils. All three cytopathologists unequivocally established Candida blastospores and (pseudo)hyphae in 27 out of the 40 PAS-stained vaginal smears, whereas in the remaining 13 smears Candida was not found. All 10 patients had Candida in their smears during the second half of their menstrual cycle. Self sampled smears prove to be reliable for establishing the presence of Candida in symptomatic patients with candidiasis. Candida is associated with a lactobacillus -predominated vaginal flora, but with the absence of Gardnerella vaginalis. Further studies may be directed towards the interaction between the various members of the vaginal flora. This study should open molecular methodology for determining the possible interactions of lactobacilli and Candida. Diagn. Cytopathol. 2007;35:635,639. © 2007 Wiley-Liss, Inc. [source] The study of cell-mediated immune response in recurrent vulvovaginal candidiasisFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 2 2000U. Nawrot Abstract The aim of this work was to examine in vitro the ability of cells from patients with recurrent vulvovaginal candidiasis (RVVC) to cell-mediated immune response. Peripheral blood mononuclear cells (PBMC) and whole blood cells (WBC) of 37 RVVC patients in acute infection and 14 in remission were examined for the ability to proliferation and cytokines production (IFN, TNF, IL-6). As a control, a group of 25 healthy women were examined. The cells were stimulated with Candida antigen (HKCA), LPS and PHA. To indicate the level of cytokines, the following cell-lines were used: A549 for IFN, WEHI 164 for TNF and 7TD1 for IL-6. The proliferation/death of cells was determined by colorimetric test using MTT. Distinct suppression of cell-mediated immune response (CMI) was shown in all patients comparing to the control. Greatest suppression was found in the acute phase of the disease. The ability of cells to proliferate and produce IFN increases only in remission. The data seem to suggest that in this phase of disease, the ability of cell-mediated immune response is restored. It was also indicated that IFN may take part in protection against Candida infection. [source] Monthly cycle-dependent itraconazole is more effective than classic homeopathy in the treatment of recurrent vulvovaginal candidiasisFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 4 2009Article first published online: 3 JUN 2010 [source] Comprehensive review of conventional and non-conventional methods of management of recurrent vulvovaginal candidiasisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2007Cathy WATSON Abstract Recurrent vulvovaginal candidiasis (VVC) is a condition what causes women a great deal of discomfort, inconvenience, and sometimes has psychological sequelae.1 This condition is notoriously difficult to manage. Conventional management is generally favoured by medical practitioners. Some practitioners prefer not to offer other options because of significant possible side-effects and the lack of research supporting alternative treatments. There are many studies and much available information surrounding uncomplicated VVC, including two systematic reviews.2,3 In the area of recurrent VVC however, quality conclusive studies are scarce, and recurrent VVC is featured infrequently in randomised controlled trials (RCTs). Systematic reviews that strongly support a particular pharmacological method of conventional management of recurrent VVC over another are absent from medical literature. Recommendations are largely formed on the basis of scanty RCTs and expert opinion. There is even less conclusive evidence in the area of alternative therapies; yet despite this, anecdotally many practitioners (both alternative and mainstream) continue to advocate certain treatments in the absence of any reliable cure that can be confidently prescribed. As the use of methods other than mainstream medicine becomes more widespread, it is important to be aware of both conventional and non-conventional management of recurrent vulvovaginal candidiasis. Practitioners need to ascertain their patient's preference and treatment history. It is difficult to find comprehensive literature assessing both approaches. Giving women the most up-to-date and relevant information, and different management options, is essential in allowing them to make informed decisions. This review critically assesses both mainstream and less conventional approaches in the management of recurrent VVC. [source] Mannose-binding lectin gene polymorphism and resistance to therapy in women with recurrent vulvovaginal candidiasisBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2008GGG Donders Precis, Women with recurrent vulvovaginal candidiasis (RVC) due to a polymorphism in codon 54 of the MBL2 gene respond better to fluconazole maintenance therapy than do women with other underlying causes. Objective, To explain differences in response rates to maintenance therapy with fluconazole in women suffering from RVC by evaluating associations with a polymorphism in the gene coding for mannose-binding lectin (MBL). Design, Follow-up study, neted case-control group. Setting, Women attending vulvoginitis clinic for RVC. Population, Women participating in a multicentric study in Belgium with a degressive dose of fluconazole for RVC (the ReCiDiF trial) were divided into good responders, intermediate responders and nonresponders according to the number of relapses they experienced during therapy. From 109 of these women with adequate follow-up data, vaginal lavage with 2 ml of saline were performed at the moment of a proven acute attack at inclusion in the study, before maintenance treatment was started. A buccal swab was obtained from 55 age-matched women without a history of Candida infections, serving as a control group. Methods, Extracted DNA from buccal or vaginal cells was tested for codon 54 MBL2 gene polymorphism by polymerase chain reaction and endonuclease digestion. Main outcome measures, Frequency of MBL2 condon 54 allele B in women with optimal or poor response to maintenance therapy in composition with controls. Results, Women (n = 109) suffering from RVC were more likely to carry the variant MBL2 codon 54 allele B than control women (20 versus 6.6%, OR 3.4 [95% CI 1.3,8.2], P = 0.01). B alleles were present in 25% of the 36 women not suffering from any recurrence during the maintenance therapy with decreasing doses of fluconazole (OR 4.9 [95% CI 1.9,12.5], P = 0.0007 versus controls), in 20% of the 43 women with sporadic recurrences (OR 3.6 [95% CI 1.4,9.2], P = 0.007 versus controls) and in 15% of the 30 women who had to interrupt the treatment regimen due to frequent relapses (P = 0.097 versus controls). Conclusions, The MBL2 codon 54 gene polymorphism is more frequent in Belgian women suffering from RVC than in controls. The presence of the B allele is associated with a superior response to fluconazole maintenance therapy as compared with RVC patients without this polymorphism. We conclude that RVC due to deficient MBL production is more easily helped with antifungal medication than is RVC due to some other mechanism. [source] | ||||||||||