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Factors Affecting the Microflora of the Lower Genital Tract of Healthy Women
Published in Michael J. Hill, Philip D. Marsh, Human Microbial Ecology, 2020
The proportion of women who present with the classical picture of epithelial cells and lactobacilli is relatively small. However, our knowledge of the stimuli that can change the vaginal ecology is still incomplete. The changes associated with the clinical condition known as bacterial vaginosis are a good example. This distinct condition presents as an increased vaginal discharge in the absence of any recognized pathogen. The vaginal secretion shows an altered ecology with large numbers of epithelial cells covered with a mixed bacterial flora, including G. vaginalis, anaerobes (particularly Bacteroides spp. and Peptococcus), and M. hominis. All of these organisms may be isolated from the endogenous microflora but are present in far greater numbers in bacterial vaginosis. Despite these associated organisms, the precise etiological agent(s) of bacterial vaginosis is still unclear despite considerable interest during the last 30 years. Many workers believe the condition to be a specific bacterial infection caused by G. vaginalis or anaerobes, either individually or in a symbiotic relationship. This remains unproven and the possibility that the stimulus for the change in ecology is a response to the host’s physiology or lifestyle has not been excluded.
The physical exam in the pediatric and adolescent patient
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Certain patients will present with symptoms that require the collection of vaginal secretion samples. When cultures are indicated, moistened small male urethral Dacron swabs may be utilized (Figure 3.10). The hymeneal aperture is small in this age group, and the use of traditional cotton swabs creates discomfort due to their larger size. It may also traumatize the surrounding tissue, creating lesions that are not pathologic in nature, but may confuse the examining practitioner. Another helpful method is a catheter-within-a-catheter technique in which a 10-cm intravenous catheter is inserted into the proximal end of a No. 12 red rubber bladder catheter. This is then connected to a syringe with fluid and passed carefully into the vagina. The fluid is then inserted and aspirated multiple times to allow a good mixture of secretions (Figure 3.11).4
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Colonic fistulas, although considered uncommon, can also be classified as external, internal (colocutaneous), and mixed. Â 52 Among the internal fistulas, the most common are colovesical, followed by colovaginal and coloenteric. The most evident sign of colocutaneous fistulas is the passage of air and feces through an incision in the abdominal wall following surgery. Other signs and symptoms are sepsis, fever, tachycardia, leukocytosis, and pain due to abscess with local peritonitis. Patients with an internal fistula complain of various symptoms according to the viscera involved. Patients with colovesical fistulas frequently complain of cystitis, high fever, shivering, and sweating and, if the fistulous tract is wide, pneumaturia and fecaluria. Patients with colovaginal fistulas suffer from an increase of vaginal secretion, sometimes associated with the passage of feces. Patients with coloenteric fistulas suffer from abdominal pain and abundant diarrhea. Â 53
Vaginal collagen I and III changes after carbon dioxide laser application in postmenopausal women with the genitourinary syndrome: a pilot study
Published in Climacteric, 2022
T. L. B. Bretas, M. C. A. Issa, S. C. A. V. Fialho, E. A. G. Villar, L. G. C. Velarde, F. R. Pérez-López
The laser procedures were performed using the fractional microablative FemiLift iPixel CO2 laser (Alma Lasers, Caesarea, Israel). The participants were asked to abstain from sexual activity for 7 days before and after the laser session. There was no need for analgesia or anesthesia. Before treatment, the participant was placed in a dorsal lithotomy position. A vaginal speculum was inserted, and after a quick inspection to rule out any current infection, vaginal secretion was removed with dry gauze. Then, the cylindrical vaginal laser probe with a disposable cover was inserted, allowing the light to irradiate circumferentially throughout most of the vaginal wall. During treatment, the probe was rotated 45° clockwise until it reached the initial 360° position (12:00). It was withdrawn by 1 cm until complete exposition of the probe circumferential marks. The probe was then reinserted, and two more complete passes were performed in each session. The laser was set to medium pulse, 9 × 9 pixels, 2 Hz frequency and 60 mJ energy in the first session, 75 mJ in the second session and 90 mJ in the third session.
The impact of Ureaplasma infections on pregnancy complications
Published in Libyan Journal of Medicine, 2020
Daiva Bartkeviciene, Gina Opolskiene, Agne Bartkeviciute, Audrone Arlauskiene, Dalia Lauzikiene, Jolita Zakareviciene, Diana Ramasauskaite
All the patients underwent a gynaecological speculum examination. During this examination, a sample of vaginal secretion taken from the posterior vaginal fornix with a cotton-tipped swab was placed on two glass slides, dried and sent to a local microbiology laboratory for Gram stain analysis. The Gram stain analysis evaluated the count of polymorphonuclear leukocytes per high power field, epithelial cells, clue cells, Trichomonas, budding yeast, or hyphae. Taking into account that the vaginal smear evaluation could have been affected by the leakage of amniotic fluid found in almost half of the subjects (23%), only large leukocytes (covering the field of vision) from vaginal smears were used in statistical analysis.
Focused ultrasound: a novel therapy for improving vaginal microecology in patients with high-risk HPV infection
Published in International Journal of Hyperthermia, 2023
Hua Tao, Dingyuan Zeng, Wenzhi Chen, Fang Li, Haijing Zhong, Jinjian Fu, Hanzhi Liu, Ting Ying, Li Wang, Jing Chen, Zhibiao Wang, Qiuling Shi
Samples of vaginal secretions were collected for vaginal microecological detection. Vaginal microecology detection using Comet-800 vaginal microecology detection kit(Shandong ShiDaSi Biological Industry Co., Ltd.China). The detection was divided into two parts: (1) Dry chemical method to detect catalase, leukocyte lipase, sialidase and pH value; (2) Gram staining. Vaginal secretion specimens were dried and fixed and their microflora was analyzed under an oil microscope after Gram staining. The analysis included the proportion of Lactobacillus, flora density, flora diversity and Nagent score to allow the evaluation of the microecological status of the specimen.