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1

Test-Retest Reliability of an Instrumented Speculum For Measuring Vaginal Closure Force  

PubMed Central

Aims The study aimed to a) determine reliability of an instrumented speculum designed for measuring intravaginal closure pressure, and b) compare findings with a comparable device reported in the literature. The goal of these new devices is to reduce subjectivity, improve precision, and acknowledge reliability issues in quantifying levator ani closure force acting on the vagina. Methods The instrumented speculum consisted of two parallel aluminum bills, similar in size to a Peterson speculum. Strain gages located near the root of each bill measure the magnitude of force exerted in the distal vagina. A contraction of the “U-shaped” levator ani muscle closes the levator hiatus with resultant reaction force measured by the speculum in the mid-sagittal plane. We tested the device in twelve nulliparous women making repeated measures within and across 3 different visit days. All measures were made by the same investigator. Results Same day measures were repeatable within ±3.8 N by the third visit, with lesser repeatability on the 1st and 2nd visit days. Across days, repeatability was improved by Visits 2 and 3 with a coefficient of repeatability between those days of ±5.5 N. Better repeatability was obtained using averaged scores rather than `best effort'; but average scores can underestimate best effort. Conclusion Reasonable within-visit repeatability was found. Across-visit repeatability is consistent with the known difficulty that women have in maximally isolating and activating their levator ani muscles. The results corroborate the repeatability results of Dumoulin et al. [2004] using a similar type of dynamometer. PMID:17357114

Miller, Janis M.; Ashton-Miller, James A; Perruchicni, D.; DeLancey, John O.L.

2009-01-01

2

Barbed Suture for Vaginal Cuff Closure in Laparoscopic Hysterectomy  

PubMed Central

Background and Objectives: Our aim was to evaluate whether the use of barbed suture for vaginal cuff closure is associated with a decrease in postoperative vaginal bleeding compared with cuff closure with polyglactin 910 in patients who have undergone laparoscopic hysterectomy. Methods: We performed a cohort study of patients who underwent laparoscopic hysterectomy between January 2008 and July 2012 by the minimally invasive gynecologic surgery division of the Gynecology, Obstetrics and Human Reproduction Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Results: A total of 232 women were studied: 163 were in the polyglactin 910 group, and 69 were in the barbed suture group. The main outcome, postoperative vaginal bleeding, was documented in 53 cases (32.5%) in the polyglactin 910 group and in 13 cases (18.8%) in the barbed suture group (relative risk, 0.57; 95% confidence interval, 0.34–0.9; P = .03). No statistically significant differences were found in other postoperative outcomes, such as emergency department admission, vaginal cuff dehiscence, infectious complications, and the presence of granulation tissue. Conclusion: In this study an inverse association was observed between the use of barbed suture for vaginal cuff closure during laparoscopic hysterectomy and the presence of postoperative vaginal bleeding. PMID:24680149

Medina, Byron Cardoso; Riaño, Giovanni; Hoyos, Luis R.; Otalora, Camila

2014-01-01

3

Vaginitis  

MedlinePLUS

... serious diseases. The most common vaginal infections are Bacterial Vaginosis Trichomoniasis Vaginal Yeast Infection Some vaginal infections are ... most vaginal infections in women are due to bacterial vaginosis, trichomoniasis, or yeast, there may be other causes ...

4

50 CFR 660.509 - Accountability measures (season closures).  

Code of Federal Regulations, 2014 CFR

...2014-10-01 false Accountability measures (season closures). 660.509 Section 660...660.509 Accountability measures (season closures). (a) General rule. ...beginning of the next fishing period or season. Regional Administrator shall...

2014-10-01

5

50 CFR 660.509 - Accountability measures (season closures).  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Accountability measures (season closures). 660.509 Section 660...660.509 Accountability measures (season closures). (a) General rule. ...beginning of the next fishing period or season. Regional Administrator shall...

2012-10-01

6

50 CFR 660.509 - Accountability measures (season closures).  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Accountability measures (season closures). 660.509 Section 660...660.509 Accountability measures (season closures). (a) General rule. ...beginning of the next fishing period or season. Regional Administrator shall...

2013-10-01

7

Validating a turbulence closure against estuarine microstructure measurements  

Microsoft Academic Search

A simple k–? turbulence closure is introduced which has no stability functions but instead a Richardson number-dependent turbulent Prandtl number. Its free parameters are determined in a comparison with microstructure observations from a stratified and sheared tidal estuary and laboratory measurements. The closure is able to simulate observed turbulent dissipation rates (?) and turbulent length scales (lth) in regions of

Hartmut Peters; Helmut Z. Baumert

2007-01-01

8

50 CFR 648.24 - Fishery closures and accountability measures.  

Code of Federal Regulations, 2014 CFR

...Management Measures for the Atlantic Mackerel, Squid, and Butterfish Fisheries § 648.24...Fishery closure procedures —(1) Longfin squid. NMFS shall close the directed fishery in the EEZ for longfin squid when the Regional Administrator...

2014-10-01

9

50 CFR 648.24 - Fishery closures and accountability measures.  

Code of Federal Regulations, 2013 CFR

...Management Measures for the Atlantic Mackerel, Squid, and Butterfish Fisheries § 648.24...Fishery closure procedures —(1) Longfin squid. NMFS shall close the directed fishery in the EEZ for longfin squid when the Regional Administrator...

2013-10-01

10

50 CFR 648.24 - Fishery closures and accountability measures.  

Code of Federal Regulations, 2012 CFR

...Management Measures for the Atlantic Mackerel, Squid, and Butterfish Fisheries § 648.24...Fishery closure procedures —(1) Longfin squid. NMFS shall close the directed fishery in the EEZ for longfin squid when the Regional Administrator...

2012-10-01

11

Three-dimensional measurements of fatigue crack closure  

NASA Technical Reports Server (NTRS)

Fatigue crack growth and retardation experiments conducted in polycarbonate test specimen are described. The transparent test material allows optical interferometry measurements of the fatigue crack opening (and closing) profiles. Crack surface displacements are obtained through the specimen thickness and three dimensional aspects of fatigue crack closure are discussed.

Ray, S. K.; Grandt, A. F., Jr.

1984-01-01

12

Clindamycin Vaginal  

MedlinePLUS

... an infection caused by an overgrowth of harmful bacteria in the vagina). Clindamycin is in a class ... works by slowing or stopping the growth of bacteria. Vaginal clindamycin cannot be used to treat vaginal ...

13

Optical instrument for measurement of vaginal coating thickness by drug delivery formulations  

SciTech Connect

An optical device has been developed for imaging the human vaginal epithelial surfaces, and quantitatively measuring distributions of coating thickness of drug delivery formulations - such as gels - applied for prophylaxis, contraception or therapy. The device consists of a rigid endoscope contained within a 27-mm-diam hollow, polished-transparent polycarbonate tube (150 mm long) with a hemispherical cap. Illumination is from a xenon arc. The device is inserted into, and remains stationary within the vagina. A custom gearing mechanism moves the endoscope relative to the tube, so that it views epithelial surfaces immediately apposing its outer surface (i.e., 150 mm long by 360 deg. azimuthal angle). Thus, with the tube fixed relative to the vagina, the endoscope sites local regions at distinct and measurable locations that span the vaginal epithelium. The returning light path is split between a video camera and photomultiplier. Excitation and emission filters in the light path enable measurement of fluorescence of the sited region. Thus, the instrument captures video images simultaneously with photometric measurement of fluorescence of each video field [{approx}10 mm diameter; formulations are labeled with 0.1% w/w United States Pharmacoepia (USP) injectable sodium fluorescein]. Position, time and fluorescence measurements are continuously displayed (on video) and recorded (to a computer database). The photomultiplier output is digitized to quantify fluorescence of the endoscope field of view. Quantification of the thickness of formulation coating of a surface sited by the device is achieved due to the linear relationship between thickness and fluorescence intensity for biologically relevant thin layers (of the order of 0.5 mm). Summary measures of coating have been developed, focusing upon extent, location and uniformity. The device has begun to be applied in human studies of model formulations for prophylaxis against infection with HIV and other sexually transmitted pathogens.

Henderson, Marcus H.; Peters, Jennifer J.; Walmer, David K.; Couchman, Grace M.; Katz, David F. [Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina 27710 (United States); Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 and Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina 27710 (United States)

2005-03-01

14

Vaginal Treatment of Vaginal Cuff Dehiscence with Visceral Loop Prolapse: A New Challenge in Reparative Vaginal Surgery?  

PubMed Central

Vaginal cuff dehiscence is a rare, but potentially morbid, complication of total hysterectomy and refers to separation of the vaginal cuff closure. The term vaginal cuff dehiscence is frequently interchanged with the terms of cuff separation or cuff rupture. All denote the separation of a vaginal incision that was previously closed at time of total hysterectomy. After dehiscence of the vaginal cuff, abdominal or pelvic contents may prolapse through the vaginal opening. Bowel evisceration, outside the vulvar introitus, can lead to serious sequelae, including peritonitis, bowel injury and necrosis, or sepsis. Therefore, although prompt surgical and medical intervention is required to replace prolapsed structures, the main problem remains the reconstruction of vaginal vault. In case of recent hysterectomy, vaginal reparation only requires the approximation of vaginal walls, including their fascia, while if dehiscence occurs after a long time from hysterectomy, the adequate suspension of the vaginal vault has to be taken into consideration. In this report we describe the case of a postmenopausal patient, undergoing surgical emergency because of the evisceration of an intestinal loop through a dehiscence of vaginal vault, after numerous reconstructive vaginal surgeries for vaginal prolapse. This paper analyzes clinical circumstances, risk factors, comorbidity, and clinical and surgical management of this complication. PMID:25525534

Di Naro, Edoardo; Schonauer, Luca Maria; Loverro, Maria Teresa; Indellicati, Beatrice; Barnaba, Mario; Loverro, Giuseppe

2014-01-01

15

Agreement between rectal and vaginal temperature measured with temperature loggers in dairy cows.  

PubMed

The overall objective of this study was to evaluate agreement between rectal (RT) and vaginal temperature (VT) measured with the same temperature loggers in dairy cows. Three experiments were conducted. The study began with a validation in vitro of 24 temperature loggers comparing them to a calibrated liquid-in-glass thermometer as a reference method. The association and agreement between the 24 temperature loggers with the reference method was r=0.996 (P<0.001) with a negligible coefficient of variance (0.005) between the loggers. In-vivo temperature loggers were tested in 11 healthy post-partum cows (Experiment 2) and 12 early post-partum cows with greater body temperature (Experiment 3). Temperature loggers were set to record VT and RT at 1-min intervals. To prevent rectal and vaginal straining and potential expulsion of temperature logger an epidural injection of 2.5 ml of 2% Procain was administered. Association between RT and VT was r=0.92 (P<0.001; Experiment 2) and r=0.94 (P<0.001; Experiment 3) with a negligible difference of -0.1 and 0.01 °C. Bland-Altman plots demonstrated agreement between RT and VT for healthy and early post-partum cows with greater body temperature in Experiments 2 and 3, respectively. Furthermore the intra-class correlation coefficient between RT and VT measured with identical loggers within cows of Experiments 2 and 3 also demonstrated greater agreements (P<0.001). Therefore, continuous VT monitoring with temperature loggers can be used as a measure of body temperature in dairy cows. PMID:23506659

Suthar, Vishal; Burfeind, Onno; Maeder, Britta; Heuwieser, Wolfgang

2013-05-01

16

MCNP modelling of vaginal and uterine applicators used in intracavitary brachytherapy and comparison with radiochromic film measurements  

Microsoft Academic Search

Brachytherapy is an advanced cancer treatment that is minimally invasive, minimising radiation exposure to the surrounding healthy tissues. Microselectron© Nucletron devices with 192Ir source can be used for gynaecological brachytherapy, in patients with vaginal or uterine cancer. Measurements of isodose curves have been performed in a PMMA phantom and compared with Monte Carlo calculations and TPS (Plato software of Nucletron

E. Ceccolini; I. Gerardy; J. Ródenas; M. van Dycke; S. Gallardo; D. Mostacci

2009-01-01

17

Closure measures for coarse-graining of the tent map  

SciTech Connect

We quantify the relationship between the dynamics of a time-discrete dynamical system, the tent map T and its iterations T{sup m}, and the induced dynamics at a symbolical level in information theoretical terms. The symbol dynamics, given by a binary string s of length m, is obtained by choosing a partition point ??[0,1] and lumping together the points x?[0,1] s.t. T{sup i}(x) concurs with the i ? 1th digit of s—i.e., we apply a so called threshold crossing technique. Interpreting the original dynamics and the symbolic one as different levels, this allows us to quantitatively evaluate and compare various closure measures that have been proposed for identifying emergent macro-levels of a dynamical system. In particular, we can see how these measures depend on the choice of the partition point ?. As main benefit of this new information theoretical approach, we get all Markov partitions with full support of the time-discrete dynamical system induced by the tent map. Furthermore, we could derive an example of a Markovian symbol dynamics whose underlying partition is not Markovian at all, and even a whole hierarchy of Markovian symbol dynamics.

Pfante, Oliver, E-mail: pfante@mis.mpg.de; Olbrich, Eckehard; Bertschinger, Nils [Max Planck Institute for Mathematics in the Sciences, Inselstrasse 22, 04103 Leipzig (Germany)] [Max Planck Institute for Mathematics in the Sciences, Inselstrasse 22, 04103 Leipzig (Germany); Ay, Nihat; Jost, Jürgen [Max Planck Institute for Mathematics in the Sciences, Inselstrasse 22, 04103 Leipzig (Germany) [Max Planck Institute for Mathematics in the Sciences, Inselstrasse 22, 04103 Leipzig (Germany); Department of Mathematics and Computer Science, Leipzig University, PF 100920, 04009 Leipzig (Germany); Santa Fe Institute, 1399 Hyde Park Road, Santa Fe, New Mexico 87501 (United States)

2014-03-15

18

Closure measures for coarse-graining of the tent map.  

PubMed

We quantify the relationship between the dynamics of a time-discrete dynamical system, the tent map T and its iterations T(m), and the induced dynamics at a symbolical level in information theoretical terms. The symbol dynamics, given by a binary string s of length m, is obtained by choosing a partition point [Formula: see text] and lumping together the points [Formula: see text] s.t. T(i)(x) concurs with the i - 1th digit of s-i.e., we apply a so called threshold crossing technique. Interpreting the original dynamics and the symbolic one as different levels, this allows us to quantitatively evaluate and compare various closure measures that have been proposed for identifying emergent macro-levels of a dynamical system. In particular, we can see how these measures depend on the choice of the partition point ?. As main benefit of this new information theoretical approach, we get all Markov partitions with full support of the time-discrete dynamical system induced by the tent map. Furthermore, we could derive an example of a Markovian symbol dynamics whose underlying partition is not Markovian at all, and even a whole hierarchy of Markovian symbol dynamics. PMID:24697398

Pfante, Oliver; Olbrich, Eckehard; Bertschinger, Nils; Ay, Nihat; Jost, Jürgen

2014-03-01

19

Vaginal Cancer  

MedlinePLUS

Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human ... test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its ...

20

Calculated and measured drift closure during the spent-fuel test in Climax granite  

SciTech Connect

Horizontal and vertical measurements of drift closures have been made with a manually operated tape extensometer since about 6 weeks after the emplacement of the spent fuel at various locations along the length of the drifts. The averaged closures are less than 0.6 mm from the onset of measurements through about two years after the spent fuel emplacement. These results have been compared with thermo-elastic finite element calculations using measured medium properties. The comparisons show that most of the closure of the drifts occurred between the time the spent fuel was emplaced and the time of first measurement. The comparisons show that the results track each other, in that where closure followed by dilation is measured, the calculations also show this effect. The agreement is excellent, although where closures of less than 0.2 mm are measured the comparison with calculations is limited by measurement reproducability. Once measurements commenced the averaged measured closures remain to within 30% of the calculated total closure in each drift. 9 figures, 1 table.

Yow, J.L. Jr.; Butkovich, T.R.

1982-04-01

21

Estrogen Vaginal  

MedlinePLUS

... estradiol vaginal ring is also used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) ... mild soap and warm water. Do not use hot water or boil the applicator. Ask your pharmacist ...

22

Vaginal Pessary  

MedlinePLUS

... your vagina). A pessary can also help many women who have stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women who have incontinence can also use a vaginal ...

23

Vaginal Bleeding  

MedlinePLUS

Menstruation, or period, is a woman's monthly bleeding. Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, lasts several weeks, or happens before ...

24

Vaginal Discharge  

MedlinePLUS

... on the lookout for symptoms of yeast infections, bacterial vaginosis and trichomoniasis, 3 infections that can cause changes ... vulva Intense itching Painful sexual intercourse Signs of bacterial vaginosis A white, gray or yellowish vaginal discharge A ...

25

Vaginal reconstruction  

SciTech Connect

Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

Lesavoy, M.A.

1985-05-01

26

Vaginal fetal fibronectin measurements from 8 to 22 weeks’ gestation and subsequent spontaneous preterm birth  

Microsoft Academic Search

Objective: We sought to determine the range of fetal fibronectin values in the vagina from 8 to 22 weeks’ gestation, the factors associated with both low and high values, and whether high values are associated with gestational age at birth. Study Design: Vaginal fetal fibronectin was quantitatively determined in a prospective cohort study of 13,360 women being evaluated for participation

Robert L. Goldenberg; Mark Klebanoff; J. Christopher Carey; Cora MacPherson; Kenneth J. Leveno; Atef H. Moawad; Baha Sibai; R. P. Heine; J. M. Ernest; Mitchell P. Dombrowski; Menachem Miodovnik; Ronald J. Wapner; Jay D. Iams; Oded Langer; Mary J. O’Sullivan; James M. Roberts

2000-01-01

27

Modelling and measurement of crack closure and crack growth following overloads and underloads  

NASA Technical Reports Server (NTRS)

Ignoring crack growth retardation following overloads can result in overly conservative life predictions in structures subjected to variable amplitude fatigue loading. Crack closure is believed to contribute to the crack growth retardation, although the specific closure mechanism is dabatable. The delay period and corresponding crack growth rate transients following overload and overload/underload cycles were systematically measured as a function of load ratio and overload magnitude. These responses are correlated in terms of the local 'driving force' for crack growth, i.e. the effective stress intensity factor range. Experimental results are compared with the predictions of a Dugdale-type (1960) crack closure model, and improvements in the model are suggested.

Dexter, R. J.; Hudak, S. J.; Davidson, D. L.

1989-01-01

28

Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries  

PubMed Central

Objective To evaluate the effectiveness of the systematic use of a transparent plastic collector bag to measure postpartum blood loss after vaginal delivery in reducing the incidence of severe postpartum haemorrhage. Design Cluster randomised trial. Setting 13 European countries. Participants 78 maternity units and 25?381 women who had a vaginal delivery. Interventions Maternity units were randomly assigned to systematic use of a collector bag (intervention group) or to continue to visually assess postpartum blood loss after vaginal delivery (control group). Main outcome measures The primary outcome was the incidence of severe postpartum haemorrhage in vaginal deliveries, defined as a composite of one or more of blood transfusion, intravenous plasma expansion, arterial embolisation, surgical procedure, admission to an intensive care unit, treatment with recombinant factor VII, and death. Results Severe postpartum haemorrhage occurred in 189 of 11?037 of vaginal deliveries (1.71%) in the intervention group compared with 295 of 14?344 in the control group (2.06%). The difference was not statistically significant either in individual level analysis (adjusted odds ratio 0.82, 95% confidence interval 0.26 to 2.53) or in cluster level analysis (difference in weighted mean rate adjusted for baseline rate 0.16%, 95% confidence interval ?0.69% to 1.02%). Conclusion Compared with visual estimation of postpartum blood loss the use of a collector bag after vaginal delivery did not reduce the rate of severe postpartum haemorrhage. Trial registration Current Controlled Trials ISRCTN66197422. PMID:20123835

2010-01-01

29

Techniques for measuring phase closure at 11 microns  

Microsoft Academic Search

The U.C. Berkeley Infrared Spatial Interferometer (ISI), previously described by Hale et al. as a two-telescope stellar interferometer operating in the mid-infrared regime of 9-12 mum, is now testing a recently constructed third telescope and centralized laser local oscillator and beam combining facilities for operation of a three-telescope system with phase closure. This new system will allow the ISI Array

David D. S. Hale; Walter Fitelson; John D. Monnier; Jonathon Weiner; Charles H. Townes

2003-01-01

30

Using image processing to measure tree crown diameters and estimate percent crown closure  

E-print Network

USING IMAGE PROCESSING TO MEASURE TREE CROWN DIAMETERS AND ESTIMATE PERCENT CROWN CLOSURE A THESIS by DARREN KYLE GABRIEL Submitted to Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE... Diameters And Estimate Percent Crown Closure. (December 1994) Darren Kyle Gabriel, B. S. , Texas ARM University Chair of Advisory Committee: Dr. Robert D. Baker It was the intent of this research to determine if the use of a scanner, computers...

Gabriel, Darren Kyle

1994-01-01

31

Vaginal Cancer  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a The vagina can be a common site of secondary involvement, either through direct extension from the cervix and vulva or by\\u000a lymphatic and vascular spread.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Invasive cancers most commonly present with irregular vaginal bleeding or discharge (often postcoital), followed by vaginal\\u000a discharge or dysuria. Vaginal intraepithelial neoplasia (VaIN) is diagnosed on routine screening.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Diagnostic workup should include

Nitika Thawani; Subhakar Mutyala; Aaron H. Wolfson

32

Closure Properties and Negatively Associated Measures violating the van den Berg-Kesten  

E-print Network

Closure Properties and Negatively Associated Measures violating the van den Berg-Kesten Inequality which does not satisfy the van den Berg-Kesten inequality. Next we show that the class of measures satisfying the van den Berg-Kesten inequality is not closed under either of conditioning, introduction

Markström, Klas

33

An interdisciplinary framework for measuring and supporting adherence in HIV prevention trials of ARV-based vaginal rings  

PubMed Central

Introduction Product adherence and its measurement have emerged as a critical challenge in the evaluation of new HIV prevention technologies. Long-acting ARV-based vaginal rings may simplify use instructions and require less user behaviour, thereby facilitating adherence. One ARV-based ring is in efficacy trials and others, including multipurpose rings, are in the pipeline. Participant motivations, counselling support and measurement challenges during ring trials must still be addressed. In previous HIV prevention trials, this has been done largely using descriptive and post-hoc methods that are highly variable and minimally evaluated. We outline an interdisciplinary framework for systematically investigating promising strategies to support product uptake and adherence, and to measure adherence in the context of randomized, blinded clinical trials. Discussion The interdisciplinary framework highlights the dual use of adherence measurement (i.e. to provide feedback during trial implementation and to inform interpretation of trial findings) and underscores the complex pathways that connect measurement, adherence support and enacted adherence behaviour. Three inter-related approaches are highlighted: 1) adherence support – sequential efforts to define motivators of study product adherence and to develop, test, refine and evaluate adherence support messages; 2) self-reported psychometric measures – creation of valid and generalizable measures based in easily administered scales that capture vaginal ring use with improved predictive ability at screening, baseline and follow-up that better engage participants in reporting adherence; and 3) more objective measurement of adherence – real-time adherence monitoring and cumulative measurement to correlate adherence with overall product effectiveness through innovative designs, models and prototypes using electronic and biometric technologies to detect ring insertion and/or removal or expulsion. Coordinating research along these three pathways will result in a comprehensive approach to product adherence within clinical trials. Conclusions Better measurement of adherence will not, by itself, ensure that future effectiveness trials will be able to address the most basic question: if the product is used per instructions, will it prevent HIV transmission? The challenges to adherence measurement must be addressed as one component of a more integrated system that has as its central focus adherence as a behaviour emerging from the social context of the user. PMID:25224617

MacQueen, Kathleen M; Tolley, Elizabeth E; Owen, Derek H; Amico, K Rivet; Morrow, Kathleen M; Moench, Thomas; Friend, David R; Friedland, Barbara

2014-01-01

34

Vaginal Birth  

NSDL National Science Digital Library

This patient education program reviews female reproductive anatomy and explains vaginal birth. It also discusses the stages of labor and delivery, as well as potential risks and complications. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

35

Is uterine depth measurement by trans-vaginal ultrasound alone as accurate as measurement carried out by trans-abdominal ultrasound-guided trial transfer?  

PubMed Central

Objectives: To assess the reliability of trans-vaginal-scan (TVS) in measuring the uterine depth (UD) in comparison with ultrasound-guided trial-transfer (UTT). Methods: This prospective study was conducted in 66 consecutive patients undergoing in-vitro fertilization and embryo transfer (IVF-ET). The study took place in a private IVF center in Jeddah, Saudi Arabia between November 2013 and January 2014. The patients underwent UD measurements using TVS and UTT, sequentially. All scans were performed by a single sonographer, and all UTT were carried out by a single physician who was blinded to the TVS measurement. Results: The median (95% confidence interval) UD measurement using the TVS method was 6.9 cm (5.0-12.5) and UTT was 7.1 cm (5.9-13.5), (p<0.0001). Fifteen patients (22.7%) had a difference of >1 cm between the 2 measurement modalities (group-B). When measured by UTT, 93.3% of patients in group-B had UD ?8cm, compared with 9.8% of patients in group-A, (p<0.0001). Group-B had a significantly longer uterine cavity when measured by UTT (p<0.0001), and a trend towards significance when measured by TVS (p=0.055). The TVS measurements generally underestimated UD when compared with UTT. Conclusion: Trans-vaginal-scan is less reliable than UTT and should not be used as a substitute. Larger sample-size studies involving different personnel, and equipment is needed. PMID:25316468

Edris, Fawaz E.

2014-01-01

36

An Evaluation of the Plasticity-Induced Crack-Closure Concept and Measurement Methods  

NASA Technical Reports Server (NTRS)

An assessment of the plasticity-induced crack-closure concept is made, in light of some of the questions that have been raised on the validity of the concept, and the assumptions that have been made concerning crack-dp damage below the crack-opening stress. The impact of using other crack-tip parameters, such as the cyclic crack-tip displacement, to model crack-growth rate behavior was studied. Crack-growth simulations, using a crack-closure model, showed a close relation between traditional Delta K eff, and the cyclic crack-tip displacement (Delta eff) for an aluminum alloy and a steel. Evaluations of the cyclic hysteresis energy demonstrated that the cyclic plastic damage below the crack-opening stress was negligible in the Paris crack-growth regime. Some of the standard and newly proposed remote measurement methods to determine the 'effective' crack-tip driving parameter were evaluated on middle-crack tension specimens. A potential source of the Kmax effect on crack-growth rates was studied on an aluminum alloy. Results showed that the ratio of Kmax to Kc had a strong effect on crack-growth rates at high stress ratios and at low stress ratios for very high stress levels. The crack-closure concept and the traditional crack-growth rate equations were able to correlate and predict crack-growth rates under these extreme conditions.

Newman, James C., Jr.

1998-01-01

37

Vaginal and Vulvar Cancer  

MedlinePLUS

... sixth type of gynecologic cancer is the very rare fallopian tube cancer.) This fact sheet about vaginal ... get them. Vaginal and vulvar cancers are very rare. Together, they account for 6-7 percent of ...

38

What Is Vaginal Cancer?  

MedlinePLUS

... cancer There are several types of vaginal cancer. Squamous cell carcinoma About 70 of every 100 cases of vaginal cancer are squamous cell carcinomas . These cancers begin in the squamous cells that ...

39

77 FR 60945 - 2012-2013 Accountability Measure and Closure for Commercial Black Sea Bass in the South Atlantic  

Federal Register 2010, 2011, 2012, 2013, 2014

...Accountability Measure and Closure for Commercial Black Sea Bass in the South Atlantic AGENCY...measure (AM) for the commercial sector of black sea bass in the exclusive economic zone...equal to the commercial quota) for black sea bass will have been reached by...

2012-10-05

40

Large posterior vaginal cyst in pregnancy.  

PubMed

A 20-year-old primigravida presented in labour with a mass protruding from her vagina during uterine contractions. The mass was a large tense cyst measuring 8 × 8 cm arising from the posterior vaginal wall. The cyst was present since puberty but increased in size during pregnancy. It collapsed following aspiration and uneventful vaginal delivery was conducted. Following delivery, the cyst was excised and vaginal wall repaired. On histopathology the cyst was identified as a Müllerian cyst. The patient recovered and remained asymptomatic on follow-up. PMID:25604504

Lallar, Meenakshi; Nandal, Rajesh; Sharma, Deepak; Shastri, Sweta

2015-01-01

41

Episiotomy for vaginal birth  

PubMed Central

Background Episiotomy is done to prevent severe perineal tears, but its routine use has been questioned. The relative effects of midline compared with midlateral episiotomy are unclear. Objectives The objective of this review was to assess the effects of restrictive use of episiotomy compared with routine episiotomy during vaginal birth. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2008). Selection criteria Randomized trials comparing restrictive use of episiotomy with routine use of episiotomy; restrictive use of mediolateral episiotomy versus routine mediolateral episiotomy; restrictive use of midline episiotomy versus routine midline episiotomy; and use of midline episiotomy versus mediolateral episiotomy. Data collection and analysis The two review authors independently assessed trial quality and extracted the data. Main results We included eight studies (5541 women). In the routine episiotomy group, 75.15% (2035/2708) of women had episiotomies, while the rate in the restrictive episiotomy group was 28.40% (776/2733). Compared with routine use, restrictive episiotomy resulted in less severe perineal trauma (relative risk (RR) 0.67, 95% confidence interval (CI) 0.49 to 0.91), less suturing (RR 0.71, 95% CI 0.61 to 0.81) and fewer healing complications (RR 0.69, 95% CI 0.56 to 0.85). Restrictive episiotomy was associated with more anterior perineal trauma (RR 1.84, 95% CI 1.61 to 2.10). There was no difference in severe vaginal/perineal trauma (RR 0.92, 95% CI 0.72 to 1.18); dyspareunia (RR 1.02, 95% CI 0.90 to 1.16); urinary incontinence (RR 0.98, 95% CI 0.79 to 1.20) or several pain measures. Results for restrictive versus routine mediolateral versus midline episiotomy were similar to the overall comparison. Authors’ conclusions Restrictive episiotomy policies appear to have a number of benefits compared to policies based on routine episiotomy. There is less posterior perineal trauma, less suturing and fewer complications, no difference for most pain measures and severe vaginal or perineal trauma, but there was an increased risk of anterior perineal trauma with restrictive episiotomy. PMID:19160176

Carroli, Guillermo; Mignini, Luciano

2014-01-01

42

Towards closure between measured and modelled UV under clear skies at four diverse sites  

NASA Astrophysics Data System (ADS)

The purpose of this work is determine the extent of closure between measurements and models of UV irradiances at diverse sites using state of the art instruments, models, and the best available data as inputs to the models. These include information about aerosol optical depth (unfortunately not extending down as far into the UVB region as desirable because such information is not generally available), ozone column amounts, as well as vertical profiles of ozone and temperature. We concentrate on clear-sky irradiances, and report the results in terms of UV Index (UVI). Clear-sky data from one year of measurements at each of four diverse sites (Lauder - New Zealand, Mauna Loa Observatory - Hawaii, Boulder - Colorado, and Melbourne - Australia) have been analysed in detail, also taking account of different measurements of ozone, including satellite-derived values, as well as ground measured values, both from Dobson instruments and as retrieved from the UV spectra under study. Previous studies have generally focussed on data from a single site, and for shorter periods. Consequently, this study is the most comprehensive of its kind to date. At Lauder, which is the cleanest low altitude site, we obtained agreement between measurement and model at 5% level, which is consistent with the best agreement found previously. At Mauna Loa Observatory, similar agreement was achieved, but model calculations need to allow for reflections from cloud that are present below the observatory. At this site, there are occasional problems with using satellite-derived ozone. At Boulder, mean agreements were similar but the dispersion around the mean was slightly larger, corresponding to larger uncertainties in the aerosol inputs to the model. However, at Melbourne, which is the only non-NDACC (Network for the Detection of Atmospheric Composition Change) site, there remain unexplained discrepancies. The measured values are significantly lower than the calculated values. We investigate the extent to which this discrepancy can be explained by incomplete knowledge of aerosol extinctions in the UV at this site. We conclude that further information about aerosol optical depth and single scattering albedo in the UVB region is needed to resolve the issues. At the three NDACC sites, the closure provided by the study gives confidence in both the measurements and our ability to model them. The study revealed a limitation in the use of PTFE diffusers when temperatures are lower than approximately 20°C. It also documents the range of clear sky UVI values expected at these diverse sites.

Badosa, J.; McKenzie, R. L.; Kotkamp, M.; Calbó, J.; González, J. A.; Johnston, P. V.; O'Neill, M.; Anderson, D. J.

2007-01-01

43

Towards closure between measured and modelled UV under clear skies at four diverse sites  

NASA Astrophysics Data System (ADS)

The purpose of this work is determine the extent of closure between measurements and models of UV irradiances at diverse sites using state of the art instruments, models, and the best available data as inputs to the models. These include information about aerosol optical depth (unfortunately not extending down as far into the UVB region as desirable because such information is not generally available), ozone column amounts, as well as vertical profiles of temperature. We concentrate on clear-sky irradiances, and report the results in terms of UV Index (UVI). Clear-sky data from one year of measurements at each of four diverse sites (Lauder - New Zealand, Mauna Loa Observatory - Hawaii, Boulder - Colorado, and Melbourne - Australia) have been analysed in detail, also taking account of different measurements of ozone, including satellite-derived values, as well as ground measured values, both from Dobson instruments and as retrieved from the UV spectra under study. Previous studies have generally focussed on data from a single site, and for shorter periods. As such, it is the most comprehensive study of its kind to date. At Lauder, which is the cleanest low altitude site, we obtained agreement between measurement and model at 5% level, which is consistent with the best agreement found previously. At Mauna Loa Observatory, similar agreement was achieved, but model calculations need to allow for reflections from cloud that are present below the observatory. At this site, there are occasional problems with using satellite-derived ozone. At Boulder, mean agreements were similar but the dispersion around the mean was slightly larger, corresponding to larger uncertainties in the aerosol inputs to the model. However, at Melbourne, which is the only non-NDACC (Network for the Detection of Atmospheric Composition Change) site, there remain unexplained discrepancies. The measured values are significantly lower than the calculated values. We investigate the extent to which this discrepancy can be explained by incomplete knowledge of aerosol extinctions in the UV at this site. We conclude that further information about aerosol optical depth and single scattering albedo in the UVB region is needed to resolve the issues. For more polluted sites (the four considered locations show in general small aerosol load), the uncertainties in the aerosol input parameters would lead to less confidence on the modelling approach. At the three NDACC sites, the closure provided by the study gives confidence in both the measurements and our ability to model them. This study revealed a limitation in the use of PTFE diffusers when temperatures are lower than approximately 20°C. It also documents the range of clear sky UVI values expected at these diverse sites.

Badosa, J.; McKenzie, R. L.; Kotkamp, M.; Calbó, J.; González, J. A.; Johnston, P. V.; O'Neill, M.; Anderson, D. J.

2007-06-01

44

Management of persistent vaginitis.  

PubMed

With vaginitis remaining a common condition that leads women to seek care, it is not surprising that some women develop chronic vulvovaginal problems that are difficult to diagnose and treat. With a differential diagnosis that encompasses vulvar disorders and infectious and noninfectious causes of vaginitis, accurate diagnosis is the cornerstone of choosing effective therapy. Evaluation should include a symptom-specific history, careful vulvar and vaginal examination, and office-based tests (vaginal pH, amine test, saline and 10% potassium hydroxide microscopy). Ancillary tests, especially yeast culture with speciation, are frequently crucial to obtaining a correct diagnosis. A heavy but normal physiologic discharge can be determined by excluding other causes. With vulvovaginal candidiasis, differentiating between Candida albicans and non-albicans Candida infection has important treatment ramifications. Most patients with C albicans infections can be successfully treated with maintenance antifungal therapy, usually with fluconazole. Although many non-albicans Candida, particularly Candida glabrata, may at times be innocent bystanders, vaginal boric acid therapy is an effective first choice for many true non-albicans Candida infections. Recurrent bacterial vaginosis, a difficult therapeutic challenge, can often be controlled with maintenance therapy. Multiple options, especially high-dose tinidazole, have been used for metronidazole-resistant trichomoniasis. With the aging of the U.S. population, atrophic vaginitis and desquamative inflammatory vaginitis, both associated with hypoestrogenism, are encountered frequently in women with persistent vaginitis. PMID:25415165

Nyirjesy, Paul

2014-12-01

45

Linking powered by eXtyles Crack closure and stress intensity factor measurements in nodular  

E-print Network

Introduction Fatigue crack closure was first described by Elber [1] more than 30 years ago. Although before the minimum load of the fatigue cycle is reached. The underlying mechanisms are diverse and may and induce Roughness- Induced Crack Closure (RICC). This mechanism becomes significant near the fatigue

46

Large Vaginal and Bladder Calculi in a Woman With Previous Operation of Bladder Exstrophy: A Case Report  

PubMed Central

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones. PMID:24719809

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2013-01-01

47

Relationship among eye and muzzle temperatures measured using digital infrared thermal imaging and vaginal and rectal temperatures in hair sheep and cattle.  

PubMed

Digital infrared thermal imaging (DITI) using a thermal camera has potential to be a useful tool for the production animal industry. Thermography has been used in both humans and a wide range of animal species to measure body temperature as a method to detect injury or inflammation. The objective of these experiments was to compare the temperature of the eye (EYE) or muzzle (MUZ) measured using DITI to vaginal (VT) and rectal temperature (RT) as measures of core body temperature in hair sheep and beef cattle. In Exp.1 EYE, VT and RT were measured in lactating, multiparous hair sheep ewes (St. Croix White, n = 10, and Dorper × St. Croix White, n = 10) in a non-febrile state 5 times over a 48-h period. Data loggers were used to measure VT and a digital veterinary thermometer was used to measure RT. There was a high correlation (P < 0.001) between VT and RT (r = 0.95), EYE and RT (r = 0.76) and EYE and VT (r = 0.77). In Exp. 2 EYE, MUZ, VT and RT were measured in multiparous, lactating ewes (St. Croix White, n = 2, and Barbados Blackbelly, n = 12) at -12, -1, 0, 1, 2, 3, 4, 6, 12, 24, 36, and 48 h after being administered lipopolysaccharide (LPS; n = 7; 0.2 µg/kg BW, i.v.) or saline (n = 7; 0.5 mL, i.v.). Data loggers were used to measure VT and a digital veterinary thermometer was used to measure RT. When data were combined across treatments (LPS and saline) there was a high correlation (P < 0.001) between VT and RT (r = 0.96), EYE and RT (r = 0.82), MUZ and RT (r = 0.72), and EYE and VT (r = 0.93). In Exp. 3 EYE, MUZ, VT and RT were measured in multiparous, non-lactating, pregnant Senepol cattle (n = 44) between 0900 and 1200 h on a single day. A digital veterinary thermometer was used to measure both VT and RT. There was a high correlation (P < 0.001) between VT and RT (r = 0.78), a moderate correlation (P < 0.001) between VT and EYE (r = 0.52), RT and EYE (r = 0.58) and EYE and MUZ (r = 0.48). There was no correlation (P > 0.10) between RT or VT and MUZ. The findings of these three studies indicate that temperature of the eye, measured using DITI, can be used as an indicator of core body temperature in hair sheep and beef cattle as an alternative to using vaginal or rectal temperature. PMID:25253816

George, W D; Godfrey, R W; Ketring, R C; Vinson, M C; Willard, S T

2014-11-01

48

Vaginal yeast infection  

MedlinePLUS

... help prevent and treat vaginal discharge: Keep your genital area clean and dry. Avoid soap and rinse ... feminine hygiene sprays, fragrances, or powders in the genital area. Avoid wearing tight-fitting pants or shorts, ...

49

Vaginal birth - series (image)  

MedlinePLUS

This presentation illustrates key stages of a normal vaginal delivery. Please keep in mind that every birth is unique, ... fluid, blood, and mucus from his nose and mouth. More contractions and pushing help deliver the baby's ...

50

Vaginal sponge and spermicides  

MedlinePLUS

Birth control - over the counter; Contraceptives - over the counter ... Spermicides and vaginal sponges do not work as well at preventing ... control at all. SPERMICIDES Spermicides are chemicals that stop ...

51

How Is Vaginitis Treated?  

MedlinePLUS

... to learn the specific type of vaginitis. 1 Bacterial Vaginosis Bacterial vaginosis (BV) is treated with an antibiotic that gets ... Date: 05/21/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) ...

52

Airborne Sunphotometer Studies of Aerosol Properties and Effects, Including Closure Among Satellite, Suborbital Remote, and In situ Measurements  

NASA Technical Reports Server (NTRS)

Airborne sunphotometry has been used to measure aerosols from North America, Europe, and Africa in coordination with satellite and in situ measurements in TARFOX (1996), ACE-2 (1997), PRIDE (2000), and SAFARI 2000. Similar coordinated measurements of Asian aerosols are being conducted this spring in ACE-Asia and are planned for North American aerosols this summer in CLAMS. This paper summarizes the approaches used, key results, and implications for aerosol properties and effects, such as single scattering albedo and regional radiative forcing. The approaches exploit the three-dimensional mobility of airborne sunphotometry to access satellite scenes over diverse surfaces (including open ocean with and without sunglint) and to match exactly the atmospheric layers sampled by airborne in situ measurements and other radiometers. These measurements permit tests of the consistency, or closure, among such diverse measurements as aerosol size-resolved chemical composition; number or mass concentration; light extinction, absorption, and scattering (total, hemispheric back and 180 deg.); and radiative fluxes. In this way the airborne sunphotometer measurements provide a key link between satellite and in situ measurements that helps to understand any discrepancies that are found. These comparisons have led to several characteristic results. Typically these include: (1) Better agreement among different types of remote measurements than between remote and in situ measurements. (2) More extinction derived from transmission measurements than from in situ measurements. (3) Larger aerosol absorption inferred from flux radiometry than from in situ measurements. Aerosol intensive properties derived from these closure studies have been combined with satellite-retrieved fields of optical depth to produce fields of regional radiative forcing. We show results for the North Atlantic derived from AVHRR optical depths and aerosol intensive properties from TARFOX and ACE-2. Companion papers show analogous, preliminary results for Asian-Pacific aerosols and results of SAFARI-2000 closure studies on African aerosols.

Russlee, Philip B.; Schmid, B.; Redemann, J.; Livingston, J. M.; Bergstrom, R. W.; Ramirez, S. A.; Hipskind, R. Stephen (Technical Monitor)

2001-01-01

53

[Vaginal sonography versus vaginal palpation: initial experiences in 120 pregnant patients with suspected cervix insufficiency].  

PubMed

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 120 pregnant women with cervical insufficiency between 16th and 33rd week of gestation were examined by a 5-MHz vaginal sectorscanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Another group of 50 pregnant women with unsuspicious obstetrical findings were also examined to gain information about normal sonographical morphology and length of the competent uterine cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage. In case of suspected cervical incompetence continuous sonographical examination can supervise the development of the uterine cervix during pregnancy. In future the number of prophylactic cerclage-operations perhaps decreases by using the technique of transvaginal sonography. PMID:2669397

Böhmer, S; Degenhardt, F; Gerlach, C; Jagla, K; Schneider, J

1989-01-01

54

High-precision mass measurements of nickel, copper, and gallium isotopes and the purported shell closure at N=40  

E-print Network

High-precision mass measurements of more than thirty neutron-rich nuclides around the Z=28 closed proton shell were performed with the triple-trap mass spectrometer ISOLTRAP at ISOLDE/CERN to address the question of a possible neutron shell closure at N=40. The results, for 57,60,64-69Ni (Z=28), 65-74,76Cu (Z=29), and 63-65,68-78Ga (Z=31), have a relative uncertainty of the order of 10^8. In particular, the masses of 72-74,76Cu have been measured for the first time. We analyse the resulting mass surface for signs of magicity, comparing the behavior of N=40 to that of known magic numbers and to mid-shell behavior. Contrary to nuclear spectroscopy studies, no indications of a shell or sub-shell closure are found for N=40.

C. Guenaut; G. Audi; D. Beck; K. Blaum; G. Bollen; P. Delahaye; F. Herfurth; A. Kellerbauer; H. -J. Kluge; J. Libert; D. Lunney; S. Schwarz; L. Schweikhard; C. Yazidjian

2007-01-22

55

Women's Psychological Adjustment Following Emergency Cesarean versus Vaginal Delivery.  

ERIC Educational Resources Information Center

Investigated psychological adjustment and satisfaction in women who had given birth vaginally or by cesarean section. Cesarean mothers reported significantly less satisfaction with the delivery than did vaginal mothers; however no differences were found in postpartum psychological adjustment as measured by depression, anxiety, and confidence in…

Padawer, Jill A.; And Others

1988-01-01

56

Vaginal bleeding in early pregnancy  

MedlinePLUS

Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception ( ... out of every 10 pregnant women have vaginal bleeding during their first 20 weeks of pregnancy.

57

Vaginal Toxic Shock Reaction Triggering Desquamative Inflammatory Vaginitis  

PubMed Central

Objective To report two cases of desquamative inflammatory vaginitis (DIV) associated with toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus strains. Materials and Methods Case report of two patients, one with an acute and one with a chronic presentation, diagnosed with DIV on the basis of clinical findings and wet mount microscopy. Pre- and posttreatment vaginal bacterial and yeast cultures were obtained. Results Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial cultures following oral antibiotic therapy were negative. Conclusions DIV may be triggered through TSST-1-mediated vaginal toxic shock reaction. PMID:23222054

Pereira, Nigel; Edlind, Thomas D.; Schlievert, Patrick M.; Nyirjesy, Paul

2012-01-01

58

Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief?  

PubMed

In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0.31). At V2, the percentage improvement rates were 84 and 89 % (p = 0.13), respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream (p[0.05), respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. In the majority of women, the vaginal microenvironment remained unaffected by treatment. However, the proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events (suspected to be) related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggest using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause. PMID:24178484

Stute, Petra

2013-12-01

59

Vaginitis in adolescents.  

PubMed

Vaginitis is a common complaint of adolescent females. It can cause extreme distress for some patients, especially those with recurrent symptoms. Thus, it is important to take care when evaluating these patients and to acknowledge their frustration when appropriate. A thoughtful and thorough history will determine most causes, with the most common being yeast, trichomoniasis, and BV. PMID:15449843

Syed, Tahniat S; Braverman, Paula K

2004-06-01

60

Extinction of the N=20 neutron-shell closure for 32Mg examined by direct mass measurements  

E-print Network

The 'island of inversion' around $^{32}$Mg is one of the most important paradigm for studying the disappearance of the stabilizing 'magic' of a shell closure. We present the first Penning-trap mass measurements of the exotic nuclides $^{29-31}$Na and $^{30-34}$Mg, which allow a precise determination of the empirical shell gap for $^{32}$Mg. The new value of 1.10(3) MeV is the lowest observed shell gap for any nuclide with a canonical magic number.

A. Chaudhuri; C. Andreoiu; T. Brunner; U. Chowdhury; S. Ettenauer; A. T. Gallant; G. Gwinner; A. A. Kwiatkowski; A. Lennarz; D. Lunney; T. D. Macdonald; B. E. Schultz; M. C. Simon; V. V. Simon; J. Dilling

2013-10-09

61

Extension of the Averaging Time in Eddy-Covariance Measurements and Its Effect on the Energy Balance Closure  

NASA Astrophysics Data System (ADS)

The modified ogive analysis and the block ensemble average were employed to investigate the impact of the averaging time extension on the energy balance closure over six land-use types. The modified ogive analysis, which requires a steady-state condition, can extend the averaging time up to a few hours and suggests that an averaging time of 30 min is still overall sufficient for eddy-covariance measurements over low vegetation. The block ensemble average, which does not require a steady-state condition, can extend the averaging time to several days. However, it can improve the energy balance closure for some sites during specific periods, when secondary circulations exist in the vicinity of the sensor. These near-surface secondary circulations mainly transport sensible heat, and when near-ground warm air is transported upward, the sensible heat flux observed by the block ensemble average will increase at longer averaging times. These findings suggest an alternative energy balance correction for a ground-based eddy-covariance measurement, in which the attribution of the residual depends on the ratio of sensible heat flux to the buoyancy flux. The fraction of the residual attributed to the sensible heat flux by this energy balance correction is larger than in the energy balance correction that preserves the Bowen ratio.

Charuchittipan, Doojdao; Babel, Wolfgang; Mauder, Matthias; Leps, Jens-Peter; Foken, Thomas

2014-09-01

62

High-precision mass measurements of nickel, copper, and gallium isotopes and the purported shell closure at N=40  

SciTech Connect

High-precision mass measurements of more than 30 neutron-rich nuclides around the Z=28 closed proton shell were performed with the triple-trap mass spectrometer ISOLTRAP at ISOLDE/CERN to address the question of a possible neutron shell closure at N=40. The results for {sup 57,60,64-69}Ni (Z=28), {sup 65-74,76}Cu (Z=29), and {sup 63-65,68-78}Ga (Z=31) have a relative uncertainty of the order of 10{sup -8}. In particular, the mass of {sup 76}Cu was measured for the first time. We analyze the resulting mass surface for signs of magicity, comparing the behavior of N=40 with that of known magic numbers and with midshell behavior. While the classic indications from the mass surface show no evidence for a shell closure at N=40, there is evidence for a weak--and very localized--effect for Z=28, consistent with findings from nuclear spectroscopy studies.

Guenaut, C.; Audi, G.; Lunney, D. [CSNSM-IN2P3-CNRS, F-91405 Orsay-Campus (France); Beck, D.; Herfurth, F.; Yazidjian, C. [GSI, Planckstrasse 1, D-64291 Darmstadt (Germany); Blaum, K. [GSI, Planckstrasse 1, D-64291 Darmstadt (Germany); Johannes Gutenberg-Universitaet, Institut fuer Physik, D-55099 Mainz (Germany); Bollen, G.; Schwarz, S. [NSCL, Michigan State University, East Lansing, Michigan 48824 (United States); Delahaye, P.; Kellerbauer, A. [CERN, Physics Department, CH-1211 Geneve 23 (Switzerland); Kluge, H.-J. [GSI, Planckstrasse 1, D-64291 Darmstadt (Germany); Physikalisches Institut, Universitaet Heidelberg, D-69120 Heidelberg (Germany); Libert, J. [Institut de Physique Nucleaire, IN2P3-CNRS, F-91406 Orsay-Campus (France); Schweikhard, L. [Institut fuer Physik, Ernst-Moritz-Arndt-Universitaet, D-17487 Greifswald (Germany)

2007-04-15

63

Pyomyositis after vaginal delivery  

PubMed Central

Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted. PMID:22693277

Gaughan, Eve; Eogan, Maeve; Holohan, Mary

2011-01-01

64

Vaginal Vault Prolapse  

PubMed Central

Introduction. Vaginal vault prolapse is a common complication following vaginal hysterectomy with negative impact on women's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanism for the uterus and vagina is important in making the right choice of corrective procedure. Management should be individualised, taking into consideration the surgeon's experience, patients age, comorbidities, previous surgery and sex life. Result. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced at hysterectomy to prevent vault prolapse. Studies have shown the McCall's culdoplasty under direct visualisation to be superior. Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future. PMID:19936123

Uzoma, Azubuike; Farag, K. A.

2009-01-01

65

Vaginal immunity in bacterial vaginosis  

Microsoft Academic Search

Vaginal immunity in response to microbial perturbation is still poorly understood and may be crucial for protection from adverse\\u000a outcomes associated with bacterial vaginosis (BV). BV is the most prevalent vaginal disorder in adult women worldwide. However,\\u000a its pathogenesis is still elusive. In BVpositive women, inflammatory signs are scant—approximately 50% of women are asymptomatic.\\u000a The number of vaginal neutrophils in

Sabina Cauci

2004-01-01

66

Vaginal Discharge: What's Normal, What's Not  

MedlinePLUS

... Dealing With Anger Vaginal Discharge: What's Normal, What's Not KidsHealth > Teens > Sexual Health > For Girls > Vaginal Discharge: What's Normal, What's Not Print A A A Text Size Normal vaginal ...

67

Newly developed vaginal atrophy symptoms II and vaginal pH: a better correlation in vaginal atrophy?  

PubMed

Objectives The primary objective of this study was to evaluate the correlation among symptoms, signs, and the number of lactobacilli in postmenopausal vaginal atrophy. The secondary objective was to develop a new parameter to improve the correlation. Study design A cross-sectional descriptive study. Methods Naturally postmenopausal women aged 45-70 years with at least one clinical symptom of vaginal atrophy of moderate to severe intensity were included in this study. All of the objective parameters (vaginal atrophy score, vaginal pH, the number of lactobacilli, vaginal maturation index, and vaginal maturation value) were evaluated and correlated with vaginal atrophy symptoms. A new parameter of vaginal atrophy, vaginal atrophy symptoms II, was developed and consists of the two most bothersome symptoms (vaginal dryness and dyspareunia). Vaginal atrophy symptoms II was analyzed for correlation with the objective parameters. Results A total of 132 naturally postmenopausal women were recruited for analysis. Vaginal pH was the only objective parameter found to have a weak correlation with vaginal atrophy symptoms (r = 0.273, p = 0.002). The newly developed vaginal atrophy symptoms II parameter showed moderate correlation with vaginal pH (r = 0.356, p < 0.001) and a weak correlation with the vaginal atrophy score (r = 0.230, p < 0.001). History of sexual intercourse within 3 months was associated with a better correlation between vaginal atrophy symptoms and the objective parameters. Conclusion Vaginal pH was significantly correlated with vaginal atrophy symptoms. The newly developed vaginal atrophy symptoms II was associated with a better correlation. The vaginal atrophy symptoms II and vaginal pH may be better tools for clinical evaluation and future study of the vaginal ecosystem. PMID:25374401

Tuntiviriyapun, P; Panyakhamlerd, K; Triratanachat, S; Chatsuwan, T; Chaikittisilpa, S; Jaisamrarn, U; Taechakraichana, N

2015-04-01

68

Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery  

PubMed Central

The presence of an abnormal vaginal microflora in early pregnancy is a risk factor for preterm delivery. There is no investigation on vaginal flora dominated by lactic acid bacteria and possible association with preterm delivery. We assessed the dominant vaginal Lactobacillus species in healthy pregnant women in early pregnancy in relation to pregnancy outcome. We observed 111 low risk pregnant women with a normal vaginal microflora 11 + 0 to 14 + 0 weeks of pregnancy without subjective complaints. Vaginal smears were taken for the identification of lactobacilli using denaturing gradient gel electrophoresis (DGGE). Pregnancy outcome was recorded as term or preterm delivery (limit 36 + 6 weeks of gestation). The diversity of Lactobacillus species in term vs. preterm was the main outcome measure. L. iners alone was detected in 11 from 13 (85%) women who delivered preterm. By contrast, L. iners alone was detected in only 16 from 98 (16%) women who delivered at term (p < 0.001). Fifty six percent women that delivered at term and 8% women that delivered preterm had two or more vaginal Lactobacillus spp. at the same time. This study suggests that dominating L. iners alone detected in vaginal smears of healthy women in early pregnancy might be associated with preterm delivery. PMID:24875844

Petricevic, Ljubomir; Domig, Konrad J.; Nierscher, Franz Josef; Sandhofer, Michael J.; Fidesser, Maria; Krondorfer, Iris; Husslein, Peter; Kneifel, Wolfgang; Kiss, Herbert

2014-01-01

69

Assessing outcome after a modified vaginal wall sling for stress incontinence with intrinsic sphincter deficiency  

Microsoft Academic Search

Forty women with stress incontinence, intrinsic sphincter deficiency (ISD), associated or not with urethral hypermobility, a Valsalva leak point pressure (VLLP) 20 and a maximum urethral closure pressure 20 underwent in situ vaginal wall sling. The main modification to the technique was the use of two small Marlex meshes placed at the lateral edges of the sling. Outcome was assessed

Elisabetta Costantini; Luigi Mearini; Ettore Mearini; Cinzia Pajoncini; Federico Guercini; Vittorio Bini; Massimo Porena

2005-01-01

70

Treatment of vaginal atrophy.  

PubMed

Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced lubrication, itching, burning, irritable bladder symptoms and painful intercourse. This impacts quality of life and sexual health, but increases with time rather than reduces, as with most other menopausal symptoms. With early identification, treatments can improve these symptoms and reverse the physical changes. However, when embedded, bladder and sexual changes have occurred and these may be more difficult to remedy. Therefore, it is important to educate both healthcare professionals and women about these symptoms and advise on the range of interventions available. PMID:24601810

Domoney, Claudine

2014-03-01

71

[Vaginal sonography as a method of study in the evaluation of cervix insufficiency. A useful complement to vaginal palpation?].  

PubMed

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 53 pregnant women between 20th und 31st week of gestation were examined by a 5 MHz vaginal sector-scanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage. PMID:2652287

Böhmer, S; Degenhardt, F; Gerlach, C; Behrens, O; Mühlhaus, K

1989-02-01

72

Vaginal vein thrombosis in pregnancy.  

PubMed Central

Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly described. Surgical management is suggested as being both simple and effective. Images Fig. 1 PMID:6634550

Gitstein, S.; Ballas, S.; Peyser, M. R.

1983-01-01

73

Predictors of the vaginal microflora  

Microsoft Academic Search

Objective: Our purpose was to define influences on the patterns of the vaginal microflora. Study Design: We enrolled 617 African American and Mexican American women in a 1-year longitudinal study of sexual behaviors and the vaginal microflora on the basis of the presence of gonorrhea, chlamydial infection, trichomoniasis, or syphilis at the initial visit. The patients were assigned randomly to

Edward R. Newton; Jeanna M. Piper; Rochelle N. Shain; Sondra T. Perdue; William Peairs

2001-01-01

74

Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse  

Microsoft Academic Search

Objective: The anatomic and functional success of suspension of the vaginal cuff to the proximal uterosacral ligaments is described. Study Design: Forty-six women underwent vaginal site-specific repair of endopelvic fascia defects with suspension of the vaginal cuff to the proximal uterosacral ligaments for pelvic organ prolapse. Outcome measures included operative complications, pelvic organ prolapse quantitation, and assessment of pelvic floor

Matthew D. Barber; Anthony G. Visco; Alison C. Weidner; Cindy L. Amundsen; Richard C. Bump

2000-01-01

75

Urethral pressure increase on effort originates from within the urethra, and continence from musculovaginal closure.  

PubMed

The aim of the study was to determine the contribution of intra-abdominal pressure transmission to urinary continence in the female. Five patients with genuine stress incontinence (GSI) were studied. Pressure transmission was measured in equivalent positions inside and outside the urethra and bladder during the Intravaginal Slingplasty procedure, a surgical operation used for treatment of urinary incontinence, and performed under local anaesthesia. A 6 mm diameter channel was created alongside the urethra. Two separate microtransducer catheters appropriately marked for length were inserted, one inside the urethra, and the other inside the described channel. With the vaginal hammock intact, an average of 10 simultaneous pressure measurements were made intraoperatively in response to coughing and straining in equivalent positions inside the urethra, and directly outside. Significantly higher pressure readings were found inside the urethra (P = 0.0025), indicating that an active component within the urethra may have created this pressure rise. After opening out two suburethral vaginal flaps, large quantities of urine were lost on coughing in all patients. Continence was achieved on tightening the suburethral vagina, indicating that an adequately tight vaginal hammock is a critical element in the continence process. The findings of this study question intraabdominal pressure as a mechanism contributing to continence, but support an alternative mechanism, musculovaginal closure of the urethra. PMID:7581470

Petros, P E; Ulmsten, U

1995-01-01

76

Evaluation of the Effects of a New Intravaginal Gel, Containing Purified Bovine Colostrum, on Vaginal Blood Flow and Vaginal Atrophy in Ovariectomized Rat  

PubMed Central

Introduction Vaginal dryness due to vaginal atrophy is a common complaint of postmenopausal women, interfering with sexual function and quality of life. Hormone replacement therapy is the only effective therapy but with known risks that leave unmet medical needs. A new product, ZP-025 vaginal gel, containing purified (dialyzed lyophilized) bovine colostrum, has been developed for the treatment of vaginal dryness secondary to vaginal atrophy. Aim The study aims to investigate the effects of intravaginal application of ZP-025 on vaginal atrophy using an animal model. Methods Ovariectomized female Sprague-Dawley rats were used. Three weeks after surgery, rats were divided into four groups and treated for 4 weeks (twice a day) with placebo or ZP-025 at low (0.5%) or high (2.3%) concentrations of colostrum; in the control group, rats did not receive any treatment. Changes in vaginal blood flow due to pelvic nerve stimulation were assessed by laser Doppler flowmetry and vaginal tissue was collected for histological assay. Main Outcome Measures The main outcome measures were vaginal blood flow before and after pelvic nerve stimulation and histology of vaginal epithelium. Results Treatment with ZP-025 to ovariectomized rats induced an increase of vaginal blood flow parameters (vascular capacitance, amplitude and area under the curve of the response) in response to pelvic nerve stimulation compared with control group, statistically significant at 2.3%. Vaginal epithelium showed a physiological estrous cycle aspect in treated animals, with at least five cell layers vs. one or two cell layers in control rats. As expected from a topical formulation, systemic effects on body weights and uterine wet weights were not observed with application of ZP-025. Conclusions In this study, the new product ZP-025, containing purified colostrum, was shown to have beneficial effects on vaginal atrophy in ovariectomized rats, improving vaginal hemodynamics and thickness of vaginal epithelium. Vailati S, Melloni E, Riscassi E, Behr Roussel D, and Sardina M. Evaluation of the effects of a new intravaginal gel, containing purified bovine colostrum, on vaginal blood flow and vaginal atrophy in ovariectomized rat. Sex Med 2013;1:35–43. PMID:25356286

Vailati, Silvia; Melloni, Elsa; Riscassi, Ermanno; Behr Roussel, Delphine; Sardina, Marco

2013-01-01

77

50 CFR 648.141 - Closure.  

Code of Federal Regulations, 2010 CFR

...NORTHEASTERN UNITED STATES Management Measures for the Black Sea Bass Fishery § 648.141 Closure. EEZ closure...Regional Administrator shall close the EEZ to fishing for black sea bass by commercial vessels issued a moratorium...

2010-10-01

78

Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device  

PubMed Central

Objectives To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery. Design A prospective observational study Setting Two tertiary referral Urogynaecology practices. Population Ninety-five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD. Methods Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality-of-life (QOL) questionnaires preoperatively and at 6 and 12 months. Main outcome measures Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients’ satisfaction. Results Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001). Conclusion Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study. Please cite this paper as:Carey M, Slack M, Higgs P, Wynn-Williams M, Cornish A. Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device. BJOG 2008;115:391–397. PMID:18190377

Carey, M; Slack, M; Higgs, P; Wynn-Williams, M; Cornish, A

2008-01-01

79

Instrumental vaginal delivery--back to basics.  

PubMed

Assisted vaginal delivery using forceps or a vacuum extractor is an essential part of obstetric practice. Operative vaginal delivery rates in the UK have remained stable between 10% and 15%, yielding safe and satisfactory outcomes for the majority of mothers and their babies. However, there has been an increase in medico-legal cases due to an increasing awareness of the potential morbidity for both the mother and the baby. There are many factors that can play a part in both the maternal and fetal complications resulting from instrumental deliveries. The aim of this educational review is to address these factors and identify measures to reduce them by adherence to the basics and relevant evidence. PMID:24219713

Keriakos, R; Sugumar, S; Hilal, N

2013-11-01

80

Careful Measurements and Energy Balance Closure - The Case of Soil Heat Flux  

Technology Transfer Automated Retrieval System (TEKTRAN)

An area of persistent concern in micrometeorological measurements is the failure to close the energy balance at surface flux stations. While most attention has focused on corrections associated with the eddy fluxes, none of the energy balance terms are measured without error. The flux plate method i...

81

Sexual absorption of vaginal progesterone: a randomized control trial.  

PubMed

Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA) or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P = 0.0075). Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P = 0.0008). Conclusion(s). Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464. PMID:25713585

Merriam, Kathryn S; Leake, Kristina A; Elliot, Mollie; Matthews, Michelle L; Usadi, Rebecca S; Hurst, Bradley S

2015-01-01

82

Sexual Absorption of Vaginal Progesterone: A Randomized Control Trial  

PubMed Central

Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA) or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P = 0.0075). Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P = 0.0008). Conclusion(s). Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464. PMID:25713585

Merriam, Kathryn S.; Leake, Kristina A.; Elliot, Mollie; Matthews, Michelle L.; Usadi, Rebecca S.; Hurst, Bradley S.

2015-01-01

83

Drugs Approved for Vaginal Cancer  

Cancer.gov

This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

84

Vaginal itching and discharge - child  

MedlinePLUS

... girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed. A foreign body ... abdominal pain or has a fever. You suspect sexual abuse. Also call if: There are blisters or ulcers ...

85

Vaginal bleeding in late pregnancy  

MedlinePLUS

One out of 10 women will have vaginal bleeding during their third trimester. At times, it may ... few months of pregnancy, you should always report bleeding to your health care provider right away. You ...

86

Can Vaginal Cancer Be Prevented?  

MedlinePLUS

... can be spread during sex – including vaginal intercourse, anal intercourse, and oral sex – but sex doesn’t ... not letting others come in contact with your anal or genital area, but even then there could ...

87

Results of the Round Robin on opening-load measurement conducted by ASTM Task Group E24.04.04 on Crack Closure Measurement and Analysis  

NASA Technical Reports Server (NTRS)

An experimental Round Robin on the measurement of the opening load in fatigue crack growth tests was conducted on Crack Closure Measurement and Analysis. The Round Robin evaluated the current level of consistency of opening load measurements among laboratories and to identify causes for observed inconsistency. Eleven laboratories participated in the testing of compact and middle-crack specimens. Opening-load measurements were made for crack growth at two stress-intensity factor levels, three crack lengths, and following an overload. All opening-load measurements were based on the analysis of specimen compliance data. When all of the results reported (from all participants, all measurement methods, and all data analysis methods) for a given test condition were pooled, the range of opening loads was very large--typically spanning the lower half of the fatigue loading cycle. Part of the large scatter in the reported opening-load results was ascribed to consistent differences in results produced by the various methods used to measure specimen compliance and to evaluate the opening load from the compliance data. Another significant portion of the scatter was ascribed to lab-to-lab differences in producing the compliance data when using nominally the same method of measurement.

Phillips, Edward P.

1989-01-01

88

Vaginal films for drug delivery.  

PubMed

Vaginal dosage forms have been studied in relation to many drugs as the vagina presents several advantages as a site for drug delivery, such as large surface area, rich blood supply, avoidance of the first-pass effect, relatively high permeability to several drugs, and self-insertion. Traditional vaginal dosage forms have been associated with disadvantages such as low residence time and discomfort and have been surpassed by newly designed drug delivery systems, particularly those based on bioadhesive polymers. Vaginal films are solid dosage forms that rapidly dissolve in contact with vaginal fluids and are unlikely to be associated with leakage and messiness. They have been studied for some female genital problems, aiming either contraceptive, antimicrobial, or microbicide effects. Precise and complex processes of manufacturing and characterization are required to achieve successful film formulation. Although scarce, the available user's acceptability studies show promising results. Vaginal films gather a lack of opportunities for both therapeutic and prophylactic actions, and therefore should be considered when designing and developing new vaginal drug delivery systems. PMID:23649325

Machado, Rita M; Palmeira-de-Oliveira, Ana; Martinez-De-Oliveira, José; Palmeira-de-Oliveira, Rita

2013-07-01

89

Duct closure  

DOEpatents

A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

Vowell, Kennison L. (Canoga Park, CA)

1987-01-01

90

VARIATION AND PREDICTORS OF VAGINAL DOUCHING BEHAVIOR  

PubMed Central

Introduction Vaginal douching is a widespread practice among American women. Little research has been done examining variation in the practice or identifying risk factors. Methods We collected data on douching, as well as hypothesized predictors of vaginal douching, as part of a cohort study on preterm birth. African-American women residing in Baltimore City, Maryland, were enrolled if they received prenatal care or delivered at The Johns Hopkins Medical Institution. Interview data were collected on 872 women between March 2001 and July 2004, with a response rate of 68%. Logistic regression analysis was selected to identify factors associated with douching in the 6 months prior to pregnancy. Results Almost two thirds of women reported ever douching and more than two thirds of those women reported douching in the 6 months prior to pregnancy. Variation was seen in the practice of douching with regard to frequency as well as technique. After adjusting for several confounders, prenatal enrollment (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.29, 2.53), more unmet needs for time for “nonessentials” (OR, 1.83; 95% CI, 1.27, 2.63), smoking in the year prior to the birth (OR, 1.78; 95% CI, 1.22, 2.60), and age > 19 years (OR, 2.60; 95% CI, 1.36, 4.97) were significant predictors of douching in the 6 months prior to pregnancy. Discussion We identified considerable heterogeneity in the practice of vaginal douching in a cohort of low income African-American women. Conclusions Future studies should incorporate measures of the predictors of douching and detailed exposure information to determine the independent contribution of vaginal douching to health outcomes. PMID:17055380

Misra, Dawn P.; Trabert, Britton; Atherly-Trim, Shelly

2007-01-01

91

Results of the second Round Robin on opening-load measurement conducted by ASTM Task Group E24.04.04 on crack closure measurement and analysis  

NASA Technical Reports Server (NTRS)

A second experimental Round Robin on the measurement of the crack opening load in fatigue crack growth tests has been completed by the ASTM Task Group E24.04.04 on Crack Closure Measurement and Analysis. Fourteen laboratories participated in the testing of aluminum alloy compact tension specimens. Opening-load measurements were made at three crack lengths during constant Delta K, constant stress ratio tests by most of the participants. Four participants made opening-load measurements during threshold tests. All opening-load measurements were based on the analysis of specimens compliance behavior, where the displacement/strain was measured either at the crack mouth or the mid-height back face location. The Round Robin data were analyzed for opening load using two non-subjective analysis methods: the compliance offset and the correlation coefficient methods. The scatter in the opening load results was significantly reduced when some of the results were excluded from the analysis population based on an accept/reject criterion for raw data quality. The compliance offset and correlation coefficient opening load analysis methods produced similar results for data populations that had been screened to eliminate poor quality data.

Phillips, E. P.

1993-01-01

92

Results of the second Round Robin on opening-load measurement conducted by ASTM Task Group E24.04.04 on crack closure measurement and analysis  

NASA Astrophysics Data System (ADS)

A second experimental Round Robin on the measurement of the crack opening load in fatigue crack growth tests has been completed by the ASTM Task Group E24.04.04 on Crack Closure Measurement and Analysis. Fourteen laboratories participated in the testing of aluminum alloy compact tension specimens. Opening-load measurements were made at three crack lengths during constant Delta K, constant stress ratio tests by most of the participants. Four participants made opening-load measurements during threshold tests. All opening-load measurements were based on the analysis of specimens compliance behavior, where the displacement/strain was measured either at the crack mouth or the mid-height back face location. The Round Robin data were analyzed for opening load using two non-subjective analysis methods: the compliance offset and the correlation coefficient methods. The scatter in the opening load results was significantly reduced when some of the results were excluded from the analysis population based on an accept/reject criterion for raw data quality. The compliance offset and correlation coefficient opening load analysis methods produced similar results for data populations that had been screened to eliminate poor quality data.

Phillips, E. P.

1993-11-01

93

Pharmacological profiling of neuropeptides on rabbit vaginal wall and vaginal artery smooth muscle in vitro  

PubMed Central

Background and purpose: Hypothalamic neuropeptides centrally modulate sexual arousal. However, the role of neuropeptides in peripheral arousal has been ignored. Vascular and non-vascular smooth muscle relaxation in the vagina is important for female sexual arousal. To date, in vitro studies have focused on vaginal strips with no studies on vaginal arteries. The aim of this study was to compare the effects of sexual hypothalamic neuropeptides on rabbit vaginal wall strips and arteries. Experimental approach: Tissue bath and wire myography techniques were used to measure isometric tension from strips and arteries, respectively. Key results: Pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) relaxed both preparations, effects that were only antagonized by the VIP/PACAP antagonist VIP6–28 (10?nM) and the PAC1 antagonist PACAP 6–38 (1??M). The melanocortin agonist ?-melanocortin-stimulating hormone (1??M), but not bremelanotide (1??M), also relaxed both preparations. Oxytocin and vasopressin contracted vaginal preparations, which could be antagonized by the V1A antagonist SR 49059. Neuropeptide Y (NPY) and the NPY Y1 agonist Leu31, Pro34 NPY only contracted arteries, which was antagonized by the NPY Y1 receptor antagonist BIBP 3226. Melanin-concentrating hormone (MCH; 1??M) contracted arteries. Conclusion and implications: Hypothalamic neuropeptides can exert contractile and relaxant effects on vaginal strips and arteries. NPY Y1, V1A, MCH1 antagonists as well as VIP/PAC1 agonists may have therapeutic potential in both central and peripheral female sexual arousal. Differences in effect of neuropeptides between preparations raise the question of which preparation is important for female sexual arousal. PMID:18587425

Aughton, K L; Hamilton-Smith, K; Gupta, J; Morton, J S; Wayman, C P; Jackson, V M

2008-01-01

94

MTN-001: Randomized Pharmacokinetic Cross-Over Study Comparing Tenofovir Vaginal Gel and Oral Tablets in Vaginal Tissue and Other Compartments  

PubMed Central

Background Oral and vaginal preparations of tenofovir as pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection have demonstrated variable efficacy in men and women prompting assessment of variation in drug concentration as an explanation. Knowledge of tenofovir concentration and its active form, tenofovir diphosphate, at the putative vaginal and rectal site of action and its relationship to concentrations at multiple other anatomic locations may provide key information for both interpreting PrEP study outcomes and planning future PrEP drug development. Objective MTN-001 was designed to directly compare oral to vaginal steady-state tenofovir pharmacokinetics in blood, vaginal tissue, and vaginal and rectal fluid in a paired cross-over design. Methods and Findings We enrolled 144 HIV-uninfected women at 4 US and 3 African clinical research sites in an open label, 3-period crossover study of three different daily tenofovir regimens, each for 6 weeks (oral 300 mg tenofovir disoproxil fumarate, vaginal 1% tenofovir gel [40 mg], or both). Serum concentrations after vaginal dosing were 56-fold lower than after oral dosing (p<0.001). Vaginal tissue tenofovir diphosphate was quantifiable in ?90% of women with vaginal dosing and only 19% of women with oral dosing. Vaginal tissue tenofovir diphosphate was ?130-fold higher with vaginal compared to oral dosing (p<0.001). Rectal fluid tenofovir concentrations in vaginal dosing periods were higher than concentrations measured in the oral only dosing period (p<0.03). Conclusions Compared to oral dosing, vaginal dosing achieved much lower serum concentrations and much higher vaginal tissue concentrations. Even allowing for 100-fold concentration differences due to poor adherence or less frequent prescribed dosing, vaginal dosing of tenofovir should provide higher active site concentrations and theoretically greater PrEP efficacy than oral dosing; randomized topical dosing PrEP trials to the contrary indicates that factors beyond tenofovir’s antiviral effect substantially influence PrEP efficacy. Trial Registration ClinicalTrials.gov NCT00592124 PMID:23383037

Hendrix, Craig W.; Chen, Beatrice A.; Guddera, Vijayanand; Hoesley, Craig; Justman, Jessica; Nakabiito, Clemensia; Salata, Robert; Soto-Torres, Lydia; Patterson, Karen; Minnis, Alexandra M.; Gandham, Sharavi; Gomez, Kailazarid; Richardson, Barbra A.; Bumpus, Namandje N.

2013-01-01

95

High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse  

Microsoft Academic Search

Objective: The purpose of this study was to review retrospectively the functional and anatomic outcomes of women who underwent vaginal repair of enterocele and vault prolapse with the use of an intraperitoneal suspension of the vaginal vault to the uterosacral ligaments in conjunction with fascial reconstruction of the anterior and posterior vaginal wall. Study Design: Two hundred two women with

M. Karram; S. Goldwasser; S. Kleeman; A. Steele; B. Vassallo; P. Walsh

2001-01-01

96

Vaginitis: current microbiologic and clinical concepts.  

PubMed Central

Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID:3510698

Hill, L V; Embil, J A

1986-01-01

97

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the...

2010-04-01

98

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2011 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the...

2011-04-01

99

21 CFR 884.3575 - Vaginal pessary.  

Code of Federal Regulations, 2012 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3575 Vaginal pessary. (a) Identification. A vaginal pessary is a removable structure...

2012-04-01

100

On the measurement of the crack tip stress field as a means of determining Delta K(sub eff) under conditions of fatigue crack closure  

NASA Astrophysics Data System (ADS)

The optical method of caustics has been successfully extended to enable stress intensity factors as low as 1MPa square root of m to be determined accurately for central fatigue cracks in 2024-T3 aluminium alloy test panels. The feasibility of using this technique to study crack closure, and to determine the effective stress intensity factor range, Delta K(sub eff), has been investigated. Comparisons have been made between the measured values of stress intensity factor, K(sub caus), and corresponding theoretical values, K(sub theo), for a range of fatigue cracks grown under different loading conditions. The values of K(sub caus) and K(sub theo) were in good agreement at maximum stress, where the cracks are fully open, while K(sub caus) exceeded K(sub theo) at minimum stress, due to crack closure. However, the levels of crack closure and values of Delta K(sub eff) obtained could not account for the variations of crack growth rate with loading conditions. It is concluded that the values of Delta K(sub eff), based on caustic measurements in a 1/square root of r stress field well outside the plastic zone, do not fully reflect local conditions which control crack tip behavior.

Wallhead, Ian R.; Edwards, Lyndon; Poole, Peter

1994-09-01

101

On the measurement of the crack tip stress field as a means of determining Delta K(sub eff) under conditions of fatigue crack closure  

NASA Technical Reports Server (NTRS)

The optical method of caustics has been successfully extended to enable stress intensity factors as low as 1MPa square root of m to be determined accurately for central fatigue cracks in 2024-T3 aluminium alloy test panels. The feasibility of using this technique to study crack closure, and to determine the effective stress intensity factor range, Delta K(sub eff), has been investigated. Comparisons have been made between the measured values of stress intensity factor, K(sub caus), and corresponding theoretical values, K(sub theo), for a range of fatigue cracks grown under different loading conditions. The values of K(sub caus) and K(sub theo) were in good agreement at maximum stress, where the cracks are fully open, while K(sub caus) exceeded K(sub theo) at minimum stress, due to crack closure. However, the levels of crack closure and values of Delta K(sub eff) obtained could not account for the variations of crack growth rate with loading conditions. It is concluded that the values of Delta K(sub eff), based on caustic measurements in a 1/square root of r stress field well outside the plastic zone, do not fully reflect local conditions which control crack tip behavior.

Wallhead, Ian R.; Edwards, Lyndon; Poole, Peter

1994-01-01

102

A Universal Combination Treatment for Vaginitis  

Microsoft Academic Search

Background: We compared a novel vaginal tablet consisting of 100 mg of clotrimazole and 100 mg of metronidazole (‘Clo-Met’) to a 100-mg clotrimazole tablet in the treatment of vaginitis. Methods: A multicenter, double-blind, randomized controlled study. Women with vaginal discharge and diagnosed as suffering from vaginitis caused by Trichomonas vaginalis, bacterial vaginosis or Candida albicans, or any combination of the

Jacob Bornstein; Doron Zarfati

2008-01-01

103

Closure Times Measured by the Platelet Function Analyzer PFA100® Are Longer in Neonatal Blood Compared to Cord Blood Samples  

Microsoft Academic Search

Background: Although neonatal platelets have been shown to be hyporesponsive to most agonists in vitro, several groups have reported shorter closure times (CT) in term cord blood samples than in children and adults. It is unknown whether this is also true for preterm neonates, or for neonates of any gestational age (GA) during the 1st week of life, since limited

Matthew A. Saxonhouse; Rachel Garner; Lauren Mammel; Qin Li; Keith E. Muller; Jewel Greywoode; Cindy Miller; Martha Sola-Visner

2010-01-01

104

Borehole creep closure measurements and numerical calculations at the Big Hill Texas SPR (Strategic Petroleum Reserve) storage site  

Microsoft Academic Search

The Big Hill Texas salt dome is being developed as an additional site for the US Strategic Petroleum Reserve (SPR). Ten deep (1433 m) boreholes were drilled in 1983 for leaching the first five storage caverns. Leaching has been delayed and the ten wells have been used to study the in-situ creep behavior of rock salt. Creep closure has been

D. S. Preece; R. R. Beasley; K. L. Goin

1986-01-01

105

The vaginal microbiome, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth.  

PubMed

Ascending bacterial infection is implicated in about 40-50% of preterm births. The human vaginal microbiota in most women is dominated by lactobacilli. In women whose vaginal microbiota is not lactobacilli-dominated anti-bacterial defence mechanisms are reduced. The enhanced proliferation of pathogenic bacteria plus degradation of the cervical barrier increase bacterial passage into the endometrium and amniotic cavity and trigger preterm myometrial contractions. Evaluation of protocols to detect the absence of lactobaciili dominance in pregnant women by self-measuring vaginal pH, coupled with measures to promote growth of lactobacilli are novel prevention strategies that may reduce the occurrence of preterm birth in low-resource areas. PMID:25316066

Witkin, S S

2015-01-01

106

Shell closure effects in the stable 74-82Se isotopes from magnetic moment measurements using projectile excitation and the transient field technique  

NASA Astrophysics Data System (ADS)

Projectile excitation and the transient field technique have been used to measure the g factors of the 2+1, 2+2, and 4+1 states in 74-82Se in order to study the influence of the N=50 shell closure at low excitation energies. The states of interest were populated by Coulomb exciting beams of the appropriate isotope by the same natural Si target. The results demonstrate that inverse kinematics provides a very powerful technique, highly suitable for measurements with radioactive beams. The g factors obtained for 74-82Se are compared with results from IBM-II calculations.

Speidel, K.-H.; Benczer-Koller, N.; Kumbartzki, G.; Barton, C.; Gelberg, A.; Holden, J.; Jakob, G.; Matt, N.; Mayer, R. H.; Satteson, M.; Tanczyn, R.; Weissman, L.

1998-05-01

107

Identifying vaginitis in general practice.  

PubMed

Clinicians conducted a study of 154 women who presented themselves at a health center of the University of Wales College of Medicine with symptoms of vaginitis. A nurse examined the vagina with a speculum to note the appearance of the cervix, the color and amount of discharge, and the presence of odor and inquired about soreness during the examination. The nurse took 3 endocervical swabs and 2 high vaginal swabs. Upon microscopic examination, any vaginal discharge with epithelial cells stippled with small coccobacilli indicated a possible Gardnerella vaginalis infection. Laboratory personnel identified G. vaginalis either alone or in combination with other organisms in 53% of the women. Those with G. vaginalis alone or in combination with anaerobes reported more symptoms than those women who had negative cultures. In addition, women with G. vaginalis alone and those G. vaginalis in combination with other organisms had more discharge, described as yellow and runny, than those with negative cultures. 77% of the women infected with G. vaginalis had a high cheese or fishy odor. 75% of the women with G. vaginalis came to the health center between 2-4 weeks or even longer after they 1st noticed symptoms. On the other hand, women who were infected with C. albicans presented to the health center within a week of the start of the symptoms. Clinicians had previously treated erroneously many of the women with G. vaginalis with an antifungal agent. These women should be treated with metronidazole or, if a yeast infection is also present, with an antifungal agent and metronidazole. All women who present themselves to a nurse or physician with vaginal symptoms should have a history taken, an examination, and vaginal discharge samples taken and evaluated in the laboratory. PMID:3498151

Smail, J

108

Anterior Chamber Depth Measurement as a Screening Tool for Primary Angle-closure Glaucoma in an East Asian Population  

Microsoft Academic Search

Objective: To evaluate anterior chamber depth mea- surement as a method of screening for primary angle- closure glaucoma in an East Asian population. Design: Two-phase, cross-sectional, community- based study. Setting: Rural and urban locations in the Hovsgol and Omnogobi provinces, Mongolia. Participants: Nine hundred forty-two (94.2%) of 1000 individuals in Hovsgol (1995) and 775 (96.9%) of 1000 individuals in Omnogobi

Joe G. Devereux; Paul J. Foster; Jamyanjav Baasanhu; Davaatseren Uranchimeg; Pak-Sang Lee; T. Erdenbeleig; David Machin; Gordon J. Johnson; Poul Helge Alsbirk

109

Systemic and Topical Hormone Therapies Reduce Vaginal Innervation Density in Post-Menopausal Women  

PubMed Central

Objective Menopause is often accompanied by vaginal discomfort including burning, itching, dryness and spontaneous or provoked pain. While direct effects of estrogen withdrawal on vaginal cells are implicated, surgical menopause in rodents causes autonomic and sensory nerves to proliferate, suggesting that indirect effects mediated by changes in vaginal innervation may contribute. We assessed whether post-menopausal women display hormone-dependent changes in vaginal innervation. Methods Vaginal biopsies from 20 postmenopausal women undergoing surgery for stress urinary incontinence and pelvic organ prolapse were fixed and immunostained for the pan-neuronal marker, PGP9.5, the sympathetic marker tyrosine hydroxylase, the parasympathetic marker vasoactive intestinal polypeptide, and the sensory nociceptor marker calcitonin gene-related peptide. Innervation density was measured as apparent percentage of section area occupied by immunofluorescent axons. Specimens were grouped according to whether participants received systemic hormone therapy (HT), topical (vaginal) HT, or no HT. Results Women not receiving HT showed relatively high levels of total innervation, with most axons expressing tyrosine hydroxylase or vasoactive intestinal polypeptide immunoreactivity. In patients receiving systemic HT, overall innervation was reduced, as were presumptive parasympathetic, sympathetic and sensory axon populations. Topical HT elicited more dramatic reductions in innervation than systemic HT. Conclusions Hormone therapy reduces autonomic and sensory vaginal innervation density, which may in part contribute to relief from vaginal discomfort. Moreover, topical therapy is more effective than systemic therapy, which may help explain the greater improvement reported with topical as compared to systemic HT. PMID:22205148

Griebling, Tomas L.; Liao, Zhaohui; Smith, Peter G.

2011-01-01

110

50 CFR 648.22 - Closure of the fishery.  

Code of Federal Regulations, 2010 CFR

...UNITED STATES Management Measures for the Atlantic Mackerel, Squid, and Butterfish Fisheries § 648.22 Closure of the fishery...mail notification of the closure to all holders of mackerel, squid, and butterfish fishery permits at least 72 hours...

2010-10-01

111

The vaginal microbiome: rethinking health and diseases  

PubMed Central

Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others comprise a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal conditions and is vaguely characterized as the disruption of the equilibrium of the ‘normal’ vaginal microbiots. A better understanding of ‘normal’ and ‘healthy’ vaginal ecosystems that is based on its ‘true’ function and not simply on its composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases. PMID:22746335

Ma, Bing; Forney, Larry J.; Ravel, Jacques

2013-01-01

112

Perineal and vaginal wall reconstruction using a combined inferior gluteal and pudendal artery perforator flap: a case report.  

PubMed

Reliable perineal and posterior vaginal wall restoration following extensive abdominoperineal excision or pelvic exenteration is a reconstructive challenge, especially if the rectus abdominis is unavailable or insufficient for transpelvic transposition. In this short report, we present a novel combined perforator-based technique, in which an inferior gluteal perforator flap is used for perineal reconstruction whereas vaginal reconstruction is performed simultaneously by means of a pudendal artery perforator flap. This procedure circumvents functional muscle loss, permits a tension-free closure of difficult three-dimensional defects and offers a high degree of reconstructive flexibility, which allows a straightforward and independent reconstruction of two different anatomical units. PMID:22652285

Schmidt, Volker J; Horch, Raymund E; Dragu, Adrian; Weber, Klaus; Göhl, Jonas; Mehlhorn, Grit; Kneser, Ulrich

2012-12-01

113

Fluconazole Susceptibility of Vaginal Isolates Obtained from Women with Complicated Candida Vaginitis: Clinical Implications  

Microsoft Academic Search

Despite considerable evidence of azole resistance in oral candidiasis due to Candida species, little is known about the azole susceptibilities of the genital tract isolates responsible for vaginitis. The fluconazole suscep- tibilities of vaginal isolates obtained during a multicenter study of 556 women with complicated Candida vaginitis were determined by evaluating two fluconazole treatment regimens. Of 393 baseline isolates of

J. D. Sobel; M. Zervos; B. D. Reed; T. Hooton; D. Soper; P. Nyirjesy; M. W. Heine; J. Willems; H. Panzer

2003-01-01

114

Results of tension-free vaginal tape in patients with or without vaginal hysterectomy  

Microsoft Academic Search

Objective: To assess complications and cure rates of tension-free vaginal tape (TVT) procedure performed with or without vaginal hysterectomy. Study design: Retrospective comparison of 41 women with urinary incontinence treated by a TVT procedure alone and 40 combined with vaginal hysterectomy. Objective cure was evaluated by clinical and urodynamic examination and by the contilife questionnaire. All patients were operated under

Louis Jeffry; Bruno Deval; Anca Birsan; Olivier Kadoch; David Soriano

2002-01-01

115

The changing landscape of the vaginal microbiome.  

PubMed

Deep sequence analysis of the vaginal microbiome is revealing an unexpected complexity that was not anticipated as recently as several years ago. The lack of clarity in the definition of a healthy vaginal microbiome, much less an unhealthy vaginal microbiome, underscores the need for more investigation of these phenomena. Some clarity may be gained by the careful analysis of the genomes of the specific bacteria in these women. Ongoing studies will clarify this process and offer relief for women with recurring vaginal maladies and hope for pregnant women to avoid the experience of preterm birth. PMID:25439274

Huang, Bernice; Fettweis, Jennifer M; Brooks, J Paul; Jefferson, Kimberly K; Buck, Gregory A

2014-12-01

116

What Are the Key Statistics about Vaginal Cancer?  

MedlinePLUS

... factors for vaginal cancer? What are the key statistics about vaginal cancer? Vaginal cancer is rare. Only ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

117

Is a Vaginal Birth Possible After a Cesarean Delivery?  

MedlinePLUS

... Resources and Publications En Español Is a vaginal birth possible after a cesarean delivery? Skip sharing on social media links Share this: Page Content Vaginal birth after cesarean (VBAC) describes vaginal delivery by a ...

118

50 CFR 648.101 - Closures.  

Code of Federal Regulations, 2010 CFR

...Management Measures for the Summer Flounder Fisheries...101 Closures. (a) EEZ closure. ...EEZ to fishing for summer flounder by commercial...remainder of the calendar year by publishing notification...in § 648.100(a) to be exceeded...have been reopened without causing the...

2010-10-01

119

Energy balance closure at FLUXNET sites  

Microsoft Academic Search

A comprehensive evaluation of energy balance closure is performed across 22 sites and 50 site-years in FLUXNET, a network of eddy covariance sites measuring long-term carbon and energy fluxes in contrasting ecosystems and climates. Energy balance closure was evaluated by statistical regression of turbulent energy fluxes (sensible and latent heat (LE)) against available energy (net radiation, less the energy stored)

Kell Wilson; Allen Goldstein; Eva Falge; Marc Aubinet; Dennis Baldocchi; Paul Berbigier; Christian Bernhofer; Reinhart Ceulemans; Han Dolman; Chris Field; Achim Grelle; Andreas Ibrom; B. E. Law; Andy Kowalski; Tilden Meyers; John Moncrieff; Russ Monson; Walter Oechel; John Tenhunen; Riccardo Valentini; Shashi Verma

2002-01-01

120

Vaginal swab specimen processing methods influence performance of rapid semen detection tests: A cautionary tale  

PubMed Central

Background Detection of semen biomarkers in vaginal fluid can be used to assess women’s recent exposure to semen. Quantitative tests for detection of prostate-specific antigen (PSA) perform well, but are expensive and require specialized equipment. We assessed two rapid immunochromatographic strip tests for identification of semen in vaginal swabs. Study Design We tested 581 vaginal swabs collected from 492 women. Vaginal secretions were eluted into saline, and PSA was measured using the quantitative IMx (Abbott Laboratories) assay. Specimens were also tested using the ABAcard p30 test (Abacus Diagnostics) for detection of PSA and RSID-Semen test (Independent Forensics) for detection of semenogelin (Sg). Results Vaginal swab extraction using saline was compatible with direct assessment of vaginal swab eluates using ABAcard for PSA detection, but not for Sg detection using RSID. The rapid PSA test detected 91% of specimens containing semen compared to 74% by the rapid Sg test. Conclusion Investigators are urged to optimize vaginal swab specimen preparation methods for performance of RSID or other tests to detect semen components other than PSA. Previously described methods for PSA testing are not uniformly applicable to other tests. PMID:20705160

Hobbs, Marcia M.; Steiner, Markus J.; Rich, Kimberly D.; Gallo, Maria F.; Warner, Lee; Macaluso, Maurizio

2010-01-01

121

Closure for Jason Frank  

E-print Network

Closure for HPM Onno Bokhove & Jason Frank Introduction Hamiltonian Parcel Vlasov Dynamics.leeds.ac.uk/~obokhove/ & http://www.staff.science.uu.nl/~frank011/ December 9, 2013 #12;Closure for HPM Onno Bokhove & Jason References #12;Closure for HPM Onno Bokhove & Jason Frank Introduction Hamiltonian Parcel Vlasov Dynamics

Wirosoetisno, Djoko

122

Vaginal intercourse frequency and heart rate variability.  

PubMed

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck Personality Inventory were excluded from analyses). As in a previous smaller study, greater HRV was associated with greater FSI (but not masturbation or non-coital sex with a partner) and rated importance of intercourse. There were no sex differences in the HRV-FSI relationship, and the relationship was not explained by including measures of Extraversion, Neuroticism, Depression, Trait Anxiety, or partnership satisfaction. However, the previously obtained negative association of FSI with DBP was not replicated. PMID:14504008

Brody, Stuart; Preut, Ragnar

2003-01-01

123

Supracervical hysterectomy – the vaginal route  

PubMed Central

Removal of the cervix during hysterectomy is not mandatory. There has been no irrefutable evidence so far that total hysterectomy is more beneficial to patients in terms of pelvic organ function. The procedure that leaves the cervix intact is called a subtotal hysterectomy. Traditional approaches to this surgery include laparoscopic and abdominal routes. Vaginal total hysterectomy has been proven to present many advantages over the other approaches. Therefore, it seems that this route should also be applied in the case of subtotal hysterectomy. We present 9 cases of patients who underwent subtotal hysterectomy performed through the vagina for benign gynecological diseases. PMID:25097688

Cie?lak, Jaros?aw; Malinowski, Andrzej

2014-01-01

124

Comparative Study of Oral and Vaginal Misoprostol for Induction of Labour, Maternal and Foetal Outcome  

PubMed Central

Background: Misoprostol is a new promising agent for cervical ripening and induction of labour .The ideal dose, route and frequency of administration of misoprostol are still under investigation. Although, vaginal application of misoprostol has been validated as a reasonable mean of induction, there is a patient resistance to digital examination and there is a risk of ascending infection. For this reason, oral administration of misoprostol for cervical ripening and labour induction has been tried. Aims and Objectives: To compare 50?g of oral misoprostol versus 25?g of intravaginal misoprostol for induction of labour at term and maternal, foetal outcomes. Methods: Two hundred women who were at term, with indication for induction of labour and Bishop scores of ?5 were randomly assigned to receive misoprostol 50?g or 25?g intravaginal, every 4-6 hours, for a maximum of 5 doses. In either group, pregnant females with inadequate uterine contractions despite being given maximum 5 doses of misoprostol, were augmented using oxytocin. The primary outcome measure was time-interval from induction to vaginal delivery and vaginal delivery rate within 24 hours. Results: The median induction to vaginal delivery time in oral group (12.92h) and vaginal group (14.04 h) was not significant. Oral misoprostol resulted in more number of vaginal deliveries as compared to vaginal misoprostol (94% as compared to 86%), which was not significant. There was a significantly higher incidence of uterine tachysystole in the vaginal group, as compared to oral group. There were no significant differences between the groups with respect to oxytocin augmentation, caesarean section rate, analgesic requirement and neonatal outcome. Conclusion: Oral misoprostol is as efficacious as vaginal misoprostol because of shorter induction delivery interval, lower caesarean section rates, and lower incidence of failed induction rates. Lower incidence of foetal distress and easy intake are observed if the drug is administered orally. PMID:24551660

Komala, Kambhampati; Reddy, Meherlatha; Quadri, Iqbal Jehan; B., Suneetha; V., Ramya

2013-01-01

125

Long-term Outcome after Surgical Closure of Atrial Septal Defect in Childhood with Extensive Assessment Including MRI Measurement of the Ventricles  

Microsoft Academic Search

Surgical closure of the secundum type of atrial septal defect (ASD) in childhood leads to excellent survival. However, relevant\\u000a morbidity has been reported. Transcatheter closure of these defects has now become an alternative approach. To compare the\\u000a results of the two different interventions, reliable data are needed on the long-term morbidity after defect closure with\\u000a both methods. Patients were evaluated

D. Bolz; T. Lacina; P. Buser; M. Buser; J. Guenthard

2005-01-01

126

Neutron Multiplicity Measurements for 19F+194,196,198Pt Systems to Investigate the Effect of Shell Closure on Nuclear Dissipation  

SciTech Connect

Pre- and post-scission neutron multiplicities are measured for the three isotopes of Fr (217Fr, 215Fr, and 213Fr) in the excitation energy range of 48 91.8 MeV. Out of these three isotopes, 213Fr has shell closure (NC = 126) while the other two are non-closed-shell nuclei. Statistical model calculations using Kramers fission width are performed to investigate shell effects on the dissipation strength which fit the experimental data. It is observed that shell correction to the binding energies of the evaporated particles strongly affects the fitted values of the dissipation strength. However, the best-fit dissipation strength is only weakly influenced by the inclusion of shell correction in fission barrier.

Singh, Varinderjit [Panjab University, Chandigarh, India; Behera, B. R. [Panjab University, Chandigarh, India; Kaur, Maninder [Panjab University, Chandigarh, India; Kumar, A. [Panjab University, Chandigarh, India; Sugathan, P. [Inter University Accelerator Centre, New Delhi, India; Golda, K. S. [Inter University Accelerator Centre, New Delhi, India; Jhingan, A. [Inter University Accelerator Centre, New Delhi, India; Chatterjee, M. B. [Inter University Accelerator Centre, New Delhi, India; Bhowmik, R. K. [Inter University Accelerator Centre, New Delhi, India; Siwal, Davinder [Delhi University, Delhi, India; Goyal, S. [Delhi University, Delhi, India; Sadhukhan, Jhilam [UTK/ORNL; Pal, Santanu [Variable Energy Cyclotron Centre, Kolkata, India; Saxena, A. [Bhabha Atomic Research Centre, Mumbai, India; Santra, S. [Bhabha Atomic Research Centre, Mumbai, India; Kailas, S. [Bhabha Atomic Research Centre, Mumbai, India

2013-01-01

127

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn  

PubMed Central

Background The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. Methods Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. Results One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. Conclusions One-year postoperative findings for patients in this series indicate that patients with stage II–III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique. PMID:24973955

2014-01-01

128

Effect of vaginal or systemic estrogen on dynamics of collagen assembly in the rat vaginal wall.  

PubMed

The objective of this study was to compare the effects of systemic and local estrogen treatment on collagen assembly and biomechanical properties of the vaginal wall. Ovariectomized nulliparous rats were treated with estradiol or conjugated equine estrogens (CEEs) either systemically, vaginal CEE, or vaginal placebo cream for 4 wk. Low-dose local CEE treatment resulted in increased vaginal epithelial thickness and significant vaginal growth without uterine hyperplasia. Furthermore, vaginal wall distensibility increased without compromise of maximal force at failure. Systemic estradiol resulted in modest increases in collagen type I with no change in collagen type III mRNA. Low-dose vaginal treatment, however, resulted in dramatic increases in both collagen subtypes whereas moderate and high dose local therapies were less effective. Consistent with the mRNA results, low-dose vaginal estrogen resulted in increased total and cross-linked collagen content. The inverse relationship between vaginal dose and collagen expression may be explained in part by progressive downregulation of estrogen receptor-alpha mRNA with increasing estrogen dose. We conclude that, in this menopausal rat model, local estrogen treatment increased total and cross-linked collagen content and markedly stimulated collagen mRNA expression in an inverse dose-effect relationship. High-dose vaginal estrogen resulted in downregulation of estrogen receptor-alpha and loss of estrogen-induced increases in vaginal collagen. These results may have important clinical implications regarding the use of local vaginal estrogen therapy and its role as an adjunctive treatment in women with loss of vaginal support. PMID:25537371

Montoya, T Ignacio; Maldonado, P Antonio; Acevedo, Jesus F; Word, R Ann

2015-02-01

129

Vaginitis  

MedlinePLUS

... itching, burning, and pain on the vulva. What causes it? » Last Updated Date: 11/15/2013 Last Reviewed Date: 05/21/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) ...

130

Determination of closure disk rupture parameters  

SciTech Connect

The necessity of decoupling strain rate from burn rate effects for tests designed to characterize closure disks is discussed. A method for simulating the high rates of pressure increase to which closure disks are subjected and which does not employ pyrotechnic material as a means of pressurization is presented. It consists of slowly pressurizing both sides of a closure disk to a high pressure and then rapidly releasing the pressure from one side of the disk. Means of rapidly releasing gas from the downstream side of the closure disk and measuring the pressure differential across the closure disk are discussed in detail. Rates of pressure decrease as high as 335,000,000 psi/sec downstream from the closure disk have been attained. Baseline disks slotted by wire EDM failed at an average pressure differential of 10,150 psi. Disks slotted by chemical etching exhibited a higher burst pressure differential and greater variability. Glass-ceramic closure disks had the lowest average burst pressure and highest variability. An increase in the diameter of a closure disk was found to lower the pressure differential required to rupture the disk. Burst pressure was found to increase linearly with the thickness of the web in the slot. 5 refs., 6 figs., 5 tabs.

Merten, C.W.; Robinson, M.A. (EG and G Mound Applied Technologies, Miamisburg, OH (USA)); Evans, N.A. (Sandia National Labs., Albuquerque, NM (USA))

1990-01-01

131

Alexithymia is inversely associated with women's frequency of vaginal intercourse.  

PubMed

The study examined the relation between frequency of penile-vaginal intercourse (FSI; contrasted with other sexual behavior) and alexithymia (difficulty recognizing, identifying, and communicating emotions, reduced fantasy capacity, and an externally oriented cognitive style). To minimize response bias, persons scoring above the 86th percentile on the Eysenck Personality Inventory Lie scale were excluded. Participants (54 female and 39 male healthy young adults) completed the German version of the Toronto Alexithymia Scale (TAS-20), and provided both recall and diary measures of FSI, partner sex without vaginal intercourse, and masturbation. For women, TAS-20 scores were inversely associated with both recall and diary measures of FSI but not other sexual behavior. For men, TAS-20 scores were unrelated to all sexual behavior measures. Thus, for normal women but not men, alexithymia was specifically associated with lower FSI. Results are discussed in terms of the unique nature of penile-vaginal intercourse, emotional integration and sexuality, and both less alexithymia and greater FSI being associated with indices of better physical and psychological health. PMID:12597274

Brody, Stuart

2003-02-01

132

New thermal method for evaluating vaginal blood flow.  

PubMed

The goal of this study was the development noninvasive technique for measurement of vaginal blood flow. A vaginal probe (diameter 1.84 cm; length 7.0 cm) was constructed by winding 23 m of 34-gauge enameled copper wire around a hollow cylinder of epoxy-impregnated glass wool. Resistance of the wire was 20 omega at 40 degrees C. Surface area of coil was 40.5 cm2. The temperature of the wire midway along the coil was measured continuously with a thermcouple. Temperature difference (delta T) between coil and vagina was raised by delivery of 300 mA with a resultant production of 1.8 W. In ewes treated with 1 mg estrone im., delta T fell significantly (p less than 0.025) by 90 min and (p less than 0.005) by 120 min after injection. There was a significant correlation between delta T and vaginal blood flow as measured by the radiolabeled microsphere technique. PMID:7262635

Frisinger, J E; Abrams, R M; Graichen, H; Cassin, S

1981-01-01

133

Vaginal rings for delivery of HIV microbicides  

PubMed Central

Following the successful development of long-acting steroid-releasing vaginal ring devices for the treatment of menopausal symptoms and contraception, there is now considerable interest in applying similar devices to the controlled release of microbicides against HIV. In this review article, the vaginal ring concept is first considered within the wider context of the early advances in controlled-release technology, before describing the various types of ring device available today. The remainder of the article highlights the key developments in HIV microbicide-releasing vaginal rings, with a particular focus on the dapivirine ring that is presently in late-stage clinical testing. PMID:23204872

Malcolm, R Karl; Fetherston, Susan M; McCoy, Clare F; Boyd, Peter; Major, Ian

2012-01-01

134

Angiomyofibroblastoma of the Vaginal Portion  

PubMed Central

Introduction: Angiomyofibroblastoma is a tumor which is consists of two components: blood vessels and stromal cells, with always prominent vascular component. Angiomyofibroblastoma is benign tumor, but in literature is reported a case of recurrence and one case with sarcomatous transformation, which shoved that these tumors may rarely be associated with malignant component. Case report: A 78-year-old multiparous housewife was hospitalized at University Clinical Center because of painless, asymptomatic tumor of vaginal portion (posterior side). Tumor size was 7 millimeters in diameter. Internal genital organs did not present abnormalities. The patient underwent operative removal of the tumor and went to home at some day. At the histological examination the tumor presented as a angiomyofibroblastoma cervices uteri. PMID:25648716

Fatusic, Jasenko; Hudic, Igor; Fatusic, Zlatan; Mustedanagic-Mujanovic, Jasminka

2014-01-01

135

Morbidity of colostomy closure.  

PubMed

An unexpectedly high morbidity (28 per cent) followed colostomy closure in 100 patients. One patient died postoperatively because of sepsis resulting from disruption of the colon anastomosis. Wound infection (10 per cent), intraperitoneal abscess (1 per cent), bowel obstruction (7 per cent), and fecal fistula (4 per cent) were other significant complications. Wound sepsis was greater after primary than after delayed wound closure. Obstruction did not correlate with the use of either an open or closed technic of anastomosis. Three patients required reoperation for complications. Temporary colostomy was constructed for colon injury in 85 per cent of patients. In view of the considerable morbidity of colostomy closure, alternate technics of managing colon trauma should be considered. Such technics include primary closure and exteriorization of repaired colon. When temporary colostomy is unavoidable, closure is best done by open, two layer anastomosis with delayed wound closure. Colostomy should be recognized as an important procedure associated with significant morbidity. PMID:786053

Yajko, R D; Norton, L W; Bloemendal, L; Eiseman, B

1976-09-01

136

Vaginal indicators of amniotic fluid infection in preterm labor  

Microsoft Academic Search

Objective: To determine whether vaginal interleukin-6, interleukin-8, neutrophils, bacterial vaginosis, and selected vaginal bacteria are predictors of amniotic fluid (AF) infection among women in preterm labor.Methods: One hundred ninety-seven afebrile women in preterm labor with intact membranes had vaginal and AF samples collected for Gram stain, culture, and interleukin-8 and interleukin-6 determinations. Vaginal interleukin-6, interleukin-8, neutrophils, and vaginal flora were

Jane Hitti; Sharon L Hillier; Kathy J Agnew; Marijane A Krohn; Dale P Reisner; David A Eschenbach

2001-01-01

137

The effect of vitamin D on vaginal atrophy in postmenopausal women  

PubMed Central

Background: Most of the women suffer from vaginal atrophy and dryness, and therefore, efficient and safe treatment is needed to improve vaginal lubrication. Vitamin D has several important functions which may be effective in proliferation and repair of the epithelial tissue. This study aimed to evaluate the effect of vitamin D vaginal suppositories on maturation index, pH, and dryness in postmenopausal women. Materials and Methods: Women were enrolled in this double-blind clinical trial, in whom menopause occurred at least one year ago. Those women who had an abnormal Papanicolaou smear, had undergone hormonal treatment, or have had vaginal infection in the previous year were excluded. Forty-four women who found eligible were randomized into two equal groups, the treatment and control groups, which received vitamin D and placebo vaginal suppository daily for 8 weeks, respectively. Vaginal pH and maturation value were measured at the beginning and end of the study. Pain, dryness, and paleness were assessed before treatment and at the end of the 2, 4, and 8 weeks of treatment. Results: In the treatment group, the number (Mean ± SD) of superficial cells increased (69.76 ± 12.4) and vaginal pH decreased (1.42 ± 0.67) significantly compared to the control group after 56 days. The mean pain significantly reduced after 8 weeks in the treatment group (1.23 ± 0.53) compared to the control group 1.95 ± 0.74 (P < 0.001). The mean of dryness and paleness reduced significantly in the treatment group versus control at 56 days. Conclusions: Vitamin D is effective in improving the maturation index and decreased the pH and dryness of the vaginal atrophy due to menopause.

Rad, Parastou; Tadayon, Mitra; Abbaspour, Mohammadreza; Latifi, Seyed Mahmood; Rashidi, Iran; Delaviz, Hamdollah

2015-01-01

138

Development of an in vitro alternative assay method for vaginal irritation  

PubMed Central

The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus-2. Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed using the rabbit vaginal irritation (RVI) assay. In the current study, we investigated whether the organotypic, highly differentiated EpiVaginal™ tissue could be used as a non-animal alternative to the RVI test. The EpiVaginal tissue was exposed to a single application of ingredients commonly found in feminine hygiene products and the effects on tissue viability (MTT assay), barrier disruption (measured by transepithelial electrical resistance, TEER and sodium fluorescein (NaFl) leakage), and inflammatory cytokine release (interleukin (IL)-1?, IL-1?, IL-6, and IL-8) patterns were examined. When compared to untreated controls, two irritating ingredients, nonoxynol 9 and benzalkonium chloride, reduced tissue viability to <40% and TEER to <60% while increasing NaFl leakage by 11–24% and IL-1? and IL-1? release by >100%. Four other non-irritating materials had minimal effects on these parameters. Assay reproducibility was confirmed by testing the chemicals using three different tissue production lots and by using tissues reconstructed from cells obtained from three different donors. Coefficients of variation between tissue lots reconstructed with cells obtained from the same donor or lots reconstructed with cells obtained from different donors were less than 10% and 12%, respectively. In conclusion, decreases in tissue viability and barrier function and increases in IL-1? and IL-1? release appear to be useful endpoints for preclinical screening of topically applied chemicals and formulations for their vaginal irritation potential. PMID:20937349

Ayehunie, Seyoum; Cannon, Chris; LaRosa, Karen; Pudney, Jeffrey; Anderson, Deborah J.; Klausner, Mitchell

2010-01-01

139

Functional vaginal rejuvenation with elastic silicone threads: a 4-year experience with 180 patients.  

PubMed

Recently, there has been growing interest in female genital plastic surgery. To the authors' knowledge, no studies have adopted elastic silicone thread for vaginal rejuvenation. This study introduces clinical experience over 4 years with vaginal rejuvenation using elastic silicone thread to specifically assess the overall patient satisfaction (sexual function and correction of the vaginal width). It is hypothesised that this novel surgical method can improve sexual function. Between 2007-2011, 180 patients underwent vaginal rejuvenation using elastic silicone thread performed by the authors at a single institution. Patients with persistent feeling of a wide vagina and/or a decreased ability to reach orgasm were included. Patients were excluded from the study if they were unavailable for follow-up, or if they had been diagnosed with any gynecologic diseases. To measure the 15 degree of improvement with regard to sexual function, this study adopted the validated system; Female Sexual Function Index (FSFI). 92.8% (167/180) of the patients were satisfied with outcome with regard to feelings of correction of vaginal width. Vaginal rejuvenation using elastic silicone thread significantly improved postoperative outcomes, resulting in improved sexual function, with a focus on improving the FSFI score. This is especially prominent in FSFI orgasm subscore. However, a prospective multicentre study would be beneficial to provide patients with the best possible management. PMID:25141944

Park, Tae Hwan; Park, Hye June; Whang, Kwi Whan

2015-02-01

140

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2013 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2013-04-01

141

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2014 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2014-04-01

142

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2012 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2012-04-01

143

Vaginal childbirth and pelvic floor disorders  

PubMed Central

Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study. PMID:23638782

Memon, Hafsa U; Handa, Victoria L

2013-01-01

144

Shortwave Radiative Closure Studies for Clear Skies During the Atmospheric Radiation Measurement 2003 Aerosol Intensive Observation Period  

SciTech Connect

The Department of Energy's Atmospheric Radiation Measurement (ARM) program sponsored a large aerosol intensive observation period (AIOP) to study aerosol during the month of May 2003 around the Southern Great Plains (SGP) Climate Research Facility (CRF) in north central Oklahoma. Redundant measurements of aerosol optical properties were made using different techniques at the surface as well as in vertical profile with sensors aboard two aircraft. One of the principal motivations for this experiment was to resolve the disagreement between models and measurements of diffuse horizontal broadband shortwave irradiance at the surface, especially for modest aerosol loading. This paper focuses on using the redundant aerosol and radiation measurements during this AIOP to compare direct beam and diffuse horizontal broadband shortwave irradiance measurements and models at the surface for a wide range of aerosol cases that occurred during 30 clear-sky periods on 13 days of May 2003. Models and measurements are compared over a large range of solar-zenith angles. Six different models are used to assess the relative agreement among them and the measurements. Better agreement than previously achieved appears to be the result of better specification of input parameters and better measurements of irradiances than in prior studies. Biases between modeled and measured direct irradiances are in the worst case 1%, and biases between modeled and measured diffuse irradiances are less than 1.9%.

Michalsky, Joseph J.; Anderson, Gail; Barnard, James C.; Delamere, Jennifer; Gueymard, C.; Kato, Seiji; Kiedron, P.; McComiskey, A.; Ricchiazzi, P.

2006-07-20

145

78 FR 72583 - Reef Fish Fishery of the Gulf of Mexico; 2013 Accountability Measure and Closure for Hogfish in...  

Federal Register 2010, 2011, 2012, 2013, 2014

...the Generic Annual Catch Limits/Accountability Measures Amendment to the Red Drum, Reef Fish Resources, Shrimp, and Coral and Coral Reefs Fishery Management Plans for the Gulf of Mexico (Generic ACL Amendment; 76 FR 82044) as prepared...

2013-12-03

146

Adherence of Human Vaginal Lactobacilli to Vaginal Epithelial Cells and Interaction with Uropathogens  

Microsoft Academic Search

Three strains of Lactobacillus, identified as Lactobacillus acidophilus, Lactobacillus gasseri, and Lactobacillus jensenii, were selected from among 70 isolates from the vaginas of healthy premenopausal women for properties relevant to mucosal colonization or antagonism. All three self-aggregated and adhered to epithelial vaginal cells, displacing well-known vaginal pathogens, such as G. vaginalis, and inhibiting the growth in vitro of Escherichia coli

SOLEDAD BORIS; JUAN E. SUAREZ; FERNANDO VAZQUEZ; COVADONGA BARBES

1985-01-01

147

EMAS clinical guide: low-dose vaginal estrogens for postmenopausal vaginal atrophy.  

PubMed

Vaginal atrophy is common in postmenopausal women. This clinical guide provides the evidence for the clinical use of vaginal estrogens for this condition focussing on publications since the 2006 Cochrane systematic review. Use after breast cancer, before assessment of cervical cytology and prolapse surgery is also discussed. PMID:22818886

Rees, Margaret; Pérez-López, Faustino R; Ceasu, Iuliana; Depypere, Herman; Erel, Tamer; Lambrinoudaki, Irene; Schenck-Gustafsson, Karin; Simoncini, Tommaso; van der Schouw, Yvonne; Tremollieres, Florence

2012-10-01

148

Semaphorin 4D induces vaginal epithelial cell apoptosis to control mouse postnatal vaginal tissue remodeling.  

PubMed

The opening of the mouse vaginal cavity to the skin is a postnatal tissue remodeling process that occurs at approximately five weeks of age for the completion of female genital tract maturation at puberty. The tissue remodeling process is primarily composed of a hormonally triggered apoptotic process predominantly occurring in the epithelium of the distal section of the vaginal cavity. However, the detailed mechanism underlying the apoptotic induction remains to be elucidated. In the present study, it was observed that the majority of BALB/c mice lacking the class 4 semaphorin, semaphorin 4D (Sema4D), developed imperforate vagina and hydrometrocolpos resulting in a perpetually unopened vaginal cavity regardless of a normal estrogen level comparable with that in wild?type (WT) mice. Administration of ??estradiol to infant Sema4D?deficient (Sema4D?/?) mice did not induce precocious vaginal opening, which was observed in WT mice subjected to the same ??estradiol administration, excluding the possibility that the closed vaginal phenotype was due to insufficient estrogen secretion at the time of vaginal opening. In order to assess the role of Sema4D in the postnatal vaginal tissue remodeling process, the expression of Sema4D and its receptor, plexin?B1, was examined as well as the level of apoptosis in the vaginal epithelia of five?week?old WT and Sema4D?/? mice. Immunohistochemical analyses confirmed the localization of Sema4D and plexin?B1 in the mouse vaginal epithelia. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay and immunohistochemistry detecting activated caspase?3 revealed significantly fewer apoptotic cells in situ in the vaginal mucosa of five?week?old Sema4D?/? mice compared with WT mice. The addition of recombinant Sema4D to Sema4D?/? vaginal epithelial cells in culture significantly enhanced apoptosis of the vaginal epithelial cells, demonstrating the apoptosis?inducing activity of Sema4D. The experimental reduction of plexin?B1 expression in vaginal epithelial cells demonstrated the integral role of plexin?B1 in Sema4D?induced apoptotic cell death. These results suggest a non?redundant role of Sema4D in the postnatal tissue remodeling process in five?week?old BALB/c mice, which involves the induction of vaginal epithelial cell apoptosis through Sema4D binding to plexin?B1. PMID:25351707

Ito, Takuji; Bai, Tao; Tanaka, Tetsuji; Yoshida, Kenji; Ueyama, Takashi; Miyajima, Masayasu; Negishi, Takayuki; Kawasaki, Takahiko; Takamatsu, Hyota; Kikutani, Hitoshi; Kumanogoh, Atsushi; Yukawa, Kazunori

2015-02-01

149

Crack closure and healing studies in WIPP (Waste Isolation Pilot Plant) salt using compressional wave velocity and attenuation measurements: Test methods and results  

SciTech Connect

Compressional wave ultrasonic data were used to qualitatively assess the extent of crack closure during hydrostatic compression of damaged specimens of WIPP salt. Cracks were introduced during constant strain-rate triaxial tests at low confining pressure (0.5 MPa) as specimens were taken to either 0.5, 1.0, or 1.5 percent axial strain. For three specimens taken to 1.0 percent axial strain, the pressure was increased to 5, 10 or 15 MPa. For the remaining specimens, pressure was raised to 15 MPa. Waveforms for compressional waves traveling both parallel and perpendicular to the direction of maximum principal stress were measured in the undamaged state, during constant strain-rate tests, and then monitored as functions of time while the specimens were held at pressure. Both wave velocities and amplitudes increased over time at pressure, indicating that cracks closed and perhaps healed. The recovery of ultrasonic wave characteristics depended upon both pressure and damage level. The higher the pressure, the greater the velocity recovery; however, amplitude recovery showed no clear correlation with pressure. For both amplitudes and velocities, recoveries were greatest in the specimens with the least damage. 13 refs., 15 figs., 1 tab.

Brodsky, N.S. (RE/SPEC, Inc., Rapid City, SD (USA))

1990-11-01

150

Clinical Features of Bacterial Vaginosis in a Murine Model of Vaginal Infection with Gardnerella vaginalis  

PubMed Central

Bacterial vaginosis (BV) is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and Gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells). G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and associated complications. PMID:23527214

Gilbert, Nicole M.; Lewis, Warren G.; Lewis, Amanda L.

2013-01-01

151

Vaginal ultrasonography in patients with postmenopausal bleeding.  

PubMed

Our objective was to define a subset of women with postmenopausal bleeding in whom the accepted practice of endometrial sampling could be safely omitted. Vaginal endosonographic measurements were compared to the histological findings of curettings following diagnostic dilatation and curettage in 129 women with post-menopausal bleeding who were not receiving hormonal therapy. Atrophy was diagnosed in 49%, slight proliferation in 10%, endometrial polyps in 11%, hypoplasia in 12%, and adenocarcinoma in 12%. Endometrial atrophy was associated with a mean sonographic thickness of 2.6 mm of the double layer (range 0-6.5 mm). Of the women with a final histological diagnosis of atrophy, 92% had an endometrial thickness of 3 mm or less. Furthermore, all women with a sonographic endometrial thickness of 3 mm or less had atrophic endometrium (p < 0.0001). An endometrial thickness of 3 mm or less would have reduced the number of dilation and curettage procedures by 45% and no cases of endometrial pathologies would have been missed. In women presenting with postmenstrual bleeding, meticulous scanning of the endometrium can select a group where endometrial sampling can be omitted from the protocol. PMID:12797245

Auslender, R; Bornstein, J; Dirnfeld, M; Kogan, O; Atad, J; Abramovici, H

1993-11-01

152

A comprehensive review of vaginitis phytotherapy.  

PubMed

To overview phytotherapy of vaginitis in order to identify new approaches for new pharmacological treatments. All related literature databases were searched for herbal medicinal treatment in vaginitis. The search terms were plant, herb, herbal therapy, phytotherapy, vaginitis, vaginal, anti-candida, anti-bacterial and anti-trichomonas. All of the human, animal and in vitro studies were included. Anti-candida, anti-bacterial and anti-trichomonas effects were the key outcomes. The plants including carvacrol, 1,8-cineole, geranial, germacrene-D, limonene, linalool, menthol, terpinen-4-ol and thymol exhibited anti-candida effects. A very low concentration of geranium oil and geraniol blocked mycelial growth, but not yeast. Tea tree oil including terpinen-4-ol, alpha-terpinene, gamma-terpinene and alpha-terpineol showed anti-bacterial, anti-fungal and anti-protozoal properties against trichomonas. Allium hirtifolium (persian shallot) comparable to metronidazole exhibited anti-trichomonas activity due to its components such as allicin, ajoene and other organosulfides. The plants having beneficial effects on vaginitis encompass essential oils that clear the pathway that future studies should be focused to standardize theses herbs. PMID:22514885

Azimi, Hanieh; Fallah-Tafti, Mehrnaz; Karimi-Darmiyan, Maliheh; Abdollahi, Mohammad

2011-11-01

153

Administration of oral and vaginal prebiotic lactoferrin for a woman with a refractory vaginitis recurring preterm delivery: appearance of lactobacillus in vaginal flora followed by term delivery.  

PubMed

Lactoferrin (LF) is one of the prebiotics present in the human body. A 38-year-old multiparous woman with poor obstetrical histories, three consecutive preterm premature rupture of membrane at the 19th, 23rd and 25th week of pregnancy, was referred to our hospital. She was diagnosed as having refractory vaginitis. Although estriol vaginal tablets were used for 4 months, the vaginitis was not cured. We administrated vaginal tablets and oral agents of prebiotic LF, resulting in a Lactobacillus predominant vaginal flora. When she was pregnant, she continued to use the LF, and the Lactobacillus in the vaginal flora was continuously observed during pregnancy. An elective cesarean section was performed at the 38th week of pregnancy. When the administration of LF was discontinued after the delivery, Lactobacillus in the vaginal flora was disappeared. PMID:24118573

Otsuki, Katsufumi; Tokunaka, Mayumi; Oba, Tomohiro; Nakamura, Masamitsu; Shirato, Nahoko; Okai, Takashi

2014-02-01

154

Evaluation of Rapidly Disintegrating Vaginal Tablets of Tenofovir, Emtricitabine and Their Combination for HIV-1 Prevention  

PubMed Central

Vaginal tablets are being developed as an alternative to gels as an inexpensive, discreet dosage form for the administration of microbicides. This work describes the pharmacokinetic (PK) evaluation of rapidly disintegrating vaginal tablets containing tenofovir (TFV, 10 mg), emtricitabine (FTC, 10 mg), and the combination of TFV and FTC (10 mg each) under in vitro and in vivo conditions, and in direct comparison to the clinical TFV 1% gel, a microbicide product in Phase III clinical testing. The PK of TFV and FTC from tablets were also evaluated in female rabbits following intravaginal administration. Direct comparison of a single dose of TFV tablets (intact or predissolved at 10 mg/mL) and TFV 1% gel showed no differences in the vaginal PK of TFV between groups; however systemic bioavailability of TFV was significantly higher from the gel. When rabbits were dosed either once or daily for seven days with intact tablets of TFV, FTC, or the combination of TFV/FTC, vaginal and systemic concentrations of TFV and FTC were unaffected by co-formulation. Moreover, plasma PK parameters were similar following a single dose or seven once-daily doses. Tissue concentrations of TFV and FTC in the cranial vagina 4 h after administration ranged between 104 and 105 ng/g. Concentrations of TFV-diphospate (TFV-DP, the active metabolite) were also high (over 103 ng/g or about 3000 to 6000 fmol/mg) in the cranial vagina 4 h after administration and similar to those measured following administration of TFV 1% gel. These data demonstrate that rapidly disintegrating vaginal tablets may be a suitable topical microbicide dosage form providing similar vaginal TFV PK to that of TFV 1% gel. The data also support co-administration of FTC with TFV in a single vaginal tablet to create a combination microbicide in a simple and inexpensive dosage form. PMID:25494201

Clark, Meredith R.; Peet, M. Melissa; Davis, Sarah; Doncel, Gustavo F.; Friend, David R.

2014-01-01

155

Feline immunodeficiency virus Gag- and Env-specific immune responses after vaginal versus intravenous infection.  

PubMed

To better understand the correlation of mucosal and systemic immune responses with lentiviral containment, we contrasted the early mucosal and systemic immune responses induced by vaginal versus intravenous exposure of cats to feline immunodeficiency virus (FIV) isolates of differing pathogenicity and clade (i.e., FIV-B-2542 and FIV-A-PPR). We found that despite divergence in viral genotype, the mucosal and systemic immune responses induced differed more with route of exposure than virus isolate. In intravenously exposed cats, Gag-specific antibody (both IgG and IgA isotype) predominated in the serum, saliva, and vaginal wash fluid irrespective of infecting virus isolate. While Env-specific responses were more variable, they were more often detected in vaginally infected cats. Both IgG and IgA directed against Gag and Env were consistently present in vaginal wash fluids independent of route of infection or virus isolate. FIV Gag- and Env-specific cytotoxic lymphocytes (CTLs) were detected in blood and tissue lymphocytes of cats infected with either virus strain but were greatest in intravenously infected animals. Likewise, FIV-specific CTLs were detected in CD8(+) vaginal lymphocytes of animals infected by either route but were also more frequent in intravenously inoculated animals. In summary, we found qualitative differences in the immune responses following vaginal infection but no evidence (1) that mucosal immune responses were enhanced in vaginally exposed cats, (2) that local mucosal infection led to measurably greater immune responses in either compartment; or (3) that more prominent immune responses correlated with lower viral burden. PMID:11788028

Burkhard, M J; Mathiason, C K; Bowdre, T; Hoover, E A

2001-12-10

156

What Should You Ask Your Doctor about Vaginal Cancer?  

MedlinePLUS

... for vaginal cancer? What should you ask your doctor about vaginal cancer? It’s important to have honest, ... cancer care team. Keep in mind, too, that doctors are not the only ones who can provide ...

157

Vaginitis: How Many Women Are Affected/at Risk?  

MedlinePLUS

... and Publications How many women are affected/at risk? Skip sharing on social media links Share this: ... trichomoniasis. Who gets vaginitis and who is at risk? Vaginitis affects women of all ages, races, and ...

158

Necrotizing ruptured vaginal leiomyoma mimicking a malignant neoplasm  

PubMed Central

Leiomyomas are common benign uterine tumors. However, the incidence of vaginal myoma is very rare and may be confused with a variety of vaginal tumors. We report a case of 43-year-old nulligravida who presented with a protruding painful vaginal mass for 7 days. The mass had initially appeared 3 years prior, as 2 to 3 cm that had not subsequently increased. However suddenly, there was rapid severe enlargement over the course of 7 days. Physical exam revealed a monstrous shaped, black color with focal necrosis, odorous protruding vaginal mass about 7 cm in size. The vaginal mass was infected and degenerated. And vaginal wall was also destroyed by the enlarged mass. Because of the clinical features and radiologic findings, the preoperative diagnosis was a vaginal malignancy. We reported an extremely rare case of vaginal myoma that had several characteristics of malignancy, with a brief review of the literature. PMID:25469351

Sim, Chae Hee; Lee, Jin Hee; Kwak, Jyung Sik

2014-01-01

159

A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn  

PubMed Central

Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method. PMID:23476121

Köse, Osman; Sa?lam, Hasan S.; Kumsar, ?ükrü; Budak, Salih; Adsan, Öztu?

2013-01-01

160

Biofilm formation by vaginal Lactobacillus in vivo.  

PubMed

Biofilm formation by nonpathogenic bacteria is responsible for their stable maintenance in vivo ecosystems as it promotes long-term permanence on the host's vaginal mucosa. Biofilm formation by Lactobacilli has been reported in vitro but not in vivo. We hypothesize the presence of biofilm formation in vivo could be also documented by microscope photographs (MP) of wet mounts obtained from uninfected vaginal samples satisfying rigorous scientific identification criteria. We analyzed 400 MP from our database, and we were able to determine that 12 MP from 6 different patients contained clues of the formation of biofilm by Lactobacilli. The most probable lactobacillus involved is presumed to be Lactobacillus jensenii. The documentation of biofilm formation by vaginal Lactobacilli at fresh wet mount preparation is significant and has several important clinical preventive and therapeutic implications. PMID:25725906

Ventolini, G; Mitchell, E; Salazar, M

2015-05-01

161

The preterm prediction study: Significance of vaginal infections  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the association of bacterial vaginosis, trichomonas vaginitis, and monilial vaginitis with spontaneous preterm birth at<35 weeks 0 days.STUDY DESIGN: A total of 2929 women at 10 centers were studied at 24 and 28 weeks' gestation by Gram stain of vaginal smear, wet mount, and 10% potassium hydroxide preparations to detect vaginal infections.RESULTS: The rates

Paul J. Meis; Robert L. Goldenberg; Brian Mercer; Atef Moawad; Anita Das; Donald McNellis; Francee Johnson; Jay D. Iams; Elizabeth Thom; William W. Andrews

1995-01-01

162

Anaerobes and Gardnerella vaginalis in non-specific vaginitis  

Microsoft Academic Search

Clinical evidence of bacterial vaginosis was present in 25 (35%) of 72 patients attending a London venereology clinic and correlated significantly with abnormal organic acids in vaginal secretions (24\\/25), with Gardnerella vaginalis on culture (17\\/25), with complaints of vaginal malodour (15\\/25), and with a relative scarcity of white blood cells in vaginal secretions. Anaerobic vaginal flora were presumptively identified by

L V Hill

1985-01-01

163

Pregnancy's Stronghold on the Vaginal Microbiome  

PubMed Central

Objective To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. Methods Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8–12, 17–21, 27–31, and 36–38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3–V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. Results Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n?=?8), the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. Conclusion Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for investigating the role of the microbiome in complications of pregnancy such as preterm labor and preterm delivery. PMID:24896831

Walther-António, Marina R. S.; Jeraldo, Patricio; Berg Miller, Margret E.; Yeoman, Carl J.; Nelson, Karen E.; Wilson, Brenda A.; White, Bryan A.; Chia, Nicholas; Creedon, Douglas J.

2014-01-01

164

[HPV contamination of endocavity vaginal ultrasound probes].  

PubMed

While the use of endovaginal ultrasound probes is increasing, the risk of contamination of women with endocavity vaginal probes was not assessed. In particular, the clinical significance of detection of human papillomavirus (HPV) infection, the most common sexually transmitted viral infection, on endovaginal ultrasound probes is uncertain. The recommendations of good practice for decontamination of these probes developed by the High Council for Public Health and the Academy of Medicine have not been evaluated. The objective of this article was to review recent publications concluding to the detection of HPV and human cellular DNA after gynecological examination and disinfection of vaginal ultrasound probes. PMID:24930727

Heard, I; Favre, M

2015-02-01

165

Reviewing the options for local estrogen treatment of vaginal atrophy  

PubMed Central

Background Vaginal atrophy is a chronic condition with symptoms that include vaginal dryness, pain during sex, itching, irritation, burning, and discharge, as well as various urinary problems. Up to 45% of postmenopausal women may be affected, but it often remains underreported and undertreated. This article aims to review the current recommendations for treatment of vaginal atrophy, and current data on the effectiveness and safety of local vaginal estrogen therapies. Methods Literature regarding vaginal atrophy (2007–2012) was retrieved from PubMed and summarized, with emphasis on data related to the treatment of vaginal atrophy with local vaginal estrogen therapy. Results Published data support the effectiveness and endometrial safety of low-dose local estrogen therapies. These results further support the general recommendation by the North American Menopause Society that a progestogen is not needed for endometrial protection in patients using low-dose local vaginal estrogen. Benefits of long-term therapy for vaginal atrophy include sustained relief of symptoms as well as physiological improvements (eg, decreased vaginal pH and increased blood flow, epithelial thickness, secretions). Conclusion Currently available local vaginal estrogen therapies are well tolerated and effective in relieving symptoms of vaginal atrophy. Recent data support the endometrial safety of low-dose regimens for up to 1 year. PMID:24648775

Lindahl, Sarah H

2014-01-01

166

Correlation of Behaviors with Microbiological Changes in Vaginal Flora  

Microsoft Academic Search

Bacterial vaginosis (BV) is characterized by dramatic changes in the vaginal ecosystem. Women without evidence of vaginal infection may exhibit transient changes in their flora. We prospectively followed up women by using diaries and self-obtained vaginal smears to correlate behaviors with changes in flora. The majority of women (38\\/51, 78%) had significant, although transient, changes. Behaviors associated with unstable flora

1999-01-01

167

Testing turbulent closure models with convection simulations  

NASA Astrophysics Data System (ADS)

We compare simple analytical closure models of homogeneous turbulent Boussinesq convection for stellar applications with three-dimensional simulations. We use turbulent closure models to compute the Reynolds stresses and the turbulent heat flux as functions of rotation rate measured by the Taylor number. We also investigate cases with varying angles between the angular velocity and gravity vectors, corresponding to locating the computational domain at different latitudes ranging from the pole to the equator of the star. We perform three-dimensional numerical simulations in the same parameter regimes for comparison. The free parameters appearing in the closure models are calibrated by two fitting methods using simulation data. A unique determination of the closure parameters is possible only in the non-rotating case or when the system is placed at the pole. In the other cases the fit procedures yield somewhat differing results. The quality of the closure is tested by substituting the resulting coefficients back into the closure model and comparing with the simulation results. To eliminate the possibilities that the results obtained depend on the aspect ratio of the simulation domain or suffer from too small Rayleigh numbers we performed runs varying these parameters. The simulation data for the Reynolds stress and heat fluxes broadly agree with previous compressible simulations. The closure works fairly well with slow and fast rotation but its quality degrades for intermediate rotation rates. We find that the closure parameters depend not only on rotation rate but also on latitude. The weak dependence on Rayleigh number and on the aspect ratio of the domain indicates that our results are generally valid.

Snellman, J. E.; Käpylä, P. J.; Käpylä, M. J.; Rheinhardt, M.

2015-01-01

168

Vaginal Cuff Dehiscence: Risk Factors and Associated Morbidities  

PubMed Central

Background and Objectives: To evaluate whether the route and surgical technique by which hysterectomy is performed influence the incidence of vaginal cuff dehiscence. Methods: We performed a retrospective analysis of total hysterectomy cases performed at Brigham and Woman's Hospital or Faulkner Hospital during 2009 through 2011. Results: During the study period, 2382 total hysterectomies were performed; 23 of these (0.96%) were diagnosed with cuff dehiscence, and 4 women had recurrent dehiscence. Both laparoscopic (odds ratio, 23.4; P = .007) and robotic (odds ratio, 73; P = .0006) hysterectomies were associated with increased odds of cuff dehiscence in a multivariate regression analysis. The type of energy used during colpotomy, mode of closure (hand sewn, laparoscopic suturing, or suturing assisted by a device), and suture material did not differ significantly between groups; however, continuous suturing of the cuff was a protective factor (odds ratio, 0.24; P = .03). Women with dehiscence had more extensive procedures, as well as an increased incidence of additional major postoperative complications (17.4% vs 3%, P = .004). Conclusion: The rate of cuff dehiscence in our cohort correlates with the current literature. This study suggests that the risk of dehiscence is influenced mainly by the scope and complexity of the surgical procedure. It seems that different colpotomy techniques do not influence the rate of cuff dehiscence; however, continuous suturing of the cuff may be superior to interrupted suturing.

Fuchs Weizman, Noga; Einarsson, Jon I.; Wang, Karen C.; Vitonis, Allison F.

2015-01-01

169

A comparison of upper airway parameters in postpartum patients: vaginal delivery vs. caesarean section  

PubMed Central

Mallampati class has been shown to increase during labour. The influence of delivery mode on this change is not known yet. The aim of our study is to investigate the changes of upper airway parameters in parturients after caesarean section and vaginal delivery. Ninety parturients undergoing elective caesarean section and ninety parturients with vaginal delivery were enrolled. The parameters of Modified Mallampati test (MMT), inter-incisor distance, thyromental distance, sternomental distance, neck circumference were measured before labour (T0) and 1 h (T1), 6 h (T6) and 24 h (T24) after delivery. Overall, 39 parturients (45.3%) with increases in MMT class in the vaginal delivery group within 24 h After childbirth, were more than that in the caesarean section group [24 parturients (26.7%), P=0.01]. In the vaginal delivery group, the incidence of the increases in MMT class at T1 and T6 were similar, which were higher than that at T24 (P=0.015). In the caesarean section group, the incidence of MMT class increases at T6 was significantly higher than that at T1 (P=0.015) and T24 (P=0.015). Our findings indicate that increase in Mallamapti class may be more significant and may take place earlier in parturients undergoing vaginal delivery than in those undergoing elective caesarean section. PMID:25664060

Hu, Jianying; Huang, Shaoqiang; Tian, Fubo; Sun, Shen; Li, Ning; Xie, Yi

2014-01-01

170

Role of Oxidative Stress on Vaginal Bleeding during The First Trimester of Pregnant Women  

PubMed Central

Background: Reactive oxygen species (ROS) are produced in many metabolic and physiologic processes. Antioxidative mechanisms remove these harmful species. Our aim was to assess whether serum total antioxidant capacity and total oxidant status altered during first trimester pregnancies with vaginal bleeding. Materials and Methods: In this cross-sectional study, A group of pregnant women at less than 10 weeks of gestation with vaginal bleeding (n=25) and a control group of healthy pregnancies with similar characteristics (n=25) were included. All of the patients in the two groups were matched for age, gestational age and body mass index. Serum total antioxidant capacity and total oxidant status levels were determined using a Hitachi 912 analyzer and compared between the two groups. Results: Characteristics, including maternal age, parity, and gestational age were similar between the two groups. Serum total antioxidant capacity levels were significantly lower in the women with vaginal bleeding than in control women (1.16 ± 0.20 vs. 1.77 ± 0.08 mmol Trolox Equiv./L; p=0.001), whereas higher total oxidant status measurements were found in women with vaginal bleeding compared to the control group (4.01 ± 0.20 vs. 2.57 ± 0.65 µmol H2O2 Equiv./L; p=0.001). Conclusion: Increased total oxidant status might be involved in the pathophysiology of vaginal bleeding during early first trimester pregnancies. PMID:24520496

Deveer, Rüya; Deveer, Mehmet; Engin-Üstün, Yaprak; Akbaba, Eren; Uysal, Sema; Sarikaya, Esma; Gülerman, Cavidan; Mollamahmutoglu, Leyla

2014-01-01

171

A CLOSURE STUDY OF AEROSOL MASS CONCENTRATION MEASUREMENTS: COMPARISON OF VALUES OBTAINED WITH FILTERS AND BY DIRECT MEASUREMENTS OF MASS DISTRIBUTIONS. (R826372)  

EPA Science Inventory

We compare measurements of aerosol mass concentrations obtained gravimetrically using Teflon coated glass fiber filters and by integrating mass distributions measured with the differential mobility analyzer–aerosol particle mass analyzer (DMA–APM) technique (Aero...

172

Cloud condensation nuclei (CCN) and HR-ToF-AMS measurements at a coastal site in Hong Kong: size-resolved CCN activity and closure analysis  

NASA Astrophysics Data System (ADS)

The cloud condensation nuclei (CCN) properties of atmospheric aerosols were measured on 1-30 May 2011 at a coastal site in Hong Kong. Size-resolved CCN activation curves, the ratio of number concentration of CCN (NCCN) to aerosol concentration (NCN) as a function of particle size, were obtained at supersaturation (SS) = 0.15%, 0.35%, 0.50%, and 0.70% using a DMT CCN counter (CCNc) and a TSI scanning mobility particle sizer (SMPS). The mean bulk size-integrated NCCN ranged from ∼500 cm-3 at SS = 0.15% to ∼2100 cm-3 at SS = 0.70%, and the mean bulk NCCN / NCN ratio ranged from 0.16 at SS = 0.15% to 0.65 at SS = 0.70%. The average critical mobility diameters (D50) at SS = 0.15%, 0.35%, 0.50%, and 0.70% were 116 nm, 67 nm, 56 nm, and 46 nm, respectively. The corresponding average hygroscopic parameters (?CCN) were 0.39, 0.36, 0.31, and 0.28. The decrease in ?CCN can be attributed to the increase in organic to inorganic volume ratio as particle size decreases, as measured by an Aerodyne high resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). The ?CCN correlates reasonably well with ?AMS based on size-resolved AMS measurements: ?AMS = ?org × forg + ?inorg × finorg, where forg and finorg are the organic and inorganic volume fractions, respectively, ?org = 0.1 and ?inorg = 0.6, with a R2 of 0.51. In closure analysis, NCCN was estimated by integrating the measured size-resolved NCN for particles larger than D50 derived from ? assuming internal mixing state. Estimates using ?AMS from size-resolved AMS measurements show that the measured and predicted NCCN were generally within 10% of each other at all four SS. The deviation increased to 26% when ?AMS was calculated from bulk PM1 AMS measurements of particles because PM1 was dominated by particles of 200 nm to 500 nm in diameter, which had a larger inorganic fraction than those of D50 (particle diameter < 200 nm). A constant ? = 0.33 (the average value of size-resolved ?AMS over the course of campaign) was found to give an NCCN prediction within 12% of the actual measured values. We also compared NCCN estimates based on the measured average D50 and the average size-resolved CCN activation ratio to examine the relative importance of hygroscopicity and mixing state. NCCN was found to be relatively more sensitive to the mixing state and hygroscopicity at a high SS = 0.70% and a low SS = 0.15%, respectively.

Meng, J. W.; Yeung, M. C.; Li, Y. J.; Lee, B. Y. L.; Chan, C. K.

2014-04-01

173

Adherence of Human Vaginal Lactobacilli to Vaginal Epithelial Cells and Interaction with Uropathogens  

PubMed Central

Three strains of Lactobacillus, identified as Lactobacillus acidophilus, Lactobacillus gasseri, and Lactobacillus jensenii, were selected from among 70 isolates from the vaginas of healthy premenopausal women for properties relevant to mucosal colonization or antagonism. All three self-aggregated and adhered to epithelial vaginal cells, displacing well-known vaginal pathogens, such as G. vaginalis, and inhibiting the growth in vitro of Escherichia coli and Streptococcus agalactiae. The surface components involved in self-aggregation appeared to be proteins for L. gasseri and lipoproteins for L. acidophilus and L. jensenii, as judged by susceptibility to treatment with appropriate degrading enzymes. The factors responsible for adherence to epithelial vaginal cells seemed to be glycoproteins (L. acidophilus and L. gasseri) and carbohydrate (L. jensenii). The receptors of the vaginal cells were glycolipids, which presumably were the targets of the competition observed between the lactobacilli and the pathogenic microbes. PMID:9573080

Boris, Soledad; Suárez, Juan E.; Vázquez, Fernando; Barbés, Covadonga

1998-01-01

174

Relative contributions to filter-induced Q penalty from eye closure and OSNR degradation  

Microsoft Academic Search

Experimental measurements are made of the relative contributions to optical filter-induced Q penalties from distortion (eye closure) and OSNR degradation. An expression relating Q penalty to simulated eye closure is derived and verified experimentally.

J. D. Downie; F. Annunziata; J. Hurley; J. Amin

2004-01-01

175

Phenotypic and Functional Characterization of Vaginal Dendritic Cells in a Rat Model of Candida albicans Vaginitis  

Microsoft Academic Search

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62 VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62 VDCs

Flavia De Bernardis; Roberta Lucciarini; Maria Boccanera; Consuelo Amantini; Silvia Arancia; Stefania Morrone; Michela Mosca; Antonio Cassone; Giorgio Santoni

2006-01-01

176

Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections  

Microsoft Academic Search

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion\\u000a experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for\\u000a an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4),\\u000a which is an attribute of a healthy vagina.

Mohd Aftab Alam; Farhan Jalees Ahmad; Zeenat Iqbal Khan; Roop Krishen Khar; Mushir Ali

2007-01-01

177

Vaginal Lactobacillus: biofilm formation in vivo – clinical implications  

PubMed Central

Vaginal lactobacilli provide protection against intrusive pathogenic bacteria. Some Lactobacillus spp. produce in vitro a thick, protective biofilm. We report in vivo formation of biofilm by vaginal Lactobacillus jensenii. The biofilm formation was captured in fresh wet-mount microscopic samples from asymptomatic patients after treatment for recurrent bacterial vaginitis. In vivo documentation of biofilm formation is in our opinion noteworthy, and has significant clinical implications, among which are the possibility to isolate, grow, and therapeutically utilize lactobacilli to prevent recurrent vaginal infections and preterm labor associated with vaginal microbial pathogens. PMID:25733930

Ventolini, Gary

2015-01-01

178

Vaginal mesh erosion after abdominal sacral colpopexy  

Microsoft Academic Search

Objective: Our goal was to compare the prevalence of vaginal mesh erosion between abdominal sacral colpopexy and various sacral colpoperineopexy procedures. Study Design: We undertook a retrospective analysis of all sacral colpopexies and colpoperineopexies performed between March 1, 1992, and February 28, 1999. The patients were divided into the following 4 groups: abdominal sacral colpopexy, abdominal sacral colpoperineopexy, and 2

Anthony G. Visco; Alison C. Weidner; Matthew D. Barber; Evan R. Myers; Geoffrey W. Cundiff; Richard C. Bump; W. Allen Addison

2001-01-01

179

Aggressive vaginal angiomyxoma mimicking urethral tumor  

Microsoft Academic Search

This is a case report of a 32-year-old female patient with a neoplasia mimicking a urethral tumor. Following anterior pelvic exanteration, vulvectomy, bilateral inguinal lymphadenectomy, the pathological study established the diagnosis of aggressive vaginal angiomyxoma, CD-34 labeled.

Lucio F. Gonzaga; Fernando C. M. Freitas; Jose M. Tavares

2005-01-01

180

Vaginal Lacerations from Consensual Intercourse in Adolescents  

ERIC Educational Resources Information Center

Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

2011-01-01

181

Vaginal itching and discharge - Adult and adolescent  

MedlinePLUS

... or thin Clear, cloudy, bloody, white, yellow, or green Odorless or have a bad odor Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It can also occur on its own.

182

Primary vaginal adenocarcinoma arising in vaginal adenosis after CO2 laser vaporization and 5-fluorouracil therapy.  

PubMed

We present a case of a 45-year-old woman with a long-standing history of persistent cervical dysplasia that resulted in a hysterectomy. Subsequent vaginal smears revealed high-grade vaginal intraepithelial neoplasia (VAIN III) on Pap smear with positive human papilloma virus (HPV) testing. Over the course of 2 years, the patient underwent 2 CO(2) laser vaporization procedures of the upper vagina and intermittent 5-fluorouracil therapy. A biopsy performed at the time of the second laser procedure revealed endocervical-type well-differentiated adenocarcinoma, associated with VAIN III. HPV in situ hybridization for HPV types 16 and 18 was positive in both the glandular and squamous mucosa. The patient has no known history of intrauterine diethylstilbestrol exposure or mullerian developmental abnormalities. Subsequently, the patient underwent a radical upper vaginetcomy with bilateral pelvic lymph nodes dissection and bilateral salpingo-oophorectomy. The vaginectomy specimen showed residual adenocarcinoma associated with VAIN-III and extensive vaginal adenosis with free resection margins. This is the second reported case in the literature of adenocarcinoma arising in vaginal adenosis after 5-fluorouracil. Herein, we highlight these important findings and shed some light on the pathogenesis of vaginal adenosis and the subsequent development of vaginal adenocarcinoma. PMID:20173507

Paczos, Tamera A; Ackers, Stacey; Odunsi, Kunle; Lele, Shashikant; Mhawech-Fauceglia, Paulette

2010-03-01

183

The role of mode of delivery on elastic fiber architecture and vaginal vault elasticity: a rodent model study  

PubMed Central

We report on an experimental study of the role of mode of delivery and pregnancy on the architecture of vaginal elastic fibers and vaginal vault elasticity in female Sprague-Dawley rats. In primiparous rats submitted to spontaneous or Cesarean delivery and virgin rats submitted to simulated delivery, the tortuosity of elastic fibers (defined as the ratio of length to end-to-end distance) was observed to decrease when measured two days to two weeks postpartum. In addition, the measured tortuosity of elastic fibers in multiparous rats was greater than that of virgin rats. The tortuosity of elastic fibers of all rats measured at two days postpartum were found to be similar to that of multiparous rats. At two weeks postpartum the measured tortuosity of vaginal elastic fibers was indistinguishable from virgin rats, regardless of the delivery method. Borrowing from the field of polymer physics, a model is suggested that connects elastic fiber tortuosity to the resulting tension under an applied stress; fibers having high tortuosity are expected to provide less structural support than more linear, low tortuosity fibers. To probe the macroscopic effects in elasticity due to architectural changes observed in elastic fibers, we have measured the stiffness of the vaginal vault in each cohort using a pressure-infusion system. The vaginal vault stiffness of all primiparous rats measured two weeks postpartum was greater than that measured two days postpartum. In addition, the vaginal vault of virgin rats was stiffer than that of multiparous rats. These observations confirmed that vaginal vault elastic fibers undergo significant remodeling due to pregnancy and parturition, and that the complex remodeling may be a significant contributor to tissue elasticity. Remarkably, regardless of the mode of delivery or simulated tissue trauma, elastic fiber tortuosity is observed to decrease from two days to two weeks postpartum indicating the onset of repair and recovery of tissue stiffness. PMID:24099948

Downing, Keith; Billah, Mubashir; Raparia, Eva; Shah, Anup; Silverstein, Moshe; Ahmad, Amanda; Boutis, Gregory S.

2013-01-01

184

Vaginal Douching Among Latinas: Practices and Meaning  

PubMed Central

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices. PMID:18297379

Baquero, María; Anderson, Matthew R.; Alvarez, Adelyn; Karasz, Alison

2009-01-01

185

VAGINAL DEGENERATION FOLLOWING IMPLANTATION OF SYNTHETIC MESH WITH INCREASED STIFFNESS  

PubMed Central

Objective To compare the impact of the prototype prolapse mesh Gynemesh PS to that of two new generation lower stiffness meshes, UltraPro and SmartMesh, on vaginal morphology and structural composition. Design A mechanistic study employing a non-human primate (NHP) model. Setting Magee-Womens Research Institute at the University of Pittsburgh. Population Parous rhesus macaques, with similar age, weight, parity and POP-Q scores. Methods Following IACUC approval, 50 rhesus macaques were implanted with Gynemesh PS (n=12), UltraPro with its blue line perpendicular to the longitudinal axis of vagina (n=10), UltraPro with its blue line parallel to the longitudinal axis of vagina (n=8) and SmartMesh (n=8) via sacrocolpopexy following hysterectomy. Sham operated animals (n=12) served as controls. Main Outcome Measures The mesh-vagina complex (MVC) was removed after 12 weeks and analyzed for histomorphology, in situ cell apoptosis, total collagen, elastin, glycosaminoglycan content and total collagenase activity. Appropriate statistics and correlation analyses were performed accordingly. Results Relative to sham and the two lower stiffness meshes, Gynemesh PS had the greatest negative impact on vaginal histomorphology and composition. Compared to sham, implantation with Gynemesh PS caused substantial thinning of the smooth muscle layer (1557 ± 499?m vs 866 ± 210 ?m, P=0.02), increased apoptosis particularly in the area of the mesh fibers (P=0.01), decreased collagen and elastin content (20% (P=0.03) and 43% (P=0.02), respectively) and increased total collagenase activity (135% (P=0.01)). GAG (glycosaminoglycan), a marker of tissue injury, was the highest with Gynemesh PS compared to sham and other meshes (P=0.01). Conclusion Mesh implantation with the stiffer mesh Gynemesh PS induced a maladaptive remodeling response consistent with vaginal degeneration. PMID:23240802

Liang, Rui; Abramowitch, Steven; Knight, Katrina; Palcsey, Stacy; Nolfi, Alexis; Feola, Andrew; Stein, Susan; Moalli, Pamela A.

2012-01-01

186

The myth of closure.  

PubMed

Therapies for grief and loss have traditionally focused on the work of grieving. The goal was to reach an endpoint, now popularly called closure. There are, however, many people who, through no fault of their own, find a loss so unclear that there can be no end to grief. They have not failed in the work of grieving, but rather have suffered ambiguous loss, a type of loss that is inherently open ended. Instead of closure, the therapeutic goal is to help people find meaning despite the lack of definitive information and finality. Hope lies in increasing a family's tolerance for ambiguity, but first, professionals must increase their own comfort with unanswered questions. In this article, the authors, one a poet, the other a family therapist and theorist, offer a unique blending of theory, reflection, and poetry to experientially deepen the process of self-reflection about a kind of loss that defies closure. PMID:23230978

Boss, Pauline; Carnes, Donna

2012-12-01

187

Maturitas 41 (2002) 157165 Estrogen replacement reverses ovariectomy-induced vaginal  

E-print Network

in the rat Heather B. Bradshaw, Karen J. Berkley * Program in Neuroscience, Department of Psychology, Florida). Pressures exerted by the eight volumes on the vaginal wall were also measured, thereby permitting assessment. * Corresponding author. Tel.: +1-850-644-5741; fax: +1- 850-644-9874. E-mail address: kberkley@psy.fsu.edu (K

Berkley, Karen J.

188

Tank closure reducing grout  

SciTech Connect

A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

Caldwell, T.B.

1997-04-18

189

Lactobacillus acidophilus Contributes to a Healthy Environment for Vaginal Epithelial Cells  

PubMed Central

Lactobacillus species in the female genital tract are thought to act as a barrier to infection. Several studies have demonstrated that lactobacilli can adhere to vaginal epithelial cells. However, little is known about how the adherence of lactobacilli to vaginal epithelial cells affects the acidity, cell viability, or proliferation of the lactobacilli themselves or those of vaginal epithelial cells. Lactobacillus acidophilus was co-cultured with immortalized human vaginal epithelial cells (MS74 cell line), and the growth of L. acidophilus and the acidity of the culture medium were measured. MS74 cell density and viability were also assessed by counting cell numbers and observing the cell attachment state. L. acidophilus showed exponential growth for the first 6 hr until 9 hr, and the pH was maintained close to 4.0-5.0 at 24 hr after culture, consistent with previous studies. The growth curve of L. acidophilus or the pH values were relatively unaffected by co-culture with MS74 cells, confirming that L. acidophilus maintains a low pH in the presence of MS74 cells. This co-culture model could therefore potentially be used to mimic vaginal conditions for future in vitro studies. On the other hand, MS74 cells co-cultured with L. acidophilus more firmly attached to the culture plate, and a higher number of cells were present compared to cells cultured in the absence of L. acidophilus. These results indicate that L. acidophilus increases MS74 cell proliferation and viability, suggesting that lactobacilli may contribute to the healthy environment for vaginal epithelial cells. PMID:22072832

Pi, Woojin; Ryu, Jae-Sook

2011-01-01

190

The vaginal microflora in relation to gingivitis  

PubMed Central

Background Gingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty. Methods Vaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range: 18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at ? 20% of tooth sites. Results A Nugent score of 0–3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women (27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had higher counts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginal samples (> 1.0 × 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8–7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001). Conclusion Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections. PMID:19161595

2009-01-01

191

Critical parameters and measurement methods for post closure monitoring: A review of the state of the art and recommendations for further studies  

SciTech Connect

Both NRC and EPA regulations require programs of post closure monitoring to detect substantial and detrimental deviations from expected performance. The unexpected in this case would involve anomalous stress changes that might rupture the canisters or changes in the hydrologic regime that might accelerate corrosion. In the event of leakage brought about by any means transport of radionuclides to the accessible environment could occur through unexpected changes in the hydrologic flow regime caused either by the long term effects of the thermal loading by the waste or by changes in regional stress or hydrology. Studies of performance confirmation have identified six parameters or conditions that should be monitored that are associated with the thermal, mechanical and hydrologic phenomena introduced by the waste heat: temperature, stress, displacement, pore pressure, groundwater velocity and permeability. Since it is the thermal load that continues to increase after decommissioning, and which continues to alter the stress field and the hydrological regime, these same six parameters remain the critical ones in post closure monitoring. At two of the repository sites fractures have been clearly shown to be critical in modelling and performance confirmation; at the tuff site fluid saturation is also a critical parameter and for all the sites estimates of the groundwater velocity through the site are very important. Changes in fracture properties, saturation and fluid flow are thus of continuing importance in post closure monitoring. 14 refs., 19 figs.

Morrison, H.F.; Majer, E.L.; Tsang, C.F.

1987-05-01

192

Efficient Transitive Closure Algorithms  

Microsoft Academic Search

We have developed some efficient algorithms for computing the transitive closure of a directed graph. This paper presents the algorithms for the problem of reachability. The algorithms, however, can be adapted to deal with path computations and a signitkantJy broader class of queries based on onesided recursions. We analyze these algorithms and compare them to algorithms in the literature. The

Yannis E. Ioannidis; Raghu Ramakrishnan

1988-01-01

193

Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer  

ClinicalTrials.gov

Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

2014-04-21

194

Fatigue Crack Closure Analysis Using Digital Image Correlation  

NASA Technical Reports Server (NTRS)

Fatigue crack closure during crack growth testing is analyzed in order to evaluate the critieria of ASTM Standard E647 for measurement of fatigue crack growth rates. Of specific concern is remote closure, which occurs away from the crack tip and is a product of the load history during crack-driving-force-reduction fatigue crack growth testing. Crack closure behavior is characterized using relative displacements determined from a series of high-magnification digital images acquired as the crack is loaded. Changes in the relative displacements of features on opposite sides of the crack are used to generate crack closure data as a function of crack wake position. For the results presented in this paper, remote closure did not affect fatigue crack growth rate measurements when ASTM Standard E647 was strictly followed and only became a problem when testing parameters (e.g., load shed rate, initial crack driving force, etc.) greatly exceeded the guidelines of the accepted standard.

Leser, William P.; Newman, John A.; Johnston, William M.

2010-01-01

195

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles.  

PubMed

Background: The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05). Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively). Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment. PMID:25317769

Pereira, Vanessa S; Hirakawa, Humberto S; Oliveira, Ana B; Driusso, Patricia

2014-10-10

196

Vaginal Evisceration: An Unexpected Complication of Conization  

PubMed Central

Background. Large loop excision of the transformation zone (LLETZ) is routinely performed for the management of high grade intracervical neoplasia (CIN). Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management. Case. A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair. Conclusions. Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management. PMID:25506010

Ghassani, Ali; Andre, Benoit; Simon-Toulza, Caroline; Tanguy le Gac, Yann; Martinez, Alejandra; Vidal, Fabien

2014-01-01

197

Adolescent Experiences with the Vaginal Ring  

PubMed Central

Purpose To understand racial/ethnic minority adolescent females’ experiences with the vaginal ring. Methods We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15–24 years who had used the vaginal ring. Results Qualitative analysis using grounded theory revealed that adolescents undergo a multi-stage process when trying the ring and adopting ring use. These stages include hearing about the ring, initial reactions, first experiences with insertion and removal, and first sexual experiences. Adolescents subsequently enter an assessment and adjustment stage in which they decide whether to adopt or discontinue ring use. Ultimately they share their experiences with friends. Conclusions The model developed provides a context within which providers may advise adolescents as they begin use of the ring. Some specific recommendations are offered. PMID:18565439

Epstein, Laura B.; Sokal-Gutierrez, Karen; Ivey, Susan L.; Raine, Tina; Auerswald, Colette

2011-01-01

198

Improvements of vaginal atrophy without systemic side effects after topical application of Pueraria mirifica, a phytoestrogen-rich herb, in postmenopausal cynomolgus macaques.  

PubMed

The estrogenic efficacy of topical vaginal application of Pueraria mirifica extract (PM) on the restoration of vaginal atrophy, and the presence of any systemic side effects, were investigated in postmenopausal cynomolgus macaques. Twelve postmenopausal cynomolgus macaques, with complete cessation of menstruation for at least 5 years before start of this experiment, were divided into three groups. They received a topical vaginal application daily of 0.1 or 1% (w/w) PM cream or a conjugated equine estrogen (CEE) cream (a mixture of estrone, equilin, 17?-dihydroequilin, 17?-estradiol and 17?-dihydroequilin at 0.625 mg total estrogen/g cream) for 28 days. Estrogenic efficacy was assessed weekly by vaginal cytology assay and vaginal pH measurement, whilst the plasma luteinizing hormone (LH) and sex skin coloration levels were determined at the end of each treatment period to evaluate the systemic side effects. PM significantly increased the proportion of superficial cells in a dose-dependent manner, with a similar efficacy between 1% (w/w) PM and CEE. Together with increased vaginal maturation, PM decreased the vaginal pH to acidic levels, as observed in the CEE group. PM induced no detected systemic side effects, whilst CEE decreased the plasma LH level and increased the reddish color of the sex skin during the posttreatment period. Topical vaginal treatment with PM stimulated the maturation of the vaginal epithelium without causing systemic side effects in postmenopausal monkeys. The implication is that PM could be a safer alternative to treat vaginal atrophy in postmenopausal women. PMID:24748397

Jaroenporn, Sukanya; Urasopon, Nontakorn; Watanabe, Gen; Malaivijitnond, Suchinda

2014-01-01

199

Improvements of Vaginal Atrophy without Systemic Side Effects after Topical Application of Pueraria mirifica, a Phytoestrogen-rich Herb, in Postmenopausal Cynomolgus Macaques  

PubMed Central

The estrogenic efficacy of topical vaginal application of Pueraria mirifica extract (PM) on the restoration of vaginal atrophy, and the presence of any systemic side effects, were investigated in postmenopausal cynomolgus macaques. Twelve postmenopausal cynomolgus macaques, with complete cessation of menstruation for at least 5 years before start of this experiment, were divided into three groups. They received a topical vaginal application daily of 0.1 or 1% (w/w) PM cream or a conjugated equine estrogen (CEE) cream (a mixture of estrone, equilin, 17?-dihydroequilin, 17?-estradiol and 17?-dihydroequilin at 0.625 mg total estrogen/g cream) for 28 days. Estrogenic efficacy was assessed weekly by vaginal cytology assay and vaginal pH measurement, whilst the plasma luteinizing hormone (LH) and sex skin coloration levels were determined at the end of each treatment period to evaluate the systemic side effects. PM significantly increased the proportion of superficial cells in a dose-dependent manner, with a similar efficacy between 1% (w/w) PM and CEE. Together with increased vaginal maturation, PM decreased the vaginal pH to acidic levels, as observed in the CEE group. PM induced no detected systemic side effects, whilst CEE decreased the plasma LH level and increased the reddish color of the sex skin during the posttreatment period. Topical vaginal treatment with PM stimulated the maturation of the vaginal epithelium without causing systemic side effects in postmenopausal monkeys. The implication is that PM could be a safer alternative to treat vaginal atrophy in postmenopausal women. PMID:24748397

JAROENPORN, Sukanya; URASOPON, Nontakorn; WATANABE, Gen; MALAIVIJITNOND, Suchinda

2014-01-01

200

50 CFR 648.101 - Closures.  

Code of Federal Regulations, 2011 CFR

...Management Measures for the Summer Flounder Fisheries...29, 2011. (a) EEZ closure. ...EEZ to fishing for summer flounder by commercial...remainder of the calendar year by publishing notification...in § 648.100(a) to be exceeded...have been reopened without causing the...

2011-10-01

201

Vaginal Intercourse Frequency and Heart Rate Variability  

Microsoft Academic Search

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck

STUART BRODY; RAGNAR PREUT

2003-01-01

202

Posterior vaginal prolapse and bowel function  

Microsoft Academic Search

Objective: This study’s objectives were to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse. Study Design: One hundred forty-three women completed a questionnaire assessment of bowel function and underwent standardized physical examination according to the International Continence Society’s system for grading uterovaginal prolapse. Results: The

Anne M. Weber; Mark D. Walters; Lester A. Ballard; Delbert L. Booher; Marion R. Piedmonte

1998-01-01

203

Vaginal Drug Delivery Systems for HIV Prevention  

Microsoft Academic Search

Microbicides have become a principal focus for HIV prevention strategies. The successful design of drug delivery systems for\\u000a vaginal microbicide drug candidates brings with it a multitude of challenges. It is imperative that the chemical and physical\\u000a characteristics of the drug candidate and its mechanism of action be clearly understood and considered to successfully deliver\\u000a and target drug candidates efficiently.

Lisa Cencia Rohan; Alexandra B. Sassi

2009-01-01

204

Complications of anterior compartment vaginal surgery  

Microsoft Academic Search

Many complications can be associated with anterior compartment surgery of the vagina. With the integration of synthetic materials\\u000a into the surgical armamentarium for the repair of stress urinary incontinence in the form of midurethral slings, and for the\\u000a repair of vaginal prolapse as a primary procedure or to augment an existing repair, the spectrum of complications related\\u000a to this type

Eric S. Rovner

2007-01-01

205

Strength of Preference for Vaginal Birth as a Predictor of Delivery Mode Among Women who Attempt a Vaginal Delivery  

PubMed Central

OBJECTIVE To assess the relationship between strength of preference for vaginal birth and likelihood of vaginal delivery among women attempting this delivery mode. STUDY DESIGN We conducted a longitudinal study of mode of delivery preferences among women who were less than 36 weeks pregnant. Participants completed a sociodemographic and clinical questionnaire and were asked if they preferred vaginal or cesarean delivery. Participants who preferred vaginal delivery completed a standard gamble exercise to assess the strength of this preference on a 0-to-1 scale (higher scores indicate stronger preference for vaginal delivery); those preferring cesarean delivery were assigned a value of 0. Data on clinical characteristics and delivery mode was obtained via telephone interview or chart review. Logistic regression was used to identify predictors of delivery mode among women who attempted a vaginal delivery. RESULTS Of 210 participants, 156 attempted a vaginal delivery. Their mean and median vaginal delivery preference scores were 0.70 (SD 0.31) and 0.75 (IQR 0.50–0.99), respectively. In multivariate analyses, women with a prior cesarean delivery (aOR 0.08, CI 0.02–0.39) or who delivered an infant ?4000 grams (aOR 0.04, CI 0.01–0.28) had significantly lower odds of having a vaginal delivery. After controlling for potential confounders, participants with a stronger preference for vaginal delivery were at significantly higher odds of having a vaginal delivery (aOR 1.54, CI 1.01–2.34 for every 0.2 increase on the 0-to-1 scale). CONCLUSION Among women who attempt a vaginal delivery, the strength of preference for vaginal birth is predictive of the delivery mode ultimately undergone. PMID:24246523

WU, Erica; KAIMAL, Anjali; HOUSTON, Kathryn; YEE, Lynn; NAKAGAWA, Sanae; KUPPERMANN, Miriam

2014-01-01

206

Urinary tract infection in vaginitis: a condition often overlooked.  

PubMed

Despite the differences between the organisms that cause vaginitis and urinary tract infections (UTI), it is possible that women with vaginitis develop UTI. The main objective of the study was to find the association of the common types of infectious vaginitis with UTI. Cross sectional study was conducted for six months in a referral hospital at Lalitpur, Nepal. Three hundred and sixmid-stream urine samples and high vaginal swabs (HVS) collected from non pregnant women were investigated by standard microbiological techniques. Among the women with bacterial vaginosis (BV), 75% also had UTI. Similarly, 46% and 13% of those with vaginal candidiasis and trichomoniasis respectively had concurrent UTI. Considering this strong association of UTI and vaginitis, women with either of these conditions should be tested for the other. PMID:24592798

Amatya, R; Bhattarai, S; Mandal, P K; Tuladhar, H; Karki, B M S

2013-03-01

207

Differential tissue-specific protein markers of vaginal carcinoma  

Microsoft Academic Search

The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant

K Hellman; A A Alaiya; S Becker; M Lomnytska; K Schedvins; W Steinberg; A-C Hellström; S Andersson; U Hellman; G Auer

2009-01-01

208

Protocols for Vaginal Inoculation and Sample Collection in the Experimental Mouse Model of Candida vaginitis  

PubMed Central

Vulvovaginal candidiasis (VVC), caused by Candida species, is a fungal infection of the lower female genital tract that affects approximately 75% of otherwise healthy women during their reproductive years18,32-34. Predisposing factors include antibiotic usage, uncontrolled diabetes and disturbance in reproductive hormone levels due to pregnancy, oral contraceptives or hormone replacement therapies33,34. Recurrent VVC (RVVC), defined as three or more episodes per year, affects a separate 5 to 8% of women with no predisposing factors33. An experimental mouse model of VVC has been established and used to study the pathogenesis and mucosal host response to Candida3,4,11,16,17,19,21,25,37. This model has also been employed to test potential antifungal therapies in vivo13,24. The model requires that the animals be maintained in a state of pseudoestrus for optimal Candida colonization/infection6,14,23. Under such conditions, inoculated animals will have detectable vaginal fungal burden for weeks to months. Past studies show an extremely high parallel between the animal model and human infection relative to immunological and physiological properties3,16,21. Differences, however, include a lack of Candida as normal vaginal flora and a neutral vaginal pH in the mice. Here, we demonstrate a series of key methods in the mouse vaginitis model that include vaginal inoculation, rapid collection of vaginal specimens, assessment of vaginal fungal burden, and tissue preparations for cellular extraction/isolation. This is followed by representative results for constituents of vaginal lavage fluid, fungal burden, and draining lymph node leukocyte yields. With the use of anesthetics, lavage samples can be collected at multiple time points on the same mice for longitudinal evaluation of infection/colonization. Furthermore, this model requires no immunosuppressive agents to initiate infection, allowing immunological studies under defined host conditions. Finally, the model and each technique introduced here could potentially give rise to use of the methodologies to examine other infectious diseases of the lower female genital tract (bacterial, parasitic, viral) and respective local or systemic host defenses. PMID:22215135

Yano, Junko; Fidel, Jr., Paul L.

2011-01-01

209

Systemic Effects of Vaginally Administered Estrogen Therapy: A Review  

PubMed Central

Hormone Therapy (HT) was considered the standard of care prior to the publication of the Women’s Health Initiative (WHI). After the study was published, the use of systemic HT dramatically decreased resulting in an increased incidence of menopausal symptoms such as hot flashes, vaginal dryness and dyspareunia experienced by women. Use of vaginal estrogen offers women a unique alternative for relief of these symptoms. This article reviews the systemic effects of vaginally administered estrogen. Effects on serum hormone levels, vasomotor symptoms, lipid profiles and use in women with breast cancer are reviewed. An accompanying review examines the local effects of vaginally administered estrogen. PMID:22453284

Krause, Megan; Wheeler, Thomas L.; Richter, Holly E.; Snyder, Thomas E.

2015-01-01

210

21 CFR 884.5940 - Powered vaginal muscle stimulator for therapeutic use.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Powered vaginal muscle stimulator for therapeutic use. 884...Devices § 884.5940 Powered vaginal muscle stimulator for therapeutic use. (a) Identification. A powered vaginal muscle stimulator is an electrically...

2014-04-01

211

75 FR 3745 - NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice  

Federal Register 2010, 2011, 2012, 2013, 2014

...Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice...Consensus Development Conference on Vaginal Birth After Cesarean: New Insights'' to be...it will be open to the public. Vaginal birth after cesarean (VBAC) is the...

2010-01-22

212

Behavioral Intervention Program versus Vaginal Cones on Stress Urinary Incontinence and Related Quality of Life: A Randomized Clinical Trial  

PubMed Central

Objective To compare the efficacy of behavioral intervention program and vaginal cones on stress urinary incontinence. Methods In this randomized clinical trial, 60 women aged 25-65 years with stress urinary incontinence were randomly divided into two groups, those who participated in a behavioral intervention program (n=30) and those who used vaginal cones (n=30). The women in the behavioral intervention group were instructed on pelvic floor exercise and bladder control strategies. In the other group, pelvic floor exercises were performed using the vaginal cones. All participants were treated for 12 weeks and followed-up every 2 weeks. The subjective changes in severity of stress urinary incontinence were measured using a detection stress urinary incontinence severity questionnaire, leakage index, and a 3-day urinary diary. The objective changes were measured by pad test. For better evaluation of the effects, two questionnaires were used: Incontinence Quality of Life and King’s Health Questionnaire. Results Among the 51 women who completed the study, 25 subjects were in the vaginal cones group and 26 participated in the behavioral intervention program. The changes in leakage rate on pad test and leakage index in the behavioral intervention program group were significantly higher than in the vaginal cones group (p=0.001 and p=0.008, respectively), but the severity of stress urinary incontinence was not significantly different between the two groups (p=0.2). The changes in strength of the pelvic floor, Incontinence Quality of Life, and King’s Health Questionnaire scores showed no significant differences between the two groups after 12 weeks of intervention. Conclusion Vaginal cones and behavioral intervention programs are both effective methods of treatment for mild to moderate stress urinary incontinence, but the behavioral intervention program is superior to vaginal cones in terms of cost-effectiveness and side effects. PMID:24498480

Golmakani, Nahid; Khadem, Nayereh; Arabipoor, Arezoo; Kerigh, Behzad Feizzadeh; Esmaily, Habibollah

2014-01-01

213

A Transitive Closure Algorithm  

Microsoft Academic Search

An algorithm is given for computing the transitive closure of a directed graph in a time no greater thana1N1n+a2n2 for largen wherea1 anda2 are constants depending on the computer used to execute the algorithm,n is the number of nodes in the graph andN1 is the number of arcs (not counting those arcs which are part of a cycle and not

Paul Walton Purdom Jr.

1970-01-01

214

Vault Prolapse II: Restoration of Dynamic Vaginal Supports by Infracoccygeal Sacropexy, an Axial Day-Case Vaginal Procedure  

Microsoft Academic Search

:   Our objective was to present and critically analyze the first 75 infracoccygeal sacropexy (ICS) operations for cure of vault\\u000a prolapse. Level 1 reconstruction was achieved by the insertion of a tension-free vaginal tape (nylon) via the ischiorectal\\u000a fossa into a transversely incised posterior vaginal fornix. Level 2 defects were repaired by cutting a central ‘bridge’ in\\u000a the posterior vaginal

P. E. Papa Petros

2001-01-01

215

Rheological properties of the anterior vaginal fluid from superovulated dairy heifers at estrus.  

PubMed

Anterior vaginal fluid samples were collected from 25 dairy heifers induced to superovulation at 12 to 20 hours after estrus detection. Thixotropy and flow behavior were evaluated. In samples from 19 heifers, structural variation was registered and the fluids were considered to be thixotropic; in the remaining samples (6 heifers), structural variation was not registered and the fluids were considered to be nonthixotropic. The mean estradiol concentration of the thixotropic fluids (20.8 pg/ml) was lower (P=0.0002) than of the nonthixotropic samples (56.7 pg/ml). All the nonthixotropic samples of anterior vaginal fluid exhibited Newtonian behavior. Of the 25 thixotropic anterior vaginal fluid samples, 10 exhibited Newtonian behavior while 9 exhibited non-Newtonian behavior. Heifers in which samples exhibited Newtonian behavior had a higher mean estradiol concentration (38.8 pg/ml; P=0.003) than heifers in which samples exhibited non-Newtonian behavior (12.8 pg/ml). Estradiol concentrations were correlated negatively (P=0.02) with the index of consistency (r = -0.46) and were not related to structural variation (P=0.08), although a certain tendency was shown. These results have shown that thixotropic and flow behavior measurements in the anterior vaginal fluid of superovulated estrous heifers vary over a wide range and even qualitatively. This variation is related to estrogen levels: Fluidity increases with increased plasma estrogen values, and the integrity of the gel structure tends toward elimination. PMID:16727303

López-Gatius, F; Miró, J; Sebastián, I; Ibarz, A; Labèrnia, J

1993-07-01

216

Effect of semen and seminal amyloid on vaginal transmission of simian immunodeficiency virus  

PubMed Central

Background Semen and semen-derived amyloid fibrils boost HIV infection in vitro but their impact on sexual virus transmission in vivo is unknown. Here, we examined the effect of seminal plasma (SP) and semen-derived enhancer of virus infection (SEVI) on vaginal virus transmission in the SIV/rhesus macaque (Macacca mulatta) model. Results A total of 18 non-synchronized female rhesus macaques (six per group) were exposed intra-vaginally to increasing doses of the pathogenic SIVmac239 molecular clone in the presence or absence of SEVI and SP. Establishment of productive virus infection was assessed by measuring plasma viral RNA loads at weekly intervals. We found that the first infections occurred at lower viral doses in the presence of SP and SEVI compared to the control group. Furthermore, the average peak viral loads during acute infection were about 6-fold higher after exposure to SP- and SEVI-treated virus. Overall infection rates after a total of 27 intra-vaginal exposures to increasing doses of SIV, however, were similar in the absence (4 of 6 animals) and presence of SP (5 of 6), or SEVI (4 of 6). Furthermore, the infectious viral doses required for infection varied considerably and did not differ significantly between these three groups. Conclusions Semen and SEVI did not have drastic effects on vaginal SIV transmission in the present experimental setting but may facilitate spreading of virus infection after exposure to low viral doses that most closely approximate the in vivo situation. PMID:24308721

2013-01-01

217

Vaginal fold histology reduces the variability introduced by vaginal exfoliative cytology in the classification of mouse estrous cycle stages  

PubMed Central

Vaginal exfoliative cytology is commonly used in biomedical and toxicological research to classify the stages of the rodent estrous cycle. However, mouse vaginal exfoliative cytology is commonly used as a stand-alone tool and has not been evaluated in reference to vaginal histology and serum sex hormone levels. In this study, the direct and Giemsa-stained methods of vaginal exfoliative cytology were compared in reference to vaginal fold histology and serum sex hormone levels. Both methods predicted the estrous stages similarly with mean discordance rates of 55%, 77%, 46% and 31%, for diestrus, proestrus, estrus and metestrus, respectively. From these results we conclude that vaginal exfoliative cytology may be used as a general guide to determine the desired estrous stage endpoint, and that a definitive confirmation of the estrous stage should obtained from evaluation of vaginal fold histology. Confirmation of the stage of the estrous cycle by vaginal fold histology will decrease the variability otherwise introduced by misclassification of estrous cycle stages with vaginal exfoliative cytology. PMID:24705880

Arnon, Gal; Po-Ching, Lin; Anne M, Barger; Amy L, MacNeill; CheMyong, Ko

2015-01-01

218

A New Wireless Biosensor for Intra-Vaginal Temperature Monitoring  

PubMed Central

Wireless Body Sensors for medical purposes offer valuable contributions to improve patients’ healthcare, including diagnosis and/or therapeutics monitoring. Body temperature is a crucial parameter in healthcare diagnosis. In gynecology and obstetrics it is measured at the skin’s surface, which is very influenced by the environment. This paper proposes a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in a Wireless Sensor Network (WSN) for remote data access and monitoring. We present the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used in different medical applications, including preterm labor prevention and fertility and ovulation period detection. The features of the constructed testbed were validated in laboratory tests verifying its accuracy and performance. PMID:22163471

Caldeira, João M. L. P.; Rodrigues, Joel J. P. C.; Garcia, João F. R.; de la Torre, Isabel

2010-01-01

219

Suture Closure versus Non-Closure of Subcutaneous Fat and Cosmetic Outcome after Cesarean Section: A Randomized Controlled Trial  

PubMed Central

Introduction To investigate the effect of subcutaneous fat suture closure versus non-closure at cesarean section (CS) on long-term cosmetic outcome. Material and Methods Women undergoing planned or unplanned CS were randomized to either subcutaneous fat suture closure or non-closure using a 1?1 allocation algorithm. Participants and outcome assessors were blinded to group allocation. Scar evaluation was performed after two and six months. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS) summary scores six months after surgery. Secondary outcome measures were Vancouver Scar Scale (VSS) summary scores, retraction of the scar below the level of the surrounding skin, duration of surgery, and development of hematoma, seroma, surgical site infection (SSI) or wound disruption. Data were analyzed according to the intention to treat principle. Results A total of 116 women were randomized and 91 participants, 47 in the closure and 44 in the non-closure group, completed the trial and were analyzed. There were no differences in patient morphometrics or surgery indications between groups. At two and six months no significant differences were found with respect to POSAS or VSS scores between groups. After two months significantly more women in the non-closure group described their scar as being retracted below the level of the skin (36% vs. 15%, p?=?0.02) whereas no difference was observed at six months. There were significantly more hematomas in the non-closure (25%) compared to the closure group (4%) (p?=?0.005). There was no difference in duration of surgery, SSI, seroma formation or wound disruption between groups. Conclusions Suture closure of the subcutaneous fat at CS does not affect long-term cosmetic outcome. (Level I evidence). Trial Registration ClinicalTrials.gov NCT01542346. PMID:25494177

Husslein, Heinrich; Gutschi, Martina; Leipold, Heinz; Herbst, Christoph; Franz, Maximilian; Worda, Christof

2014-01-01

220

Nevada Test Site closure program  

SciTech Connect

This report is a summary of the history, design and development, procurement, fabrication, installation and operation of the closures used as containment devices on underground nuclear tests at the Nevada Test Site. It also addresses the closure program mothball and start-up procedures. The Closure Program Document Index and equipment inventories, included as appendices, serve as location directories for future document reference and equipment use.

Shenk, D.P.

1994-08-01

221

Fibroepithelial vaginal polyp in a newborn  

PubMed Central

A fibroepithelial polyp of the vagina (FEPV) is a mucosal polypoid lesion with a connective tissue core covered by a benign squamous epithelium. A vaginal polyp must be considered in the evaluation of interlabial masses in prepubertal girls. This article describes a newborn girl with an interlabial mass that the histological analysis revealed to be an FEPV. Surgical excision of the mass was performed, and the patient has not experienced recurrence after 1-year of follow-up. A review of the literature revealed that our case was the third reported case of a fibroepithelial polyp in a neonate.

Alotay, Abdulhakim A.; Sarhan, Osama; Alghanbar, Mustafa; Nakshabandi, Ziyad

2015-01-01

222

Pathology Case Study: Bloody Vaginal Discharge  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman experienced bloody vaginal discharge long after menopause. Visitors are given both the microscopic pap smear and biopsy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

Dickson, H.

223

Update in management of vaginal mesh erosion.  

PubMed

Mesh erosion is one of the major complications of prolapse surgery conducted by transvaginal approach. Following the extensive use of meshes and warning about potential complications, a new classification of mesh-related adverse events has been proposed. Due to the wide scope of clinical features, no standardized approach has been proposed. Surgery is required after failure of conservative management, mostly based on mesh partial or total excision by transvaginal route, following the classic rules of re-do vaginal surgery. Complex cases are best managed in tertiary reference centers. PMID:23873511

Cornu, Jean-Nicolas; Peyrat, Laurence; Haab, François

2013-10-01

224

Microbiology of vaginal discharge in Nairobi, Kenya.  

PubMed Central

Among women attending a sexually transmitted disease (STD) clinic in Nairobi with vaginal discharge, Neisseria gonorrhoeae and Chlamydia trachomatis were isolated from the cervix in 32 (26%) of 122 and four (7%) of 58 women respectively. Infection with Trichomonas vaginalis, Candida albicans, Gardnerella vaginalis, and Mycoplasma spp were diagnosed in 42 of 122 (34%), 26 of 110 (24%), 75 of 100 (75%), and 42 of 89 (47%) women respectively. Mixed infections with at least two pathogens were found in 23 (26%) of 89 women examined for all microorganisms. Infection with N gonorrhoeae was significantly associated with abdominal pain. PMID:6405973

Mirza, N B; Nsanze, H; D'Costa, L J; Piot, P

1983-01-01

225

Vaginal mass following uncemented total hip arthroplasty  

PubMed Central

A 53-year-old woman developed a vaginal mass following an uncemented total hip arthroplasty. The mass was in direct communication with the hip through an acetabular medial wall defect after loosening of the acetabular component. The mass formation was caused simultaneously by changes secondary to polyethylene wear, a tiny delamination of the porous titanium mesh coating and a broken antirotational tab on the acetabular cup, all of which may have served as sources of metal particles. A careful evaluation of the patient's history, symptoms, X-ray findings and computed tomography scans should always be performed to ensure accurate diagnosis. PMID:25404779

Shin, Young-Soo; Jung, Tae-Wan; Han, Seung-Beom

2014-01-01

226

Vaginal "fisting" as a cause of death.  

PubMed

We describe the death of a young girl that resulted from the insertion of a clenched hand and forearm into her vagina during heterosexual activity. (The male homosexual practice of rectal fist insertion has been described previously.) We believe this death to be the first reported case of a "fisting" death due to vaginal fist insertion during heterosexual activity. This death is reported to alert forensic pathologists, medicolegal death investigators, and coroners aware of the role of aberrant sexual activity and its potential to cause death. PMID:2929548

Fain, D B; McCormick, G M

1989-03-01

227

System for closure of a physical anomaly  

DOEpatents

Systems for closure of a physical anomaly. Closure is accomplished by a closure body with an exterior surface. The exterior surface contacts the opening of the anomaly and closes the anomaly. The closure body has a primary shape for closing the anomaly and a secondary shape for being positioned in the physical anomaly. The closure body preferably comprises a shape memory polymer.

Bearinger, Jane P; Maitland, Duncan J; Schumann, Daniel L; Wilson, Thomas S

2014-11-11

228

Fluconazole Susceptibility of Vaginal Isolates Obtained from Women with Complicated Candida Vaginitis: Clinical Implications  

PubMed Central

Despite considerable evidence of azole resistance in oral candidiasis due to Candida species, little is known about the azole susceptibilities of the genital tract isolates responsible for vaginitis. The fluconazole susceptibilities of vaginal isolates obtained during a multicenter study of 556 women with complicated Candida vaginitis were determined by evaluating two fluconazole treatment regimens. Of 393 baseline isolates of Candida albicans, 377 (96%) were highly susceptible to fluconazole (MICs, <8 ?g/ml) and 14 (3.6%) were resistant (MICs, ?64 ?g/ml). Following fluconazole therapy, one case of in vitro resistance developed during 6 weeks of monitoring. In accordance with the NCCLS definition, in vitro fluconazole resistance correlated poorly with the clinical response, although a trend of a higher mycological failure rate was found (41 versus 19.6% on day 14). By using an alternative breakpoint of 1 ?g/ml, based upon the concentrations of fluconazole achievable in vaginal tissue, no significant differences in the clinical and mycological responses were observed when isolates (n = 250) for which MICs were ?1 ?g/ml were compared with isolates (n = 30) for which MICs were >1 ?g/ml, although a trend toward an improved clinical outcome was noted on day 14 (odds ratio, >2.7; 95% confidence interval, 0.91, 8.30). Although clinical failure was uncommon, symptomatic recurrence or mycological relapse almost invariably occurred with highly sensitive strains (MICs, <1.0 ?g/ml). In vitro fluconazole resistance developed in 2 of 18 initially susceptible C. glabrata isolates following fluconazole exposure. Susceptibility testing for women with complicated Candida vaginitis appears to be unjustified. PMID:12499165

Sobel, J. D.; Zervos, M.; Reed, B. D.; Hooton, T.; Soper, D.; Nyirjesy, P.; Heine, M. W.; Willems, J.; Panzer, H.

2003-01-01

229

Global Expression of Molecular Transporters in the Human Vaginal Tract: Implications for HIV Chemoprophylaxis  

PubMed Central

Background Pre-exposure chemoprophylaxis (PrECP) using antiretroviral agents is a promising strategy for the prevention of sexual HIV transmission in women. Molecular transporters in the human vaginal tract (VT) may play a pivotal role in determining drug disposition and, consequently, pharmacodynamic outcomes in these efforts. Little is known, however, on the expression of these transporters in vaginal tissues, representing a critical knowledge gap. Methodology/Principal Findings Our study analyzed the genome-wide transcriptome in 44 vaginal tissue samples from 6 reproductive-age women undergoing gynecologic surgeries. The analysis revealed that, unexpectedly, a large number (43%) of gene isoforms corresponding to membrane transporters were over-expressed (above the median expression level) in all samples. A subset of 12 highly expressed membrane transporters was identified and contained 10 members (83%) of the solute carrier superfamily. The largest difference in membrane transporter gene expression was observed across subjects, but more subtle differential expression also was found along the anterior-posterior axis of the VT. Cross-validation of the microarray analyses with measurements RT-qPCR demonstrated high concordance between these data sets. Immunofluorescence labeling of membrane transporter proteins in vaginal tissues was highly dependent on tissue/cell types. Conclusions/Significance Antiretroviral PrECP drugs currently under evaluation are substrates for molecular transporters that were commonly expressed, but fell into both over- or under-expressed categories in all samples, suggesting a complex role for carrier-mediated processes in determining the disposition of these xenobiotics in vaginal tissues. These findings hold important implications for the successful development of products, either oral or intravaginal, for female-controlled HIV PrECP. PMID:24143220

Gunawardana, Manjula; Mullen, Madeline; Moss, John A.; Pyles, Richard B.; Nusbaum, Rebecca J.; Patel, Jignesh; Vincent, Kathleen L.; Wang, Charles; Guo, Chao; Yuan, Yate-Ching; Warden, Charles D.; Baum, Marc M.

2013-01-01

230

Vaginal Eroticism and Female Orgasm: A Current Appraisal  

Microsoft Academic Search

In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and

Heli Alzate

1985-01-01

231

Gestational trophoblastic disease: the significance of vaginal metastases.  

PubMed

Six patients with gestational trophoblastic disease whose presenting symptom was hemorrhage from vaginal metastases are discussed. The clinical features, management, and response to treatment are outlined and it is suggested that the presence of vaginal metastases should be regarded as a poor prognostic factor and an indication for multiple cytotoxic agent chemotherapy. PMID:6313492

Bloch, B; Atad, J

1983-10-01

232

What Are the Risk Factors for Vaginal Cancer?  

MedlinePLUS

... know what causes vaginal cancer? What are the risk factors for vaginal cancer? A risk factor is anything that affects your chance of getting ... disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is ...

233

Vaginal delivery in patients with a prior cesarean section.  

PubMed

To assess the risks and benefits of vaginal delivery in patients with prior cesarean section, the English literature on this subject from 1950 to 1980 was reviewed. The following conclusions were reached: 1) Properly conducted vaginal delivery after cesarean section is relatively safe, with a 0.7% incidence of uterine rupture, 0.93 perinatal mortality, and no maternal deaths due to uterine rupture. 2) Of those patients allowed a trial of labor, 66.7% were successfully delivered vaginally. Successful vaginal delivery occurred in 74.2% of those patients with a nonrecurrent indication for their previous cesarean section and in 33.3% of those patients whose indication for previous cesarean section was cephalopelvic disproportion. Sixty-seven percent of those patients with a prior vaginal delivery versus 47.1% of those patients without a prior vaginal delivery subsequently delivered vaginally. 3) A classic uterine scar clearly increases the probability of uterine rupture. However, the precise magnitude of the increased risk cannot be accurately determined. 4) Certain basic safety requirements such as available operating room facilities and adequate personnel for careful observation are mandatory, but other management policies that remain controversial include use of regional anesthesia, oxytocin administration, timing of hospital admission, artificial rupture of membranes, mode of delivery, proper method to evaluate the uterine scar, and delivery of fetuses in breech presentation and twins. 5) A policy of selective vaginal deliveries among patients with prior cesarean sections will result in cost reductions due to decreased postpartum hospitalization. PMID:7078857

Lavin, J P; Stephens, R J; Miodovnik, M; Barden, T P

1982-02-01

234

Delayed Macular Hole Closure  

PubMed Central

Purpose The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods We present an interventional case report and a short review of the pertinent literature. Results We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible. PMID:24847257

Distelmaier, Peter; Meyer, Linda M.; Fischer, Marie T.; Philipp, Sebastian; Paquet, Patrick; Mammen, Antje; Haller, Katharina; Schönfeld, Carl-Ludwig

2014-01-01

235

Monitoring Vaginal Epithelial Thickness Changes Noninvasively in Sheep Using Optical Coherence Tomography  

PubMed Central

Objective High-resolution optical coherence tomography (OCT), can be used noninvasively to evaluate vaginal morphologic features, including epithelial thickness, to assess this protective barrier in transmission of sexually transmitted infections and to monitor tissue response to topical medications and hormonal fluctuations. We examined the utility of OCT to measure epithelial thickness noninvasively before and after topical treatment with a drug that causes epithelial thinning. Study Design Twelve female sheep were treated with intravaginal placebo (n=4) or nonoxynol-9 (n=8). Vaginal OCT images were obtained before and 24 hours after treatment. Four sheep in the nonoxynol-9 group were also examined on days 3 and 7. Vaginal biopsies were obtained on the last exam day. Epithelial thickness was measured in OCT images and in H&E-stained histological sections from biopsies. Statistical analysis was performed using ANOVA (significance p<0.05). Results Baseline OCT epithelial thickness measurements were similar (85±19 ?m placebo, 78±20 ?m nonoxynol-9; p=0.52). Epithelial thinning was significant after nonoxynol-9 (32±22 ?m) compared to placebo (80±15 ?m) 24 hours after treatment (p<0.0001). In the four nonoxynol-9-treated sheep followed for 7 days, epithelial thickness returned to baseline by day 3, and increased significantly on day 7. Epithelial thickness measurements from histology were not significantly different than OCT (p=0.98 N-9, p=0.93 HEC). Conclusion Drug-induced changes in the epithelium were clearly detectable using OCT imaging. OCT and histology epithelial thickness measurements were similar, validating OCT as a noninvasive method for epithelial thickness measurement, providing an important tool for quantitative and longitudinal monitoring of vaginal epithelial changes. PMID:23333551

VINCENT, Kathleen L.; VARGAS, Gracie; WEI, Jingna; BOURNE, Nigel; MOTAMEDI, Massoud

2013-01-01

236

8. Launch closure, closure track apron, tracks and track beam, ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Launch closure, closure track apron, tracks and track beam, view towards west - Ellsworth Air Force Base, Delta Flight, Launch Facility D-6, 4 miles north of Badlands National Park Headquarters, 4.5 miles east of Jackson County line on county road, Interior, Jackson County, SD

237

FINAL CLOSURE PLAN SURFACE IMPOUNDMENTS CLOSURE, SITE 300  

SciTech Connect

Lawrence Livermore National Laboratory of the University of California (LLNL) operates two Class II surface impoundments that store wastewater that is discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater is the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years has significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners are nearing the end of their service life. The purpose of this project is to clean close the surface impoundments and provide new wastewater storage using portable, above ground storage tanks at six locations. The tanks will be installed prior to closure of the impoundments and will include heaters for allowing evaporation during relatively cool weather. Golder Associates (Golder) has prepared this Final Closure Plan (Closure Plan) on behalf of LLNL to address construction associated with the clean closure of the impoundments. This Closure Plan complies with State Water Resources Control Board (SWRCB) Section 21400 of the California Code of Regulations Title 27 (27 CCR {section}21400). As required by these regulations and guidance, this Plan provides the following information: (1) A site characterization, including the site location, history, current operations, and geology and hydrogeology; (2) The regulatory requirements relevant to clean closure of the impoundments; (3) The closure procedures; and, (4) The procedures for validation and documentation of clean closure.

Lane, J E; Scott, J E; Mathews, S E

2004-09-29

238

Vaginal breech delivery: results of a prospective registration study  

PubMed Central

Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar?vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p?vaginal delivery group (p?vaginal group without long-term sequelae. PMID:23883361

2013-01-01

239

Development and characterization of a solid dispersion film for the vaginal application of the anti-HIV microbicide UAMC01398.  

PubMed

The purpose of this work was to design and evaluate a vaginal film delivery system for UAMC01398, a novel non-nucleoside reverse transcriptase inhibitor currently under investigation for use as an anti-HIV microbicide. UAMC01398 (1mg) films consisting of hydroxypropylmethylcellulose (HPMC) and polyethylene glycol 400 (PEG400) in different ratios were prepared by solvent evaporation. Based on its flexibility, softness and translucent appearance, the 30% PEG400 and 70% HPMC containing film was selected for further assessment. The vaginal film formulation was fast-dissolving (<10 min in 1 mL of vaginal fluid simulant), stable up to at least one month and safe toward epithelial cells and lactobacilli. Furthermore, formulating UAMC01398 into the film dosage form did not influence its antiviral activity. Powder X-ray diffraction revealed the amorphous nature of the UAMC01398 film, resulting in enhanced compound permeation across the epithelial HEC-1A cell layer, presumably owing to the induction of supersaturation. The in vivo vaginal tissue uptake of UAMC01398 in rabbits, as measured by systemic concentrations, was increased compared to the previously established non-solubilizing gel (significant difference) and sulfobutyl ether-?-cyclodextrin (5%) containing gel. To conclude, we identified a film formulation suitable for the vaginal delivery of UAMC01398. PMID:25175729

Grammen, Carolien; Van den Mooter, Guy; Appeltans, Bernard; Michiels, Johan; Crucitti, Tania; Ariën, Kevin K; Augustyns, Koen; Augustijns, Patrick; Brouwers, Joachim

2014-11-20

240

27 CFR 19.523 - Affixing closures.  

Code of Federal Regulations, 2013 CFR

...DEPARTMENT OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Liquor Bottle, Label, and Closure Requirements Closure Requirements § 19.523 Affixing closures. Each bottle or other container of spirits having a capacity of one...

2013-04-01

241

27 CFR 19.523 - Affixing closures.  

Code of Federal Regulations, 2014 CFR

...DEPARTMENT OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Liquor Bottle, Label, and Closure Requirements Closure Requirements § 19.523 Affixing closures. Each bottle or other container of spirits having a capacity of one...

2014-04-01

242

27 CFR 19.523 - Affixing closures.  

Code of Federal Regulations, 2012 CFR

...DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Liquor Bottle, Label, and Closure Requirements Closure Requirements § 19.523 Affixing closures. Each bottle or other container of spirits having a capacity of one...

2012-04-01

243

27 CFR 19.523 - Affixing closures.  

Code of Federal Regulations, 2011 CFR

...DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Liquor Bottle, Label, and Closure Requirements Closure Requirements § 19.523 Affixing closures. Each bottle or other container of spirits having a capacity of one...

2011-04-01

244

Perineal muscle strength during pregnancy and postpartum: the correlation between perineometry and digital vaginal palpation.  

PubMed

Digital vaginal palpation performed during clinical practice can help diagnose urinary, intestinal and sexual disorders, while perineometry is more useful for performing perineal exercises with biofeedback. This study verifies whether there is a correlation between values of Pelvic Floor Muscle Strength (PFMS) obtained through perineometry performed with an electronic perineometer and through digital vaginal palpation using the Oxford scale. This is a prospective cohort study with 330 measurements carried out in 110 women. Data were collected from 2007 to 2008 in the health service system in Itapecerica da Serra, São Paulo, Brazil. Evaluations were carried out at three points in time: up to 12 weeks of pregnancy; between 36-40 weeks; and between 42-60 days postpartum. The Spearman coefficient indicated a strong positive correlation between the two evaluation methods for the three evaluations (p<0.0001). The conclusion is that both methods are valid for measuring PFMS during pregnancy and after delivery. PMID:21340279

Riesco, Maria Luiza Gonzalez; Caroci, Adriana de Souza; de Oliveira, Sonia Maria Junqueira Vasconcellos; Lopes, Maria Helena Baena de Moraes

2010-01-01

245

SOLID CLOSURE by Melvin Hochster  

E-print Network

SOLID CLOSURE by Melvin Hochster In memory of my father, Lothar Hochster, April 20, 1906 -- February 17, 1991 Contents 1. Introduction 2. Solid modules and solid algebras 3. Formally solid modules and algebras 4. Generic forcing algebras 5. Solid closure 6. Minimal solid algebras 7. S­regular rings 8

Hochster, Melvin

246

Transapical access closure: the TA PLUG device†  

PubMed Central

OBJECTIVES Percutaneous closure of the transapical (TA) access site for large-calibre devices is an unsolved issue. We report the first experimental data on the TA PLUG device for true-percutaneous closure following large apical access for transcatheter aortic valve implantation. METHODS The TA PLUG, a self-sealing full-core closure device, was implanted in an acute animal study in six pigs (60.2 ± 0.7 kg). All the pigs received 100 IU/kg of heparin. The targeted activated clotting time was left to normalize spontaneously. After accessing the left ventricular apex with a 39 French introducer, the closure plug device was delivered with a 33 French over-the-wire system under fluoroscopic guidance into the apex. Time to full haemostasis as well as rate of bleeding was recorded. Self-anchoring properties were assessed by haemodynamic push stress under adrenalin challenge. An additional feasibility study was conducted in four pigs (58.4 ± 1.1 kg) with full surgical exposure of the apex, and assessed device anchoring by pull-force measurements with 0.5 Newton (N) increments. All the animals were electively sacrified. Post-mortem analysis of the heart was performed and the renal embolic index assessed. RESULTS Of six apical closure devices, five were correctly inserted and fully deployed at the first attempt. One became blocked in the delivery system and was placed successfully at the second attempt. In all the animals, complete haemostasis was immediate and no leak was recorded during the 5-h observation period. Neither leak nor any device dislodgement was observed under haemodynamic push stress with repeated left ventricular peak pressure of up to 220 mmHg. In the feasibility study assessing pull-stressing, device migration occurred at a force of 3.3 ± 0.5 N corresponding to 247.5 mmHg. Post-mortem analyses confirmed full expansion of all devices at the intended target. No macroscopic damage was identified at the surrounding myocardium. The renal embolic index was zero. CONCLUSIONS True-percutaneous left ventricular apex closure following large access is feasible with the self-sealing TA PLUG. The device allows for immediate haemostasis and a reliable anchoring in the acute animal setting. This is the first report of a true-percutaneous closure for large-calibre transcatheter aortic valve implantation access. PMID:23842759

Brinks, Henriette; Nietlispach, Fabian; Göber, Volkhard; Englberger, Lars; Wenaweser, Peter; Meier, Bernhard; Carrel, Thierry; Huber, Christoph

2013-01-01

247

Increases in clitoral and vaginal blood flow following clitoral and pelvic plexus nerve stimulations in the female rat.  

PubMed

The objective of this present study is to establish a model in the rat for the study of female clitoral and vaginal vascular changes during sexual excitation. A laser Doppler was used to measure blood flow changes following clitoral and pelvic plexus nerve stimulations. Results show an increase in clitoral blood flow following clitoral nerve (df1 = 12, df2 = 108, F = 21.4, P < 0.001) and pelvic plexus nerve stimulations (n = 3). A vaginal blood flow increase is also observed following pelvic plexus nerve stimulations (df1 = 12, df2 = 108, F = 4.75, P < 0.001). The female rat can therefore be used as a model for the study of the physiology, pharmacology and sexual dysfunction relating to blood flow in clitoral and vaginal tissue. PMID:10982313

Vachon, P; Simmerman, N; Zahran, A R; Carrier, S

2000-02-01

248

Lip interactions and closure duration in labial consonants  

NASA Astrophysics Data System (ADS)

This study examines interactions between the upper and lower lips in labial consonants where the duration of the oral closure is varied for linguistic purposes. Earlier work has shown that such interactions occur and that their magnitude is partly related to the duration of the oral closure. Lip movements were recorded in native Japanese speakers using a magnetometer system. Results show a positive correlation between the vertical positions of the upper and lower, when both are measured at the point in time where the lower lip reached its peak position during the oral closure. Since the peak vertical position of the lower lip increased with closure duration, the upper lip also had a higher vertical position at the same point in time for long than for short consonants. During the oral closure, the lower lip continued to move upward with a larger movement for long than for short consonants. Due to the mechanical interaction between the lips, the upper lip reversed its downward movement at the onset of the oral closure and also moved upward during the closure, again with a larger movement for long than for short consonants. [Work supported by NIH.

Lofqvist, Anders

2003-04-01

249

Effects of estroprogestins containing natural estrogen on vaginal flora.  

PubMed

Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG - Klaira®) in a quadriphasic regimen, while the other 30 women were administered 17-? estradiol with nomestrol acetate (EV+NOMAC - Zoely®) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs. PMID:24993504

De Seta, Francesco; Restaino, Stefano; Banco, Rubina; Conversano, Ester; De Leo, Rossella; Tonon, Maddalena; Maso, Gianpaolo; Barbati, Giulia; Lello, Stefano

2014-11-01

250

CPT-hole closure  

USGS Publications Warehouse

The long-term stability of deep holes 1.75 inches. (4.4 cm) in diameter by 98.4 feet (30 m) created by cone penetration testing (CPT) was monitored at a site in California underlain by Holocene and Pleistocene age alluvial fan deposits. Portions of the holes remained open both below and above the 28.6-foot (8.7 m)-deep water table for approximately three years, when the experiment was terminated. Hole closure appears to be a very slow process that may take decades in the stiff soils studied here. Other experience suggests holes in softer soils may also remain open. Thus, despite their small diameter, CPT holes may remain open for years and provide paths for rapid migration of contaminants. The observations confirm the need to grout holes created by CPT soundings as well as other direct-push techniques in areas where protection of shallow ground water is important.

Noce, T.E.; Holzer, T.L.

2003-01-01

251

A comparative study of Neo Sampoon, Ortho Vaginal Tablets and Emko Vaginal Tablets in Accra, Ghana.  

PubMed

Neo Sampoon is an effervescent contraceptive vaginal tablet manufactured in Japan that contains 60 mg of the spermicide menfegol. Ortho Vaginal Tablets (OVT) and Emko Vaginal Tablets (EVT), both containing 100 mg of the spermicide nonoxynol-9, were manufactured in the USA. The three products were compared in a randomized clinical trial conducted at the family planning clinics of the Korle-Bu Teaching Hospital and the Kotobaabi Polyclinic in Accra, Ghana. Three-hundred volunteers participated. At 12 months, the life-table pregnancy rates were 9.6, 11.3 and 12.5 per 100 women in the Neo Sampoon, OVT and EVT groups, respectively (p greater than 0.10). More EVT than Neo Sampoon or OVT users discontinued because of discomfort as well as for other product-related reasons (p less than 0.01). The most common reason for discontinuation was the temporary absence of sexual partner, with more than 40% of the women overall terminating for this reason. The 12-month life-table continuation rates per 100 women were higher for the Neo Sampoon group (62.4) than the OVT group (48.6) or the EVT group (38.5) (p less than 0.01). The effectiveness of the three products seems to be similar, but Neo Sampoon and OVT appear to be more acceptable than EVT in this Ghanaian population. PMID:3002720

Lamptey, P; Klufio, C; Smith, S C; Feldblum, P J

1985-11-01

252

A system-wide initiative to prevent retained vaginal sponges.  

PubMed

As any perinatal nurse knows, retained vaginal sponges are an obstetrical and postpartum patient safety problem. As surgical sponge counts are not routine in some obstetrical units for vaginal births, our healthcare system chose to institute a rigorous process to eliminate retained sponges in all vaginal births. This article describes this process, along with the lessons learned, when Catholic Healthcare West implemented the Sponge ACCOUNTing System in its 32 hospitals in California, Arizona, and Nevada. Implementation of this process involved the standardization of practice for obstetricians, certified nurse midwives, nurses, obstetric technicians, radiologists, and radiology technicians in the management and accounting of surgical sponges. PMID:21857202

Chagolla, Brenda A; Gibbs, Verna C; Keats, John P; Pelletreau, Barbara

2011-01-01

253

Improving Vaginal Examinations Performed by Midwives  

PubMed Central

A vaginal examination (VE) is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant, embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE) using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management of pain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE. PMID:23984031

Muliira, Rhoda S.; Seshan, Vidya; Ramasubramaniam, Shanthi

2013-01-01

254

Angle closure in younger patients.  

PubMed Central

PURPOSE: Angle-closure glaucoma is rare in children and young adults. Only scattered cases associated with specific clinical entities have been reported. We evaluated the findings in patients in our database aged 40 or younger with angle closure. METHODS: Our database was searched for patients with angle closure who were 40 years old or younger. Data recorded included age at initial consultation; age at the time of diagnosis; gender; results of slit-lamp examination, gonioscopy, and ultrasound biomicroscopy (from 1993 onward); clinical diagnosis; and therapy. Patients with previous incisional surgery were excluded, as were patients with anterior chamber proliferative mechanisms leading to angle closure. RESULTS: Sixty-seven patients (49 females, 18 males) met entry criteria. Mean age (+/- SD) at the time of consultation was 34.4 +/- 9.4 years (range, 3-68 years). Diagnoses included plateau iris syndrome (35 patients), iridociliary cysts (8 patients), retinopathy of prematurity (7 patients), uveitis (5 patients), isolated nanophthalmos (3 patients), relative pupillary block (2 patients), Weill-Marchesani syndrome (3 patients), and 1 patient each with Marfan syndrome, miotic-induced angle closure, persistent hyperplastic primary vitreous, and idiopathic lens subluxation. CONCLUSION: The etiology of angle closure in young persons is different from that in the older population and is typically associated with structural or developmental ocular anomalies rather than relative pupillary block. Following laser iridotomy, these eyes should be monitored for recurrent angle closure and the need for additional laser or incisional surgical intervention. PMID:12545694

Chang, Brian M; Liebmann, Jeffrey M; Ritch, Robert

2002-01-01

255

Minimizing genital tract trauma and related pain following spontaneous vaginal birth.  

PubMed

Genital tract trauma is common following vaginal childbirth, and perineal pain is a frequent symptom reported by new mothers. The following techniques and care measures are associated with lower rates of obstetric lacerations and related pain following spontaneous vaginal birth: antenatal perineal massage for nulliparous women, upright or lateral positions for birth, avoidance of Valsalva pushing, delayed pushing with epidural analgesia, avoidance of episiotomy, controlled delivery of the baby's head, use of Dexon (U.S. Surgical; Norwalk, CT) or Vicryl (Ethicon, Inc., Somerville, NJ) suture material, the "Fleming method" for suturing lacerations, and oral or rectal ibuprofen for perineal pain relief after delivery. Further research is warranted to determine the role of prenatal pelvic floor (Kegel) exercises, general exercise, and body mass index in reducing obstetric trauma, and also the role of pelvic floor and general exercise in pelvic floor recovery after childbirth. PMID:17467591

Albers, Leah L; Borders, Noelle

2007-01-01

256

Human epididymis protein 4 and secretory leukocyte protease inhibitor in vaginal fluid: relation to vaginal components and bacterial composition.  

PubMed

Human epididymis protein 4 (HE4) is a protease inhibitor and a recently identified serum biomarker for ovarian cancer. Properties of HE4 in the genital tract of healthy women have not been evaluated. We evaluated associations between HE4 and a second vaginal protease inhibitor, secretory leukocyte protease inhibitor (SLPI), with vaginal concentrations of innate immune mediators or proteases and with the types of vaginal bacterial communities. Vaginal secretions were collected from 18 healthy reproductive age women and assayed by enzyme-linked immunosorbent assay for concentrations of HE4, SLPI, kallikrein 5, cathepsin B, interleukin 1? (IL-1), IL-1 receptor antagonist (IL-1 ra), mannose-binding lectin (MBL), the inducible 70-kDa heat shock protein, and matrix metalloproteinase (MMP)-8. The species composition of vaginal bacterial communities in 16 women was characterized by sequencing amplicons derived from 16S bacterial ribosomal RNA genes. Correlations between any 2 assays were analyzed by the Spearman rank correlation tests. Differences in the concentrations of HE4 and SLPI, and between soluble components and vaginal community types, were analyzed by the Mann-Whitney U tests. Vaginal HE4 concentrations, but not SLPI levels, were positively correlated with levels of IL-1? (P = .0152), IL-1ra (P = .0061), MBL (P = .0100), and MMP-8 (P = .0315). The median vaginal HE4 level, as well as concentrations of MBL, IL-1?, IL-1ra, and MMP-8, was highest when Gardnerella vaginalis dominated a vaginal community. The association between HE4, elevated levels of proteases, immune mediators and high proportions of G vaginalis strongly suggests that HE4 is a component of the proinflammatory immune response in the female genital tract. PMID:24023032

Orfanelli, Theofano; Jayaram, Aswathi; Doulaveris, Georgios; Forney, Larry J; Ledger, William J; Witkin, Steven S

2014-04-01

257

Comparison of Abdominal Muscle Thickness with Vaginal Pressure Changes in Healthy Women  

PubMed Central

[Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5?years and that of Group II was 49.69?years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH2O in Group I, and at 20 cmH2O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles. PMID:24707099

Kim, Bo-In; Hwang-Bo, Gak; Kim, Ha-Roo

2014-01-01

258

Mouse estrous cycle regulation of vaginal versus uterine cytokines, chemokines, ?-/?-defensins and TLRs  

PubMed Central

This study investigates the cyclic changes in innate immunity in the female reproductive tract (FRT) of mice during the estrous cycle. By examining uterine and vaginal tissues and secretions we show that innate immunity varies with the stage of the estrous cycle and site in the FRT. Secretions from the uterine lumen contained cytokines and chemokines that were significantly higher at proestrus and estrus relative to that measured at diestrus. In contrast, analysis of vaginal secretions indicated that only IL-1? and CXCL1/mouse KC changed during the cycle, with highest levels measured at diestrus and estrus. In contrast, vaginal ?-defensin 2 and ?-defensins 1–4 mRNA levels peaked at proestrus and estrus and are expressed 1–4 logs greater than that seen in the uterus. These studies further indicate that TLR5 and TLR12 in the uterus, and TLR1, TLR2, TLR5 and TLR13 in the vagina varies with stage of the estrous cycle, with some peaking at proestrus/estrus and others at diestrus. Overall, these studies indicate that innate immune parameters in the uterus and vagina are separate and discrete, and regulated precisely during the estrous cycle. PMID:22855555

Hickey, Danica K; Fahey, John V; Wira, Charles R

2015-01-01

259

Closure report for N Reactor  

SciTech Connect

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

Not Available

1994-01-01

260

Autocracy bias in informal groups under need for closure.  

PubMed

Two experiments investigated the tendency of groups with members under high (vs. low) need for cognitive closure to develop an autocratic leadership structure in which some members dominate the discussion, constitute the "hubs" of communication, and influence the group more than other members. The first experiment found that high (vs. low) need for closure groups, as assessed via dispositional measure of the need for closure, manifested greater asymmetry of conversational floor control, such that members with autocratic interactional style were more conversationally dominant and influential than less autocratic members. The second experiment manipulated the need for closure via time pressure and utilized a social network analysis. Consistent with expectation, groups under time pressure (vs. no pressure) showed a greater asymmetry of participation, of centrality, and of prestige among the group members, such that the more focal members were perceived to exert the greater influence over the groups' decisions. PMID:15273017

Pierro, Antonio; Mannetti, Lucia; De Grada, Eraldo; Livi, Stefano; Kruglanski, Arie W

2003-03-01

261

Closure of fatigue cracks at high strains  

NASA Technical Reports Server (NTRS)

Experiments were conducted on smooth specimens to study the closure behavior of short cracks at high cyclic strains under completely reversed cycling. Testing procedures and methodology, and closure measurement techniques, are described in detail. The strain levels chosen for the study cover from predominantly elastic to grossly plastic strains. Crack closure measurements are made at different crack lengths. The study reveals that, at high strains, cracks close only as the lowest stress level in the cycle is approached. The crack opening is observed to occur in the compressive part of the loading cycle. The applied stress needed to open a short crack under high strain is found to be less than for cracks under small scale yielding. For increased plastic deformations, the value of sigma sub op/sigma sub max is observed to decrease and approaches the value of R. Comparison of the experimental results with existing analysis is made and indicates the limitations of the small scale yielding approach where gross plastic deformation behavior occurs.

Iyyer, N. S.; Dowling, N. E.

1985-01-01

262

[The meshes in the cure of cystocele by vaginal way].  

PubMed

The advantages of vaginal way in the treatment of cystocele are simplicity, rapidity, peritoneal security. Raphy is subject to recidive. The meshes replace the weak fascia in its role of hammock (Delancey) for the bladder. The mesh covers the central and lateral fascial defects. The procedure consists in a short vertical colpotomy, vesicovaginal dissection, uterine preservation (if uterus is not pathologic), no vaginal excision. The mesh can be spread without fixation, fixed or anchored by arms in the obturator foramen. The results show a significative improvement in the risk of redux cystocele. Complications become less frequent with the expertise and quality of new meshes. Implants are a new vaginal evolving surgery: it must be evaluated by experts and practiced by experienced in vaginal approach surgeons. PMID:19969274

Delmas, V; Haab, F; Costa, P

2009-12-01

263

Martius graft for management of exposed vaginal prolapse mesh.  

PubMed

Although the use of vaginal mesh kits in treatment of pelvic organ prolapse (POP) has decreased the number of surgical failures, mesh exposure can occur. When conservative management fails, removing the exposed material is associated with the risk of recurrence of POP and could be challenging. We report a successful outcome of treatment of exposed mesh via use of a Martius bulbocavernosus fat pad. A 46-year-old woman had urinary incontinence and POP, which was treated using a vaginal mesh kit and tension-free vaginal tape. At 2 months after the procedure, the mesh was found to be exposed. After failed conservative management, use of a Martius graft was used, with preservation of the mesh. At 2-, 5-, and 10-month follow-up, the patient was completely asymptomatic and continent. This procedure may be a practical alternative in patients with synthetic mesh-induced vaginal erosion after failed conservative management. PMID:23295200

Al-Badr, Ahmed

2013-01-01

264

Mucus-penetrating nanoparticles for vaginal and gastrointestinal drug delivery  

NASA Astrophysics Data System (ADS)

A method that could provide more uniform and longer-lasting drug delivery to mucosal surfaces holds the potential to greatly improve the effectiveness of prophylactic and therapeutic approaches for numerous diseases and conditions, including sexually transmitted infections and inflammatory bowel disease. However, the body's natural defenses, including adhesive, rapidly cleared mucus linings coating nearly all entry points to the body not covered by skin, has limited the effectiveness of drug and gene delivery by nanoscale delivery systems. Here, we investigate the use of muco-inert mucus-penetrating nanoparticles (MPP) for improving vaginal and gastrointestinal drug delivery. Conventional hydrophobic nanoparticles strongly adhere to mucus, facilitating rapid clearance from the body. Here, we demonstrate that mucoadhesive polystyrene nanoparticles (conventional nanoparticles, CP) become mucus-penetrating in human cervicovaginal mucus (CVM) after pretreatment with sufficient concentrations of Pluronic F127. Importantly, the diffusion rate of large MPP did not change in F127 pretreated CVM, implying there is no affect on the native pore structure of CVM. Additionally, there was no increase in inflammatory cytokine release in the vaginal tract of mice after daily application of 1% F127 for one week. Importantly, HSV virus remains adherent in F127-pretreated CVM. Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that hypotonically-induced fluid uptake could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We evaluated hypotonic formulations for delivering water-soluble drugs and for drug delivery with MPP. Hypotonic formulations markedly increased the rate at which drugs and MPP reached the epithelial surface. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that isotonic formulations failed to reach. However, hypotonic formulations caused free drugs to be drawn through the epithelium, reducing vaginal retention. In contrast, hypotonic formulations caused MPP to accumulate rapidly and uniformly on vaginal surfaces, ideally positioned for sustained drug delivery. Using a mouse model of vaginal genital herpes (HSV-2) infection, we found that hypotonic delivery of free drug led to improved immediate protection, but diminished longer-term protection. Minimally hypotonic formulations provided rapid and uniform delivery of MPP to the entire vaginal surface, thus enabling formulations with minimal risk of epithelial toxicity. We then describe an ex vivo method for characterizing particle transport on freshly excised mucosal tissues. By directly observing MPP transport on vaginal, gastrointestinal, and respiratory tissue, we were able to determine an innate difference in mucus mesh size at different anatomical locations. In addition, we were able to optimize particle size for gastrointestinal delivery in mice. As described here, there are numerous barriers to effective drug delivery in the gastrointestinal tract, including the mucus barrier. We go on to demonstrate that MPP can improve delivery in the gastrointestinal tract, both by rectal and oral administration. Finally, we describe the use of MPP for improving vaginal drug delivery. Incomplete drug coverage and short duration of action limit the effectiveness of vaginally administered drugs, including microbicides for preventing sexually transmitted infections. We show that MPP provide uniform distribution over the vaginal epithelium, whereas CP are aggregated by mouse vaginal mucus, leading to poor distribution. By penetrating into the deepest mucus layers in the rugae, more MPP were retained in the vaginal tract compared to CP. After 24 h, when delivered in a conventional vaginal gel, patches of a model drug remained on the vaginal epithelium, whereas the epithelium was coated with drug delivered by MPP. We then demonstrate that when administered 30 min prior to inoculum, anti-HSV-2 MPP protected

Ensign-Hodges, Laura

265

Vaginal pH: Home-Use Tests  

MedlinePLUS

... provide a more thorough assessment of your vaginal status through your history, physical exam, and other laboratory tests than you can using a single pH test in your home. Useful Links MedlinePlus: ...

266

Trichomoniasis as Seen in a Chronic Vaginitis Clinic  

PubMed Central

Objective: We sought to determine the clinical and laboratory features of trichomonas vaginitis (TV) in a chronic vaginitis clinic. Methods: We studied 45 women with symptomatic TV attending a specialty chronic vaginitis clinic. These patients were older than the usual symptomatic patients with TV. They frequently described unusual chronicity of symptoms, half being referred because of clinical resistance and the other half referred because of chronic vaginitis of unknown etiology. Results: In spite of the chronicity of infection, the signs and symptoms of florid inflammation were still evident and high numbers of polymorphonuclear leukocytes and parasitic load were present. Conclusions: A longstanding infection, especially if previously untreated, invariably responded to conventional nitroimidazole therapy. In addition, the majority of patients seen with clinical resistance to the conventional doses of metronidazole responded to high-dose oral metronidazole therapy. Unsuspected TV should always be considered in low-risk patients with chronic vulvovaginal symptoms. PMID:18476071

Dan, Michael

1996-01-01

267

HPV-Associated Vaginal Cancer Rates by Race and Ethnicity  

MedlinePLUS

... Is Doing Related Links Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ... Cancer Home HPV-Associated Vaginal Cancer Rates by Race and Ethnicity Language: English Español (Spanish) Recommend on ...

268

Management of Vaginal Atrophy: Implications from the REVIVE Survey  

PubMed Central

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA. PMID:24987271

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

269

Diversity of the Vaginal Microbiome Correlates With Preterm Birth  

PubMed Central

Reproductive tract infection is a major initiator of preterm birth (PTB). The objective of this prospective cohort study of 88 participants was to determine whether PTB correlates with the vaginal microbiome during pregnancy. Total DNA was purified from posterior vaginal fornix swabs during gestation. The 16S ribosomal RNA gene was amplified using polymerase chain reaction primers, followed by chain-termination sequencing. Bacteria were identified by comparing contig consensus sequences with the Ribosomal Database Project. Dichotomous responses were summarized via proportions and continuous variables via means ± standard deviation. Mean Shannon Diversity index differed by Welch t test (P = .00016) between caucasians with PTB and term gestation. Species diversity was greatest among African Americans (P = .0045). Change in microbiome/Lactobacillus content and presence of putative novel/noxious bacteria did not correlate with PTB. We conclude that uncultured vaginal bacteria play an important role in PTB and race/ethnicity and sampling location are important determinants of the vaginal microbiome. PMID:23715799

Hyman, Richard W.; Fukushima, Marilyn; Jiang, Hui; Fung, Eula; Rand, Larry; Johnson, Brittni; Vo, Kim Chi; Caughey, Aaron B.; Hilton, Joan F.; Davis, Ronald W.; Giudice, Linda C.

2014-01-01

270

Massive Delayed Vaginal Hemorrhage after Laparoscopic Supracervical Hysterectomy  

PubMed Central

Background. A known complication of supracervical hysterectomy is cyclical bleeding from the retained cervix when functioning endometrial tissue is not totally removed. We present a rare case of delayed postoperative vaginal hemorrhage after supracervical hysterectomy. Case. A 44-year-old woman presented on postoperative day 15 after laparoscopic supracervical hysterectomy with massive vaginal hemorrhage requiring emergent re-operation. Her bleeding was controlled with vaginally placed sutures. Ultrasound confirmed no intraperitoneal free fluid. The etiology was thought to be induced by postoperative tissue necrosis from cautery applied to the endocervical canal during the original surgery. Conclusion. Delayed vaginal hemorrhage from a retained cervix is a rare complication of laparoscopic supracervical hysterectomy. Caution should be exercised when cauterizing the endocervical canal as induced tissue necrosis may increase the risk of postoperative bleeding. PMID:22919525

Holloran-Schwartz, M. Brigid; Potter, Shannon J.; Kao, Ming-Shian

2012-01-01

271

Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy  

PubMed Central

Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function. PMID:25379314

Pieh-Holder, Kelly L.; DeVente, James E.

2014-01-01

272

ANNOUNCES CLOSURE ALERT ON SEARSVILLE ROAD  

E-print Network

ANNOUNCES CLOSURE ALERT ON SEARSVILLE ROAD AUGUST 29 ­ OCTOBER 3, 2014 The Department of Environmental Health and Safety (EH&S) would like to alert the Stanford community and public to a road closure&S Access Road Closure Alert! Aug. 29 ­ Oct. 3 Searsville Rd. Blocked EH&S Access Only Sta STANFORD CAMPUS

273

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

SciTech Connect

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions.

Supe, Sanjay S. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)], E-mail: sanjayssupe@gmail.com; Bijina, T.K.; Varatharaj, C.; Shwetha, B.; Arunkumar, T.; Sathiyan, S.; Ganesh, K.M.; Ravikumar, M. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)

2009-04-01

274

Rate of Vaginal Cuff Separation Following Laparoscopic or Robotic Hysterectomy  

PubMed Central

Objective Vaginal cuff separation is a rare but serious complication following hysterectomy. The goal of our study was to determine the rate of vaginal cuff separation and associated risk factors in patients undergoing laparoscopic or robotic hysterectomy. Methods We retrospectively identified patients who underwent a minimally invasive simple or radical hysterectomy at one institution between January 2000 and 2009. Fisher's exact test, Wilcoxon rank sum test and multiple logistic regression was used to determine associations between variables and increased risk of separation. Results A total of 417 patients underwent laparoscopic (n=285) or robotic (n=132) hysterectomy during the study period. Three hundred and sixty-two underwent simple hysterectomy (249 laparoscopic, 113 robotic) and 57 underwent radical hysterectomy (36 laparoscopic, 19 robotic). Seven (1.7%) patients developed a cuff complication and all had a diagnosis of malignancy. Three (1.1%) patients in the laparoscopy group suffered a vaginal cuff evisceration (n=2) or separation (n=1). Four patients in the robotic group (3.0%) had a vaginal evisceration (n=1) or separation (n=3). There was no difference based on surgical approach (p=0.22). Vaginal cuff complications were 9.46-fold higher among patients who had a radical hysterectomy (p<0.01). Median time to presentation of vaginal cuff complication was 128 days (58–175) in the laparoscopy group and 37 days (range: 32–44) in the robotic group. Conclusions The overall risk of vaginal cuff complication was 1.7%. There appears to be no difference in cuff complication rates based on surgical approach. Radical hysterectomy, however, was associated with a 9-fold increase in vaginal cuff complications. PMID:20869763

Nick, Alpa M.; Lange, Jimena; Frumovitz, Michael; Soliman, Pamela T.; Schmeler, Kathleen M.; Schlumbrecht, Matthew P.; dos Reis, Ricardo; Ramirez, Pedro T.

2015-01-01

275

Management of Vaginal Erosion of Polypropylene Mesh Slings  

Microsoft Academic Search

PurposeThe SPARC (American Medical Systems, Minneapolis, Minnesota) polypropylene sling has recently been introduced as an alternative delivery system to TVT (Ethicon, New Brunswick, New Jersey) tension-free vaginal tape for placement of a tension-free mid urethral sling. Erosion must always be considered a risk of synthetic materials. We present 4 cases of vaginal erosion of polypropylene mesh placed with this system

KATHLEEN C. KOBASHI; FRED E. GOVIER

2003-01-01

276

Robotic removal of eroded vaginal mesh into the bladder.  

PubMed

Vaginal mesh erosion into the bladder after midurethral sling procedure or cystocele repair is uncommon, with only a few cases having been reported in the literature. The ideal surgical management is still controversial. Current options for removal of eroded mesh include: endoscopic, transvaginal or abdominal (either open or laparoscopic) approaches. We, herein, present the first case of robotic removal of a large eroded vaginal mesh into the bladder and discuss potential benefits and limitations of the technique. PMID:23600850

Macedo, Francisco Igor B; O'Connor, Jeffrey; Mittal, Vijay K; Hurley, Patrick

2013-11-01

277

Ileal pouch vaginal fistulas: Incidence, etiology, and management  

Microsoft Academic Search

Some of the initial problems associated with the ileonal reservoir have been solved. In their place, other complications have\\u000a been recognized. Among these, the ileal pouch vaginal fistula stands out as a recently recognized difficult management problem.\\u000a This multicenter study was undertaken to gain insight into the causes for, and treatment of, pouch vaginal fistulas. Cases\\u000a were gathered from 11

Steven D. Wexner; David A. Rothenberger; Linda Jensen; Stanley M. Goldberg; Emmanuel G. Balcos; Paul Belliveau; Bradley H. Bennett; John G. Buls; Jeffrey M. Cohen; Harold L. Kennedy; Steven J. Medwell; Theodore M. Ross; David J. Schoetz; Lee E. Smith; Alan G. Thorson

1989-01-01

278

Urinary and vaginal criteria for detecting ovulation in the mare  

E-print Network

, anger, anxiety, etc. cause an inczeased secretion of epinephrine which leads to glycogen mobilization and resultant nervous glyco- suria. Cunningham and Friend (1965) demonstrated this nervous glycosuzia in pigs. Normal blood glucose levels of 94 mg... the secretory phase of the human menstrual cycle. Sexual stimulation also increases the quantity of vaginal fluid, according to PLasters (1959). In 1934 Cruickshsnk postulated that glycogenolysis occurs in living vaginal cells and stated that a glycogen...

Householder, D. Douglas

1973-01-01

279

Vaginal vault prolapse following cystectomy: transvaginal reconstruction by mesh interposition.  

PubMed

The present study aims to introduce a transvaginal interposition of polypropylene mesh as a reproducible procedure for women with vaginal vault prolapse following cystectomy due to bladder carcinoma. No recurrent prolapse occurred in two cases 16 and 4 months after the operation. With apical fixation of the mesh, vaginal length can be maintained. No perioperative complications appeared. Performing the technique in a reproducible way seems feasible irrespective of differing anatomical conditions. PMID:22955251

Graefe, Flora; Beilecke, Kathrin; Tunn, Ralf

2013-08-01

280

Bioadhesive Mini-Tablets for Vaginal Drug Delivery  

PubMed Central

Different non-ionic cellulose ethers (methyl cellulose, MC; hydroxyethyl cellulose, HEC; hydroxypropyl cellulose, HPC; hydroxypropylmethyl cellulose, HPMC) and microcrystalline cellulose (MCC) were investigated as matrix formers for preparation of mini-tablets targeting vaginal drug delivery. Hexyl aminolevulinat hydrochloridum (HAL) was used as a model drug. The mini-tablets were characterized with respect to their mechanical strength, bioadhesion towards cow vaginal tissue in two independent tests (rotating cylinder test, detachment test using texture analyzer), and dissolution rate in two media mimicking the pH levels of fertile, healthy and post-menopausal women (vaginal fluid simulant pH 4.5, phosphate buffer pH 6.8). Mini-tablets with a matrix of either HPMC or HPC were found to possess adequate mechanical strength, superior bioadhesive behavior towards vaginal tissue, and pH independent controlled release of the model drug, suggesting that both systems would be suited for the treatment of women regardless of age, i.e., respective of their vaginal pH levels. Bioadhesive mini-tablets offer a potential for improved residence time in the vaginal cavity targeting contact with mucosal tissue and prolonged release of the drug. PMID:25166286

Hiorth, Marianne; Nilsen, Susanne; Tho, Ingunn

2014-01-01

281

Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus.  

PubMed

This study investigated the roles of vaginal spasm, pain, and behavior in vaginismus and the ability of psychologists, gynecologists, and physical therapists to agree on a diagnosis of vaginismus. Eighty-seven women, matched on age, relationship status, and parity, were assigned to one of three groups: vaginismus, dyspareunia resulting from vulvar vestibulitis syndrome (VVS), and no pain with intercourse. Diagnostic agreement was poor for vaginismus; vaginal spasm and pain measures did not differentiate between women in the vaginismus and dyspareunia/VVS groups; however, women in the vaginismus group demonstrated significantly higher vaginal/pelvic muscle tone and lower muscle strength. Women in the vaginismus group also displayed a significantly higher frequency of defensive/avoidant distress behaviors during pelvic examinations and recalled past attempts at intercourse with more affective distress. These data suggest that the spasm-based definition of vaginismus is not adequate as a diagnostic marker for vaginismus. Pain and fear of pain, pelvic floor dysfunction, and behavioral avoidance need to be included in a multidimensional reconceptualization of vaginismus. PMID:14739686

Reissing, Elke D; Binik, Yitzchak M; Khalifé, Samir; Cohen, Deborah; Amsel, Rhonda

2004-02-01

282

Anatomic study of vaginal width in male-to-female transsexual surgery.  

PubMed

Despite the recent improvement in the design of male-to-female sex reassignment operations to enlarge the vaginal vault and depth, the size of the neovagina remains somewhat limited and the exterior of the neovagina may be compressed by the bony structure of pubic rami. The purpose of this study was to determine by anatomic study the possible cause of this limitation. Eighteen male and 10 female cadavers were dissected to measure the distance between the bilateral bony pubic rami (interramic distance) at a level that corresponds to the same level in the vaginal canal of females. At the same level of the vaginal canal in the female, which corresponds to the lower border of the prostate in the male, empirically 3 cm below the bony symphysis pubis, the mean value of the interramic distance was 3.95 +/- 0.25 cm in the male and 5.20 +/- 0.36 cm in the female (p = 0.000). The interramic distance in the male and female is significantly different. In those who have undergone the male-to-female transsexual operation, the newly structured vagina may be ventrolaterally limited. Several factors cause narrowing of the vaginal orifice in male-to-female transsexuals. On the basis of this study, it seems that the bony structure of the pubic rami compresses the vagina ventrolaterally. This finding may suggest refinements of the structural design of the neovagina and prompt procedural changes in male-to-female sex reassignment operations. Future investigation should be directed toward modifying vaginoplasty so that neovaginal width can be increased to the patient's satisfaction. PMID:12900609

Fang, Rong-Hwang; Chen, Tzyy-Jiin; Chen, Tien-Hua

2003-08-01

283

Homogeneity of the vaginal microbiome at the cervix, posterior fornix, and vaginal canal in pregnant Chinese women.  

PubMed

The vaginal microbiome is an emerging concern in prenatal health. Because the sampling process of vaginal microbiota may pose potential risks for pregnant women, the choice of sampling site should be carefully considered. However, whether the microbial diversity is different across various sampling sites has been controversial. In the present study, three repeated swabs were collected at the cervix (C), posterior fornix (P), and vaginal canal (V) from 34 Chinese women during different pregnancy stages, and vaginal species were determined using the Illumina sequencing of 16S rRNA tag sequences. The identified microbiomes were classified into four community state types (CSTs): CST I (dominated by L. crispatus), CST II (dominated by L. gasseri), CST III (dominated by L. iners), and CST IV-A (characterized by a low abundance of Lactobacillus, but with proportions of various species previously shown to be associated with bacterial vaginosis). All individuals had consistent CST at the three sampling sites regardless of pregnancy stage and CST group. In addition, there was little heterogeneity across community structures within each individual, as determined by LEfSe, indicating high vaginal microbiome homogeneity at the three sampling sites. The present study also revealed different beta diversity during pregnancy stages. The vaginal microbiome variation among women during trimester T1 (9?±?2.6 weeks) is larger than that of non-pregnant women and women from other trimesters, as demonstrated by the UniFrac distance (P?vaginal microbiome of postpartum women compare to women in gestation. These results will be useful for future studies of the vaginal microbiota during pregnancy. PMID:25230887

Huang, Yi-E; Wang, Yan; He, Yan; Ji, Yong; Wang, Li-Ping; Sheng, Hua-Fang; Zhang, Min; Huang, Qi-Tao; Zhang, Dong-Jing; Wu, Jing-Jing; Zhong, Mei; Zhou, Hong-Wei

2015-02-01

284

Management of recto-vaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse  

PubMed Central

AIM: To communicate our findings on successful treatment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with prosthetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febrile episodes. These symptoms were reported after a mean period of 18 mo after POP repair. As a first intervention, three patients underwent ablation of the prosthetic material (PM). As a second intervention, open proctectomy with a primary anastomosis, an omental patch, and a protective ileostomy were performed in two patients. One patient required a terminal colostomy due to complete destruction of the anal sphincters. In two other patients, ablation of the PM and proctectomy was performed as a one-step procedure. The postoperative course in all patients was uneventful, with a mean length of hospitalization of 20 d (range: 15-30). Closure of the ileostomy was achieved in all four patients within four months. After a mean period of 35 mo (range: 4-60) of follow-up, no recurrence was observed with normal continence in four patients. CONCLUSION: In our experience, the definitive treatment of high RVFs after PM repair for POP necessitates ablation of the PM, proctectomy with a primary colo-rectal anastomosis, an omental patch interposition, and a temporary ileostomy. PMID:20572304

Ouaïssi, Mehdi; Cresti, Silvia; Giger, Urs; Sielezneff, Igor; Pirrò, Nicolas; Berthet, Bruno; Grandval, Philippe; Consentino, Bernard; Sastre, Bernard

2010-01-01

285

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2012 CFR

... INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 265.258 Closure and post-closure care. (a) At closure, the owner or operator must remove or...

2012-07-01

286

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2014 CFR

... INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 265.258 Closure and post-closure care. (a) At closure, the owner or operator must remove or...

2014-07-01

287

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2011 CFR

... INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 265.258 Closure and post-closure care. (a) At closure, the owner or operator must remove or...

2011-07-01

288

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2010 CFR

... INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 265.258 Closure and post-closure care. (a) At closure, the owner or operator must remove or...

2010-07-01

289

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

... INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 265.258 Closure and post-closure care. (a) At closure, the owner or operator must remove or...

2013-07-01

290

Composition of the Vaginal Microbiota in Women of Reproductive Age – Sensitive and Specific Molecular Diagnosis of Bacterial Vaginosis Is Possible?  

PubMed Central

Background and Objective Bacterial vaginosis (BV) is the most common vaginal disorder, characterized by depletion of the normal lactobacillus-dominant microbiota and overgrowth of commensal anaerobic bacteria. This study aimed to investigate the composition of the vaginal microbiota in women of reproductive age (healthy women and women with BV), with the view of developing molecular criteria for BV diagnosis. Materials and Methods Vaginal samples from 163 women (79 control, 73 BV and 11 intermediate (Lactobacillary grade II flora) cases) were analyzed using 454 pyrosequencing of the hypervariable regions V3–V4 of the 16S rRNA gene and 16 quantitative bacterial species/genus-specific real-time PCR assays. Sensitivities and specificities of potential BV markers were computed using the Amsel criteria as reference standard for BV. The use of quantitative thresholds for prediction of BV, determined for both relative abundance measured with 454 pyrosequencing and bacterial load measured with qPCR, was evaluated. Results Relative to the healthy women, the BV patients had in their vaginal microbiota significantly higher prevalence, loads and relative abundances of the majority of BV associated bacteria. However, only Gardnerella vaginalis, Atopobium vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 detected at or above optimal thresholds were highly predictable for BV, with the best diagnostic accuracy shown for A. vaginae. The depletion of Lactobacillus species combined with the presence of either G. vaginalis or A. vaginae at diagnostic levels was a highly accurate BV predictor. Conclusions Quantitative determination of the presence of G. vaginalis, A. vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Measurements of abundance of normal and BV microbiota relative to total bacteria in vaginal fluid may provide more accurate BV diagnosis, and be used for test-of-cure, rather than qualitative detection or absolute counts of BV related microorganisms. PMID:23585843

Shipitsyna, Elena; Roos, Annika; Datcu, Raluca; Hallén, Anders; Fredlund, Hans; Jensen, Jørgen S.; Engstrand, Lars; Unemo, Magnus

2013-01-01

291

Inflammation biomarkers in vaginal fluid and preterm delivery  

PubMed Central

STUDY QUESTION Which inflammation biomarkers detected in the vaginal fluid are most informative for identifying preterm delivery (PTD) risk? SUMMARY ANSWER Elevated interleukin (IL)-6 at mid-trimester was associated with increased odds of spontaneous PTD at <35 weeks and with PTD plus histologic chorioamnionitis (HCA), and had the greatest sensitivity for detecting these two PTD subtypes. WHAT IS KNOWN ALREADY Maternal and/or fetal inflammation play a role in some preterm deliveries, therefore inflammation biomarkers might help to identify women at greater risk. STUDY DESIGN, SIZE, DURATION We examined 1115 women from the Pregnancy Outcomes and Community Health Study, a cohort study conducted from September 1998 through June 2004, for whom data were available on mid-pregnancy inflammatory biomarkers. PARTICIPANTS/MATERIALS, SETTING, METHODS At enrollment at 16–27 weeks gestation, vaginal fluid samples were collected from a swab and 15 eluted biomarkers were measured using the Meso Scale Discovery multiplex electrochemiluminescence platform. Associations of biomarkers with PTD were examined, according to clinical circumstance, week at delivery and presence/absence of HCA. Weighted logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) adjusted for race. Sensitivity and specificity were compared between individual and multiple biomarkers, identified by a bootstrapping method. MAIN RESULTS AND THE ROLE OF CHANCE Elevated IL-6 (>75th percentile) displayed the strongest association with spontaneous PTD <35 weeks (OR 2.3; CI 1.3–4.0) and PTD with HCA (OR 2.8; CI 1.4–6.0). The sensitivity of IL-6 to detect spontaneous PTD <35 weeks or PTD with HCA was 0.43 and 0.51, respectively, while specificity was 0.74 and 0.75, respectively. IL-6 plus IL1?, IL-6r, tumor necrosis factor-alpha or granulocyte-macrophage colony-stimulating factor increased specificity (range 0.84–0.88), but decreased sensitivity (range 0.28–0.34) to detect both PTD subtypes. Results were similar when a combination of IL-6 and bacterial vaginosis (BV) was explored. Thus, the use of multiple biomarkers did not detect PTD subtypes with a greater sensitivity than IL-6 alone, and IL-6 is a specific but non-sensitive marker for the detection of spontaneous PTD. LIMITATIONS, REASONS FOR CAUTION Our ability to find small effect size associations between PTD and inflammation biomarkers (OR <2.0) might have been limited by the modest number of less common PTD subtypes in our population (e.g. spontaneous delivery <35 weeks, PTD accompanied by HCA) and by relatively higher variability for some cytokines, for example tumor necrosis factor-?, IL-12p70, IL-10 and granulocyte-macrophage colony-stimulating factor, that are less stable and commonly undetectable or detectable at low levels in human vaginal secretions. WIDER IMPLICATIONS OF THE FINDINGS Larger studies are needed to further explore a role of inflammation biomarkers in combination with other risk factors, including specific BV-associated organisms, for the prediction of PTD subtypes. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Child Health and Human Development, National Institute of Nursing, March of Dimes Foundation, Thrasher Research Foundation and Centers for Disease Control and Prevention. The authors have no conflicts of interest. PMID:23416276

Taylor, Brandie D.; Holzman, Claudia B.; Fichorova, Raina N.; Tian, Yan; Jones, Nicole M.; Fu, Wenjiang; Senagore, Patricia K.

2013-01-01

292

Firmness Perception Influences Women’s Preferences for Vaginal Suppositories  

PubMed Central

Microbicides are being actively researched and developed as woman-initiated means to prevent HIV transmission during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have developed carrageenan-based semisoft vaginal suppositories and have previously evaluated how physical properties such as firmness, size and shape influence women’s willingness to try them. Firmness has previously been quantified in terms of small-strain storage modulus, G’, however large-strain properties of the gels may also play a role in the firmness perception. In the current study we prepared two sets of suppositories with the same G’ but different elongation properties at four different G’ values (250, 2500, 12,500, 25,000 Pa): For convenience we refer to these as “brittle” and “elastic”, although these terms were never provided to study participants. In the first of two tests conducted to assess preference, women compared pairs of brittle and elastic suppositories and indicated their preference. We observed an interaction, as women preferred brittle suppositories at lower G’ (250, 2500 Pa) and elastic ones at a higher G’ (25,000 Pa). In the second test, women evaluated samples across different G’, rated the ease-of-insertion and willingness-to-try and ranked the samples in order of preference. Brittle suppositories at G’ of 12,500 Pa were most preferred. In vitro studies were also conducted to measure the softening of the suppositories in contact with vaginal simulant fluid (VSF). Release of antiretroviral drug tenofovir in VSF was quantified for the brittle and elastic suppositories at G’ of 12,500 Pa to determine the effect of suppository type on release. The initial rate of release was 20% slower with elastic suppositories as compared to brittle suppositories. Understanding how different physical properties simultaneously affect women’s preferences and pharmacological efficacy in terms of drug release is required for the optimization of highly acceptable and efficacious microbicides. PMID:25211123

Zaveri, Toral; Primrose, Rachel J.; Surapaneni, Lahari; Ziegler, Gregory R.; Hayes, John E.

2014-01-01

293

Vaginal intraepithelial neoplasia: a therapeutical dilemma.  

PubMed

Vaginal intraepithelial neoplasia (VaIN) represents a rare and asymptomatic pre-neoplastic lesion. Its natural history and potential evolution into invasive cancer are uncertain. VaIN can occur alone or as a synchronous or metachronous lesion with cervical and vulvar HPV-related intra epithelial or invasive neoplasia. Its association with cervical intraepithelial neoplasia is found in 65% of cases, with vulvar intraepithelial neoplasia in 10% of cases, while for others, the association with concomitant cervical or vulvar intraepithelial neoplasias is found in 30-80% of cases. VaIN is often asymptomatic and its diagnosis is suspected in cases of abnormal cytology, followed by colposcopy and colposcopically-guided biopsy of suspicious areas. In the past, high-grade VaIN and multifocal VaIN have been treated by radical surgery, such as total or partial upper vaginectomy associated with hysterectomy and radiotherapy. The need to maintain the integrity of reproductive capacity has determined the transition from radical therapies to conservative ones, according to the different patients' characteristics. PMID:23267125

Frega, Antonio; Sopracordevole, Francesco; Assorgi, Chiara; Lombardi, Danila; DE Sanctis, Vitaliana; Catalano, Angelica; Matteucci, Eleonora; Milazzo, Giusi Natalia; Ricciardi, Enzo; Moscarini, Massimo

2013-01-01

294

Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction  

SciTech Connect

Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery.

Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

1983-06-01

295

Linearly exact parallel closures for slab geometry  

SciTech Connect

Parallel closures are obtained by solving a linearized kinetic equation with a model collision operator using the Fourier transform method. The closures expressed in wave number space are exact for time-dependent linear problems to within the limits of the model collision operator. In the adiabatic, collisionless limit, an inverse Fourier transform is performed to obtain integral (nonlocal) parallel closures in real space; parallel heat flow and viscosity closures for density, temperature, and flow velocity equations replace Braginskii's parallel closure relations, and parallel flow velocity and heat flow closures for density and temperature equations replace Spitzer's parallel transport relations. It is verified that the closures reproduce the exact linear response function of Hammett and Perkins [Phys. Rev. Lett. 64, 3019 (1990)] for Landau damping given a temperature gradient. In contrast to their approximate closures where the vanishing viscosity coefficient numerically gives an exact response, our closures relate the heat flow and nonvanishing viscosity to temperature and flow velocity (gradients)

Ji, Jeong-Young; Held, Eric D. [Department of Physics, Utah State University, Logan, Utah 84322 (United States)] [Department of Physics, Utah State University, Logan, Utah 84322 (United States); Jhang, Hogun [National Fusion Research Institute, 52 Yeoeun-dong, Yusung-Gu, Daejon (Korea, Republic of)] [National Fusion Research Institute, 52 Yeoeun-dong, Yusung-Gu, Daejon (Korea, Republic of)

2013-08-15

296

Clear Sky Column Closure Studies of Urban-Marine and Mineral-Dust Aerosols Using Aircraft, Ship, Satellite and Ground-Based Measurements in ACE-2  

NASA Technical Reports Server (NTRS)

As part of the second Aerosol Characterization Experiment (ACE-2), European urban-marine and African mineral-dust aerosols were measured aboard the Pelican aircraft, the Research Vessel Vodyanitskiy from the ground and from satellites.

Schmid, Beat; Russell, Philip B.; Livingston, John M.; Gasso, Santiago; Hegg, Dean A.; Collins, Donald R.; Flagan, Richard C.; Seinfeld, John H.; Oestroem, Elisabeth; Noone, Kevin J.; Durkee, Philip A.; Jonsson, Haflidi H.; Welton, Ellsworth J.; Voss, Kenneth J.; Gordon, Howard R.; Formenti, Paola; Andreae, Meinrat O.; Kapustin, Vladimir N.; Bates, Timothy S.; Quinn, Patricia K.

2000-01-01

297

A comparison of three algebraic stress closures for combustor flow calculations  

NASA Technical Reports Server (NTRS)

A comparison is made of the performance of two locally nonequilibrium and one equilibrium algebraic stress closures in calculating combustor flows. Effects of four different pressure-strain models on these closure models are also analyzed. The results show that the pressure-strain models have a much greater influence on the calculated mean velocity and turbulence field than the algebraic stress closures, and that the best mean strain model for the pressure-strain terms is that proposed by Launder, Reece and Rodi (1975). However, the equilibrium algebraic stress closure with the Rotta return-to-isotropy model (1951) for the pressure-strain terms gives as good a correlation with measurements as when the Launder et al. mean strain model is included in the pressure-strain model. Finally, comparison of the calculations with the standard k-epsilon closure results show that the algebraic stress closures are better suited for simple turbulent flow calculations.

Nikjooy, M.; So, R. M. C.; Hwang, B. C.

1985-01-01

298

Converting Potential Abdominal Hysterectomy to Vaginal One: Laparoscopic Assisted Vaginal Hysterectomy  

PubMed Central

Background. The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy. Material and methods. A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise. Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06 + 31.97?min versus 135.25 + 31.72 min; P < 0.05). However, the mean blood loss in LAVH was 100?mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79?mL versus 340.00 + 119.86?mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups. PMID:24729873

Shetty, Jyothi; Shanbhag, Asha

2014-01-01

299

Air demand behind high head gates during emergency closure  

Microsoft Academic Search

Pressure drop and consecutive air demand behind high head gates during emergency closure is studied by physical and mathematical models. Measurements are done on hydraulic model of a leaf gate installed in the intake structure of a penstock. Local loss coefficients are determined as functions of Reynolds number and gate openings from measurements of discharge and piezometric levels at static

Ismail Aydin

2002-01-01

300

Vaginal cells of smokers are more resistant to human papillomavirus infection than that of non-smokers  

PubMed Central

To evaluate effect of HPV and smoking on DNA double-strand breaks in vaginal samples, vaginal specimens collected from participants (n=76) were classified based on HPV and smoking status and DNA double-strand breaks measured using comet assay. Mean tail length (31.2 +/? 18.7 ?m) and tail moment (2.4 +/? 2.8 arbitrary units) for HPV-positive patients were lower (p<0.001) compared with HPV-negative patients (61.7 +/? 22.6 ?m; 8.7 +/? 4.9). Never-smokers were found to have higher level (p<0.001) of double-strand breaks (57.7 +/? 24.5 ?m, 7.5 +/? 5.5 AU) compared with ever smokers (35.3 +/? 21.9 ?m; 3.4 +/? 3.7 AU). Among HPV infected patients, never-smokers have more double-strand breaks compared to smokers (p<0.001) which correlated with age (p<0.001). Highly differentiated vaginal epithelium may be resistant to DNA damage associated with HPV infection and smoking, which may be attributed to adoptive survival mechanisms of vaginal epithelium. PMID:23137616

Moktar, Afsoon; Ravoori, Srivani; Vadhanm, Manicka V.; Pan, Jianmin; Rai, Shesh N; Jenson, Alfred B.; Parker, Lynn P.; Gupta, Ramesh C.

2012-01-01

301

The effect of an Rx-to-OTC switch on medication prescribing patterns and utilization of physician services: the case of vaginal antifungal products.  

PubMed Central

OBJECTIVE. We examined the impact of over-the-counter (OTC) availability of vaginal antifungal products, beginning in January 1991, on medication prescribing patterns and utilization of physician services. DATA SOURCES AND STUDY SETTING. Data on utilization of health care services and prescription medications by female members (ages 11 and older) of the Fallon Community Health Plan (FCHP), a group model health maintenance organization and a component of the Fallon Health Care System of central Massachusetts. The census for such individuals increased from 49,551 in January 1990 to 67,365 in December 1992. DESIGN. Time-series analyses were employed to assess changes in prescribing patterns of vaginal antifungal products and physician visits for vaginitis from January 1, 1990 through December 31, 1992. Monthly numbers of prescriptions for vaginal antifungal products and physician visits per 100 members were measured. Monetary savings relating to the prescription-to-OTC switch were also estimated. DATA COLLECTION METHODS. The computerized management information system of FCHP contains records on utilization of all health care services and prescriptions filled, collected as part of routine fiscal activities. We identified all vaginally administered products on the FCHP formulary used for the treatment of vaginal candidiasis and determined the number of prescriptions filled for these agents during each month of the study period. We also identified the number of physician office visits characterized by the ICD-9-CM code 616.10 ("vaginitis and vulvovaginitis, unspecified") occurring during each month of the study period. PRINCIPAL FINDINGS. For the one-year period after OTC availability of vaginal antifungal products (January 1991 through December 1991), we estimated that the number of prescriptions dispensed for these products was reduced by 6.42 per 100 female FCHP members ages 11 and older. Physician visits for vaginitis were reduced by 0.66 per 100 members. Estimated savings to the Fallon Health Care System for the one-year period following OTC availability were $42,528 in medication costs and $12,768 to $25,729 for costs associated with physician visits, depending on use of laboratory testing in patient evaluations. CONCLUSIONS. The findings of this study suggest that the prescription-to-OTC switch of vaginal antifungal treatments reduced health care costs to the insurer in the managed care setting. These favorable effects on costs for the insurer need to be weighed against shifts in medication costs to consumers and potential adverse consequences to the patient relating to errors in self-diagnosis. PMID:8537226

Gurwitz, J H; McLaughlin, T J; Fish, L S

1995-01-01

302

Some characteristics of vaginal prolapse in Nepali buffaloes.  

PubMed

Prolapse of vagina is one of the important maternal abnormalities during pregnancy in cattle and buffaloes. A field investigation was carried out on 26 Murrah graded buffaloes to study clinical characteristics of vaginal prolapse in buffaloes in Nepal. Fifty-seven percent of the 26 buffaloes with vaginal prolapse were either heifers or in first lactation. Sixty-five percent of the cases were in seventh month of pregnancy or later. About three quarters of the cases occurred between June and October. Twelve cases (63%) of the 19 animals excluding 7 heifers had a history of vaginal prolapse in previous gestations. A half of the buffaloes were showing prolapse of the vagina even when they were in standing position and showing moderate or vigorous straining. After the conventional treatments, twenty-three buffaloes retained the replaced vagina and calved normally. One animal aborted although the vagina was retained. Two buffaloes had severest degree of vaginal prolapse complicated with edema, injury and cyanosis, and they did not respond to the treatment. The two buffaloes had frequently recurrent prolapse and subsequently died. Early detection and prompt treatment may be imperative to control the vaginal prolapse in buffaloes. PMID:14665751

Sah, Shyam Kishore; Nakao, Toshihiko

2003-11-01

303

Chitosan gel containing polymeric nanocapsules: a new formulation for vaginal drug delivery  

PubMed Central

The vaginal route of administration is an alternative for several treatments for either local or systemic pharmacological effects. However, the permanence of a drug in this route represents a challenge for formulation development that can be overcome by using nanoencapsulation and chitosan gel. Thus, this work aimed to evaluate the performance of chitosan hydrogels containing cationic and anionic acrylic-based nanocapsules (Eudragit® RS 100 and Eudragit® S 100, respectively) with Nile red as a model of lipophilic substance in the vaginal route of administration, as measured by increases in the residence time and the penetration of these formulations. Several formulations were prepared with increasing chitosan concentrations, and were analyzed in terms of pH and rheological behavior so that the most suitable formulation could be selected. The enhancement of the adhesion (tensile stress test and washability profile) and penetration (confocal laser scanning microscopy and extraction followed by quantification) properties of the formulations, when applied to porcine vaginal mucosa, were evaluated. The nanocapsule suspensions produced presented adequate properties: size of approximately 200 nm (polydispersity index of ?v0.2); zeta potential around +10 mV for the cationic formulation and -10 mV for the anionic formulation; and pH values of 6.1±0.1 (Eudragit RS 100), 5.3±0.2 (Eudragit S 100), 6.2±0.1 (Nile red loaded Eudragit RS 100), and 5.1±0.1 (Nile red loaded Eudragit S 100). The chitosan formulation presented suitable viscosity for vaginal application and acidic pH (approximately 4.5). The tensile stress test showed that both formulations containing polymeric nanocapsules presented higher mucoadhesion when compared with the formulation without nanocapsules. In the washability experiment, no significant differences were found between formulations. Confocal microscopy and fluorescence quantification after extraction from the mucosa showed higher penetration of Nile red when it was nanoencapsulated, particularly in cationic nanocapsules. The formulations developed based on chitosan gel vehicle at 2.5% weight/weight containing polymeric nanocapsules, especially the cationic nanocapsules, demonstrated applicability for the vaginal delivery of hydrophobic substances. PMID:25061292

Frank, Luiza A; Sandri, Giuseppina; D’Autilia, Francesca; Contri, Renata V; Bonferoni, Maria Cristina; Caramella, Carla; Frank, Alejandro G; Pohlmann, Adriana R; Guterres, Silvia S

2014-01-01

304

Vaginal douching by women with vulvovaginitis and relation to reproductive health hazards  

PubMed Central

Background Vaginal douching (VD) is a common practice among married women all over the world specially those in the Middle East. It is used for personal hygiene or for other aesthetic reasons in many countries. The current study investigates the prevalence of VD among patients with vulvovaginitis in Egypt. It also compares the reproductive health hazards among women performing routine VD with those using external hygiene. It also investigates why, and how women practice this douching. Methods A cross sectional observational study was conducted in a tertiary university affiliated hospital in Assiut, Egypt. An interview administered questionnaire was administered to 620 women by two trained clinic nurses. Women presented to the outpatient clinic and diagnosed to have any type of vaginal infections were approached for participation. The principle outcome was the history of preterm labor in women who routinely performed VD versus those who did not (upon which sample size was estimated). Other outcome measures were the types of vaginal infections, and reproductive implications comprising, ectopic pregnancy, abortion and pelvic inflammatory disease (PID). Results The participants were predominantly multiparas from semi-urban background and middle socioeconomic level. Considering VD as a religious duty and a kind of personal cleanliness were the most common reasons for performing VD in 88.9% and 80.6% of the studied population, respectively. History of preterm labor was reported in 19.2% versus 11.9% (p=0.048), while history of PID in 13.2% versus 6.0% (p=0.008) in women performing VD compared to those not performing this habit, respectively. There were no significant differences between the two groups as regard the history of ectopic pregnancy or the number of previous abortions. Conclusion Vaginal douching is a prevalent practice in Egypt and has traditional and religious roots within the community. There are many misbeliefs around this habit in Egypt. Vaginal douching increases certain reproductive health hazards especially preterm labor and PID. Much effort and awareness campaigns are needed to increase women awareness about health hazards of this incorrect practice and to limit its use. PMID:23672530

2013-01-01

305

Humid site stabilization and closure  

SciTech Connect

The purpose of the work described here is to identify and evaluate the importance of factors that are expected to dictate the nature of site stabilization and closure requirements. Subsequent efforts will plan for implementation of such requirements. Two principal areas of site stabilization and closure effort will be pursued initially - geological management and vegetation management. The geological effort will focus on chemical weathering and surficial erosion. Such catastrophic geologic events as landslides, flooding, earthquakes, volcanos, etc. are already considered in site selection and operation and these factors will not be emphasized initially. Vegetation management will be designed to control erosion, to minimize nuclide mobilization by roots and to be compatible with natural successional pressures. It is anticipated that the results of this work will be important both to site selection and operation as well as the actual stabilization and closure procedure.

Cutshall, N.H.

1981-01-01

306

77 FR 8900 - Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal...  

Federal Register 2010, 2011, 2012, 2013, 2014

...COMMISSION [Investigation No. 337-TA-768] Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on...within the United States after importation of certain vaginal birth control devices by reason of infringement of certain...

2012-02-15

307

40 CFR 265.280 - Closure and post-closure.  

Code of Federal Regulations, 2014 CFR

...Compliance with § 265.276 concerning the growth of food-chain crops. (b) The owner or operator must consider...its post-closure use; (3) Assure that growth of food chain crops complies with § 265.276; and (4)...

2014-07-01

308

40 CFR 265.280 - Closure and post-closure.  

Code of Federal Regulations, 2013 CFR

...Compliance with § 265.276 concerning the growth of food-chain crops. (b) The owner or operator must consider...its post-closure use; (3) Assure that growth of food chain crops complies with § 265.276; and (4)...

2013-07-01

309

BLT Humanized Mice as Model to Study HIV Vaginal Transmission  

PubMed Central

The majority of human immunodeficiency virus type 1 (HIV-1) infections occur by sexual exposure, and vaginal transmission accounts for more than half of all newly acquired infections. Studies of vaginal transmission of simian immunodeficiency virus to nonhuman primates (NHPs) have suggested an important role for immune cell trafficking in the establishment of infection as well is in the process of viral dissemination. However, NHP models do not permit the study of HIV transmission and dissemination. The improvement of humanized mouse models with robust human immune cell reconstitution of the female genital tract renders these mice susceptible to intravaginal HIV infection. Thus humanized mouse models of HIV vaginal infection will allow the study of the mechanisms involved in HIV transmission and dissemination in vivo. PMID:24151319

Deruaz, Maud; Luster, Andrew D.

2013-01-01

310

Sustained release of proteins from a modified vaginal ring device  

PubMed Central

A new vaginal ring technology, the insert vaginal ring (InVR), is presented. The InVR overcomes the current shortfall of conventional vaginal rings (VRs) that are generally ineffectual for the delivery of hydrophilic and/or macromolecular actives, including peptides, proteins and antibodies, due to their poor permeation characteristics in the hydrophobic polymeric elastomers from which VRs are usually fabricated. Release of the model protein BSA from a variety of insert matrices for the InVR is demonstrated, including modified silicone rods, directly compressed tablets and lyophilised gels, which collectively provided controlled release profiles from several hours to beyond 4 weeks. Furthermore, the InVR was shown to deliver over 1 mg of the monoclonal antibody 2F5 from a single device, offering a potential means of protecting women against the transmission of HIV. PMID:21055465

Morrow, Ryan J.; Woolfson, A. David; Donnelly, Louise; Curran, Rhonda; Andrews, Gavin; Katinger, Dietmar; Malcolm, R. Karl

2013-01-01

311

Vaginal antisepsis for hysterectomy: a review of the literature.  

PubMed

Infectious complications of hysterectomy remain common despite the use of prophylactic antibiotics. Most are caused by contamination of the surgical site by vaginal bacteria which are not controlled by current methods of pre-operative antisepsis. The medical literature concerning antiseptic preparation of the vagina for surgery was reviewed to discover the evidence on which practice may be based. A search using Medline, Current Contents, the Cochrane Library and the reference lists of articles on the subject and of major gynaecology textbooks produced 13 comparative studies. No conclusive randomized controlled trials were found and most of the studies had severe methodological problems limiting interpretation of their results. The scant available data suggest that use of vaginal antiseptics before the patient arrives in the operating room is probably not useful, and that application of povidone-iodine vaginal gel at the beginning of abdominal hysterectomy is sufficiently promising to justify further investigation. PMID:9403256

Eason, E L

1997-01-01

312

40 CFR 265.404 - Closure.  

Code of Federal Regulations, 2011 CFR

...STORAGE, AND DISPOSAL FACILITIES Chemical, Physical, and Biological Treatment § 265.404 Closure. At closure, all...be removed from treatment processes or equipment, discharge control equipment, and discharge confinement structures....

2011-07-01

313

40 CFR 265.404 - Closure.  

Code of Federal Regulations, 2010 CFR

...STORAGE, AND DISPOSAL FACILITIES Chemical, Physical, and Biological Treatment § 265.404 Closure. At closure, all...be removed from treatment processes or equipment, discharge control equipment, and discharge confinement structures....

2010-07-01

314

40 CFR 265.404 - Closure.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) SOLID WASTES (CONTINUED) INTERIM...OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL...Chemical, Physical, and Biological Treatment § 265.404 Closure...closure, all hazardous waste and hazardous...

2013-07-01

315

40 CFR 265.404 - Closure.  

Code of Federal Regulations, 2012 CFR

...CONTINUED) SOLID WASTES (CONTINUED) INTERIM...OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL...Chemical, Physical, and Biological Treatment § 265.404 Closure...closure, all hazardous waste and hazardous...

2012-07-01

316

40 CFR 265.404 - Closure.  

Code of Federal Regulations, 2014 CFR

...CONTINUED) SOLID WASTES (CONTINUED) INTERIM...OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL...Chemical, Physical, and Biological Treatment § 265.404 Closure...closure, all hazardous waste and hazardous...

2014-07-01

317

50 CFR 622.246 - Area closures.  

Code of Federal Regulations, 2013 CFR

...Area closures. 622.246 Section 622.246 Wildlife and Fisheries...MEXICO, AND SOUTH ATLANTIC Golden Crab Fishery of the South Atlantic...246 Area closures. (a) Golden crab trap closed areas. In the golden crab northern zone, a...

2013-10-01

318

50 CFR 622.246 - Area closures.  

Code of Federal Regulations, 2014 CFR

...Area closures. 622.246 Section 622.246 Wildlife and Fisheries...MEXICO, AND SOUTH ATLANTIC Golden Crab Fishery of the South Atlantic...246 Area closures. (a) Golden crab trap closed areas. In the golden crab northern zone, a...

2014-10-01

319

Microcrack closure in rocks under stress: direct observation  

SciTech Connect

Microcrack closure in rocks under increasing stress was observed directly with a scanning electron microscope. Uniaxial stresses to 300 bars were applied with a small hydraulic press to specimens of Westerly (RI) granite, both unheated and previously heat cycled to 500/sup 0/C, and of Frederick (MD) diabase, heat cycled to 700/sup 0/C. Closure characteristics (rate, final closure pressure, etc.) depend on crack orientation, shape, surface roughness, and on the nature of fracture intersections and interactions. Cracks perpendicular to the applied stress closed while those parallel to the stress tended to open. Long, narrow cracks (low aspect ratio) closed at relatively low pressures. At some intersections, one fracture would open while another simultaneously closed, depending upon their orientations. Many fractures closed uniformly even though offset by other fractures. Local stress concentrations often caused new fracturing at low applied stress. Some fractures were propped open until material lodged inside was crushed. Significant irreversible damage occurred during the first stress cycle. Closure characteristics varied significantly among the samples. The unheated granite has cracks with rough, pitted, and mismatched walls. Only partial closure occurred under stress with many sections remaining open. Crack porosity is reduced but continues to be interconnected. Fractures in the preheated granite and diabase are also irregular, but the walls are well-matched and closure is nearly complete. The cracks in the heated granite closed at lower stresses than in the diabase. As the maximum stress was approached for the heated granite, new transgranular cracks formed and preexisting cracks were enlarged. The variations in closure rate and character were also observed in strain measurements.

Batzle, M.L.; Simmons, G.; Siegfried, R.W.

1980-12-10

320

Magnetic resonance imaging in the evaluation of vaginal foreign bodies in a young girl.  

PubMed

A 7-year-old girl with foul-smelling, bloody vaginal discharge for more than 2 years was initially suspected of suffering from vaginal foreign bodies. Although plain radiography revealed no abnormal findings in the pelvis, magnetic resonance imaging (MRI) showed multiple low intensity objects and an intact vaginal wall. Four plastic toys were removed with forceps under general anesthesia. MRI is supposed to be the best technique for evaluating vaginal foreign bodies in young girls. PMID:11789752

Kihara, M; Sato, N; Kimura, H; Kamiyama, M; Sekiya, S; Takano, H

2001-11-01

321

Depomedroxyprogesterone-induced hypoestrogenism and changes in vaginal flora and epithelium  

Microsoft Academic Search

Objective: To identify the effects of depomedroxyprogesterone acetate (DMPA) on vaginal microbial flora and epithelium.Methods: Women who desired DMPA for contraception were evaluated before and at 3 and 6 months after initiation of 150-mg DMPA injections every 3 months. At each visit, we assessed genital symptoms, vaginal signs, vaginal microflora, and histopathology by vaginal biopsies.Results: Among 38 women observed for

Leslie Miller; Dorothy L Patton; Amalia Meier; Soe Soe Thwin; Thomas M Hooton; David A Eschenbach

2000-01-01

322

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance.  

PubMed

Bacterial communities colonizing the reproductive tracts of primates (including humans) impact the health, survival and fitness of the host, and thereby the evolution of the host species. Despite their importance, we currently have a poor understanding of primate microbiomes. The composition and structure of microbial communities vary considerably depending on the host and environmental factors. We conducted comparative analyses of the primate vaginal microbiome using pyrosequencing of the 16S rRNA genes of a phylogenetically broad range of primates to test for factors affecting the diversity of primate vaginal ecosystems. The nine primate species included: humans (Homo sapiens), yellow baboons (Papio cynocephalus), olive baboons (Papio anubis), lemurs (Propithecus diadema), howler monkeys (Alouatta pigra), red colobus (Piliocolobus rufomitratus), vervets (Chlorocebus aethiops), mangabeys (Cercocebus atys) and chimpanzees (Pan troglodytes). Our results indicated that all primates exhibited host-specific vaginal microbiota and that humans were distinct from other primates in both microbiome composition and diversity. In contrast to the gut microbiome, the vaginal microbiome showed limited congruence with host phylogeny, and neither captivity nor diet elicited substantial effects on the vaginal microbiomes of primates. Permutational multivariate analysis of variance and Wilcoxon tests revealed correlations among vaginal microbiota and host species-specific socioecological factors, particularly related to sexuality, including: female promiscuity, baculum length, gestation time, mating group size and neonatal birth weight. The proportion of unclassified taxa observed in nonhuman primate samples increased with phylogenetic distance from humans, indicative of the existence of previously unrecognized microbial taxa. These findings contribute to our understanding of host-microbe variation and coevolution, microbial biogeography, and disease risk, and have important implications for the use of animal models in studies of human sexual and reproductive diseases. PMID:25036926

Yildirim, Suleyman; Yeoman, Carl J; Janga, Sarath Chandra; Thomas, Susan M; Ho, Mengfei; Leigh, Steven R; Consortium, Primate Microbiome; White, Bryan A; Wilson, Brenda A; Stumpf, Rebecca M

2014-12-01

323

Vaginal dilator therapy for women receiving pelvic radiotherapy  

PubMed Central

Background Many vaginal dilator therapy guidelines advocate routine vaginal dilation during and after pelvic radiotherapy to prevent stenosis (abnormal narrowing of the vagina). The UK Gynaecological Oncology Nurse Forum recommend dilation “three times weekly for an indefinite time period”. The UK patient charity Cancer Backup advises using vaginal dilators from two to eight weeks after the end of radiotherapy treatment. Australian guidelines recommend dilation after brachytherapy “as soon as is comfortably possible” and “certainly within four weeks and to continue for three years or indefinitely if possible”. However, dilation is intrusive, uses health resources and can be psychologically distressing. It has also caused rare but very serious damage to the rectum. Objectives To review the benefits and harms of vaginal dilation therapy associated with pelvic radiotherapy for cancer. Search methods Searches included the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 4), MEDLINE (1950 to 2008), EMBASE (1980 to 2008) and CINAHL (1982 to 2008). Selection criteria Any comparative randomised controlled trials (RCT) or data of any type which compared dilation or penetration of the vagina after pelvic radiotherapy treatment for cancer. Data collection and analysis The review authors independently abstracted data and assessed risk of bias. We analysed the mean difference in sexual function scores and the risk ratio for non-compliance at six weeks and three months in single trial analyses. No trials met the inclusion criteria. Main results Dilation during or immediately after radiotherapy can, in rare cases, cause damage and there is no persuasive evidence from any study to demonstrate that it prevents stenosis. Data from one RCT showed no improvement in sexual scores in women who were encouraged to practice dilation. Two case series and one comparative study using historical controls suggest that dilation might be associated with a longer vaginal length but these data cannot reasonably be interpreted to show that dilation caused the change in the vagina. Authors’ conclusions Routine dilation during or soon after cancer treatment may be harmful. There is no reliable evidence to show that routine regular vaginal dilation during or after radiotherapy prevents the late effects of radiotherapy or improves quality of life. Gentle vaginal exploration might separate the vaginal walls before they can stick together and some women may benefit from dilation therapy once inflammation has settled but there are no good comparative supporting data. PMID:20824858

Miles, Tracie; Johnson, Nick

2014-01-01

324

Effect of dehydroepiandrosterone on vaginal and uterine histomorphology in the rat  

Microsoft Academic Search

Dehydroepiandrosterone (DHEA) applied on the dorsal skin of ovariectomized animals, at the twice daily dose of 30mg, resulted in a complete reversal of the vaginal atrophy seen 1, 3 and 6months after ovariectomy, and induced proliferation and mucification of the vaginal epithelium. A similar mucification of the vaginal epithelium related to androgenic action was observed in intact rats treated with

Antigone Sourla; Michel Flamand; Alain Bélanger; Fernand Labrie

1998-01-01

325

Successful pregnancy outcome in an untreated case of concomitant transverse complete vaginal septum with unicornuate uterus.  

PubMed

Transverse vaginal septum is a result of faulty canalization of embryonic vagina. Septum may be complete but usually has laterally placed tiny hole giving an impression of vaginal vault without cervix. We described a case of untreated transverse vaginal septum with small central aperture diagnosed during labor and unicornuate uterus diagnosed intraoperatively, with successful pregnancy outcome. PMID:25624665

Kumar, Naina; Tayade, Surekha

2014-01-01

326

76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation  

Federal Register 2010, 2011, 2012, 2013, 2014

...In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation...after importation of certain vaginal ring birth control devices by reason of infringement...after importation of certain vaginal ring birth control devices that infringe claim 1...

2011-03-29

327

Analysis of Bacterial Vaginosis-Related Amines in Vaginal Fluid by Gas Chromatography and Mass Spectrometry  

Microsoft Academic Search

The presence of various amines in vaginal fluid from women with malodorous vaginal discharge has been reported before. The investigations have used several techniques to identify the amines. However, an optimized quantification, together with a sensitive analysis method in connection with a diagnostic procedure for vaginal discharge, including the syndrome of bacterial vaginosis, as defined by the accepted \\

HELEN WOLRATH; URBAN FORSUM; P. G. LARSSON; HANS BOREN

2001-01-01

328

Free Glycogen in Vaginal Fluids Is Associated with Lactobacillus Colonization and Low Vaginal pH  

PubMed Central

Objective Lactobacillus dominates the lower genital tract microbiota of many women, producing a low vaginal pH, and is important for healthy pregnancy outcomes and protection against several sexually transmitted pathogens. Yet, factors that promote Lactobacillus remain poorly understood. We hypothesized that the amount of free glycogen in the lumen of the lower genital tract is an important determinant of Lactobacillus colonization and a low vaginal pH. Methods Free glycogen in lavage samples was quantified. Pyrosequencing of the 16S rRNA gene was used to identify microbiota from 21 African American women collected over 8–11 years. Results Free glycogen levels varied greatly between women and even in the same woman. Samples with the highest free glycogen had a corresponding median genital pH that was significantly lower (pH 4.4) than those with low glycogen (pH 5.8; p<0.001). The fraction of the microbiota consisting of Lactobacillus was highest in samples with high glycogen versus those with low glycogen (median?=?0.97 vs. 0.05, p<0.001). In multivariable analysis, having 1 vs. 0 male sexual partner in the past 6 months was negatively associated, while BMI ?30 was positively associated with glycogen. High concentrations of glycogen corresponded to higher levels of L. crispatus and L. jensenii, but not L. iners. Conclusion These findings show that free glycogen in genital fluid is associated with a genital microbiota dominated by Lactobacillus, suggesting glycogen is important for maintaining genital health. Treatments aimed at increasing genital free glycogen might impact Lactobacillus colonization. PMID:25033265

Mirmonsef, Paria; Hotton, Anna L.; Gilbert, Douglas; Burgad, Derick; Landay, Alan; Weber, Kathleen M.; Cohen, Mardge; Ravel, Jacques; Spear, Gregory T.

2014-01-01

329

Higher Separation Axioms in Generalized Closure Spaces  

E-print Network

Higher Separation Axioms in Generalized Closure Spaces B¨arbel M.R. Stadler1, and Peter F. Stadler1://www.tbi.univie.ac.at/~{baer,studla} corresponding author Abstract The hierarchy of separation axioms that is familiar from topological spaces of the closure function must be assumed. Keywords: extended topologies, closure spaces, separation axioms

Stadler, Peter F.

330

Closure constraints for hyperbolic tetrahedra  

E-print Network

We investigate the generalization of loop gravity's twisted geometries to a q-deformed gauge group. In the standard undeformed case, loop gravity is a formulation of general relativity as a diffeomorphism-invariant SU(2) gauge theory. Its classical states are graphs provided with algebraic data. In particular closure constraints at every node of the graph ensure their interpretation as twisted geometries. Dual to each node, one has a polyhedron embedded in flat space R^3. One then glues them allowing for both curvature and torsion. It was recently conjectured that q-deforming the gauge group SU(2) would allow to account for a non-vanishing cosmological constant Lambda, and in particular that deforming the loop gravity phase space with real parameter q>0 would lead to a generalization of twisted geometries to a hyperbolic curvature. Following this insight, we look for generalization of the closure constraints to the hyperbolic case. In particular, we introduce two new closure constraints for hyperbolic tetrahedra. One is compact and expressed in terms of normal rotations (group elements in SU(2) associated to the triangles) and the second is non-compact and expressed in terms of triangular matrices (group elements in SB(2,C)). We show that these closure constraints both define a unique dual tetrahedron (up to global translations on the three-dimensional one-sheet hyperboloid) and are thus ultimately equivalent.

Christoph Charles; Etera R. Livine

2015-01-05

331

Panel Closure Redesign: August 2011  

E-print Network

represented in Performance Assessment · Salado Mass Concrete NMED Hazardous Waste Facility Permit (operational Salado Mass Concrete with generic salt-based concrete. (EPA/NMED) 2. Replace isolation wall) ·Run Performance Assessment with the new panel closure design represented in the models. (EPA

332

CIRSE Vascular Closure Device Registry  

SciTech Connect

Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0-14.5] for antegrade access and 1.8% (95% CI 1.1-2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only <0.5% of patients. Postdeployment bleeding occurred in 6.4%, and most these (51.5%) could be managed with light manual compression. During follow-up, other device-related complications were reported in 1.3%: seven false aneurysms, three hematoma >5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Mueller-Huelsbeck, Stefan [Academic Hospitals, Department of Radiology (Germany); Libicher, Martin [University Clinics, Department of Radiology (Germany); Atar, Eli [Hasharon Hospital, Department of Radiology (Israel); Trentmann, Jens [University Clinics Schleswig-Holstein, Department of Radiology (Germany); Goffette, Pierre [University Clinics St. Luc, Department of Radiology (Belgium); Borggrefe, Jan [University Clinics Schleswig-Holstein, Department of Radiology (Germany); Zelenak, Kamil [University Hospital, Department of Radiology (Slovakia); Hooijboer, Pieter [Scheper Ziekenhuis, Department of Radiology (Netherlands); Belli, Anna-Maria [St. Georges Hospital, Department of Radiology (United Kingdom)

2011-02-15

333

Repository Closure and Sealing Approach  

Microsoft Academic Search

The scope of this analysis will be to develop the conceptual design of the closure seals and their locations in the Subsurface Facilities. The design will be based on the recently established program requirements for transitioning to the Site Recommendation (SR) design as outlined by ''Approach to Implementing the Site Recommendation Baseline'' (Stroupe 2000) and the ''Monitored Geologic Repository Project

A. T. Watkins

2000-01-01

334

Vagifem is superior to vaginal Premarin in induction of endometrial thickness in the frozen-thawed cycle patients with refractory endometria: A randomized clinical trial  

PubMed Central

Background: Embryo transfer to a developed endometrium is an important prognostic factor in frozen-thawed embryo transfer cycle outcome. Vaginal estrogen, such as Vagifem vaginal tablets and Premarin vaginal cream, is a regimen used for the patients with refractive endometria. Objective: Our objective was to compare the effects of Vagifem and Premarin on the endometrial thickness of the patients with refractive endometria. Materials and Methods: In this randomized clinical trial, 30 patients with refractive endometria in frozen-thawed embryo transfer cycles received Vagifem vaginal tablets and 30 women received Premarin vaginal cream. Endometrial thickness was measured on the 14th day of drug administration. Results: Comparing the endometrial thicknesses of the two groups showed that the endometria of the Vagifem group was significantly thicker than that of the Premarin group (5.93±0.38 vs. 6.74±0.32; p<0.001). Conclusion: Vagifem is superior to Premarin in induction of endometrial thickness in frozen-thawed embryo transfer cycles in the patients with refractive endometria. PMID:25071850

Zolghadri, Jaleh; Haghbin, Hossein; Dadras, Nasrin; Behdin, Shabnam

2014-01-01

335

FIELD AND LABORATORY EVALUATION OF PETROLEUM LAND TREATMENT SYSTEM CLOSURE  

EPA Science Inventory

The objectives of the research were to measure and interpret the surface soil changes in relation to the quality of runoff water from petroleum refinery land treatment (LT) systems undergoing simulated closure. Waste/soils from four LT sites were studied for chemical transformati...

336

A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child  

PubMed Central

Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic. PMID:25738041

Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish

2015-01-01

337

Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence  

Microsoft Academic Search

Objective: We sought to describe sexual function in women before and after surgery for either prolapse or urinary incontinence, or both. Study Design: Women completed questionnaires, and vaginal dimensions were measured before and at least 6 months after surgery for prolapse or incontinence. Comparisons were made with signed-rank tests or the McNemar test. Results: Eighty-one (49%) of 165 women were

Anne M Weber; Mark D Walters; Marion R Piedmonte

2000-01-01

338

Labial Adhesion with Acute Urinary Retention Secondary to Vaginitis  

PubMed Central

Labial adhesion occurs most often in infants and girls and is usually associated with low estrogen levels. Labial adhesion in the reproductive age group is extremely rare due to abundance of estrogen. Herein we present a case of almost complete labial adhesion with acute urinary retention in a 21-year-old virgin woman secondary to a probable untreated severe vaginitis. PMID:25105038

?entürk, ?enol; Üstüner, Pelin; Bal?k, Gül?ah; Ka??tc?, Mehmet; Ural, Ülkü Mete; ?ahin, Figen K?r

2014-01-01

339

Penile – vaginal intercourse is better: evidence trumps ideology  

Microsoft Academic Search

It has often been asserted that all sexual behaviours are equal. However, empirical research demonstrates that different sexual behaviours differ in many physiological and psychological domains. These differences are remarkably consistent in revealing an association between specifically penile-vaginal intercourse and indices of better physiological and psychological function. Other sexual behaviours (masturbation, partner masturbation, oral sex, anal sex, or any other

2006-01-01

340

Adaptive Plasticity of Vaginal Innervation in Term Pregnant Rats  

PubMed Central

Changes in reproductive status place varied functional demands on the vagina. These include receptivity to male intromission and sperm transport in estrus, barrier functions during early pregnancy, and providing a conduit for fetal passage at parturition. Peripheral innervation regulates vaginal function, which in turn may be influenced by circulating reproductive hormones. We assessed vaginal innervation in diestrus and estrus (before and after the estrous cycle surge in estrogen), and in the early (low estrogen) and late (high estrogen) stages in pregnancy. In vaginal sections from cycling rats, axons immunoreactive for the pan-neuronal marker protein gene product 9.5 (PGP 9.5) showed a small reduction at estrus relative to diestrus, but this difference did not persist after correcting for changes in target size. No changes were detected in axons immunoreactive for tyrosine hydroxylase (sympathetic), vesicular acetylcholine transporter (parasympathetic), or calcitonin gene-related peptide and transient receptor potential vanilloid type 1 (TRPV-1; sensory nociceptors). In rats at 10 days of pregnancy, innervation was similar to that observed in cycling rats. However, at 21 days of pregnancy, axons immunoreactive for PGP 9.5 and each of the subpopulation-selective markers were significantly reduced both when expressed as percentage of sectional area or after correcting for changes in target size. Because peripheral nerves regulate vaginal smooth muscle tone, blood flow, and pain sensitivity, reductions in innervation may represent important adaptive mechanisms facilitating parturition. PMID:21666101

Liao, Zhaohui; Smith, Peter G.

2011-01-01

341

Benefits of Laser Therapy in Postmenopausal Vaginal Atrophy  

NASA Astrophysics Data System (ADS)

Maybe the worst aspect of menopause is the decline of the quality of the sexual life. The aim of the study is to demonstrate the beneficial effects of laser therapy in comparison with topical application of estrogen preparations, for the treatment of vaginal atrophy and sexual dysfunctions induced by menopause. A total of 50 menopausal patients were examined during a one year period. The methods used for objectifying vaginal atrophy and sexual dysfunctions were history taking, local clinical exam and PAP smear. From this group, 40 patients had vaginal atrophy with sexual dysfunctions. They have been treated differently, being included in four groups: patients treated with local estrogens, patients treated with intravaginal laser therapy, patients treated with both laser therapy and estrogens, patients treated with estrogens and placebo laser therapy. Therapeutic benefit, improvement of vaginal atrophy and quality of sexual life, were objectified by anamnesis (questionnaire), local and general clinical examination and PAP smear. The best results have been obtained, by far, in the 3rd group, followed by the women treated only with laser. In conclusion, we can say that laser therapy is the best way for solving the sexual inconveniences of menopause.

Brînzan, Daniela; P?iu?an, Lucian; Da?c?u, Voicu; Fur?u, Gheorghe

2011-08-01

342

Conservative Management of Placenta Accreta/Increta after Vaginal Birth  

PubMed Central

Aim: Aim of the study was to show that conservative management with preservation of the uterus and of fertility is possible in patients with placenta accreta/increta after vaginal delivery. Method: A retrospective analysis of patients with placental attachment disorders after vaginal delivery was done in a perinatal centre between November 2009 and April 2011. The patient collective was identified using the ICD-10 codes for placenta accreta/increta/percreta, and patient records were analysed for risk factors, maternal morbidity, preservation of the uterus and of fertility, and neonatal outcome. Results: Three cases of placenta increta were identified in the last 1.5 years out of a total of 1457 vaginal deliveries, and all 3 cases were treated conservatively. Mean maternal age was 35.3 years; gestational age ranged from 39 to 41 weeks, and mean duration between delivery of the child and delivery of the placenta was 44.67 days (range: 14–100 days). Two patients developed symptoms of endomyometritis, including fever, leukocytosis and increased CRP levels. All 3 women were successfully managed with preservation of the uterus. Conclusion: In selected cases with placenta accreta/increta after vaginal delivery, it is possible to avoid surgical procedures, particularly hysterectomy procedures, and successfully manage these patients conservatively with preservation of the uterus. PMID:25308979

Peiffer, S.; Reinhard, J.; Reitter, A.; Louwen, F.

2012-01-01

343

Vaginal Practices of HIV-Negative Zimbabwean Women  

PubMed Central

Background. Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84%) reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ?15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR): 1.17, 95% CI: 1.04–1.32). Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86). Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored. PMID:20871844

Turner, Abigail Norris; Morrison, Charles S.; Munjoma, Marshall W.; Moyo, Precious; Chipato, Tsungai; van de Wijgert, Janneke H.

2010-01-01

344

Vaginal Douching among University Women in the Southeastern United States  

ERIC Educational Resources Information Center

Objective: The authors assessed the knowledge, beliefs about, and practices of vaginal douching among women attending 2 universities in the southeastern United States. Participants: There were 416 participants in this study; 46.9% were black and 44.5% were white. Methods: The authors administered a 30-item questionnaire to women enrolled in…

Cottrell, Barbara Hansen; Close, Fran T.

2008-01-01

345

First trimester abortion with mifepristone and vaginal misoprostol  

Microsoft Academic Search

This study assessed the efficacy and side effects of first trimester medical abortion using mifepristone and vaginally administered misoprostol. Medical abortion was first introduced in Denmark in December 1997, and the acceptability of this new approach in a Danish population was evaluated. The study included the first 100 women seeking medical abortion. The gestational age was from 33 to 56

Ulla Breth Knudsen

2001-01-01

346

When is bacterial vaginosis not bacterial vaginosis?--a case of cervical carcinoma presenting as recurrent vaginal anaerobic infection  

Microsoft Academic Search

Vaginal anaerobic infection is the most common cause of vaginal discharge in women. We present a case of recurrent vaginal anaerobic infection and cervical carcinoma and discuss the association of the two conditions. More frequent cytology\\/colposcopy may be indicated in women who give a history of recurrent or persistent vaginal anaerobic infection.

M M Hudson; J A Tidy; T A McCulloch; K E Rogstad

1997-01-01

347

The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis  

Microsoft Academic Search

Antibacterial therapy may enhance the risk of symptomatic vulvo-vaginal candidosis in susceptible women. We addressed the\\u000a question whether oral antifungal treatment for vulvo-vaginal candidosis also influences the bacterial vaginal microflora.\\u000a One hundred and forty-two patients with a culture-proven acute episode of recurrent vulvo-vaginal candidosis (RVC) were treated\\u000a with fuconazole according to the ReCiDiF regimen (induction dose of 600 mg orally per

G. Donders; G. Bellen; J. Ausma; L. Verguts; J. Vaneldere; P. Hinoul; M. Borgers; D. Janssens

2011-01-01

348

Analysis of risk factors associated with vaginal erosion after synthetic sling procedures for stress urinary incontinence.  

PubMed

The goal of this study was to analyze the risk factors associated with vaginal erosion after synthetic sling procedure for stress urinary incontinence. Follow-up evaluations were at 1 week, 1 to 3 months, 6 months, and annually after the operation. The evaluations included detailed history taking, vaginal examinations, and perineal ultrasonographic urethrocystography. The vaginal erosion rate (6/239) after the synthetic sling procedure was 2.5%. We assessed the relationship between clinical features and vaginal erosion. Of these, only diabetes mellitus (DM) was a significant risk factor for vaginal erosion. Women with DM were 8.3 times more at risk than women without DM for developing vaginal erosion after synthetic sling procedure (p < 0.05). The vaginal erosion-free rate during the 24-month follow-up decreased significantly in women with DM. The rate of vaginal erosion associated with type III multifilamentous polypropylene sling (intravaginal slingplasty) is 10.7% more than that with type I monofilament polypropylene sling (such as tension-free vaginal tape and inside out transobturator vaginal tape) (p = 0.054). Women with DM should be informed that vaginal erosion is a possible complication after synthetic sling procedure. PMID:17594046

Chen, Huey-Yi; Ho, Ming; Hung, Yao-Ching; Huang, Li-Chia

2008-01-01

349

Oral and Vaginal Epithelial Cell Lines Bind and Transfer Cell-Free Infectious HIV-1 to Permissive Cells but Are Not Productively Infected  

PubMed Central

The majority of HIV-1 infections worldwide are acquired via mucosal surfaces. However, unlike the vaginal mucosa, the issue of whether the oral mucosa can act as a portal of entry for HIV-1 infection remains controversial. To address potential differences with regard to the fate of HIV-1 after exposure to oral and vaginal epithelium, we utilized two epithelial cell lines representative of buccal (TR146) and pharyngeal (FaDu) sites of the oral cavity and compared them with a cell line derived from vaginal epithelium (A431) in order to determine (i) HIV-1 receptor gene and protein expression, (ii) whether HIV-1 genome integration into epithelial cells occurs, (iii) whether productive viral infection ensues, and (iv) whether infectious virus can be transferred to permissive cells. Using flow cytometry to measure captured virus by HIV-1 gp120 protein detection and western blot to detect HIV-1 p24 gag protein, we demonstrate that buccal, pharyngeal and vaginal epithelial cells capture CXCR4- and CCR5-utilising virus, probably via non-canonical receptors. Both oral and vaginal epithelial cells are able to transfer infectious virus to permissive cells either directly through cell-cell attachment or via transcytosis of HIV-1 across epithelial cells. However, HIV-1 integration, as measured by real-time PCR and presence of early gene mRNA transcripts and de novo protein production were not detected in either epithelial cell type. Importantly, both oral and vaginal epithelial cells were able to support integration and productive infection if HIV-1 entered via the endocytic pathway driven by VSV-G. Our data demonstrate that under normal conditions productive HIV-1 infection of epithelial cells leading to progeny virion production is unlikely, but that epithelial cells can act as mediators of systemic viral dissemination through attachment and transfer of HIV-1 to permissive cells. PMID:24857971

Moyes, David L.; Murciano, Celia; Shen, Chengguo; Challacombe, Stephen J.; Naglik, Julian R.

2014-01-01

350

Forensic interlaboratory evaluation of the ForFLUID kit for vaginal fluids identification.  

PubMed

Identification of vaginal fluids is an important step in the process of sexual assaults confirmation. Advances in both microbiology and molecular biology defined technical approaches allowing the discrimination of body fluids. These protocols are based on the identification of specific bacterial communities by microfloraDNA (mfDNA) amplification. A multiplex real time-PCR assay (ForFLUID kit) has been developed for identifying biological fluids and for discrimination among vaginal, oral and fecal samples. In order to test its efficacy and reliability of the assay in the identification of vaginal fluids, an interlaboratory evaluation has been performed on homogeneous vaginal swabs. All the involved laboratories were able to correctly recognize all the vaginal swabs, and no false positives were identified when the assay was applied on non-vaginal samples. The assay represents an useful molecular tool that can be easily adopted by forensic geneticists involved in vaginal fluid identification. PMID:24365693

Giampaoli, Saverio; Alessandrini, Federica; Berti, Andrea; Ripani, Luigi; Choi, Ajin; Crab, Roselien; De Vittori, Elisabetta; Egyed, Balazs; Haas, Cordula; Lee, Hwan Young; Korabecná, Marie; Noel, Fabrice; Podini, Daniele; Tagliabracci, Adriano; Valentini, Alessio; Romano Spica, Vincenzo

2014-01-01

351

Nanoparticle incorporation of melittin reduces sperm and vaginal epithelium cytotoxicity.  

PubMed

Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001). However, melittin nanoparticles were not cytotoxic to sperm (p?=?0.42) or vaginal epithelium (p?=?0.48) at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ?20 µM (p<0.001) and were toxic to sperm at equivalent melittin concentrations ?40 µM (p<0.001). Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy. PMID:24748389

Jallouk, Andrew P; Moley, Kelle H; Omurtag, Kenan; Hu, Grace; Lanza, Gregory M; Wickline, Samuel A; Hood, Joshua L

2014-01-01

352

Nanoparticle Incorporation of Melittin Reduces Sperm and Vaginal Epithelium Cytotoxicity  

PubMed Central

Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001). However, melittin nanoparticles were not cytotoxic to sperm (p?=?0.42) or vaginal epithelium (p?=?0.48) at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ?20 µM (p<0.001) and were toxic to sperm at equivalent melittin concentrations ?40 µM (p<0.001). Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy. PMID:24748389

Jallouk, Andrew P.; Moley, Kelle H.; Omurtag, Kenan; Hu, Grace; Lanza, Gregory M.; Wickline, Samuel A.; Hood, Joshua L.

2014-01-01

353

Closure constraints for hyperbolic tetrahedra  

E-print Network

We investigate the generalization of loop gravity's twisted geometries to a q-deformed gauge group. In the standard undeformed case, loop gravity is a formulation of general relativity as a diffeomorphism-invariant SU(2) gauge theory. Its classical states are graphs provided with algebraic data. In particular closure constraints at every node of the graph ensure their interpretation as twisted geometries. Dual to each node, one has a polyhedron embedded in flat space R^3. One then glues them allowing for both curvature and torsion. It was recently conjectured that q-deforming the gauge group SU(2) would allow to account for a non-vanishing cosmological constant Lambda, and in particular that deforming the loop gravity phase space with real parameter q>0 would lead to a generalization of twisted geometries to a hyperbolic curvature. Following this insight, we look for generalization of the closure constraints to the hyperbolic case. In particular, we introduce two new closure constraints for hyperbolic tetrahe...

Charles, Christoph

2015-01-01

354

Repository Closure and Sealing Approach  

SciTech Connect

The scope of this analysis will be to develop the conceptual design of the closure seals and their locations in the Subsurface Facilities. The design will be based on the recently established program requirements for transitioning to the Site Recommendation (SR) design as outlined by ''Approach to Implementing the Site Recommendation Baseline'' (Stroupe 2000) and the ''Monitored Geologic Repository Project Description Document'' (CRWMS M&O 1999b). The objective of this analysis will be to assist in providing a description for the Subsurface Facilities System Description Document, Section 2 and finally to document any conclusions reached in order to contribute and provide support to the SR. This analysis is at a conceptual level and is considered adequate to support the SR design. The final closure barriers and seals for the ventilation shafts, and the north and south ramps will require these openings to be permanently sealed to limit excessive air and water inflows and prevent human intrusion. The major tasks identified with closure in this analysis are: (1) Developing the overall subsurface seal layout and identifying design and operational interfaces for the Subsurface Facilities. (2) Summarizing the general site conditions and general rock characteristic with respect to seal location and describing the seal selected. (3) Identify seal construction materials, methodology of construction and strategic locations including design of the seal and plugs. (4) Discussing methods to prevent human intrusion.

A.T. Watkins

2000-06-28

355

Evaluation of the effect of crack closure on fatigue crack growth of simulated short cracks  

NASA Technical Reports Server (NTRS)

A test program was performed to determine the influence of crack closure on fatigue crack growth (FCG) rates of short cracks. By use of the standard compact tension specimen, test procedures were devised to evaluate closure loads in the wake of the crack behind its tip. The first procedure determined the magnitude of crack closure as a function of the fatigued crack wave by incrementally removing the contacting wake surfaces and measuring closure load at each increment. The second procedure used a low-high loading sequence to simulate short crack behavior. Based on the results, it was concluded that crack closure is not the major reason for the more rapid growth of short cracks as compared to long crack growth.

Telesman, J.; Fisher, D. M.

1984-01-01

356

Filshie clip closure: determination of closure through the analysis of X-rays.  

PubMed

The Filshie method is a tubal occlusion method commonly used to prevent pregnancy. In medical negligence cases where it is suspected that closure of a Filshie clip may be faulty, lawyers may call on expert surgeons to assess whether or not a clip is closed on the basis of visual examination of the X-rays. However, it is not uncommon for experts to disagree. The aim of this work was to reduce the uncertainty in determining whether or not Filshie clips had been correctly closed. An estimate of the error in the estimate of the clip height was made by propagating measurement errors through a mathematical model. The effects of angle of presentation of the clip, digitisation of the image and resolution of the measurements were studied and the method was applied to two cases. The analysis indicated that measurement errors were least when the digitisation of the image was at 600dpi, angle of presentation of the clip was less than 40 degrees and the measurements could be made to an accuracy of +/-1pixel. Under these conditions it was possible to determine clip closure height with an error of less than +/-0.2mm. PMID:18926503

Clegg, Richard Edward

2008-11-01

357

Identification and genotyping of bacteria from paired vaginal and rectal samples from pregnant women indicates similarity between vaginal and rectal microflora  

PubMed Central

Background The vaginal microflora is important for maintaining vaginal health and preventing infections of the reproductive tract. The rectum has been suggested as the major source for the colonisation of the vaginal econiche. Methods To establish whether the rectum can serve as a possible bacterial reservoir for colonisation of the vaginal econiche, we cultured vaginal and rectal specimens from pregnant women at 35-37 weeks of gestation, identified the isolates to the species level with tRNA intergenic length polymorphism analysis (tDNA-PCR) and genotyped the isolates for those subjects from which the same species was isolated simultaneously vaginally and rectally, by RAPD-analysis. One vaginal and one rectal swab were collected from a total of each of 132 pregnant women at 35-37 weeks of gestation. Swabs were cultured on Columbia CNA agar and MRS agar. For each subject 4 colonies were selected for each of both sites, i.e. 8 colonies in total. Results Among the 844 isolates that could be identified by tDNA-PCR, a total of 63 bacterial species were present, 9 (14%) only vaginally, 26 (41%) only rectally, and 28 (44%) in both vagina and rectum. A total of 121 (91.6%) of 132 vaginal samples and 51 (38.6%) of 132 rectal samples were positive for lactobacilli. L. crispatus was the most frequently isolated Lactobacillus species from the vagina (40% of the subjects were positive), followed by L. jensenii (32%), L. gasseri (30%) and L. iners (11%). L. gasseri was the most frequently isolated Lactobacillus species from the rectum (15%), followed by L. jensenii (12%), L. crispatus (11%) and L. iners (2%). A total of 47 pregnant women carried the same species vaginally and rectally. This resulted in 50 vaginal/rectal pairs of the same species, for a total of eight different species. For 34 of the 50 species pairs (68%), isolates with the same genotype were present vaginally and rectally and a high level of genotypic diversity within species per subject was also established. Conclusion It can be concluded that there is a certain degree of correspondence between the vaginal and rectal microflora, not only with regard to species composition but also with regard to strain identity between vaginal and rectal isolates. These results support the hypothesis that the rectal microflora serves as a reservoir for colonisation of the vaginal econiche. PMID:19828036

2009-01-01

358

Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: an open, non-controlled clinical trial.  

PubMed

Menopause, due to the physiological decrease in the estrogens levels, is often associated with many symptoms related to vaginal atrophy such vaginal dryness, dyspareunia, burning, itching, decreasing in libido and therefore a worsening of the quality of life and in particular of the sexual activity. There are many pharmacological remedies to solve these events, first of all hormone replacement therapy (HRT) that up to the 90s was the therapy of choice for the care of the menopause symptoms. This hormonal therapy, however, has been re-considered due to its side effects. As alternative, a clinical trial has been performed to investigate the efficacy and safety, in postmenopausal women with urogenital atrophy, of the use of suppositories for vaginal use, containing hyaluronic acid, vitamin E and vitamin A. The trial, according to a open, non-controlled design, was performed on 150 postmenopausal women, 1 vaginal suppository per day, for the first 14 days and then a vaginal suppository, day in and day out, for other 14 days. The primary endpoint was the evaluation of vaginal dryness assessed by a Visual Analogue Scale (VAS) both by the investigator and the patient. The secondary endpoints were the evaluation of all the other symptoms and signs associated with the vaginal atrophy (itching, burning, dyspareunia, vaginal inflammation or swelling, irritation, assessed by a 4-point scale, presence of vaginal abrasions and irritation), and the recording of the adverse events occurring during the trial. The patients have not reported adverse effects during the treatment, and the results in terms of effectiveness on the vaginal atrophy symptoms were markedly positive. A high level of compliance was registered. The product tested can therefore be considered a safe and effective alternative for the treatment of vaginal atrophy symptoms in postmenopausal women, especially when HRT is not recommended. PMID:19146203

Costantino, D; Guaraldi, C

2008-01-01

359

Bioadhesive vaginal tablets containing spray dried microspheres loaded with clotrimazole for treatment of vaginal candidiasis.  

PubMed

The aim of the present investigation was to prepare and evaluate novel bioadhesive vaginal tablets containing clotrimazole loaded microspheres in order to provide long-term therapeutic activity at the site of infection. Tablets were prepared by incorporating drug loaded microspheres and using bioadhesive polymers hydroxypropylmethylcellulose, sodium carboxymethylcellulose and Carbopol. Microspheres were prepared by the spray drying technique using Eudragit RS-100 and Eudragit RL-100. Microspheres were characterized by SEM, DSC, FTIR, particle size analysis and evaluated for percentage yield, drug loading, encapsulation efficiency and in vitro drug release. To achieve bioadhesion to the mucosal tissue, optimized microspheres were incorporated into bioadhesive tablets and were evaluated for in vitro drug release, in vitro and in vivo mucoadhesion. FTIR and DSC studies showed that no chemical interaction occurred between the drug and polymers. The sphericity factor indicated that the prepared microspheres were spherical. Formulation Mt6 indicated a controlled in vitro drug release and good bioadhesive strength. The in vivo images confirmed the bioadhesion and retention property of tablets up to 24 h. The results indicated that this drug delivery system can be explored for controlled intravaginal drug release. PMID:24152896

Gupta, Naresh Vishal; Natasha, Shirodker; Getyala, Anil; Bhat, Ramnath Sudeendra

2013-09-01

360

CASE REPORT Pharyngocutaneous Fistula Closure Using Autologous Fat Grafting  

PubMed Central

Objective: Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive treatment approaches designed to reverse tissue damage or promote spontaneous healing would represent an important medical advance. Autologous fat grafts have been previously shown to promote healing of persistent wounds and improve the quality of radiation-damaged tissue. In this report, successful closure of a persistent pharyngocutaneous fistula with use of autologous fat grafting is described. Method: The history and details of pharyngocutaneous fistula closure in a patient with recurrent head and neck cancer are reported. Result: A 67-year-old patient with recurrent head and neck cancer and prior radiotherapy underwent reresection including partial pharyngectomy with pectoralis major myocutaneous flap closure. Postoperatively, he developed an enterocutaneous fistula, which failed to close with conservative measures including 8 months of nothing per os. Two rounds of autologous fat grafting were performed with successful fistula healing. Conclusion: Autologous fat grafting is a useful treatment for closure of persistent pharyngocutaneous fistulas. Autologous fat grafting should be considered in poor surgical candidates, particularly in the setting of extensive radiation-induced tissue damage. PMID:23691260

Hespe, Geoffrey E.; Albornoz, Claudia R.; Mehrara, Babak J.; Kraus, Dennis; Matros, Evan

2013-01-01

361

Predictive value of aspartate aminotransferase and alanine aminotransferase levels in vaginal fluid for the diagnosis of premature rupture of membranes  

PubMed Central

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and 30-40% of preterm labors are related to this problem. Early diagnosis of PPROM is very important due to its impact on pregnancy outcomes. Objective: To determine the diagnostic value of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in vaginal fluid for the diagnosis of preterm premature rupture of membranes as a non-invasive and available test. Materials and Methods: A total of 148 pregnant women between the 26th-36th gestational weeks were enrolled in the study. 74 patients were in PROM group and 74 in control group. AST and ALT levels in vaginal fluid were measured in each group. Mann Whitney U-test was used to compare AST and ALT levels in each group. Results: The mean of AST level in vaginal fluid was 12.77±10.06 in PROM group vs. 6.91±10.92 in control group (p<0.001), while there were no significant difference between ALT levels in PROM group 1.51±3.17 and control group 0.89±1.15 (p=0.49). Optimal cut point of AST for the diagnosis of PROM was 4.5 IU/L in this study. The sensitivity, specificity, positive and negative predictive values were 82.4%, 63.5%, 69.32% and 78.33% respectively. Conclusion: According to the findings of this study, measurement of AST level in vaginal fluid can be used as a reliable test for diagnosis of PROM, but there is no good cut point for ALT level that can be practically used. PMID:24976822

Asgharnia, Maryam; Mirblouk, Fariba; Salamat, Fatemeh; Ashrafkhani, Babak; Dirbaz, Zahra

2014-01-01

362

Selecting anti-microbial treatment of aerobic vaginitis.  

PubMed

Aerobic vaginitis (AV) is a vaginal infectious condition which is often confused with bacterial vaginosis (BV) or with the intermediate microflora as diagnosed by Nugent's method to detect BV on Gram-stained specimens. However, although both conditions reflect a state of lactobacillary disruption in the vagina, leading to an increase in pH, BV and AV differ profoundly. While BV is a noninflammatory condition composed of a multiplex array of different anaerobic bacteria in high quantities, AV is rather sparely populated by one or two enteric commensal flora bacteria, like Streptococcus agalactiae, Staphylocuccus aureus, or Escherichia coli. AV is typically marked by either an increased inflammatory response or by prominent signs of epithelial atrophy or both. The latter condition, if severe, is also called desquamative inflammatory vaginitis. As AV is per exclusionem diagnosed by wet mount microscopy, it is a mistake to treat just vaginal culture results. Vaginal cultures only serve as follow-up data in clinical research projects and are at most used in clinical practice to confirm the diagnosis or exclude Candida infection. AV requires treatment based on microscopy findings and a combined local treatment with any of the following which may yield the best results: antibiotic (infectious component), steroids (inflammatory component), and/or estrogen (atrophy component). In cases with Candida present on microscopy or culture, antifungals must be tried first in order to see if other treatment is still needed. Vaginal rinsing with povidone iodine can provide rapid relief of symptoms but does not provide long-term reduction of bacterial loads. Local antibiotics most suitable are preferably non-absorbed and broad spectrum, especially those covering enteric gram-positive and gram-negative aerobes, like kanamycin. To achieve rapid and short-term improvement of severe symptoms, oral therapy with amoxyclav or moxifloxacin can be used, especially in deep dermal vulvitis and colpitis infections with group B streptococci or (methicillin resistant) Staphylococcus aureus. Since the latter colonizations are frequent, but seldom inflammatory infections, we in general discourage the use of oral antibiotics in women with AV. In cases with a severe atrophy component (more than 10 % of epithelial cells are of the parabasal type), local estrogens can be used; and in postmenopausal or breast cancer patients with a contraindication for estrogens, even a combination of probiotics with an ultra-low dose of local estriol may be considered. PMID:25896749

Donders, Gilbert G G; Ruban, Katerina; Bellen, Gert

2015-05-01

363

Development of generic models for ambulatory vaginal surgery--a preliminary report.  

PubMed

Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from width to length or into a partial double-layered repair; the creation of artificial neoligaments; the prevention of urinary retention by avoiding tightness in the bladder neck area; local anesthetic infiltration; and buttressing vaginal tissue during wound healing. A total of 108 patients underwent vaginal surgery on an ambulatory or overnight stay basis, 72 under local anesthesia/midazolam. Minimal postoperative pain and the absence of catheterization reduced hospital stay from a statewide mean of 8 days to 1 day, and return to normal activities from 6 weeks to 7-10 days. Cure rates (18 months) were: uterovaginal prolapse 22/22, infracoccygeal sacropexy 21/23, rectocele 36/38, cystocele/anterior vaginal wall prolapse 21/25. Applied as prototypes to reconstructive vaginal surgery, the operations appear to be as effective as traditional techniques but far less invasive. They have the potential to assist working mothers, the old and infirm, and save the community up to $5,500 per patient. It is hoped that the generic models presented may act as a basis for the future development of ambulatory vaginal surgical techniques. PMID:9657174

Papa Petros, P E

1998-01-01

364

Elective colostomy closure in an AIDS patient.  

PubMed Central

This article describes a 27-year-old patient with acquired immunodeficiency syndrome (AIDS) who underwent emergency sigmoid colostomy, Hartmann's pouch, and presacral drainage for rectal perforation. Three months later, he underwent uneventful elective colostomy closure, a procedure previously unreported in an AIDS patient. He remained without gastrointestinal symptoms for 14 months after colostomy closure until he died from central nervous system toxoplasmosis. A diagnosis of AIDS alone should not preclude colostomy closure in AIDS patients. PMID:8078085

Pasquale, M. D.; Kenkel, J. M.; Holt, R. W.

1994-01-01

365

Force-closure grasping with two hands  

Microsoft Academic Search

This thesis addresses grasping of large (but not necessarily heavy) objects by using two hands. The objective is to determine force-closure grasps of rigid objects of unknown shape. A grasp is force-closure if it can completely constrain the movement of the object. In seeking force-closure conditions, the approach taken in this study is to establish useful sufficient conditions rather than

Jose-Antonio Navarro Caraza

1991-01-01

366

Closure Phase Signatures of Planet Transit Events  

E-print Network

Planet transit events present as attractive targets for the ultra-high-resolution capabilities afforded by optical interferometers. Herein is presented an evaluation of the possibility of detection of such events through measurement of high-precision closure phases with the MIRC instrument on the CHARA Array. Recovery of the transit position angle upon the sky appears readily achievable with the existing capabilities of the instrument, along with characterization of other system parameters, such as stellar radius, planet radius, and other parameters of the transit event. This technique is the only one presently available that can provide a transiting planet's orbital plane position angle, and can directly determine the planet's radius independent of any outside observations, appearing able to improve substantially upon other determinations of that radius. Additional directly observed parameters - also not dependent upon transit photometry or spectroscopy - include impact parameter, transit ingress time, transit velocity and stellar radius.

G. T. van Belle

2008-04-16

367

[Pelvic floor muscle training as treatment of stress incontinence. The effectiveness of vaginal cones].  

PubMed

Pelvic floor muscle training is the mainstream of the non-operative treatment for female stress urinary incontinence. However, in order to make this method effective, it is mandatory to learn how to correctly contract pelvic floor muscles. Thirty adult women suffering from mild stress incontinence were instructed to train their pelvic muscles using vaginal cones. They retained cones of increasing weight in the vagina by contracting pelvic floor for 15 minutes twice a day. Twenty-seven of 30 (90%) patients could complete the training in five weeks. Both incidence and degree of incontinence decreased significantly after the training. The subjective improvement rate (incontinence cured or decreased by 50%) was 70%. The cone weights which they could hold over one minute and the voluntary pelvic floor contractions measured with the perineometer increased significantly, which indicated strengthening of pelvic floor muscles. Vaginal cones have a shape similar to tampons and are accepted by Japanese women with little psychological resistance. This device helps the patients to understand how to contract pelvic floor muscles and to motivate them to continue training, thus contributing for the treatment of stress incontinence. PMID:1593830

Kato, K; Kondo, A; Hasegawa, S; Saito, M; Yamada, Y; Murase, T; Miyake, K

1992-04-01

368

Vacuum-assisted closure in the treatment of poststernotomy mediastinitis  

Microsoft Academic Search

A new technique using vacuum-assisted closure was successfully applied in 3 patients with poststernotomy mediastinitis. After surgical debridement, this vacuum-assisted closure technique has made it possible to avoid the need for secondary surgical closure (including direct secondary surgical closure and secondary surgical closure by use of vascularized muscle flaps). A healed stable sternotomy wound can be achieved using this new

Miryam C Obdeijn; Marjoleine Y de Lange; Dagna H. E Lichtendahl; Willem J de Boer

1999-01-01

369

Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer  

ClinicalTrials.gov

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Squamous Cell Carcinoma

2015-03-18

370

100-D Ponds closure plan. Revision 1  

SciTech Connect

The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit is clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure.

Petersen, S.W.

1997-09-01

371

Gemeprost vaginal pessaries for inducing third-trimester intrauterine deaths.  

PubMed

In 3rd trimester fetal death, when the cervix requires softening, labor may be induced by the administration of intravenous, intra-or extraamniotic, or vaginal prostaglandin E2 or intramuscular injections of synthetic prostaglandins, such as 15(S)-methyl prostaglandin F2 alpha. These methods all have various disadvantages. In 10 women with 3rd trimester intrauterine death, labor was induced by vaginal insertion of a 1 mg gemeprost (16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester) pessary. The mean number of pessaries s required was 1.9, and the mean duration of labor was 11.7 hours. The women remained mobile during most of the procedure. No patient required additional oxytocin, and the only side effects were mild fever and diarrhea. PMID:2804000

Shafi, M I; Constantine, G; Byrne, P; Luesley, D M; Pogmore, J R

1989-06-01

372

Chitosan/alginate complexes for vaginal delivery of chlorhexidine digluconate.  

PubMed

Chitosan/alginate complexes were prepared at different polycation/polyanion molar ratios and freeze-dried vaginal inserts were obtained for chlorhexidine digluconate local delivery in genital infections. Complex yield, FT-IR spectra, and TGA thermograms were studied to confirm the interaction between the two polyions. The influence of different complexes on physical handling, morphology, and drug distribution in the samples were evaluated by friability test, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS), respectively. In vitro water-uptake, mucoadhesion and release tests were performed as well as microbiological tests toward pathogenic vaginal microorganisms. The results showed that the selection of suitable chitosan/alginate molar ratio and drug loading allowed modulate insert ability to hydrate, adhere to the mucosa, and release chlorhexidine digluconate. The insert containing an excess of alginate was found to be the best performing formulation and showed good antimicrobial activity toward the pathogens Candida albicans and Escherichia coli. PMID:23121960

Abruzzo, A; Bigucci, F; Cerchiara, T; Saladini, B; Gallucci, M C; Cruciani, F; Vitali, B; Luppi, B

2013-01-16

373

Identification of Selected Child-Resistant Closures (Continuous Thread, Lug-Bayonet, and Snap Closures).  

ERIC Educational Resources Information Center

This publication describes a selected group of child-resistant closures used in packaging five categories of medicine and household products. The material in the document was collected to train survey personnel to identify closures for a planned household study of the effectiveness of child-resistant packaging. The 39 closures described are of…

Gross, Rosalind L.; White, Harry E.

374

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2010 CFR

...STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.258 Closure and post-closure...1) The owner or operator of a waste pile that does not comply with the liner requirements...i) Include in the closure plan for the pile under § 264.112 both a plan for...

2010-07-01

375

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.258 Closure and post-closure...1) The owner or operator of a waste pile that does not comply with the liner requirements...i) Include in the closure plan for the pile under § 264.112 both a plan for...

2013-07-01

376

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2014 CFR

...STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.258 Closure and post-closure...1) The owner or operator of a waste pile that does not comply with the liner requirements...i) Include in the closure plan for the pile under § 264.112 both a plan for...

2014-07-01

377

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2011 CFR

...STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.258 Closure and post-closure...1) The owner or operator of a waste pile that does not comply with the liner requirements...i) Include in the closure plan for the pile under § 264.112 both a plan for...

2011-07-01

378

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2012 CFR

...STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.258 Closure and post-closure...1) The owner or operator of a waste pile that does not comply with the liner requirements...i) Include in the closure plan for the pile under § 264.112 both a plan for...

2012-07-01

379

Defining patient knowledge and perceptions of vaginal mesh surgery  

PubMed Central

Objective Given recent government investigations and media coverage of the controversy regarding mesh surgery, we sought to define patient knowledge and perceptions of vaginal mesh surgery. Study Design An anonymous survey was distributed to a convenience sample of new patients at Urogynecology and Female Urology clinics at a single medical center during April–June 2012. The survey assessed patient demographics, information sources, beliefs and concerns regarding mesh surgery. Fisher’s exact test was used to identify predictors of patients’ beliefs regarding mesh. Logistic and linear regressions were used to identify predictors of aversion to surgery and higher concern regarding future surgery. Results 164 women completed the survey; 62.2% (102/164) indicated knowledge of mesh surgery for prolapse and/or incontinence and were included in subsequent analyses. Mean age was 58.0±12.5 years and 24.5% reported prior mesh surgery. The most common information source was TV commercials (57.8%); only 23.5% of women reported receiving information from a medical professional. Participants indicated the following regarding vaginal mesh: class-action lawsuit in progress (55/102, 54.0%), causes pain (47/102, 47.1%), possibility of rejection (35/102, 34.3%), can cause bleeding and become exposed vaginally (30/102, 29.4%), and should be removed due to recall (28/102, 27.5%). Of these women, 22.1% (19/86) indicated they would not consider mesh surgery. On multivariable logistic regression, level of concern, information from friends/family, and knowledge of class-action lawsuit predicted aversion to mesh surgery. Conclusion Nearly two-thirds of new patients had knowledge of vaginal mesh surgery. We identified considerable misinformation and aversion to future mesh surgery among these women. PMID:23982577

Brown, Lindsay K.; Fenner, Dee E.; Berger, Mitchell B.; Delancey, John O.L.; Morgan, Daniel M.; Patel, Divya A.; Schimpf, Megan O.

2014-01-01

380

Urinary Incontinence after Vaginal Delivery or Cesarean Section  

Microsoft Academic Search

background It is uncertain whether women who deliver by cesarean section have an increased risk of urinary incontinence as compared with nulliparous women and whether women who deliver vaginally have an even higher risk. methods We studied 15,307 women enrolled in the Epidemiology of Incontinence in the County of Nord-Trøndelag (EPINCONT) study, which involved a community-based cohort. The data base

Guri Rortveit; Anne Kjersti Daltveit; Yngvild S. Hannestad; Steinar Hunskaar

2003-01-01

381

Clitoral blood flow increases following vaginal pressure stimulation  

Microsoft Academic Search

The vascular responses of clitoral arteries to vaginal pressure stimulation in 10 volunteer women were evaluated by Doppler ultrasonography. Pressure stimulations (20–160 mm Hg) along the lower third of the vagina increased blood velocity and flow into clitoral arteries in 9 of the 10 women. The latency and duration of the Doppler responses ranged from 0.1 to 1.6 sec and

Pierre Lavoisier; Rachild Aloui; Markus H. Schmidt; Antoine Watrelot

1995-01-01

382

Vaginal intraepithelial neoplasia: clinical-therapeutic analysis of 33 cases  

Microsoft Academic Search

Vaginal intraepithelial neoplasia (VAIN) represents 1% of all intraepithelial neoplasia of the lower genital tract. Our aim\\u000a was to study the clinical-therapeutic characteristics of patients with VAIN. A retrospective study was made of all cases of\\u000a patients, who attended within the outpatient service between 1993 and 2003, with a diagnosis of VAIN. During this period,\\u000a 84,293 Papanicolaou smears (triple collection)

Eddie F. C. Murta; Milton A. Neves Junior; Luciano R. F. Sempionato; Marcos C. Costa; Paulo J. Maluf

2005-01-01

383

Management of benign adnexal masses by vaginal route.  

PubMed

Until recently, surgical treatment of a benign adnexal mass implied a laparotomy. In recent years, the development of laparoscopic surgery, as well as ultrasound-guided aspiration techniques, have significantly modified the treatment options for these patients. These procedures have shown considerable advantages. They have reduced surgical trauma and have shortened the hospital stay. We present the results of our experience on the feasibility of a trans-vaginal surgical approach for the removal of benign adnexal masses. This technique, using traditional and cheap surgical instruments, allows the surgeon to excise benign adnexal masses, by entering the peritoneum through the posterior vaginal fornix and thus avoids the trauma of laparotomy. Fifty-four patients were operated on by this technique at our Department. The mean age was 39 years (range 21-66). In all cases, the operation was completed by the trans-vaginal approach. The median operative time was 30 minutes (range 20-45), and no blood transfusion was needed. The pathological diagnoses were as follows: functional ovarian cyst; 19, endometriotic cyst; 18, dermoid cyst; 11, parovarian cyst; 4 and peduncolated fibroid of the uterine fundus; 2 cases. The diameter of the adnexal masses ranged from 3 to 10 cm (median of 6 cm). In 30 cases, a conservative surgery was done (including 2 myomectomies), whereas in 24 cases, the adnexectomy was needed. Median post-operative stay in hospital was 4 days (range 1-14). This study shows the feasibility of trans-vaginal surgical approach for benign adnexal masses. The advantages and limitations of this technique, as well as of the traditional and laparoscopic surgery are considered and discussed. We believe that the transvaginal approach could be useful and cost-effective for the treatment of selected cases of adnexal masses. PMID:9159258

Massi, G B; Savino, L; Lena, A; Susini, T

1996-01-01

384

MR Imaging of Levator Ani Muscle Recovery Following Vaginal Delivery  

Microsoft Academic Search

:   Our aim was to quantify the changes that occur in the levator ani muscles (LA) after vaginal delivery using magnetic resonance\\u000a imaging. Fourteen women underwent MRI 1 day postpartum. Six of them were also scanned 1, 2, 6 weeks and 6 months after delivery.\\u000a LA signal intensities and thickness, in areas of the urogenital and the levator hiatus were

R. Tunn; J. O. L. DeLancey; D. Howard; J. M. Thorp; J. A. Ashton-Miller; L. E. Quint

1999-01-01

385

Effects of vaginal lactobacilli in Chlamydia trachomatis infection.  

PubMed

Increasing evidence indicates that abnormal vaginal flora lacking lactobacilli facilitates the acquisition of several sexually transmitted diseases including Chlamydia trachomatis. C. trachomatis, the most common bacterial agent of genital infections worldwide, can progress from the lower to upper reproductive tract and induce severe sequelae. The ability of C. trachomatis to develop into a persistent form has been suggested as key pathogenetic mechanism underlying chronic infections and sequelae. The aim of our study was to investigate the C. trachomatis interaction with vaginal microbiota analyzing the effects of Lactobacillus strains (L. brevis and L. salivarius) on the different phases of C. trachomatis developmental cycle. In addition, the effect of lactobacilli on persistent chlamydial forms induced by HSV-2 coinfection has also been evaluated. Our results demonstrated significant inhibition of C. trachomatis multiplication by vaginal lactobacilli. L. brevis was significantly more effective than L. salivarius (p<0.05) on all the steps of chlamydial infection cycle suggesting that the ability of lactobacilli to protect from infection is strain-dependent. Lactobacilli had an adverse effect on elementary chlamydial bodies (p<0.05), on chlamydial adsorption to epithelial cells (p<0.001) and on intracellular phases of chlamydial replication (p<0.0001). Our study also demonstrated a protective effect of lactobacilli toward persistent C. trachomatis forms induced by HSV-2 coinfection. A significant increase in the production of C. trachomatis infectious progeny was observed in C. trachomatis/HSV-2 coinfection in the presence of L. brevis (p=0.01) despite a significant inhibition of C. trachomatis multiplication (p=0.028). Our data suggest that a healthy vaginal microbiota can reduce the risk of acquiring C. trachomatis infection and counteract the development of persistent chlamydial forms. PMID:24875405

Mastromarino, Paola; Di Pietro, Marisa; Schiavoni, Giovanna; Nardis, Chiara; Gentile, Massimo; Sessa, Rosa

2014-07-01

386

Vaginal hyperplasia in the bitch: Literature review and commentary  

PubMed Central

We reviewed the incidence, etiology, clinical presentations, diagnosis, treatments and prevention of canine vaginal hyperplasia, and describe a simple surgical technique for its correction as practiced at the Small Animal Clinic, State University of Utrecht, The Netherlands. Many different treatments have been used, and some are novel approaches. In many cases, prevention is accomplished if the bitch is ovariectomized; there is a high incidence of recurrence with medical treatment. PMID:17423719

Post, Klaas; Van Haaften, Bas; Okkens, Auke C.

1991-01-01

387

Clamshell closure for metal drum  

SciTech Connect

Closure ring to retain a lid in contact with a metal drum in central C-section conforming to the contact area between a lid and the rim of a drum and further having a radially inwardly directed flange and a vertically downwardly directed flange attached to the opposite ends of the C-section. The additional flanges reinforce the top of the drum by reducing deformation when the drum is dropped and maintain the lid in contact with the drum. The invention is particularly valuable in transportation and storage of fissile material.

Blanton, Paul S

2014-09-30

388

Neutralizing IgG at the Portal of Infection Mediates Protection against Vaginal Simian/Human Immunodeficiency Virus Challenge  

PubMed Central

Neutralizing antibodies may have critical importance in immunity against human immunodeficiency virus type 1 (HIV-1) infection. However, the amount of protective antibody needed at mucosal surfaces has not been fully established. Here, we evaluated systemic and mucosal pharmacokinetics (PK) and pharmacodynamics (PD) of 2F5 IgG and 2F5 Fab fragments with respect to protection against vaginal challenge with simian-human immunodeficiency virus-BaL in macaques. Antibody assessment demonstrated that 2F5 IgG was more potent than polymeric forms (IgM and IgA) across a range of cellular and tissue models. Vaginal challenge studies demonstrated a dose-dependent protection for 2F5 IgG and no protection with 2F5 Fab despite higher vaginal Fab levels at the time of challenge. Animals receiving 50 or 25 mg/kg of body weight 2F5 IgG were completely protected, while 3/5 animals receiving 5 mg/kg were protected. In the control animals, infection was established by a minimum of 1 to 4 transmitted/founder (T/F) variants, similar to natural human infection by this mucosal route; in the two infected animals that had received 5 mg 2F5 IgG, infection was established by a single T/F variant. Serum levels of 2F5 IgG were more predictive of sterilizing protection than measured vaginal levels. Fc-mediated antiviral activity did not appear to influence infection of primary target cells in cervical explants. However, PK studies highlighted the importance of the Fc portion in tissue biodistribution. Data presented in this study may be important in modeling serum levels of neutralizing antibodies that need to be achieved by either vaccination or passive infusion to prevent mucosal acquisition of HIV-1 infection in humans. PMID:23966410

Klein, Katja; Veazey, Ronald S.; Warrier, Ranjit; Hraber, Peter; Doyle-Meyers, Lara A.; Buffa, Viviana; Liao, Hua-Xin; Haynes, Barton F.; Shaw, George M.

2013-01-01

389

A disposable vaginal speculum for the chimpanzee (Pan troglodytes).  

PubMed

The unanticipated underutilization of chimpanzees (Pan troglodytes) by the National Institutes of Health (NIH) for current NIH-supported research has prompted the application of a variety of contraceptive forms. Among the many methods attempted, the intrauterine device (IUD) has been described as having an efficacy similar to that described for humans. In addition, the device is both a financially sound and practical solution to prevention of overpopulation, while minimizing disruption of normal cyclic hormonal fluctuations. However, variations in the size and shape of the sexual skin of the female chimpanzee and the depth of the vaginal vault have posed physical constraints on the use of instrumentation developed for humans for assisting with insertion of the device. In addition the literature is lacking in specific methodology for pelvic examination in chimpanzees. Previously, the University of Louisiana at Lafayette New Iberia Research Center used a 3-ml plastic syringe case as a vaginal speculum to accommodate requirements of an approved research protocol in African green monkeys (Chlorocebus aethiops). Similarly, a simple and effective disposable vaginal speculum was developed for the chimpanzee. The closed tip of a plastic syringe case of appropriate size (20 to 60 ml) was removed to provide an open tube; momentary heating smoothed the cut edge. This simple speculum allowed for sufficient visualization of the cervix for assessment and assistance in the insertion of the IUD. Variously sized speculums were prepared to accommodate differences in animal size. This simple and effective speculum was clean, disposable, and inexpensive. PMID:15934725

Hasselschwert, Dana L; Fontenot, M Babette

2005-05-01

390

Pelvic floor disorders following vaginal or cesarean delivery  

PubMed Central

Purpose of review Pelvic floor disorders affect women of all ages and are associated with significant economic burden and poor quality of life. Current literature suggests an association between childbirth and these disorders. In this review, we summarize recent advancements in our understanding of this association. Recent findings Vaginal childbirth appears to be strongly associated with stress urinary incontinence and pelvic organ prolapse. There is less evidence to suggest an association between vaginal delivery and overactive bladder symptoms. History of more than one perineal laceration increases the likelihood of developing prolapse. Similar association has not been established for episiotomy. Disruption or denervation of structural components of pelvic floor support system, particularly levator ani muscle complex, is associated with later development of pelvic floor disorders. Imbalance in homeostasis of connective tissue remodeling of the vaginal wall from overstretching during childbirth is another possible mechanism. Summary Pelvic floor disorders represent a significant health problem affecting women of all ages. Identification of potential modifiable risk factors and advancement in understanding of the underlying pathophysiology is crucial for primary and secondary prevention of these disorders and for improvement in treatment strategies. PMID:22907482

Memon, Hafsa; Handa, Victoria L.

2013-01-01

391

Characterization of Commercially Available Vaginal Lubricants: A Safety Perspective  

PubMed Central

Vaginal lubricants are widely used by women to help solve intercourse difficulties or as enhancers, but recent reports raise questions about their safety. Twelve commercially available gel products were tested for pH value, pH buffering capacity, osmolality and cytotoxicity relevant to vaginal delivery. Obtained data were analyzed in light of the recent Advisory Note by the World Health Organization (WHO) for personal lubricants to be concomitantly used with condoms. Results showed that most products do not comply with pH and osmolality recommended standards, thus posing a potential hazard. Four products presented values of osmolality around three-times higher than the maximum acceptable limit of 1200 mOsm/kg. In vitro cell testing further identified substantial cytotoxicity even at 1:100 dilutions for three products, contrasting with no significant effect of up to at least a 1:5 dilution of a Universal Placebo gel. However, no direct correlation between these last results and pH or osmolality was found, thus suggesting that the individual toxicity of specific formulation components plays an important role in the outcome of a particular product. Although further assessment is required, these results highlight potential safety issues related to the formulation of commercially available vaginal lubricants. PMID:25247884

Cunha, Ana Raquel; Machado, Rita M.; Palmeira-de-Oliveira, Ana; Martinez-de-Oliveira, José; das Neves, José; Palmeira-de-Oliveira, Rita

2014-01-01

392

Permeability of tritiated water through human cervical and vaginal tissue.  

PubMed

The increased incidence of human immunodeficiency virus infection in women has identified an urgent need to develop a female-controlled method to prevent acquisition of human immunodeficiency virus and other sexually transmitted diseases. Women would apply the product intravaginally before intercourse. Development of such a product requires a better understanding of the permeability characteristics of the tissues with which such products would come into contact. However, limited studies have been performed in this area. In the present study, water permeability of fresh human cervical and vaginal tissue was evaluated. The average apparent permeability coefficient was found to be 8 x 10(-5) cm/s for fresh human cervical tissue and 7 x 10(-5) cm/s for fresh human vaginal tissue. Considering the lack of regularity in obtaining cervical and vaginal tissue from surgical specimens, additional tests were performed to evaluate the effect of freezing on tritiated water permeability. No statistically significant differences were observed in the permeability values obtained when comparing fresh versus frozen tissues. PMID:15236450

Sassi, Alexandra B; McCullough, Kristy D; Cost, Marilyn R; Hillier, Sharon L; Rohan, Lisa Cencia

2004-08-01

393

A Novel Intra-body Sensor for Vaginal Temperature Monitoring  

PubMed Central

Over the years some medical studies have tried to better understand the internal behavior of human beings. Many researchers in this domain have been striving to find relationships between intra-vaginal temperature and certain female health conditions, such as ovulation and fertile period since woman’s intra-vaginal temperature is one of the body parameters most preferred in such studies. However, due to lack of a appropriate technology, medical research devoted to studying correlations of such body parameters with certain womans’ body phenomena could not obtain better results. This article presents the design and implementation of a novel intra-body sensor for acquisition and monitoring of intra-vaginal temperatures. This novel intra-body sensor provides data collection that is used for studying the relation between temperature variations and female health conditions, such as anticipation and monitoring of the ovulation period, detection of pregnancy contractions, preterm labor prevention, etc.. The motivation for this work focuses on the development of this new intra-body sensor that will represent a major step in medical technology. The novel sensor was tested and validated on hospitalized women as well as normal healthy women. Finally our medical team has attested to the accuracy, usability and performance of this novel intra-body sensor. PMID:22574046

Rodrigues, Joel J. P. C.; Caldeira, João; Vaidya, Binod

2009-01-01

394

Mucoadhesive liposomes as new formulation for vaginal delivery of curcumin.  

PubMed

Local delivery to the affected area represents the optimal means by which advantageous pharmacological properties of curcumin may be fully exploited as currently, due to the biopharmaceutical limitations associated with this polyphenol, its full beneficial effects remain limited. Curcumin-containing liposomes coated with bioadhesive polymers of natural and synthetic origin (chitosan and Carbopol) were evaluated in vitro. For these purposes, an in vitro model of vaginal mucus was developed allowing the monitoring of curcumin permeability in the conditions mimicking vaginal environment. The model was optimized by varying the amounts of glycoproteins, as compared to the permeabilities determined through isolated bovine mucus. The strength of bioadhesion was evaluated using the isolated bovine mucosa. Both curcumin solution and non-coated curcumin liposomes served as controls. Bioadhesive polymers enabled significantly higher (p<0.05) curcumin permeability through the artificial and isolated bovine mucus compared to the controls. Polymer coating of liposomes resulted in an increase in their bioadhesiveness. Mucoadhesive liposomes can be considered as potential novel drug delivery systems intended for vaginal administration of curcumin. PMID:24534774

Berginc, Katja; Suljakovi?, Sabina; Škalko-Basnet, Nataša; Kristl, Albin

2014-05-01

395

Collagen scaffold: a treatment for large mesh exposure following vaginal prolapse repair.  

PubMed

Transvaginal repair with mesh of pelvic organ prolapse (POP) provides women with the durability of a synthetic graft using the less-invasive route of vaginal surgery. However, morbidities such as mesh exposures are common and challenging to manage. Small intestinal submucosa (SIS) is a naturally occurring collagen matrix derived from porcine intestine. It contains growth factors and cytokines that promote healing of damaged tissue. This case report describes a large vaginal mesh exposure due to necrosis of the full thickness of the anterior vaginal wall. A remarkable and rapid regeneration of vaginal tissue over the exposed mesh was achieved with SIS placement after failure of treatment with vaginal estrogen for >6 months. Collagen scaffold is an effective, rapid, and minimally invasive treatment for large vaginal mesh exposures. PMID:24832859

Alperin, Marianna

2014-11-01

396

Vaginal surgery for uterine descent; which options do we have? A review of the literature.  

PubMed

Several vaginal procedures are available for treating uterine descent. Vaginal hysterectomy is usually the surgeon's first choice. In this literature review, complications, anatomical and symptomatic outcomes, and quality of life after vaginal hysterectomy, sacrospinous hysteropexy, the Manchester procedure, and posterior intravaginal slingplasty are described. All procedures had low complication rates, except posterior intravaginal slingplasty, with a tape erosion rate of 0-21%. Minimal anatomical success rates regarding apical support ranged from 85% and 93% in favor of the Manchester procedure. Data on symptomatic cure and quality of life are scarce. In studies comparing vaginal hysterectomy with sacrospinous hysteropexy or the Manchester procedure, vaginal hysterectomy had higher morbidity. Because no randomized, controlled trials have been performed comparing these surgical techniques, we can not conclude that one of the procedures prevails. However, one can conclude from the literature that vaginal hysterectomy is not the logical first choice. PMID:19083135

Dietz, Viviane; Schraffordt Koops, Steven E; Koops, Steven E Schraffordt; van der Vaart, C Huub

2009-03-01

397

An eddy closure for potential vorticity  

NASA Astrophysics Data System (ADS)

It is now over 40 years since a closure for the effects of mesoscale eddies in terms of Ertel potential vorticity was first proposed. The consequences of the closure that treats potential vorticity exactly the same as a passive tracer in isopycnal coordinates are explored in this paper. This leads to a momentum equation to predict the mean velocity. While the momentum equation is not unique due to the presence of an undefined potential function, the total energy equation is used to constrain its functional form. The inviscid form of the proposed eddy closure nearly conserves total energy; the error in conservation of total energy is proportional to the time derivative of the bolus velocity. The proposed eddy closure retains Kelvin's circulation theorem with mean potential vorticity conserved along particle trajectories following the transport (mean + bolus) velocity field. The relative vorticity component of the potential vorticity being diffused along isopycnals leads to terms that look like viscous stress, but these terms do not satisfy two important conditions of standard viscous closures. A numerical model based on this closure is developed, and idealized simulations in a re-entrant zonal channel are conducted to evaluate the merit of the proposed closure. When comparing various eddy closures to an eddy-resolving reference solution, the closure that both transports and diffuses potential vorticity performs marginally better than its peers, particularly with respect to the core zonal jet structure and position. However, these favorable results are obtained only if a potential vorticity diffusion coefficient is used that is smaller than the coefficient used to compute the bolus velocity. Based on these results, we conjecture that extending eddy-closures to include potential vorticity dynamics is possible, but will require the use of a closure parameter that varies temporally and spatially.

Ringler, Todd; Gent, Peter

398

Microparticulated anti-HIV vaginal gel: in vitro-in vivo drug release and vaginal irritation study.  

PubMed

The aim of this study was to develop and evaluate a Zidovudine (AZT)-loaded microparticulated bioadhesive vaginal gel (MBVG) in order to obtain a controlled releasing, safe gel delivery system. AZT microparticles (ZMPs) were evaluated for encapsulation efficiency, drug loading, surface morphology and in vitro drug release profiles and drug release mechanism and optimized. The optimized ZMPs were then encompassed in bioadhesive gel using different bioadhesive polymers and evaluated for the drug encapsulation efficiency, drug loading, in vitro and in vivo drug release profiles, drug release mechanism and vaginal irritancy study. From the dissolution data of ZMP4 and MBVG4 showed a zero-order diffusion pattern and Fickian diffusion case I transport mechanism in 24 and 36?h, respectively. On the basis of a pharmacokinetic study of MBVG4 (containing ZMP: Carbopol 1:4), it was found to have better bioavailability, larger AUC and T(max) in comparison to an oral pure suspension of AZT. PMID:20497098

Chatterjee, Arkendu; Kumar, Lalit; Bhowmik, Benoy Brata; Gupta, Amlan

2011-10-01

399

Accelerating cleanup: Paths to closure  

SciTech Connect

This document was previously referred to as the Draft 2006 Plan. As part of the DOE`s national strategy, the Richland Operations Office`s Paths to Closure summarizes an integrated path forward for environmental cleanup at the Hanford Site. The Hanford Site underwent a concerted effort between 1994 and 1996 to accelerate the cleanup of the Site. These efforts are reflected in the current Site Baseline. This document describes the current Site Baseline and suggests strategies for further improvements in scope, schedule and cost. The Environmental Management program decided to change the name of the draft strategy and the document describing it in response to a series of stakeholder concerns, including the practicality of achieving widespread cleanup by 2006. Also, EM was concerned that calling the document a plan could be misconstrued to be a proposal by DOE or a decision-making document. The change in name, however, does not diminish the 2006 vision. To that end, Paths to Closure retains a focus on 2006, which serves as a point in time around which objectives and goals are established.

Edwards, C.

1998-06-30

400

Transitional nuclei near shell closures  

SciTech Connect

High spin states in Bismuth and Thallium nuclei near the Z = 82 shell closure and Cesium nuclei near the N = 82 shell closure in A = 190 and A = 130 regions, respectively, have been experimentally investigated using heavy-ion fusion evaporation reaction and by detecting the gamma rays using the Indian National Gamma Array (INGA). Interesting shape properties in these transitional nuclei have been observed. The results were compared with the neighboring nuclei in these two regions. The total Routhian surface (TRS) calculations have been performed for a better understanding of the observed properties. In mass region A = 190, a change in shape from spherical to deformed has been observd around neutron number N = 112 for the Bi (Z = 83) isotopes with proton number above the magic gap Z = 82, whereas, the shape of Tl (Z = 81) isotopes with proton number below the magic gap Z = 82 remains stable as a function of neutron number. An important transition from aplanar to planar configuration of angular momentum vectors leading to the occurance of nuclar chirality and magnetic rotation, respectively, has been proposed for the unique parity ?h{sub 11/2}??h{sub 11/2} configuration in Cs isotopes in the mass region A ? 130 around neutron number N = 79. These results are in commensurate with the TRS calculations.

Mukherjee, G. [Variable Energy Cyclotron Centre, 1/AF Bidhan Nagar, Kolkata 700064 (India); Pai, H. [Variable Energy Cyclotron Centre, 1/AF Bidhan Nagar, Kolkata 700064, India and Present Address: Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstrasse 9, 64289 Darmstadt (Germany)

2014-08-14

401

Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency  

Microsoft Academic Search

Objective: Organic female sexual dysfunction may be related in part to vasculogenic impairment of the hypogastric-vaginal\\/clitoral arterial bed. The aim was to develop an animal model of vaginal engorgement insufficiency and clitoral erectile insufficiency. Methods: Pelvic nerve stimulated vaginal engorgement and clitoral erection were achieved in control (normal diet, n=8) and atherosclerotic (balloon injury of aorto-iliac arteries and 0.5% cholesterol

I Goldstein; C Andry; MB Siroky; RJ Krane; KM Azadzoi

1997-01-01

402

Human papillomavirus infection and vaginal tape exposure after midurethral sling: a case report.  

PubMed

Midurethral tape placement is the gold standard procedure for stress urinary incontinence (SUI). Among reported complications, tape erosion is uncommon. Several risk factors have been postulated as causes of vaginal erosion, but none have been demonstrated. Cases of vaginal erosion caused by tape infections have been described, but none has been associated with human papillomavirus (HPV) infection. We report the first case of vaginal exposure in a woman who underwent a midurethral sling procedure for SUI after HPV colonization. PMID:24052024

Balzarro, M; Rubilotta, E; Artibani, W

2013-01-01

403

Factors affecting vaginal pH levels among female adolescents attending genitourinary medicine clinics  

Microsoft Academic Search

Objectives: Vaginal pH is related to hormonal status, and adolescents experience disturbed hormonal patterns following menarche. We assessed hormonal factors and risk of abnormal vaginal pH and bacterial vaginosis (BV) among adolescents attending genitourinary medicine (GUM) clinics.Methods: In a cross sectional study adolescents within 5 years of menarche, ?17 years, or with oligo-amenorrhoea were recruited. Vaginal pH and BV were

L Brabin; S A Roberts; E Fairbrother; D Mandal; S P Higgins; S Chandiok; P Wood; G Barnard; H C Kitchener

2005-01-01

404

Vaginal Douches and Other Feminine Hygiene Products: Women's Practices and Perceptions of Product Safety  

Microsoft Academic Search

\\u000a Objective: Use of vaginal douche products has been linked with a variety of reproductive health problems; nonetheless, the practice\\u000a of douching persists. The goals of this study were to 1) determine the use of vaginal douches and other feminine hygiene products,\\u000a 2) ascertain how safe women think vaginal douche products are, and 3) evaluate women's readiness to stop douching. Methods:

Diane M. Grimley; Lucy Annang; Herman R. Foushee; F. Carol Bruce; Juliette S. Kendrick

2006-01-01

405

UC DAVIS HEALTH SYSTEM Temporary Position Closure Proposal  

E-print Network

UC DAVIS HEALTH SYSTEM Temporary Position Closure Proposal Note: In this proposal, "position--Bargaining Unit: ______________ Check one: Temporary position closure Temporary reduction in time from ______% to ______% 1. Period of position closure Begin __________________ End ___________________ 2. Reason

Leistikow, Bruce N.

406

Experimental and theoretical studies of salt creep closure of the SPR Big Hill site wells 106 through 110  

Microsoft Academic Search

An experimental program was carried out in several Big Hill wells to determine whether salt creep closure is likely to result in borehole size being reduced to that of the outside diameters of hanging strings in the wells. Measured creep closures were sufficient to indicate the need for a small leaching program to ensure the boreholes would not close into

R. R. Beasley; K. L. Goin; D. S. Preece

1986-01-01

407

Utilization and perioperative outcomes of robotic vaginal vault suspension compared to abdominal or vaginal approaches for pelvic organ prolapse  

PubMed Central

Objectives: Robot-assisted vaginal vault suspension (RAVVS) for pelvic organ prolapse (POP) represents a minimally-invasive alternative to abdominal sacrocolpopexy. We measured perioperative outcomes and utilization rates of RAVVS. Methods: RAVVS (n = 2381) and open VVS (OVVS, n = 11080) data were extracted from the 2009–2010 Nationwide Inpatient Sample. Propensity score-matched analysis compared patients undergoing RAVVS or OVVS for complications, mortality, prolonged length-of-stay, and elevated hospital charges. Results: Use of RAVVS for POP increased from 2009 to 2010 (16.3% to 19.2%). Patients undergoing RAVVS were more likely to be white (77.2% vs. 69.6%), to carry private insurance (52.8% vs. 46.0%) and to have fewer comorbidities (Charlson Comorbidity Index [CCI] ?1 = 17.5% vs. 26.6%). They were more likely to undergo surgery at urban (98.2% vs. 93.7%) and academic centres (75.7% vs. 56.7%). Patients undergoing RAVVS were less likely to receive a blood-transfusion (0.7% vs. 1.8%, p < 0.001) or experience prolonged length-of-stay (9.3% vs. 25.1%, p < 0.001). They had more intraoperative complications (6.0% vs. 4.2%, p < 0.001), and higher median hospital charges ($32 402 vs. $24 136, p < 0.001). Overall postoperative complications were equivalent (17.9%, p = 1.0), though there were differences in wound (0.4% vs. 1.3%, p < 0.001), genitourinary (4.9% vs. 6.5%, p = 0.009), and surgical (6.6% vs. 4.9%, p = 0.007) complications. Conclusions: The increasing use of RAVVS from 2009 to 2010 suggests a growth in the adoption of robotics to manage POP. We show that RAVVS is associated with decreased length of stay, fewer blood transfusions, as well as lower postoperative wound, genitourinary and vascular complications. The benefits of RAVVS are mitigated by higher hospital charges and higher rates of intra-operative complications. PMID:24839477

Li, Hanhan; Sammon, Jesse; Roghmann, Florian; Sood, Akshay; Ehlert, Michael; Sun, Maxine; Menon, Mani; Atiemo, Humphrey; Trinh, Quoc-Dien

2014-01-01

408

A simple identification method for vaginal secretions using relative quantification of Lactobacillus DNA.  

PubMed

In criminal investigations there are some cases in which identifying the presence of vaginal secretions provides crucial evidence in proving sexual assault. However, there are no methods for definitively identifying vaginal secretions. In the present study, we focused on Lactobacillus levels in vaginal secretions and developed a novel identification method for vaginal secretions by relative quantification based on real time PCR. We designed a Lactobacillus conserved region primer pair (LCP) by aligning 16S rRNA gene sequences from major vaginal Lactobacillus species (Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners and Lactobacillus jensenii), and selected the human specific primer pair (HSP) as an endogenous control for relative quantification. As a result, the ?Ct (?Ct=Ct[LCP]-Ct[HSP]) values of vaginal secretions (11 out of 12 samples) were significantly lower than those of saliva, semen and skin surface samples, and it was possible to discriminate between vaginal secretions and other body fluids. For the one remaining sample, it was confirmed that the predominant species in the microflora was not of the Lactobacillus genus. The ?Ct values in this study were calculated when the total DNA input used from the vaginal secretions was 10pg or more. Additionally, the ?Ct values of samples up to 6-months-old, which were kept at room temperature, remained unchanged. Thus, we concluded in this study that the simple ?Ct method by real time PCR is a useful tool for detecting the presence of vaginal secretions. PMID:24905338

Doi, Masanori; Gamo, Shinsuke; Okiura, Tatsuyuki; Nishimukai, Hiroaki; Asano, Migiwa

2014-09-01

409

Suburethral vaginal erosion and pyogenic granuloma formation: an unusual complication of intravaginal slingplasty (IVS).  

PubMed

We report an unusual case of suburethral vaginal erosion and pyogenic granuloma formation 14 months after intravaginal slingplasty (IVS). A 64-year-old woman underwent IVS for recurrent stress incontinence 12 years after Burch colposuspension. Following seemingly uncomplicated surgery and recovery, she developed a recurrent urinary tract infection which was treated with antibiotics. When she presented with vaginal pain and postmenopausal bleeding approximately 14 months postoperatively, she was found to have suburethral vaginal erosion of the tape and a pyogenic granuloma. The exposed tape was removed, the granuloma excised, and the overlying vaginal skin was then closed. She then made an uneventful recovery. PMID:14752602

Lim, Y N; Rane, A

2004-01-01

410

Estimating the Size of Generalized Transitive Closures  

Microsoft Academic Search

We present a framework for the estimation of the size of binary recursively defined relations. We show how the framework can be used to provide estimating algo rithms for the size of the transitive closure and gener- alizations of the transitive closure, and also show that for bounded degree relations, the algorithm runs in linear time. Such estimating algorithms are

Richard J. Lipton; Jeffrey F. Naughton

1989-01-01

411

Boolean Matrix Multiplication and Transitive Closure  

Microsoft Academic Search

Arithmetic operations on matrices are applied to the problem of finding the transitive closure of a Boolean matrix. The best transitive closure algorithm known, due to Munro, is based on the matrix multiplication method of Strassen. We show that his method requires at most O(n? ¿ P(n)) bitwise operations, where ? = log27 and P(n) bounds the number of bitwise

Michael J. Fischer; Albert R. Meyer

1971-01-01

412

Higher Separation Axioms in Generalized Closure Spaces  

E-print Network

Higher Separation Axioms in Generalized Closure Spaces BË? arbel M.R. Stadler 1,# and Peter F of separation axioms that is familiar from topological spaces generalizes to spaces with an isotone. Keywords: extended topologies, closure spaces, separation axioms, Urysohn functions, regularity, normality

Stadler, Peter F.

413

A new device for paravalvular leak closure  

PubMed Central

Percutaneous closure of a prosthetic paravalvular leak (PVL) is a challenging procedure. Operators must use devices constructed for other applications. We present the use of a device which is specifically designed for PVL closure. To the best of our knowledge, there is no publication in MEDLINE reporting the use of the device.

Ercan, Ertugrul; Tengiz, Istemihan; Turk, Ugur; Ozyurtlu, Ferhat; Alioglu, Emin

2015-01-01

414

[Endoprosthetic closure of pharyngeal fistulae (author's transl)].  

PubMed

The Häring endoprosthesis was originally designed for re-establishing an esophageal passage in patients with tumor stenosis of the esophagus. We have successfully used this prosthesis in two patients for closure of large pharyngeal fistulae following laryngectomy. The prosthesis provides a watertight closure of the pharynx and allows immediate natural feeding by the patient. PMID:521333

Masing, H

1979-11-01

415

40 CFR 258.60 - Closure criteria.  

Code of Federal Regulations, 2012 CFR

...CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Closure and Post-Closure...inventory of wastes ever on-site over the active life of the landfill facility; and (4) A schedule...notation on the deed to the landfill facility property, or...

2012-07-01

416

40 CFR 258.60 - Closure criteria.  

Code of Federal Regulations, 2013 CFR

...CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Closure and Post-Closure...inventory of wastes ever on-site over the active life of the landfill facility; and (4) A schedule...notation on the deed to the landfill facility property, or...

2013-07-01

417

40 CFR 258.60 - Closure criteria.  

Code of Federal Regulations, 2014 CFR

...CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Closure and Post-Closure...inventory of wastes ever on-site over the active life of the landfill facility; and (4) A schedule...notation on the deed to the landfill facility property, or...

2014-07-01

418

Quick release storage battery closure assembly  

SciTech Connect

A quick release storage battery closure assembly for removably engaging the inspection opening defining bosses on a storage battery, the one that replaces the individual caps that normally are used for closing the inspection openings. The closure assembly is particularly adapted for use where the storage batteries are arranged as a group, such as on a golf cart or industrial vehicle.

Braswell, R.R.

1984-10-16

419

Microcrack closure in rocks under stress - Direct observation  

NASA Technical Reports Server (NTRS)

Direct observations of the closure of microcracks in rocks under increasing stress are reported. Uniaxial stresses up to 300 bars were applied to untreated and previously heated samples of Westerly granite and Frederick diabase by a small hydraulic press which fit entirely within a scanning electron microscope. Crack closure characteristics are found to depend on crack orientation, with cracks perpendicular to the applied stress closing and those parallel tending to open, as well as crack aspect ratio, crack intersection properties, stress concentrations and surface roughness. Uniaxial and hydrostatic stress measurements are found to be strongly dependent on fracture content as observed by SEM, and the observed hysteresis in strain measurements in the first stress cycles is also related to microscopic processes

Batzle, M. L.; Simmons, G.; Siegfried, R. W.

1980-01-01

420

PLAN FOR CLOSURE OF HANFORDS CENTRAL PLATEAU  

SciTech Connect

This paper summarizes an approach to reduce risk to the public and environment through accelerated closure of Hanford's Central Plateau, based on a plan developed by Fluor Hanford and submitted to the Department of Energy (DOE)-Richland Office, for consideration, in September, 2004. This plan provides a framework and starting point for discussions with regulators and further planning for closure activities on the Plateau. The closure strategy and approach required developing a full inventory of items needing closure as well as identifying and defining technical and regulatory approaches that were compatible with current regulatory processes, reduce risks, and met DOE objectives. This effort, and the paper that follows, integrates closure activities among several contractors and two DOE field offices.

AUSTIN, B.A.

2004-12-15

421

Closure for milliliter scale bioreactor  

DOEpatents

A closure for a microreactor includes a cap that is configured to be inserted into a well of the microreactor. The cap, or at least a portion of the cap, is compliant so as to form a seal with the well when the cap is inserted. The cap includes an aperture that provides an airway between the inside of the well to the external environment when the cap is inserted into the well. A porous plug is inserted in the aperture, e.g., either directly or in tube that extends through the aperture. The porous plug permits gas within the well to pass through the aperture while preventing liquids from passing through to reduce evaporation and preventing microbes from passing through to provide a sterile environment. A one-way valve may also be used to help control the environment in the well.

Klein, David L. (Palo Alto, CA); Laidlaw, Robert D. (Albany, CA); Andronaco, Gregory (Palo Alto, CA); Boyer, Stephen G. (Moss Beach, CA)

2010-12-14

422

Multisite neural tube closure in humans.  

PubMed

We present evidence for multisite NT closure in humans with representative examples of types of NTDs that would be expected if NT closure in humans is similar to experimental mice models. We determine that the majority of NTDs can be classified by the multisite closure model. Further evidence for multisite closure of the NT is apparent in previous epidemiological studies, recognized monogenic disorders, and environmental and teratogenic exposures. Previous reliance on the single-site closure model has resulted in grouping of anomalies, obscuring evidence for multisite NT closure, etiological heterogeneity, varying recurrence risks, and site-specific effects of environmental factors. The NTDs have been previously referred to as being multifactorial, due to multiple genes and environmental factors. Etiological heterogeneity has been demonstrated previously as well. Classification of NTDs by closure site will be beneficial in better defining etiologies and environmental susceptibilities. Similarly, it is apparent to us that genetic variations in closure sequence, rate, and location are most likely monogenic and result in affected embryos being more susceptible to specific environmental factors, such as the effect of folic acid deficiency. Individual closure sites are most likely under the control of specific embryonically expressed genes, whose monogenic nature may not be apparent postnatally. For the disorders such as Meckel-Gruber syndrome and Walker-Warburg syndrome, the monogenic etiology for NTDs in affected individuals is apparent because of associated malformations. There are three important implications of this study: The first is that monogenic mouse models will be helpful in investigating the pathogenesis of NTDs in humans. The homologies between the mouse and human genome may allow linkage studies to be done in some families who have recurrence of NTDs. Second, in order to have useful results from studies of NTDs, NT anomalies need to be accurately described, either by the classical nomenclature (eg, meroacranium) or by referring to the corresponding closure site involvement (eg, closure 2 defect). Special attention needs to be addressed to those NTDs that do not appear to fit into a discrete closure site (eg, midthoracic spina bifida cystica) or laterally displaced NTDs, since they may be due to other etiologies. With improved nutrition, particularly folic acid treatment, specific etiologies for the remaining NTDs may become more apparent. Finally, recurrence risks for NTDs may vary between families based on the closure site affected, and whether or not associated anomalies are present. PMID:9125329

Van Allen, M I

1996-01-01

423

In vivo optical imaging of human vaginal gel thickness distributions with a probe-based, dual-modality instrument  

NASA Astrophysics Data System (ADS)

We used a probe-based dual-modality optical imaging instrument to measure in vivo coating thickness distributions of a gel distributed along the vaginal lumen, in a clinical study. The gel was a surrogate for one delivering an anti-HIV topical microbicide. Imaging data from Fourier-domain multiplexed low-coherence interferometry (mLCI) and fluorimetric measurements were compared to assess the feasibility and accuracy of mLCI in measuring in vivo gel coating thickness distributions. In each study session, 3.5 mL of Replens gel was inserted to the vaginal fornix while the participant was supine. The participant either: 1. remained supine (10 or 60 min) or 2. sat up (1 min), stood up (1 min), sat down (1 min) and returned to the supine position; net elapsed time was 10 or 60 min after which the gel distribution was imaged. Local coating thickness distributions were qualitatively and quantitatively similar. Here mLCI did not accurately measure thicker gel coatings (>0.8 mm), a limitation not seen with fluorimetry. However, mLCI is capable of measuring in vivo microbicide gel distributions with resolution on the order of 10 ?m, without the need for exogenous contrast agents, and can accurately capture relevant summary coating measures in good agreement with fluorimetry.

Drake, Tyler K.; DeSoto, Michael G.; Peters, Jennifer J.; Henderson, Marcus H.; Thiele, Bonnie; Bishop, Tammy Sinclair; Murtha, Amy P.; Katz, David F.; Wax, Adam

2012-11-01

424

Follow-up of small, postmenopausal ovarian cysts using vaginal ultrasound and CA-125 antigen.  

PubMed

To determine the natural history of small, simple ovarian cysts in postmenopausal women, 51 postmenopausal patients with small (< 5 cm), smooth, aseptate, hypoechogenic ovarian cysts, without ascites, were followed by vaginal ultrasound examinations every 3 months for an average period of 2.5 years. In 34, CA-125 antigen was measured and found to be within normal limits. None of the cysts showed changes in texture, nor did ascites appear. The CA-125 antigen serum levels remained low. The mean size of the cysts decreased with time. There was no statistically significant correlation between the initial size of the cyst, its tendency to grow or shrink, and the absolute CA-125 serum level. Our findings support the option of a conservative follow-up by repeated ultrasonic and CA-125 antigen examinations of small, simple cysts in postmenopausal women. PMID:8727415

Auslender, R; Atlas, I; Lissak, A; Bornstein, J; Atad, J; Abramovici, H

1996-05-01

425

Multicompartmental Pharmacokinetic Model of Tenofovir Delivery by a Vaginal Gel  

PubMed Central

Background Trials of a vaginal Tenofovir gel for pre-exposure prophylaxis (PrEP) for HIV have given conflicting results. Knowledge of concentrations of Tenofovir and its active form Tenofovir diphosphate, at putative sites of anti-HIV functioning, is central to understanding trial outcomes and design of products and dosage regimens. Topical Tenofovir delivery to the vaginal environment is complex, multivariate and non-linear; determinants relate to drug, vehicle, dosage regimen, and environment. Experimental PK methods cannot yield mechanistic understanding of this process, and have uncontrolled variability in drug sampling. Mechanistic modeling of the process could help delineate its determinants, and be a tool in design and interpretation of products and trials. Methods and Findings We created a four-compartment mass transport model for Tenofovir delivery by a gel: gel, epithelium, stroma, blood. Transport was diffusion-driven in vaginal compartments; blood concentration was time-varying but homogeneous. Parameters for the model derived from in vitro and in vivo PK data, to which model predictions gave good agreement. Steep concentration gradients occurred in stroma ?8 hours after gel release. Increasing epithelial thickness delayed initial TFV delivery to stroma and its decline: tmax increased but AUC at 24 hours was not significantly altered. At 24 and 48 hours, stromal concentrations were 6.3% and 0.2% of Cmax. Concentrations in simulated biopsies overestimated stromal concentrations, as much as ?5X, depending upon time of sampling, biopsy thickness and epithelial thickness. Conclusions There was reasonably good agreement of model predictions with clinical PK data. Conversion of TFV to TFV-DP was not included, but PK data suggest a linear relationship between them. Thus contrasts predicted by this model can inform design of gels and dosage regimens in clinical trials, and interpretation of PK data. This mass transport based approach can be extended to TFV conversion to TFV-DP, and to other drugs and dosage forms. PMID:24040241

Gao, Yajing; Katz, David F.

2013-01-01

426

Pathology Case Study: Post Coital Bleeding and Vaginal Discharge  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 33-year-old woman has a two-month history of post coital bleeding and vaginal discharge. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

Christakos, Peter

427

Acute mesenteric venous thrombosis with a vaginal contraceptive ring.  

PubMed

Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. PMID:25035742

Eilbert, Wesley; Hecht, Benjamin; Zuiderveld, Loren

2014-07-01

428

The psychosocial impact of vesico-vaginal fistula in Niger  

Microsoft Academic Search

Purpose  To explore the psycho-social impact of vesico-vaginal fistula (VVF) on women in Niger.\\u000a \\u000a \\u000a \\u000a Study design  We conducted a qualitative study on 21 women in convalescence at the DIMOL Reproductive Health Center in Niamey, Niger, in\\u000a 2008 and 2009. The women had undergone 1–3 fistula repair operations and all had stillborn infants.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Women reported many psychological consequences of VVF including depression, feelings

Amina P. Alio; Laura Merrell; Kimberlee Roxburgh; Heather B. Clayton; Phillip J. Marty; Linda Bomboka; Salamatou Traoré; Hamisu M. Salihu

2011-01-01

429

Epidemiology of vulvar and vaginal cancer in Germany  

Microsoft Academic Search

Objective  Vulvar and vaginal cancers are rare diseases with an incidence rate that increases with age. At present, epidemiological data\\u000a are rather scarce. This review article provides an epidemiologic overview of these diseases, focussing on recent German data.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This review article summarizes the information currently available in order to offer an epidemiologic overview.\\u000a \\u000a \\u000a \\u000a Results  The statistic incidence of vulvar carcinoma has been

C. Dittmer; A. Katalinic; C. Mundhenke; M. Thill; D. Fischer

2011-01-01

430

Yucca Mountain Waste Package Closure System  

SciTech Connect

The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

Herschel Smartt; Arthur Watkins; David Pace; Rodney Bitsoi; Eric Larsen; Timothy McJunkin; Charles Tolle

2006-04-01

431

Yucca Mountain Waste Package Closure System  

SciTech Connect

The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

shelton-davis; Colleen Shelton-Davis; Greg Housley

2005-10-01

432

Percutaneous closure of tricuspid paravalvular leak.  

PubMed

While transcatheter closure of mitral and aortic paravalvular leaks has been well-described, there are no prior reports of such procedures for prosthetic tricuspid valves. We describe our experience with percutaneous closure of a tricuspid paravalvular leak in a 34-year-old patient with a history of tricuspid atresia. He had previously undergone repair with placement of a right atrium-to-right ventricle conduit and most recently, placement of a bio-prosthetic tricuspid valve. He subsequently developed significant tricuspid paravalvular leak with symptoms of severe right heart failure. His clinical status was improved following successful transcatheter closure of the defect. PMID:23554068

Turner, Mariel E; Lai, Wyman W; Vincent, Julie A

2013-10-01

433

Staples vs subcuticular sutures for skin closure at cesarean delivery: a metaanalysis of randomized controlled trials.  

PubMed

Recently published randomized trials examining skin closure technique on postcesarean wound complications have produced conflicting results. We performed a metaanalysis of trials comparing staples and subcuticular sutures for skin closure at cesarean section (CS). Pooled outcome measures were calculated using random effects models. Primary outcomes were rates of wound dehiscence (separation) and a composite wound complication rate. Secondary outcomes were patient satisfaction, operating time, and postoperative pain. A total of 877 women from 5 trials were included. Both wound separation (pooled odds ratio, 4.01; P < .0001) and composite wound complication (pooled odds ratio, 2.11; P = .003) rates were higher with staples. The use of staples reduced operating time (weighted mean difference, -5.05 minutes; P = .021). Data on postoperative pain and patient satisfaction were insufficient for metaanalysis. Our findings suggest a possible benefit with subcuticular sutures compared to skin staples for skin closure at CS. However, the optimal skin closure technique at CS demands further study. PMID:21195384

Clay, Felix S H; Walsh, Colin A; Walsh, Stewart R

2011-05-01

434

A note on contact stress and closure in models of rock joints and faults  

USGS Publications Warehouse

We have re-examined asperity deformation predicted by joint closure models based on Greenwood and Williamson [1966] which use a statistical representation of loaded, rough surfaces. Although such models assume small elastic strains within contacting asperities (Hertzian contact) and well predict the observed dependence of closure on normal stress, large elastic normal strains measured in experiments violate the model assumptions. This inconsistency between observations and models can be resolved. The model dependence of closure on macroscopic normal stress results primarily from the statistics of the surface topography, and the functional dependence of closure on normal stress can be independent of assumed contact-scale elastic interactions. Thus, a joint model of the Greenwood and Williamson kind, modified to allow a portion of the elastic deformation to occur outside of the asperity contact region, predicts macroscopic behavior consistent with Hertzian models. Contact stresses derived from previously published models of this kind may be in error.

Beeler, N.M.; Hickman, S.H.

2001-01-01

435

Enhanced vaginal drug delivery through the use of hypotonic formulations that induce fluid uptake  

PubMed Central

Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that administration of hypotonic solutions would induce fluid uptake that could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We found that hypotonic formulations markedly increased the rate at which small molecule drugs and muco-inert nanoparticles (mucus-penetrating particles, or MPP), but not conventional mucoadhesive nanparticles (CP), reached the vaginal epithelial surface in vivo in mice. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that drugs or MPP in isotonic formulations failed to reach efficiently. However, hypotonic formulations caused unencapsulated “free” drugs to be drawn through the epithelium, reducing vaginal retention. In contrast, hypotonic formulations caused MPP to accumulate rapidly and uniformly on vaginal surfaces, ideally positioned for localized sustained drug delivery. Using a mouse model of vaginal genital herpes (HSV-2) infection, we found that hypotonic delivery of free drug led to improved immediate protection, but diminished longer-term protection. In contrast, as we previously demonstrated, hypotonic delivery of drug via MPP led to better long-term retention and protection in the vagina. Importantly, we demonstrate that slightly hypotonic formulations provided rapid and uniform delivery of MPP to the entire vaginal surface, thus enabling formulations with minimal risk of epithelial toxicity. Hypotonic formulations for vaginal drug delivery via MPP may significantly improve prevention and treatment of reproductive tract diseases and disorders. PMID:23769419

Ensign, Laura M.; Hoen, Timothy; Maisel, Katharina; Cone, Richard; Hanes, Justin

2013-01-01

436

A Population-Based Study of Squamous Cell Vaginal Cancer: HPV and Cofactors  

Microsoft Academic Search

Background. Little is known about the etiology of in situ or invasive squamous cell cancer of the vagina. It is thought that some vaginal cancers may have the same etiology as cervical cancer. It is also not known whether in situ and invasive vaginal cancer share the same etiologic factors. We conducted a study to evaluate risk factors for in

Janet R. Daling; Margaret M. Madeleine; Stephen M. Schwartz; Katherine A. Shera; Joseph J. Carter; Barbara McKnight; Peggy L. Porter; Denise A. Galloway; James K. McDougall; Hisham Tamimi

2002-01-01

437

Management of Recurrent VulvoVaginal Candidosis as a Chronic Illness  

Microsoft Academic Search

For sporadic acute Candida vaginitis, any oral or local antifungal therapy can be used. For women with recurrent vulvo-vaginal candidosis (RVC), on the other hand, such simple approaches are insufficient, regardless of the product chosen. Instead, RVC should be managed as any other chronic disease and requires long-term, prophylactic, suppressive antifungal treatment. A regimen using individualized, decreasing doses of oral

Gilbert G. G. Donders; Gert Bellen; Werner Mendling

2010-01-01

438

Ureteral injury during vaginal mesh excision: role of prevention and treatment options.  

PubMed

Vaginal mesh kits are increasingly used in vaginal prolapse repair. Mesh erosion, infection, and pain may necessitate removal, which can lead to urinary tract injury. We describe 2 cases of ureteral injury at the time of mesh excision. Surgeons must recognize the possibility of ureteral injury and treatment modalities available. PMID:22999155

Heisler, Christine A; Casiano, Elizabeth R; Klingele, Christopher J; Gebhart, John B; Trabuco, Emanuel C

2012-12-01

439

Assessment of two methods for rapid intrapartum detection of vaginal group B streptococcal colonisation  

Microsoft Academic Search

AIMS--To compare two methods for the rapid detection of intrapartum vaginal carriage of group B streptococci (Streptococcus agalactiae) with standard culture techniques and to establish their suitability for routine use. METHODS--Vaginal swabs from 266 patients in labour were incubated in glucose broth in an anaerobic atmosphere for four to six hours. The Wellcogen Strep B latex particle agglutination test kit

A J Simpson; J A Mawn; S R Heard

1994-01-01

440

Do not have any sex (oral, vaginal, anal or using sex  

E-print Network

Do not have any sex (oral, vaginal, anal or using sex toys) with a partner until their treatment has also been completed Prevention Preventing Chlamydia · Use condoms every time you have sex sex (oral, vaginal, anal or using sex toys) with a partner until their treatment has also been

Talbot, James P.

441

Evaluation of immune system function in neonatal pigs born vaginally or by Cesarean section  

Technology Transfer Automated Retrieval System (TEKTRAN)

Eight full term crossbred sows were selected for study of the interaction of the immune system, hypothalamus-pituitary-adrenal axis, and growth in pigs born by Cesarean section (C-section) or vaginal-birth (n=4 each for vaginal-birth and C-section). Gestation length and birth weight did not differ b...

442

Effectiveness of a procedure for disinfecting the vaginal photoplethysmograph contaminated with herpes simplex virus type 2  

Microsoft Academic Search

To test the effectiveness of a disinfecting procedure involving 2% glutaraldehyde, a vaginal photoplethysmograph was contaminated with a known amount of herpes simplex type 2 (HSV-2). The vaginal photoplethysmograph was then put through the disinfection procedure. Two virus solutions were tested, one designed to approximate the concentration found in a naturally occurring infection (low inoculum), the other with 100 times

Patricia J. Morokoff; Lin S. Myers; John Hay; Michael N. Flora

1988-01-01