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1

Effects of Electrosurgery and Vaginal Closure Technique on Postoperative Vaginal Cuff Dehiscence  

PubMed Central

Background and Objectives: The aim of our study is to evaluate the role of electrosurgery and vaginal closure technique in the development of postoperative vaginal cuff dehiscence. Methods: From prospective surgical databases, we identified 463 patients who underwent total laparoscopic hysterectomy (TLH) for benign disease and 147 patients who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) for cancer. All TLHs and LAVHs were performed entirely by use of electrosurgery, including colpotomy. Colpotomy in the TLH group was performed with Harmonic Ace Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH, USA), and in the LAVH group, it was performed with a monopolar electrosurgical pencil. The main surgical difference was vaginal cuff closure—laparoscopically in the TLH group and vaginally in the LAVH group. Results: Although patients in the LAVH group were at increased risk for poor healing (significantly older, higher body mass index, more medical comorbidities, higher blood loss, and longer operative time), there were no vaginal cuff dehiscences in the LAVH group compared with 17 vaginal cuff dehiscences (4%) in the TLH group (P = .02). Conclusion: It does not appear that the increased vaginal cuff dehiscence rate associated with TLH is due to electrosurgery; rather, it is due to the vaginal closure technique. PMID:24018078

Kesterson, Joshua; Davies, Matthew; Green, Janis; Penezic, Lindsey; Vargas, Roberto; Harkins, Gerald

2013-01-01

2

Spatial distribution of vaginal closure pressures of continent and stress urinary incontinent women.  

PubMed

Clinically the strength of the contraction of the female pelvic floor is qualitatively evaluated by vaginal tactile palpation. We therefore developed a probe to enable the quantitative evaluation of the closure pressures along the vagina. Four force sensors mounted on the four orthogonal directions of an intra-vaginal probe were used to measure the vaginal pressure profile (VPP) along the vaginal wall. Clinical experiments on 23 controls and 10 patients with stress urinary incontinence (SUI) were performed using the probe to test the hypothesis that the strength of pelvic floor muscle (PFM) contractions, imposed by voluntary contraction, is related to urinary continence. The results show that VPPs, characterized in terms of pressure distribution on the anterior and posterior vaginal walls, are significantly greater than those in the left and right vaginal walls. When the PFM contracted, the positions of the maximum posterior pressures in continent females and SUI patients were 0.63+/-0.15 cm and 1.19+/-0.2 cm proximal from their peak points of anterior pressure, which are 1.52+/-0.09 cm and 1.69+/-0.13 cm proximal from the introitus of vagina, respectively. The statistical analysis shows that the maximum posterior vaginal pressures of the controls were significantly greater than those of the SUI patients both at rest (continent: 3.4+/-0.3 N cm(-2), SUI: 2.01+/-0.36 N cm(-2), p<0.05) and during PFM contraction (continent: 4.18+/-0.26 N cm(-2), SUI: 2.25+/-0.41 N cm(-2), p<0.01). In addition, the difference between the posterior and anterior vaginal walls is significantly increased when the controls contract the PFM. By contrast, there are no significant differences in the SUI group. The results show that the VPP measured by the prototype probe can be used to quantitatively evaluate the strength of the PFM, which is a clinical index for the diagnosis or assessment of female SUI. PMID:17978426

Peng, Qiyu; Jones, Ruth; Shishido, Keiichi; Omata, Sadao; Constantinou, Christos E

2007-11-01

3

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

4

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

5

Closure measurements of naturally initiating small cracks  

NASA Technical Reports Server (NTRS)

The initiation and growth of cracks in smooth 2024-T3 aluminum specimens have been investigated using acetate replicas. Crack opening displacements were measured as a function of load at several positions along the crack as it grew across the thickness of the specimen and became a through-the-thickness crack of a few millimeters in length. Tests run for R-ratios of 0.5, 0.0 and -1.0 showed that closure loads were well predicted by Newman's (1984) model. It is noted that small cracks grow slightly faster than would be predicted by long-crack data, and it is suggested that effects other than plasticity-induced closure must be taken into account.

Sharpe, W. N., Jr.; Su, X.

1988-01-01

6

Measuring Need for Closure in Classroom Learners  

ERIC Educational Resources Information Center

Need for closure, as formulated by Kruglanski and colleagues [Kruglanski, A. W. (1990). Lay epistemic theory in social-cognitive psychology. "Psychological Inquiry," 1(3), 181-197; Kruglanski, A. W., & Webster, D. M. (1996). Motivated closing of the mind: Seizing and freezing. "Psychological Review," 103, 263-283; Webster, D. M., & Kruglanski, A.…

DeBacker, Teresa K.; Crowson, H. Michael

2008-01-01

7

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

8

Volunteer bias in research employing vaginal measures of sexual arousal  

Microsoft Academic Search

Demographic, sexual, and personality characteristics of volunteers and nonvolunteers for a laboratory study of sexual arousal were compared. Subjects were 296 female students from an introductory psychology course who had volunteered for a study on sexuality and personality. After completing several questionnaires, subjects were presented with a written description of an experiment that involved viewing sexually explicit videotapes and measurement

Sharlene A. Wolchik; S. Lee Spencer; Iris S. Lisi

1983-01-01

9

Vaginal disorders.  

PubMed

Chronic vaginitis is the most common vaginal disorder. Dogs with vaginitis show no signs of systemic illness but often lick at the vulva and have purulent or hemorrhagic vaginal discharges. Vaginitis is most commonly secondary to a noninfectious inciting factor such as congenital vaginal anomalies, clitoral hypertrophy, foreign bodies, trauma to the vaginal mucosa, or vaginal tumors. Inspection of the caudal vagina and vestibule both visually and digitally will often reveal the source of vaginal irritation. Vaginal cytology is used to establish the stage of the estrous cycle as well as distinguish uterine from vaginal sources of discharge. Vaginal cultures are used to establish the predominant offending organism associated with vaginal discharges and may be used as a guide for selection of a therapeutic agent. Vaginitis is best managed by removing the inciting cause and treating the area locally with antiseptic douches. Congenital malformations at the vestibulovaginal or vestibulovulvar junction may prevent normal intromission. Affected bitches may be reluctant to breed naturally because of pain. Such defects are detected best by digital examination. Congenital vaginal defects may be corrected by digital or surgical means. Prolapse of tissue through the lips of the vulva may be caused by clitoral hypertrophy, vaginal hyperplasia, or vaginal tumors. Enlargement of clitoral tissue is the result of endogenous or exogenous sources of androgens. Treatment of this condition includes removal of the androgen source and/or surgical removal of clitoral tissue. Vaginal hyperplasia is detected during proestrus or estrus of young bitches. Hyperplastic tissue will regress during diestrus. Tissue that is excessively traumatized and/or prolapse of the entire vaginal circumference may be removed surgically. Ovariohysterectomy may be used to prevent recurrence. Vaginal tumors are detected most often in older intact bitches. Such tumors are generally of smooth muscle or fibrous tissue origin and benign. Surgical excision of the tumor combined with ovariohysterectomy is usually curative. PMID:3487158

Soderberg, S F

1986-05-01

10

Validation of two energy balance closure parameterisations using field measurements  

NASA Astrophysics Data System (ADS)

Eddy Covariance (EC) measurements often do not close the energy balance. This indicates that surface heat fluxes are underestimated, likely because large-scale eddies and stationary circulations are not captured. Because EC is a widespread tool in environmental science to assess energy fluxes and trace gas budgets, it is essential to quantify the 'missing' fluxes. In the literature, two approaches to parameterise the lack of energy balance closure can be found. The first one by Huang et al (2008) is based on large-eddy simulations (LES) and perceives the energy imbalance as being the result of large-scale turbulent organized structures. The second approach by Panin and Bernhofer (2008) suggests an empirical approach which focuses on surface roughness heterogeneities on the landscape-scale. We tested both approaches with EC data from three sites, located in southern Germany, of the Terrestrial Environmental Observatories (TERENO) programme. Additionally, we applied the parameterisations to aircraft data from Canada, which were conducted as part of the Boreal Ecosystem-Atmosphere Study (BOREAS) experiment and the Boreal Ecosystem Research and Monitoring Sites (BERMS) programme. For each flight, the flux contribution of turbulent structures larger than 2 km, determined by wavelet analysis, serves as an estimate of the missing flux of conventional EC measurements. In most cases, the two parameterisations do not give a reliable prediction of the energy balance residual. The approach of Panin and Bernhofer (2008) disregards topographical effects, differences in surface moisture and surface temperature and thus, it cannot explain the poor energy balance closure of the TERENO sites. However, above the flat terrain of the airborne measurements in Canada, it works surprisingly well. The parameterisation by Huang et al (2008) was developed for homogeneous terrain, a condition which is almost never met in field studies. In addition, there is a general mismatch between LES and tower-based measurements: the simulations almost close the energy balance near the surface, presumably due to the too coarse grid resolution. Therefore, this parameterisation is not really applicable to typical flux measurements in heterogeneous landscapes that are usually conducted in the surface layer. References: Huang J, Lee X, Patton E (2008) A modelling study of flux imbalance and the influence of entrainment in the convective boundary layer. Boundary Layer Meteorol 127:273-292. Panin GN, Bernhofer Ch (2008) Parametrization of turbulent fluxes over inhomogeneous landscapes. Izvestiya Atmos Oceanic Phys 44:701-716.

Eder, Fabian; De Roo, Frederik; Kohnert, Katrin; Desjardins, Raymond L.; Foken, Thomas; Schmid, Hans Peter; Mauder, Matthias

2013-04-01

11

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

12

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

13

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

14

Measured and reported weight change for women using a vaginal contraceptive ring vs. a low-dose oral contraceptive  

Microsoft Academic Search

BackgroundWomen often stop hormonal contraception because of perceived weight change. We conducted a randomized trial comparing the contraceptive vaginal ring to a low-dose oral contraceptive (OC). We examined the difference between women's reported and measured baseline weights and looked at factors affecting perceived weight change.

Katharine J. O'Connell; Lauren M. Osborne; Carolyn Westhoff

2005-01-01

15

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 ...

16

[Vaginal ecosystem].  

PubMed

The vagina is original biotype with its own ecosystem, according to medical ecology science. This ecosystem has dynamic, but very unstable equilibrium. Disturb equilibrium is known as a disbiosys. It was discussed different components of this ecosystem: morphology of vaginal walls, vaginal liquidity, lacto-acid and residental flora, "invader" microorganisms, vaginal acidity, immune processes. It was shared our own experience with medicine Polygynax, remedy of Laboratoire Innotech International (Paris, France). Polygynax has such an advantage - rapidly restore disturbed ecological equlibrium in case of bacterial vulvovaginitis, caused mainly of intestine pathogenic flora. PMID:15673027

Karag'ozov, I; Shopova, E; Andreeva, P

2004-01-01

17

Rapid fluctuation of the vaginal microbiota measured by Gram stain analysis  

PubMed Central

OBJECTIVES The etiology of bacterial vaginosis (BV) remains unknown. We sought to describe longitudinal changes in vaginal microbiota. METHODS Thirty-nine women self-collected vaginal specimens twice-weekly for 16 weeks as part of a vaginal douching cessation study. In an analysis where each woman serves as her own control, we used Conditional Logistic Regression to evaluate daily, time-varying factors associated with a woman’s incident BV episode(s) as compared to her persistently BV-negative sample(s). BV was defined by Nugent’s Gram stain score ?7. RESULTS The mean age was 36.8 years; 56.4% were African-American. 46.2% of participants had BV in the first four weeks of observation. Rapid fluctuation of vaginal microbiota was observed in 226 transitions to BV or spontaneous remission. Duration of BV was often short: 51% of the episodes lasted only one sample interval (three days). Among women who had at least one BV episode, the median number of episodes per woman was 8.7 (SD=7.4, range: 1–22). Lubricant use one day prior to specimen collection (adjusted odds ratio (aOR): 11.75, 95% confidence interval (CI): 1.96–70.27) and rectal sex two days prior (aOR: 4.48, 95% CI: 2.79–7.17) were associated with BV onset. CONCLUSION Rapid fluctuation of the vaginal microbiota was observed. Longitudinal studies with long intervals between sampling are likely to miss episodes of BV. Recent report of lubricant use and rectal sex were associated with incident BV. PMID:20660593

Brotman, Rebecca M.; Ravel, Jacques; Cone, Richard A.; Zenilman, Jonathan M.

2012-01-01

18

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 ...

19

Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography  

Microsoft Academic Search

Mens sexual arousal patterns are category-specific: Men typically display significantly greater physiological responses to sexual stimuli depicting members of their preferred gender category. Category-specific patterns of sexual arousal have not been consistently reported in natal women. We used vaginal photoplethysmography to examine patterns of sexual arousal in 11 male-to-female (MtF) transsexuals following sex reassignment surgery (SRS) and in 72 natal

Anne A. Lawrence; Elizabeth M. Latty; Meredith L. Chivers; J. Michael Bailey

2005-01-01

20

Search for an effect of shell closure on nuclear dissipation via a neutron-multiplicity measurement  

NASA Astrophysics Data System (ADS)

The prescission neutron multiplicity excitation function is measured for the first time for three isotopes across a major closed shell in order to investigate the shell effects on fission hindrance. Three isotopes of Fr (213,215,217Fr) are populated by fusion of 19F+194,196,198Pt in the excitation energy range of 46.6-91.8 MeV. While 213Fr has a major neutron shell closure at N=126, 215Fr and 217Fr are away from the closed shell. It is found from the statistical model analysis of the experimental data that the strengths of nuclear dissipation for nuclei away from shell closure are very similar. On the other hand, the dissipation is relatively weaker for a shell-closed nucleus in comparison to adjacent nuclei away from shell closure.

Singh, Varinderjit; Behera, B. R.; Kaur, Maninder; Sugathan, P.; Golda, K. S.; Jhingan, A.; Sadhukhan, Jhilam; Siwal, Davinder; Goyal, S.; Santra, S.; Kumar, A.; Bhowmik, R. K.; Chatterjee, M. B.; Saxena, A.; Pal, Santanu; Kailas, S.

2012-07-01

21

Designing preclinical perceptibility measures to evaluate topical vaginal gel formulations: relating user sensory perceptions and experiences to formulation properties.  

PubMed

Abstract The effectiveness of any biomedical prevention technology relies on both biological efficacy and behavioral adherence. Microbicide trials have been hampered by low adherence, limiting the ability to draw meaningful conclusions about product effectiveness. Central to this problem may be an inadequate conceptualization of how product properties themselves impact user experience and adherence. Our goal is to expand the current microbicide development framework to include product "perceptibility," the objective measurement of user sensory perceptions (i.e., sensations) and experiences of formulation performance during use. For vaginal gels, a set of biophysical properties, including rheological properties and measures of spreading and retention, may critically impact user experiences. Project LINK sought to characterize the user experience in this regard, and to validate measures of user sensory perceptions and experiences (USPEs) using four prototype topical vaginal gel formulations designed for pericoital use. Perceptibility scales captured a range of USPEs during the product application process (five scales), ambulation after product insertion (six scales), and during sexual activity (eight scales). Comparative statistical analyses provided empirical support for hypothesized relationships between gel properties, spreading performance, and the user experience. Project LINK provides preliminary evidence for the utility of evaluating USPEs, introducing a paradigm shift in the field of microbicide formulation design. We propose that these user sensory perceptions and experiences initiate cognitive processes in users resulting in product choice and willingness-to-use. By understanding the impact of USPEs on that process, formulation development can optimize both drug delivery and adherence. PMID:24180360

Morrow, Kathleen M; Fava, Joseph L; Rosen, Rochelle K; Vargas, Sara; Shaw, Julia G; Kojic, E Milu; Kiser, Patrick F; Friend, David R; Katz, David F

2014-01-01

22

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... Approved as to style and content by: Robert D. Baker (Chair of Committee) Robert C. a (Member) David N. A el (Member) chard F. Fish (Head of Department) December l994 Major Subject: Forestry ABSTRACT Using Image Processing to Measure Tree Crown...

Gabriel, Darren Kyle

2012-06-07

23

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

24

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

25

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 ...

26

Vaginal and Vulvar Cancer  

MedlinePLUS

... vaginal and vulvar cancers are caused by the human papillomavirus (HPV), a common virus that is passed from one ... a vaccine that protects against the types of HPV that most often cause cervical, vaginal, and vulvar ...

27

Prediction and measurement of direct-normal solar irradiance: A closure experiment  

NASA Technical Reports Server (NTRS)

Direct-Normal Solar Irradiance (DNSI), the total energy in the solar spectrum incident on a plane perpendicular to the Sun's direction on a unit area at the earth's surface in unit time, depends only on the atmospheric extinction of sunlight without regard to the details of extinction-whether absorption or scattering. Here the authors describe a set of closure experiments performed in north-central Oklahoma, wherein measured atmospheric composition is input to a radiative transfer model, MODTRAN-3, to predict DNSI, which is then compared to measured values. Thirty six independent comparisons are presented; the agreement between predicted and measured values falls within the combined uncertainties in the prediction (2%) and measurement (0.2%) albeit with a slight bias ((approximately) 1% overprediction) that is independent of the solar zenith angle. Thus these results establish the adequacy of current knowledge of the solar spectrum and atmospheric extinction as embodied in MODTRAN-3 for use in climate models. An important consequence is the overwhelming likelihood that the atmospheric clear-sky absorption is accurately described to within comparable uncertainties.

Halthore, R. N.; Schwartz, S. E.; Michalsky, J. J.; Anderson, G. P.; Ferrare, R. A.; Ten Brink, H. M.

1997-01-01

28

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

...0648-XC981 Reef Fish Fishery of the Gulf of Mexico; 2013 Accountability Measure and Closure for Hogfish in the Gulf of Mexico AGENCY: National Marine Fisheries...exclusive economic zone (EEZ) of the Gulf of Mexico (Gulf) for the 2013 fishing...

2013-12-03

29

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

Federal Register 2010, 2011, 2012, 2013

...Measure and Closure for Commercial Black Sea Bass in the South Atlantic AGENCY...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

30

Particle extinction measured at ambient conditions with differential optical absorption spectroscopy. 2. Closure study.  

PubMed

Spectral particle extinction coefficients of atmospheric aerosols were measured with, to the best of our knowledge, a newly designed differential optical absorption spectroscopy (DOAS) instrument. A closure study was carried out on the basis of optical and microphysical aerosol properties obtained from nephelometer, particle soot/absorption photometer, hygroscopic tandem differential mobility analyzer, twin differential mobility particle sizer, aerodynamic particle sizer, and Berner impactors. The data were collected at the urban site of Leipzig during a period of 10 days in March 2000. The performance test also includes a comparison of the optical properties measured with DOAS to particle optical properties calculated with a Mie-scattering code. The computations take into account dry and ambient particle conditions. Under dry particle conditions the linear regression and the correlation coefficient for particle extinction are 0.95 and 0.90, respectively. At ambient conditions these parameters are 0.89 and 0.97, respectively. An inversion algorithm was used to retrieve microphysical particle properties from the extinction coefficients measured with DOAS. We found excellent agreement within the retrieval uncertainties. PMID:16607998

Müller, Thomas; Müller, Detlef; Dubois, René

2006-04-01

31

Desquamative inflammatory vaginitis.  

PubMed

Desquamative inflammatory vaginitis (DIV) is not a diagnosis in itself, and may be the presentation of a range of blistering disorders including pemphigus vulgaris, lichen planus and mucous membrane pemphigoid. The existence of an idiopathic subset of DIV remains controversial and is discussed in the present article. Desquamative inflammatory vaginitis is a rare but disabling condition. It presents in women of any age with a history of discomfort, irritation and painful sexual intercourse. Patients may also report an increased vaginal discharge. Examination of the vulva is normal, but erythematous regions on the vaginal walls are evident with increased vaginal secretion. This secretion is high in polymorphonuclear leukocytes, with an increased number of immature squamous epithelial cells. Repeated cultures are negative for bacteria, viruses and yeast. This is a sterile inflammatory vaginitis that can be difficult to treat, but successful therapy has been reported with topical steroids and clindamycin. PMID:14756890

Murphy, Ruth

2004-01-01

32

Treatment Option Overview (Vaginal Cancer)  

MedlinePLUS

... examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal ... patient has had past radiation treatment to the pelvis . Stages of Vaginal Cancer After vaginal cancer has ...

33

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

34

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

35

Vaginal repair of vaginal vault dehiscence after postpartum hysterectomy  

PubMed Central

Vaginal vault dehiscence (VVD) may occur rarely after hysterectomy. Although mostly, a vaginal cuff dehiscence is seen after robotic or laparoscopic hysterectomy, it may also be observed as a complication of abdominal or vaginal hysterectomy. Vaginal repair is one of the techniques used for VVD. Here, we will describe a case of vaginally repaired VVD, associated with intra-abdominal hematoma after postpartum hysterectomy. PMID:24876366

Avc?oglu, Sumeyra Nergiz; Alt?nkaya, Sunduz Ozlem; Kucuk, Mert; Yuksel, Hasan; Demircan-Sezer, Selda

2014-01-01

36

Preactivated thiomers for vaginal drug delivery vehicles.  

PubMed

It was the purpose of this study to design and evaluate a chitosan derivative as mucoadhesive excipient for vaginal drug delivery systems. The chemical modification of chitosan was achieved by conjugation of thioglycolic acid (TGA) resulting in 1594 ?mol thiol groups per gram of polymer followed by the linkage of mercaptonicotinic acid (MNA) to the immobilized thiol groups via disulfide bonding leading to 702 ?mol ligand per gram of preactivated polymer. The mucoadhesive properties of these polymers within newly designed vaginal formulations (Chitosan-TGA and Chitosan-TGA-MNA) and commercially available vaginal formulations (Candibene®, Daktarin®, Dalacin®, GynoPevaryl®) were tested over a time period of 24 h via a mucoadhesion test system simulating vaginal conditions, tensile studies and mucus polymer interaction studies via viscosity measurements. Within the vaginal test system simulating vaginal in situ conditions, a 1.5-fold increase in mucoadhesion could be observed for preactivated thiomer formulations after 24 h in comparison to commercially available formulations. Similar results were achieved for tensile studies, as the chitosan-TGA-MNA containing formulation resulted in a 4.9-fold increase in total work of adhesion (TWA) in comparison to Candibene which showed the highest TWA value of all tested commercial formulations. Also in terms of rheology investigations of mucus/formulation mixtures, a 5.8-fold increase in dynamic viscosity for chitosan-TGA-MNA containing mixtures could be observed in comparison to the mucus-free control. In contrast, commercially available formulations achieved a maximum enhancement of 1.9-fold. These outcomes confirm that the newly developed polymer is a promising tool for vaginal drug delivery likely providing a prolonged vaginal residence time due to its comparatively high mucoadhesive properties. PMID:23886732

Friedl, Heike E; Dünnhaupt, Sarah; Waldner, Claudia; Bernkop-Schnürch, Andreas

2013-10-01

37

Vaginal ring (image)  

MedlinePLUS

The vaginal ring is a flexible ring about 2 inches in diameter that is inserted into the vagina. It releases progestin and estrogen into the body to avoid pregnancy. The woman inserts it herself and it stays in the vagina ...

38

Review of Vaginitis  

PubMed Central

Adisruption of the dynamic equilibrium of the healthy vagina may have significant sequelae, leading to chronic or serious conditions. Therefore, all cases of vaginitis should be accurately diagnosed and appropriately treated. PMID:18475337

1993-01-01

39

Vaginal bleeding between periods  

MedlinePLUS

... Vaginal dryness due to lack of estrogen after menopause Stress Stopping and starting birth control pills or estrogens Underactive thyroid (low thyroid function) Use of blood thinners (anticoagulants) Cancer or precancer of the cervix, uterus, or (very ...

40

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

NASA Astrophysics Data System (ADS)

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 Ni57,60,64-69 (Z=28), Cu65-74,76 (Z=29), and Ga63-65,68-78 (Z=31) have a relative uncertainty of the order of 10-8. In particular, the mass of Cu76 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.

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

2007-04-01

41

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

42

Spontaneous vaginal evisceration  

PubMed Central

Management of vaginal prolapse in the elderly lacks a uniform consensus and continues to remain challenging. The authors report a case of an elderly lady who presented with a spontaneous vaginal evisceration. She had a long-standing vaginal prolapse being controlled by a shelf pessary, which, in her case became displaced 2 weeks prior to admission. The patient underwent a laparotomy with an intent to replace the bowel back within the peritoneal cavity and repair the vault. During the pelvic floor repair, she sustained an inadvertent button-hole injury to the rectum, which was oversewn. She went on to develop a rectovaginal fistula requiring a de-functioning colostomy. The patient made good recovery subsequently. PMID:22707628

I, Siddiqui; A, Samee; C, Hall; J, Cooper; F, O'Mahony

2011-01-01

43

Randomized controlled trial of a prenatal vaginal birth after cesarean section education and support program  

Microsoft Academic Search

OBJECTIVE: Our objective was to assess whether, for women with previous cesarean section, a prenatal education and support program promoting vaginal birth after cesarean delivery increases the probability of vaginal delivery.STUDY DESIGN: Women with a single previous cesarean were recruited before 28 weeks' gestation. Women's self-assessed motivation to attempt vaginal birth after a previous cesarean delivery was measured on a

William Fraser; Elizabeth Maunsell; Ellen Hodnett; Jean-Marie Moutquin

1997-01-01

44

Developmental origin of vaginal epithelium  

Microsoft Academic Search

The developmental origin of vaginal epithelium has been controversial for nearly a century, with speculation that vaginal epithelium originates from the Müllerian duct, Wolffian duct, and\\/or urogenital sinus. None of these possibilities have been definitively proven or disproven by direct scientific data. To define precisely the origin of vaginal epithelium, epithelial cells of the Müllerian duct, Wolffian duct, or urogenital

Takeshi Kurita

2010-01-01

45

Vulvar and vaginal HPV disease.  

PubMed

Human papilloma virus is associated with a multitude of lower genital tract diseases in women in addition to cervical cancer, including genital warts, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, and some vulvar, vaginal, and anal cancers that are associated with oncogenic subtypes. The degree to which HPV manifests pathology depends on viral type, host immune response, and local environmental factors. This article reviews the evaluation and management of the following vulvar and vaginal human papilloma virus diseases: condyloma, vulvar intraepithelial neoplasia, and vaginal intraepithelial neoplasia. Included is a brief discussion of the association with vulvar and vaginal cancer. PMID:23732036

Nelson, Erin L; Stockdale, Colleen K

2013-06-01

46

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

47

Vaginal Discharge (2)  

Microsoft Academic Search

\\u000a Mary is a 26-year-old woman who attends a Sexual Health clinic. For the preceding 2 weeks she has noticed a profuse, yellow\\u000a vaginal discharge that has a rather musty smell. She also has noted mild irritation on the vulva and she has had some discomfort\\u000a on passing urine. She is otherwise symptomless. Her menstrual periods are regular; the most recent

Alexander McMillan

48

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

49

Increased CCL2 expression and macrophage/monocyte migration during microbicide-induced vaginal irritation.  

PubMed

Despite availability of successful prevention strategies, HIV continues to spread at alarming rates, especially among women in developing countries. Vaginal microbicides offer a promising approach for blocking transmission of HIV when condom use cannot be negotiated with male partners. A major problem in the development of vaginal microbicides is chemically induced vaginal irritation, which can enhance the risk of HIV transmission. Evaluation of vaginal irritation prior to clinical trials typically uses an expensive and animal-intensive rabbit vaginal irritation model, which could be supplemented by measuring additional inflammatory biomarkers. We studied several immunological parameters as potential biomarkers of vaginal irritation, using the spermicides nonoxynol-9 and benzalkonium chloride as test microbicides. We measured amounts of cytokines, as well as inflammatory cells, in vaginal tissue lysates and on the vaginal surface. We observed that treatment with the selected microbicides increases quantities of the inflammatory cytokines interleukin-1beta, CXCL8, and CCL2 in the vaginal tissue parenchyma, and of CCL2 on the vaginal surface. This observation was correlated with increases in macrophages in the vaginal parenchyma. We suggest that measurements of CCL2 and macrophages can serve as new inflammatory biomarkers to evaluate the safety of promising novel microbicides for prevention of HIV. PMID:19929801

Alt, Carsten; Harrison, Travis; Dousman, Linda; Fujita, Nahoko; Shew, Ken; Tran, Thanh-Thuy; Shayesteh, Sara; Matsukawa, Akihiro; Mirsalis, Jon; D'Andrea, Annalisa

2009-11-01

50

Cadmium mass measurements between the neutron shell closures at N = 50 and 82  

SciTech Connect

The mass values of the neutron-deficient cadmium isotopes {sup 99-109}Cd and of the neutron-rich isotopes {sup 114,120,122-124,126,128}Cd have been measured using ISOLTRAP. The behavior of the separation energies of the cadmium isotopes from N = 50 to 82 is discussed.

Borgmann, Ch.; Blaum, K.; Boehm, Ch.; George, S.; Kreim, S. [Max-Planck-Institut fuer Kernphysik, 69117 Heidelberg (Germany); Breitenfeldt, M. [Instituut voor Kern- en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven (Belgium); Audi, G.; Lunney, D.; Naimi, S. [CSNSM-IN2P3-CNRS, Universite Paris-Sud 11, 91405 Orsay France (France); Baruah, S.; Rosenbusch, M.; Schweikhard, L. [Institut fuer Physik, Ernst-Moritz-Arndt-Universitaet, 17487 Greifswald (Germany); Beck, D.; Dworschak, M.; Herfurth, F.; Minaya-Ramirez, E.; Savreux, R.; Yazidjian, C. [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, 64291 Darmstadt (Germany); Cakirli, R. B. [Max-Planck-Institut fuer Kernphysik, 69117 Heidelberg (Germany); Department of Physics, University of Istanbul, Istanbul (Turkey); Casten, R. F. [Wright Nuclear Structure Laboratory, Yale University, New Haven, Connecticut 06520 (United States)

2011-10-28

51

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

52

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

53

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

54

Urinary and vaginal criteria for detecting ovulation in the mare  

E-print Network

equine urinary and vaginal protein, glucose and pH levels and to determine if any of these criteria could be used as an indicator(s) of estrus and/or approaching ovulation. Urinary samples and vaginal readings were obtained from 20 equine females... over 31 estrous cycles during which ovulation was timed by rectal palpation. Urinary protein, glucose and pH were measured semi-quantitatively by Combistix and quantitatively by a modified Lowry method, Glucostat analysis, and pH meter. Vaginal...

Householder, D. Douglas

2012-06-07

55

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

56

Colpocleisis for the treatment of vaginal vault prolapse.  

PubMed

Most females with total vault prolapse undergo reconstructive procedures to restore normal anatomy and function; however, elderly patients who no longer desire sexual intercourse or are medically unstable can be treated effectively with a vaginal closure or colpocleisis. The traditional approach to colpocleisis has been to simply invert the vagina using pursestring sutures after removing the vaginal mucosa. Although simple to perform, after repairing referred treatment failures who used this approach, we began to use a different approach that emphasizes the strength of an anterior repair and extensive posterior repair that then is sutured together. This vaginal closure is reinforced with a strong perineorrhaphy. This multicompartment colpocleisis was performed in 38 elderly females (mean age 77, range 68 to 88) with total vault prolapse. No treatment failures were noted with a mean follow-up of 24 months (range 3 to 52 months), and all patients were satisfied with the results of the procedure. No significant complications occurred, and no patient has regretted the loss of sexual function. The aim of this article is to discuss the indications, procedural aspects, and results of performing a multicompartment colpocleisis and partial colpocleisis for total vault prolapse in elderly females. PMID:11383994

Cespedes, R D; Winters, J C; Ferguson, K H

2001-06-01

57

[Vaginal evisceration following radiotherapy and surgery for cervico-uterine cancer. Report of a case].  

PubMed

A 60-year-old woman with past history of perineorrhaphy due to vaginal prolapse; squamous cell carcinoma of the uterine cervix stage IIB, treated with radiation theraphy at doses of 7500 rads administered as teletherapy and brachytherapy with Cesium 137. Ten weeks later a Piver II hysterectomy was performed, her posoperative morbidity was a vaginal abscess. Twelve years later, she developed a pulmonary metastasis. One year thereafter she had vaginal discharge of cetrinous fluid and prolapse of greater omentum through the vagina. She was treated by a midle exploratory celiotomy, primary closure of the vaginal defect and the pelvic floor was covered with an omental pedicle flap. The postoperative period was unremarkable. PMID:8714067

Luna, P; Sanchez, W

1996-02-01

58

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

59

Assisted closure of fasciotomy wounds  

PubMed Central

Introduction Negative pressure wound therapy (NPWT) and vessel loop assisted closure are two common methods used to assist with the closure of fasciotomy wounds. This retrospective review compares these two methods using a primary outcome measurement of skin graft requirement. Methods A retrospective search was performed to identify patients who underwent fasciotomy at our institution. Patient demographics, location of the fasciotomy, type of assisted closure, injury characteristics, need for skin graft, length of stay and evidence of infection within 90 days were recorded. Results A total of 56 patients met the inclusion criteria. Of these, 49 underwent vessel loop closure and seven underwent NPWT assisted closure. Patients who underwent NPWT assisted closure were at higher risk for requiring skin grafting than patients who underwent vessel loop closure, with an odds ratio of 5.9 (95% confidence interval 1.11 to 31.24). There was no difference in the rate of infection or length of stay between the two groups. Demographic factors such as age, gender, fracture mechanism, location of fasciotomy and presence of open fracture were not predictive of the need for skin grafting. Conclusion This retrospective descriptive case series demonstrates an increased risk of skin grafting in patients who underwent fasciotomy and were treated with NPWT assisted wound closure. In our series, vessel loop closure was protective against the need for skin grafting. Due to the small sample size in the NPWT group, caution should be taken when generalising these results. Further research is needed to determine if NPWT assisted closure of fasciotomy wounds truly leads to an increased requirement for skin grafting, or if the vascular injury is the main risk factor. PMID:23610668

Fowler, J. R.; Kleiner, M. T.; Das, R.; Gaughan, J. P.; Rehman, S.

2012-01-01

60

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

61

The excision of uterine fibroids by vaginal myomectomy: a prospective study  

Microsoft Academic Search

Objective: To evaluate the clinical effectiveness and safety of the excision of uterine fibroids by vaginal myomectomy.Design: Prospective study.Setting: A gynecology department of a university teaching hospital.Patient(s): Women with menorrhagia, pelvic pain, symptoms of pressure, or subfertility attributable to moderate-sized uterine fibroids who otherwise would have required abdominal or laparoscopic myomectomy.Intervention(s): Vaginal myomectomy.Main Outcome Measure(s): The feasibility of vaginal surgery,

Anthony Davies; Roger Hart; Adam L Magos

1999-01-01

62

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

63

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

64

[Treatment of uterine prolapse and vaginal vault by vaginal route].  

PubMed

All the prolapses of the median compartment (uterine or vault prolapse) of the pelvis have the same physiopathology. The surgical treatment must be reserved to symptomatic patients. Hysterectomy is discussed. The gold standard of the vaginal way is the sacrospinofixation (Richter procedure) Many other procedures are possible: colpofixation or colpocléisis. On young premenopausal women, the abdominal sacrofixation is the gold standard, but in postmenopausal ones, the vaginal way, specially the sacrospinofixation, is quicker and with less morbidity and hospitalization. PMID:19969278

de Tayrac, R; Letouzey, V; Costa, P; Haab, F; Delmas, V

2009-12-01

65

Repair of a vaginal evisceration following colpocleisis utilizing an allogenic dermal graft.  

PubMed

Vaginal evisceration following colpocleisis is a very rare event and, to our knowledge, there has only been one previous case report. An 86-year-old woman presented to the Emergency Department with acute onset of abdominal pain occurring following a bowel movement. Six months previously, she had undergone a colpocleisis for recurrent vaginal vault prolapse. On presentation to the emergency room, she was noted to have 60 cm of necrotic small bowel protruding through her vaginal introitus. She was taken to the operating room for resection of the small bowel and closure of her colpocleisis. The closure of the vaginal defect was difficult and required a vaginal approach employing an allogenic dermal graft. This was accomplished and the patient had an uneventful recovery and was discharged home. At 18 months followup, she has had no complication or recurrence. Evisceration following colpocleisis is a rare event, but can be very difficult to manage and we suggest consideration of employing a graft to reinforce the repair. PMID:11451011

Moore, R D; Miklos, J R

2001-01-01

66

Urinary incontinence - vaginal sling procedures  

MedlinePLUS

... that happens when you laugh, cough, sneeze, lift things, or exercise. A vaginal sling procedure helps close ... days. The stitches (sutures) in your vagina will dissolve after several weeks. After 1 - 3 months, you ...

67

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.

68

Can Vaginal Cancer Be Prevented?  

MedlinePLUS

... prevent this disease. Avoid HPV exposure Infection with human papillomavirus (HPV) is a risk factor for vaginal cancer. ... HPV and pass the virus to somebody else. HPV and men The 2 main factors influencing the ...

69

Anterior and Posterior Vaginal Myomectomy: a New Surgical Technique  

PubMed Central

Objective To evaluate the feasibility and safety of vaginal anterior and posterior myomectomy (A surgical technique is described.). Design Longitudinal prospective study. Setting A gynecology department of a university teaching hospital. Population Women with surgical indication for myomectomy for pelvic pain, menorrhagia, symptoms of pressure, or subfertility caused by uterine myomas. Methods From December 1998 to April 2005, all women with uterine myomas selected for surgical treatment were enrolled in a prospective study and underwent vaginal myomectomy. Main Outcome Measures Feasibility of vaginal myomectomy, surgical data and morbidity, and relief of symptoms. Results From 1998 to 2004, 54 patients underwent vaginal myomectomy. There were no cases of laparotomic conversion and hysterectomy. The average operation time was 80 minutes (range, 30 to 170 min). Average blood loss was 80 mL (range, 20 to 350 mL). No complications occurred. The average postoperative stay was 2 days (range, 1 to 3 days). Symptoms resolved in all 54 patients (100%) at 6 months follow-up, and 6 patients had a pregnancy. Conclusion Vaginal myomectomy, in well-selected cases, is feasible and well tolerated. Thanks to the “morcellation” technique, vaginal myomectomy can be useful even in case of large, numerous, and intramural fibroids and allows optimal uterine wall reconstruction with minimal tissue trauma. The procedure is also low time-consuming. PMID:16915172

Carminati, Roberto; Ragusa, Antonio; Giannice, Raffaella; Pantano, Francesco

2006-01-01

70

On closure in economics  

Microsoft Academic Search

While attempting to avoid closure, it can be argued that two of the analytical techniques employed by Lawson (1997) strongly imply closure. First, while ostensibly directed at liberating analysis from all forms of closure, the demi?reg is shown to effectively rely on implied closure. Second, when the use of control groups is compared to Mäki's method of isolation, it can

Stephen John Nash

2004-01-01

71

Vaginal Bleeding and Preterm Delivery  

Microsoft Academic Search

\\u000a Vaginal bleeding during gestation is an ominous sign indicating an adverse pregnancy outcome. Bleeding can occur during all\\u000a stages of gestation. It complicates up to 20% of pregnancies during the first trimester and is regarded as a sign of threatened\\u000a abortion. During the second and third trimesters, vaginal bleeding was found to be a risk factor for adverse maternal and

Offer Erez; Idit Erez-Weiss; Ruth Beer-Weisel; Vered Kleitman-Meir; Moshe Mazor

72

Crack-closure and crack-growth measurements in surface-flawed titanium alloy Ti6Al-4V  

NASA Technical Reports Server (NTRS)

The crack-closure and crack-growth characteristics of the titanium alloy Ti-6Al-4V were determined experimentally on surface-flawed plate specimens. Under cyclic loading from zero to tension, cracks deeper than 1 mm opened at approximately 50 percent of the maximum load. Cracks shallower than 1 mm opened at higher loads. The correlation between crack-growth rate and the total stress-intensity range showed a lower threshold behavior. This behavior was attributed to the high crack-opening loads at short cracks because the lower threshold was much less evident in correlations between the crack-growth rates and the effective stress-intensity range.

Elber, W.

1975-01-01

73

Multidisciplinary Overview of Vaginal Atrophy and Associated Genitourinary Symptoms in Postmenopausal Women  

PubMed Central

Introduction Vaginal atrophy, which may affect up to 45% of postmenopausal women, is often associated with one or more urinary symptoms, including urgency, increased frequency, nocturia, dysuria, incontinence, and recurrent urinary tract infection. Aims To provide an overview of the current literature regarding cellular and clinical aspects of vaginal atrophy and response to treatment with local vaginal estrogen therapy. Methods PubMed searches through February 2012 were conducted using the terms “vaginal atrophy,” “atrophic vaginitis,” and “vulvovaginal atrophy.” Expert opinion was based on review of the relevant scientific and medical literature. Main Outcome Measure Genitourinary symptoms and treatment of vaginal atrophy from peer-reviewed published literature. Results Typically, a diagnosis of vaginal atrophy is made based on patient-reported symptoms, including genitourinary symptoms, and an examination that reveals signs of the disorder; however, many women are hesitant to report vaginal-related symptoms, primarily because of embarrassment. Conclusions Physicians in various disciplines are encouraged to initiate open discussions about vulvovaginal health with postmenopausal women, including recommended treatment options. Goldstein I, Dicks B, Kim NN, and Hartzell R. Multidisciplinary overview of vaginal atrophy and associated genitourinary symptoms in postmenopausal women. Sex Med 2013;1:44–53. PMID:25356287

Goldstein, Irwin; Dicks, Brian; Kim, Noel N; Hartzell, Rose

2013-01-01

74

Closure or Non-Closure of Peritoneum in Cesarean Section: Outcomes of Short-Term Complications  

PubMed Central

Background Cesarean section (CS) is one of the most frequently performed surgical procedures worldwide. The complications following a CS include fever, wound infection, post-operative pain and bleeding which are not usually found in a normal vaginal delivery. Traditionally, suturing of peritoneal layers for CS patients has been done, but in some studies it has been shown that this procedure could be eliminated without affecting the rate of morbidity. Objectives The objective of this study was to assess the short-term outcomes of two different cesarean delivery techniques. Patients and Methods A total of 100 cases who underwent CS were randomly assigned equally to either closure of both the visceral and parietal peritoneum or no peritoneum closure. Duration of operation, pain scores, analgesic requirements, alterations in hemoglobin levels and febrile morbidity were assessed accordingly. Results Pain scores, analgesic requirements assessed at 24 hours and operation duration were significantly lower in the non-closure group as compared to the closure group. Febrile conditions and changes in hemoglobin levels were similar in both groups. Conclusions Non-closure of both visceral and the parietal peritoneum when performing a CS produces a significant reduction in pain, fewer analgesic requirements and a shorter operation duration without increasing the febrile morbidity and changes in hemoglobin levels as compared to the standard methods. PMID:24396774

Tabasi, Zohreh; Mahdian, Mehrdad; Abedzadeh-Kalahroudi, Masoumeh

2013-01-01

75

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

76

Prevention of Vaginal SHIV Transmission in Macaques by a Coitally-Dependent Truvada Regimen  

PubMed Central

Background Daily pre-exposure prophylaxis (PrEP) with Truvada (a combination of emtricitabine (FTC) and tenofovir (TFV) disoproxil fumarate (TDF)) is a novel HIV prevention strategy recently found to prevent HIV transmission in men who have sex with men and heterosexual couples. We previously showed that a coitally-dependent Truvada regimen protected macaques against rectal SHIV transmission. Here we examined FTC and tenofovir TFV exposure in vaginal tissues after oral dosing and assessed if peri-coital Truvada also protects macaques against vaginal SHIV infection. Methods The pharmacokinetic profile of emtricitabine (FTC) and tenofovir (TFV) was evaluated at first dose. FTC and TFV levels were measured in blood plasma, rectal, and vaginal secretions. Intracellular concentrations of FTC-triphosphate (FTC-TP) and TFV-diphosphate (TFV-DP) were measured in PBMCs, rectal tissues, and vaginal tissues. Efficacy of Truvada in preventing vaginal SHIV infection was assessed using a repeat-exposure vaginal SHIV transmission model consisting of weekly exposures to low doses of SHIV162p3. Six pigtail macaques with normal menstrual cycles received Truvada 24 h before and 2 h after each weekly virus exposure and six received placebo. Infection was monitored by serology and PCR amplification of SHIV RNA and DNA. Results As in humans, the concentration of FTC was higher than the concentration of TFV in vaginal secretions. Also as in humans, TFV levels in vaginal secretions were lower than in rectal secretions. Intracellular TFV-DP concentrations were also lower in vaginal tissues than in rectal tissues. Despite the low vaginal TFV exposure, all six treated macaques were protected from infection after 18 exposures or 4 full menstrual cycles. In contrast, all 6 control animals were infected. Conclusions We modeled a peri-coital regimen with two doses of Truvada and showed that it fully protected macaques from repeated SHIV exposures. Our results open the possibility for simplified PrEP regimens to prevent vaginal HIV transmission in women. PMID:23226529

Radzio, Jessica; Aung, Wutyi; Holder, Angela; Martin, Amy; Sweeney, Elizabeth; Mitchell, James; Bachman, Shanon; Pau, Chou-Pong; Heneine, Walid; Garcia-Lerma, J. Gerardo

2012-01-01

77

Vaginal douching practices and beliefs in Turkey  

Microsoft Academic Search

The aim of this study was to identify women's motivations for vaginal douching, vaginal douching practices, and women's reactions to situations that discourage vaginal douching. Research took place in the outskirts of Antalya, a city located on the Mediterranean coast of Turkey. A total of 776 women participated in the study. Age, religious affiliation, place of residence, and poverty were

Kamile Kukulu

2006-01-01

78

Vaginal birth after cesarean section  

Microsoft Academic Search

Vaginal birth after cesarean section (VBAC) is safe, cost effective, and the preferred obstetrical option for most parturients in health care settings which are equipped to manage intrapartum emergencies. Since 1981, cesarean sections have been the most frequently performed major surgical procedure in the United States. Approximately 1,000,000 cesarean deliveries are performed in the United States per year. The rate

Jordan Pritzker

1996-01-01

79

Complications of neglected vaginal pessaries: case presentation and literature review.  

PubMed

Vaginal pessaries are often used as first-line management of pelvic organ prolapse in women who are poor surgical candidates or who decline surgical repair. Mostly, pessaries are well tolerated but when neglected may lead to serious complications including vesicovaginal and rectovaginal fistulas. An 89-year-old woman presented with a large vesicovaginal fistula resulting from a Gellhorn pessary that had been neglected for 3 years. The base of the pessary had migrated completely inside the bladder and the fistulous opening measured 4 cm. The pessary was extracted under anesthesia using a Schuchardt incision to increase exposure. After 6 weeks of vaginal estrogen treatment, the fistula was successfully repaired using the Latzko partial colpocleisis technique. Neglect of a vaginal pessary can lead to serious complications. Patient education, local estrogen treatment, excellent fitting, and careful follow-up are of paramount importance in prevention of such complications. PMID:18301852

Arias, Beatriz E; Ridgeway, Beri; Barber, Matthew D

2008-08-01

80

Three-dimensional crack closure behavior  

NASA Technical Reports Server (NTRS)

A crack closure measurement technique involving fatigue striations was used to produce a three-dimensional crack opening load profile for 2024-T351 aluminum alloy. The crack opening load profile, determined through the specimen thickness, was compared with crack opening load measurements made with strain gages and displacement gages. The results of this study indicate that a significant three-dimensional variation in crack closure behavior occurs in the alloy examined. An understanding of this phehomenon is important in understanding crack growth behavior, predicting crack shape changes, and interpreting 'standard' crack closure measurement techniques.

Dawicke, D. S.; Grandt, A. F., Jr.; Newman, J. C., Jr.

1990-01-01

81

Light Absorbing Organic Carbon from Wood Pyrolysis: Closure Study between Measured and Modeled Optical Properties at Controlled Relative Humidity between 40 and 95%  

NASA Astrophysics Data System (ADS)

Hygroscopic aerosols uptake water at increased ambient relative humidity (RH), and this changes their size, shape, and composition. This affects their optical properties, and thus their radiative forcing. Organic carbon (OC) is an important component of the aerosol system due to its ubiquity and because its hygroscopic and light absorption properties are not well understood. In this work we have modeled the hygroscopic growth and optical properties (extinction, scattering, absorption, and single scattering albedo) at three wavelengths of OC from wood pyrolysis at increasing RH from 40 to 95%. Our goal was to reproduce laboratory measurements of the optical properties, particularly absorption of OC. Measurements included hygroscopicity with an H-TDMA, extinction with an extinction cell, and scattering with a nephelometer. Absorption was calculated by difference of extinction and scattering. The ?-Köhler model was used to model the hygroscopic growth, and different refractive index mixing rules were used to model the mixing state of OC+water mixtures. The hygroscopic growth factor (?) for OC was 0.08 ± 0.02 (corresponding to a growth factor (GF) = 1.19 ± 0.03 at 90% RH). The linear volume average mixing rule, Lorentz-Lorenz, Maxwell-Garnett, Bruggeman, and Core-Shell configuration were not able to reproduce the laboratory results. The mixing rule that was able to reproduce the structure of the absorption dependence on RH was the Dynamic Effective Medium Approximation (DEMA). Using refractive indices of m = 1.57 + 0.017i at 467 nm, 1.57 + 0.01i at 530 nm, and 1.57 + 0.002i nm at 660 nm, which were adjusted to obtain absorption measurements at dry conditions, we obtained closure at 467 nm and 530 nm wavelengths at RH from 40 to 95%, within the uncertainties of the model and the measurements. Absorption at 660 nm was very low, and it was not possible to confirm closure due to detection limitations of the measurements. Our results indicate that absorption by OC is enhanced by water uptake, twice the value at 95% RH relative to dry conditions.

Mena, F. C.; Brem, B. T.; Chen, Y.; Bond, T. C.; Rood, M. J.

2012-12-01

82

Evaluation and Management of Vaginitis  

PubMed Central

OBJECTIVE To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections, and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting. DATA SOURCES Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997 were reviewed. DATA SYNTHESIS Techniques that enable the identification of the various strains of candida have helped lead to a better understanding of the mechanisms of recurrent candida infection. From this information a rationale for the treatment of recurrent disease can be developed. Bacterial vaginosis has been associated with complications, including upper genital tract infection, preterm delivery, and wound infection. Women undergoing pelvic surgery, procedures in pregnancy, or pregnant women at risk of preterm delivery should be evaluated for bacterial vaginosis to decrease the rate of complications associated with this condition. New, more standardized criteria for the diagnosis of bacterial vaginosis may improve diagnostic consistency among clinicians and comparability of study results. Use of topical therapies in the treatment of bacterial vaginosis are effective and associated with fewer side effects than systemic medication. Trichomonas vaginalis, although decreasing in incidence, has been associated with upper genital tract infection. Therapy of T. vaginalis infection has been complicated by an increasing incidence of resistance to metronidazole. CONCLUSIONS Vaginitis is a common medical problem in women that is associated with significant morbidity and previously unrecognized complications. Research in recent years has improved diagnostic tools as well as treatment modalities for all forms of vaginitis. PMID:9613891

Carr, Phyllis L; Felsenstein, Donna; Friedman, Robert H

1998-01-01

83

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

84

Pharmacokinetics and efficacy of a vaginally administered maraviroc gel in rhesus macaques  

PubMed Central

Objectives To investigate the pharmacokinetics (PK) of maraviroc, a CCR5-targeted HIV-1 entry inhibitor, in rhesus macaques following vaginal administration of various maraviroc-loaded aqueous hydroxyethylcellulose (HEC) gels, and to correlate the PK data with efficacy in a single high-dose vaginal SHIV-162P3 challenge model. Methods Maraviroc concentrations in vaginal fluid (Weck-Cel® sponge), vaginal tissue (punch biopsy) and plasma were assessed over 72 h following single-dose vaginal application of various maraviroc-loaded HEC gels. The range of maraviroc gel concentrations was sufficiently broad (0.003%–3.3% w/w) that test gels included both fully solubilized and predominantly dispersed formulations. The efficacy of the HEC gels against a single high-dose vaginal SHIV-162P3 challenge was also measured, and correlated with the PK concentrations. Results Maraviroc concentrations in vaginal fluid (range 104–107 ng/mL), vaginal tissue (100–1200 ng/g) and plasma (<102 ng/mL) were highly dependent on maraviroc gel loading, irrespective of the form of the maraviroc component within the gel (solubilized versus dispersed). Fluid and plasma concentrations were generally highest 0.5 or 2 h after gel application, before declining steadily through to 72 h. Maraviroc concentrations in the various biological compartments correlated strongly with the extent of protection against vaginal SHIV-162P3 challenge. Complete protection was achieved with a 3.3% w/w maraviroc gel. Conclusions A high degree of correlation between PK and efficacy was observed. Based on the data obtained with the 3.3% w/w maraviroc gel, maintenance of vaginal fluid and tissue levels in the order of 107 ng/mL and 103 ng/g, respectively, are required for complete protection with this compound. PMID:23111849

Malcolm, R. Karl; Forbes, Claire J.; Geer, Leslie; Veazey, Ronald S.; Goldman, Laurie; Johan Klasse, Per; Moore, John P.

2013-01-01

85

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

86

Vaginitis test - wet mount  

MedlinePLUS

... so the provider can see inside. A sterile, moist cotton swab is gently inserted into the vagina ... slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor ...

87

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

88

Shortwave radiative closure studies for clear skies during the Atmospheric Radiation Measurement 2003 Aerosol Intensive Observation Period  

Microsoft Academic Search

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

J. J. Michalsky; G. P. Anderson; J. Barnard; J. Delamere; C. Gueymard; S. Kato; P. Kiedron; A. McComiskey; P. Ricchiazzi

2006-01-01

89

Vaginal Douching Among Latinas: Practices and Meaning  

Microsoft Academic Search

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased\\u000a risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated\\u000a with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching\\u000a among Latinas. Methods In depth qualitative interviews

M. Diane McKee; María Baquero; Matthew R. Anderson; Adelyn Alvarez; Alison Karasz

2009-01-01

90

Vaginal cuff dehiscence: Risk factors and management  

PubMed Central

Vaginal cuff dehiscence and evisceration are rare but serious complications of pelvic surgery, specifically hysterectomy. The data on risks of vaginal cuff dehiscence are variable and there is no consensus on how to manage this complication. In our review, we present a summary of the risk factors, presenting symptoms, precipitating events, and management options for patients who present with vaginal cuff dehiscence after pelvic surgery. In addition, we provide a review of the current literature on this important surgical outcome and suggestions for future research on the incidence and prevention of vaginal cuff dehiscence. PMID:21974989

Cronin, Beth; Sung, Vivian W.; Matteson, Kristen A.

2011-01-01

91

Continuous low dose estradiol released from a vaginal ring versus estriol vaginal cream for urogenital atrophy  

Microsoft Academic Search

Objectives: To determine if the efficacy of continuous low dose estradiol released from a vaginal ring is equivalent to estriol vaginal cream regarding improvement of the patient's subjective feeling of vaginal dryness and to determine if there is a preference for either of the two study treatments. Methods: Open-label randomized parallel group trial with active control with a blind evaluation

Ronald Barentsen; Peter H. M. van de Weijer; Jan H. N. Schram

1997-01-01

92

Effect of estrogen on molecular and functional characteristics of the rodent vaginal muscularis  

PubMed Central

Introduction Vaginal atrophy is a consequence of menopause however little is known concerning the effect of a decrease in systemic estrogen on vaginal smooth muscle structure and function. As the incidence of pelvic floor disorders increases with age, it is important to determine if estrogen regulates the molecular composition and contractility of the vaginal muscularis. Aim The goal of this study was to determine the effect of estrogen on molecular and functional characteristics of the vaginal muscularis utilizing a rodent model of surgical menopause. Methods 3–4 month old Sprague Dawley rats underwent sham laparotomy (Sham, n=18) or ovariectomy (Ovx, n=39). Two weeks following surgery, animals received a subcutaneous osmotic pump containing vehicle (Sham, Ovx) or 17- ? estradiol (Ovx). Animals were euthanized one week later and the proximal vagina was collected for analysis of contractile protein expression and in vitro studies of contractility. Measurements were analyzed using a one-way ANOVA followed by Tukey's post hoc analysis (?= 0.05). Main Outcome Measures Protein and mRNA transcript expression levels of contractile proteins, in vitro measurements of vaginal contractility Results Ovariectomy decreased the expression of carboxyl-terminal myosin heavy chain isoform SM1 and h-caldesmon and reduced the amplitude of contraction of the vaginal muscularis in response to KCl. Estradiol replacement reversed these changes. No differences were detected in the % vaginal muscularis, mRNA transcript expression of amino terminal MHC isoforms, l-caldesmon expression and maximal velocity of shortening. Conclusion Systemic estrogen replacement restores functional and molecular characteristics of the vaginal muscularis of ovariectomized rats. Our results indicate that menopause is associated with changes in the vaginal muscularis, which may contribute to the increased incidence of pelvic floor disorders with age. PMID:23438289

Basha, Maureen E.; Chang, Shaohua; Burrows, Lara J.; Lassmann, Jenny; Wein, Alan J.; Moreland, Robert S.; Chacko, Samuel K.

2013-01-01

93

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

94

Thinking about vaginal microbicide testing.  

PubMed Central

A vaginal microbicide could slow the spread of HIV. To date, volunteers in placebo-controlled trials of candidate microbicides have been counseled to use condoms. This does not reduce the number of volunteers exposed to possible risk, but it shifts the allotment of risk from those conducting the trial to those women who may be least able to make autonomous decisions. Alternative ways of meeting the obligation to offer volunteers active benefits are explored. Counseling the use of condoms prolongs clinical trials and could cause tens of thousands of otherwise avoidable deaths. PMID:10667178

Potts, M

2000-01-01

95

New delivery systems in contraception: vaginal rings  

Microsoft Academic Search

Vaginal rings, made of soft flexible silicone rubber, for delivery of contraceptive hormones are currently gaining clinical acceptance. This method provides extended release of hormones, which are implanted in the core of the ring and slowly disseminate into vaginal tissue. Although formulations and sizes vary, most rings are approximately 58 mm in diameter with a cross-section of 8.4 mm. Depending

Elof D. B. Johansson; Regine Sitruk-Ware

2004-01-01

96

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

97

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

98

Microscopic Evaluation of Vaginitis from a Menstrual Tampon  

Microsoft Academic Search

A simple method was studied using a menstrual tampon to collect a vaginal specimen for microscopic diagnosis of vaginal infection. The tampon specimen was compared to a specimen obtained during a vaginal speculum examination, obtained in 30 episodes of vaginal complaints from 29 college age females. Thirteen paired specimens were positive for Candida albicans. (Alternately, 1 each of the specimen

James L. Anderson; Patricia A. Sundland

1985-01-01

99

A Side by Side Comparison of Filter-Based PM(sub 2.5) Measurements at a Suburban Site: A Closure Study  

NASA Technical Reports Server (NTRS)

Reliable determination of the effects of air quality on public health and the environment requires accurate measurement of PM(sub 2.5) mass and the individual chemical components of fine aerosols. This study seeks to evaluate PM(sub 2.5) measurements that are part of a newly established national network by comparing them with a more conventional sampling system. Experiments were carried out during 2002 at a suburban site in Maryland, United States, where two samplers from the U.S. Environmental Protection Agency (USEPA) Speciation Trends Network: Met One Speciation Air Sampling System STNS and Thermo Scientific Reference Ambient Air Sampler STNR, two Desert Research Institute Sequential Filter Samplers DRIF, and a continuous TEOM monitor (Thermo Scientific Tapered Element Oscillating Microbalance) were sampling air in parallel. These monitors differ not only in sampling configuration but also in protocol-specific sample analysis procedures. Measurements of PM(sub 2.5) mass and major contributing species were well correlated among the different methods with r-values > 0.8. Despite the good correlations, daily concentrations of PM(sub 2.5) mass and major contributing species were significantly different at the 95% confidence level from 5 to 100% of the time. Larger values of PM(sub 2.5) mass and individual species were generally reported from STNR and STNS. The January STNR average PM(sub 2.5) mass (8.8 (micro)g/per cubic meter) was 1.5 (micro)g/per cubic meter larger than the DRIF average mass. The July STNS average PM(sub 2.5) mass (27.8 (micro)g/per cubic meter) was 3.8 (micro)g/per cubic meter larger than the DRIF average mass. These differences can only be partially accounted for by known random errors. Variations in flow control, face velocity, and sampling artifacts likely influence the measurement of PM(sub 2.5) speciation and mass closure. Simple statistical tests indicate that the current uncertainty estimates used in the STN network may underestimate the actual uncertainty.

Haines, Jennifer C.; Chen, Lung-Wen A.; Taubman, Brett F.; Doddridge, Bruce G.; Dickerson, Russell R.

2007-01-01

100

Effect of Semen on Vaginal Fluid Cytokines and Secretory Leukocyte Protease Inhibitor  

PubMed Central

The presence of semen in vaginal fluid, as identified by an acid phosphatase spot test, does not influence vaginal proinflammatory cytokine concentrations. Objective: determine whether semen, as detected by acid phosphatase, influences vaginal cytokines or secretory leukocyte protease inhibitor concentrations. Methods: 138 pregnant women had vaginal fluid collected for Gram stain, acid phosphatase detection by colorimetric assay, and interleukin 1-Beta, interleukin-6, interleukin-8, and secretory leukocyte protease inhibitor measurement by enzyme immunoassay. Results for women with and without acid phosphatase were compared by Mann-Whitney test. Results: of 138 subjects, 28 (20%) had acid phosphatase detected; of these, only 19 (68%) reported recent intercourse and 3 (11%) had sperm seen on Gram stain. There were no significant differences in proinflammatory cytokine concentrations; however, secretory leukocyte protease inhibitor concentrations were significantly higher among women with acid phosphatase. Conclusions: proinflammatory cytokine measurement does not appear to be affected by the presence of semen, but secretory leukocyte protease inhibitor is significantly higher when semen is present. Detection of semen by acid phosphatase was associated with higher vaginal SLPI concentrations, however, the presence of semen did not appear to influence vaginal proinflammatory cytokine concentrations. PMID:18615190

Agnew, Kathy J.; Aura, Jan; Nunez, Norma; Lee, Zandra; Lawler, Rick; Richardson, Carol E.; Culhane, Jennifer; Hitti, Jane

2008-01-01

101

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

102

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

103

Development of an in vitro alternative assay method for vaginal irritation.  

PubMed

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 (HSV-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

2011-01-11

104

Vaginal pH and Microbicidal Lactic Acid When Lactobacilli Dominate the Microbiota  

PubMed Central

Lactic acid at sufficiently acidic pH is a potent microbicide, and lactic acid produced by vaginal lactobacilli may help protect against reproductive tract infections. However, previous observations likely underestimated healthy vaginal acidity and total lactate concentration since they failed to exclude women without a lactobacillus-dominated vaginal microbiota, and also did not account for the high carbon dioxide, low oxygen environment of the vagina. Fifty-six women with low (0-3) Nugent scores (indicating a lactobacillus-dominated vaginal microbiota) and no symptoms of reproductive tract disease or infection, provided a total of 64 cervicovaginal fluid samples using a collection method that avoided the need for sample dilution and rigorously minimized aerobic exposure. The pH of samples was measured by microelectrode immediately after collection and under a physiological vaginal concentration of CO2. Commercial enzymatic assays of total lactate and total acetate concentrations were validated for use in CVF, and compared to the more usual HPLC method. The average pH of the CVF samples was 3.5 ± 0.3 (mean ± SD), range 2.8-4.2, and the average total lactate was 1.0% ± 0.2% w/v; this is a five-fold higher average hydrogen ion concentration (lower pH) and a fivefold higher total lactate concentration than in the prior literature. The microbicidal form of lactic acid (protonated lactic acid) was therefore eleven-fold more concentrated, and a markedly more potent microbicide, than indicated by prior research. This suggests that when lactobacilli dominate the vaginal microbiota, women have significantly more lactic acid-mediated protection against infections than currently believed. Our results invite further evaluations of the prophylactic and therapeutic actions of vaginal lactic acid, whether provided in situ by endogenous lactobacilli, by probiotic lactobacilli, or by products that reinforce vaginal lactic acid. PMID:24223212

O'Hanlon, Deirdre E.; Moench, Thomas R.; Cone, Richard A.

2013-01-01

105

Nursing considerations in patients with vaginitis.  

PubMed

Vaginitis is defined as an inflammation of the vagina. It can result in symptoms of any or all of the following: discharge, itching and pain, and often irritation or infection of the vulva. There is no specific cause for vaginitis, and many other conditions can cause the symptoms. Vaginitis is a distressing condition that affects many women of reproductive age and beyond, and encompasses candidiasis (also known as thrush), bacterial vaginosis, and trichomoniasis. It can occur in a single episode, or recur throughout a woman's lifetime. Some women will seek medical help, but many more self-treat with over-the-counter medications, suspecting the recurrence of Candida in particular. This article aims to explore the causes, signs and symptoms, and treatments of vaginitis to provide nurses with the necessary background information to feel more confident in dealing with women's health issues. PMID:20852467

Holloway, Debra

106

Vaginal douching practices and beliefs in Turkey.  

PubMed

The aim of this study was to identify women's motivations for vaginal douching, vaginal douching practices, and women's reactions to situations that discourage vaginal douching. Research took place in the outskirts of Antalya, a city located on the Mediterranean coast of Turkey. A total of 776 women participated in the study. Age, religious affiliation, place of residence, and poverty were found to influence women's attitudes to douching. Motivating factors included mothers' attitudes as well as women's own individual motivations. Women who douched believed that it was a normal and routine behaviour. Women who were members of the Shafii sect were much less likely to practice vaginal douching. Healthcare providers should be aware of women's beliefs and concerns about feminine hygiene and tailor their strategies accordingly. PMID:16846944

Kukulu, Kamile

2006-01-01

107

Achieving closure at Fernald  

SciTech Connect

When Fluor Fernald took over the management of the Fernald Environmental Management Project in 1992, the estimated closure date of the site was more than 25 years into the future. Fluor Fernald, in conjunction with DOE-Fernald, introduced the Accelerated Cleanup Plan, which was designed to substantially shorten that schedule and save taxpayers more than $3 billion. The management of Fluor Fernald believes there are three fundamental concerns that must be addressed by any contractor hoping to achieve closure of a site within the DOE complex. They are relationship management, resource management and contract management. Relationship management refers to the interaction between the site and local residents, regulators, union leadership, the workforce at large, the media, and any other interested stakeholder groups. Resource management is of course related to the effective administration of the site knowledge base and the skills of the workforce, the attraction and retention of qualified a nd competent technical personnel, and the best recognition and use of appropriate new technologies. Perhaps most importantly, resource management must also include a plan for survival in a flat-funding environment. Lastly, creative and disciplined contract management will be essential to effecting the closure of any DOE site. Fluor Fernald, together with DOE-Fernald, is breaking new ground in the closure arena, and ''business as usual'' has become a thing of the past. How Fluor Fernald has managed its work at the site over the last eight years, and how it will manage the new site closure contract in the future, will be an integral part of achieving successful closure at Fernald.

Bradburne, John; Patton, Tisha C.

2001-02-25

108

6. Launch closure, close up of closure motor, view towards ...  

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

6. Launch closure, close up of closure motor, view towards north - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

109

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

110

Patterns of Expression of Vaginal T-Cell Activation Markers during Estrogen-Maintained Vaginal Candidiasis  

PubMed Central

The immunosuppressive activity of estrogen was further investigated by assessing the pattern of expression of CD25, CD28, CD69, and CD152 on vaginal T cells during estrogen-maintained vaginal candidiasis. A precipitous and significant decrease in vaginal fungal burden toward the end of week 3 postinfection was concurrent with a significant increase in vaginal lymphocyte numbers. During this period, the percentage of CD3+, CD3+CD4+, CD152+, and CD28+ vaginal T cells gradually and significantly increased. The percentage of CD3+ and CD3+CD4+ cells increased from 43% and 15% at day 0 to 77% and 40% at day 28 postinfection. Compared with 29% CD152+ vaginal T cells in naive mice, > 70% of vaginal T cells were CD152+ at day 28 postinfection. In conclusion, estrogen-maintained vaginal candidiasis results in postinfection time-dependent changes in the pattern of expression of CD152, CD28, and other T-cell markers, suggesting that T cells are subject to mixed suppression and activation signals. PMID:20525139

2008-01-01

111

Clear-Sky Closure Studies of Tropospheric Aerosol and Water Vapor During ACE-2 Using Airborne Sunphotometer, Airborne In-Situ, Space-Borne, and Ground-Based Measurements  

NASA Technical Reports Server (NTRS)

We report on clear-sky column closure experiments (CLEARCOLUMN) performed in the Canary Islands during the second Aerosol Characterization Experiment (ACE-2) in June/July 1997. We present CLEARCOLUMN results obtained by combining airborne sunphotometer and in-situ (a differential mobility analyzer, three optical particle counters, three nephelometers, and one absorption photometer) measurements taken aboard the Pelican aircraft, space-borne NOAA/AVHRR data and ground-based lidars. A wide range of aerosol types was encountered throughout the ACE-2 area, including background Atlantic marine, European pollution-derived, and (although less frequently than expected) African mineral dust. During the two days discussed here, vertical profiles flown in cloud free air masses revealed three distinctly different layers: a marine boundary layer (MBL) with varying pollution levels, an elevated dust layer, and a very clean layer between the MBL and the dust layer. Based on size-resolved composition information we have established an aerosol model that allows us to compute optical properties of the ambient aerosol using the optical particle counter results. In the dust, the agreement in layer AOD (lambda=380-1060 nm) is 3-8%. In the MBL there is a tendency for the in-situ results to be slightly lower than the sunphotometer measurements (10-17% at lambda=525 nm), but these differences are within the combined error bars of the measurements and computations. Aerosol size-distribudon closure based on in-situ size distributions and inverted sunphotometer extinction spectra has been achieved in the MBL (total surface area and volume agree within 0.2, and 7%, respectively) but not in the dust layer. The fact that the three nephelometers operated at three different relative humidities (RH) allowed to parameterize hygroscopic growth and to therefore estimate optical properties at ambient RH. The parameters derived for different aerosol types are themselves useful for the aerosol modeling community. The fact that the nephelometers and the absorption photometer sampled the aerosol through a cyclone make those measurements less useful for thee closure study carried out here. Large corrections (especially in the dust) had to be applied. Therefore, it is not surprising that closure with the sunphotometer was not always achieved. Agreement within 0.02 in AOD was achieved in the dust layer when the airorne sunphotometer extinction or AOD was compared to ground-based lidar measurements. We found that the presence of the elevated dust layers removes the good agreement between satellite and sunphotometer AOD usually found in the absence of the dust layer. We still compare the scattering phase functions used in the satellite retrieval with those obtained from the aerosol or the sunphotometer measurements.

Schmid, Beat; Collins, Donald R.; Gasso, Santiago; Oestroem, Elisabeth; Powell, Donna M.; Welton, Ellsworth J.; Durkee, Philip A.; Livingston, John M.; Russell, Philip B.; Flagan, Richard C.; Seinfeld, John H.; Hegg, Dean A.; Noone, Kevin J.; Voss, Kenneth J.; Gordon, Howard R.; Reagan, John A.; Spinhirne, James D.

2000-01-01

112

Clear-Sky Closure Studies of Lower Tropospheric Aerosol and Water Vapor During ACE-2 Using Airborne Sunphotometer, Airborne In-Situ, Space-Borne, and Ground-Based Measurements  

NASA Technical Reports Server (NTRS)

We report on clear-sky column closure experiments (CLEARCOLUMN) performed in the Canary Islands during the second Aerosol Characterization Experiment (ACE-2) in June/July 1997. We present CLEARCOLUMN results obtained by combining airborne sunphotometer and in-situ (optical particle counter, nephelometer, and absorption photometer) measurements taken aboard the Pelican aircraft, space-borne NOAA/AVHRR data and ground-based lidar and sunphotometer measurements. During both days discussed here, vertical profiles flown in cloud-free air masses revealed 3 distinctly different layers: a marine boundary layer (MBL) with varying pollution levels, an elevated dust layer, and a very clean layer between the MBL and the dust layer. A key result of this study is the achievement of closure between extinction or layer aerosol optical depth (AOD) computed from continuous in-situ aerosol size-distributions and composition and those measured with the airborne sunphotometer. In the dust, the agreement in layer AOD (lambda = 380-1060 nm) is 3-8%. In the MBL there is a tendency for the in-situ results to be slightly lower than the sunphotometer measurements (10-17% at lambda = 525 nm), but these differences are within the combined error bars of the measurements and computations.

Schmid, Beat; Livingston, John M.; Russell, Philip B.; Durkee, Philip A.; Jonsson, Haflidi H.; Collins, Donald R.; Flagan, Richard C.; Seinfield, John H.; Gasso, Santiago; Hegg, Dean A.

2000-01-01

113

Poke hole closure apparatus  

SciTech Connect

A description is given of a poke hole closure assembly for a gas producer to minimize the escape of noxious or volatile gas from the producer during a poking operation, comprising closure means for a poke hole of a gas producer, said closure means comprising a block having an aperture therethrough, emans attaching said block to a gas producer so that said aperture is in substantial alignment with a poke hole, a cosure plate hinged to said block to block said aperture and poke hole during normal operating conditions and being openable to enable a poker to be inserted therethrough, and nozzle means responsive to the opening of said closure means to direct an inert gas into said poke hole, said nozzle means including passage means communicating with the interior of said aperture for conducting said inert gas to said aperture, said nozzle further including a hollow, conical insert mounted in said aperture, said insert having an opening therethrough to permit passage of said poker and having an outer conical wall spaced from an inner conical wall of said aperture, said passage means opening through said inner conical wall and into the space between said conical walls so that the inert gas will be directed downwardly and radially into said poke hole to block the outward passage of noxous or volatile gas from said poke hole when said closure plate is opened, means to prevent the entrainment of air in the downwardly and inwardly directed flow of inert gases comprising a plurality of ports extending through said insert from the space between said inner and outer conical walls to the opening through the insert to provide a blanket of inert gas which is sucked into the poke hole; to thereby prevent the entrainment of air.

Hamilton, W.

1980-07-08

114

The vaginal microbiota and susceptibility to HIV.  

PubMed

There is some evidence that the risk of HIV infection per heterosexual act is higher in low-income countries than in high-income countries. We hypothesize that variations in per sex-act transmission probability of HIV may in part be attributed to differences in the composition and function of the vaginal microbiota between different populations. This paper presents data that are in support of this hypothesis. Experimental and clinical studies have provided evidence that the normal vaginal microbiota plays a protective role against acquisition of HIV and other sexually transmitted infections. Epidemiological studies have convincingly shown that disturbances of the vaginal microbiome, namely intermediate flora and bacterial vaginosis, increase the risk of acquisition of HIV infection. A review of the literature found large differences in prevalence of bacterial vaginosis between different populations, with the highest prevalence rates found in black populations. Possible explanations for these differences are presented including data suggesting that there are ethnic differences in the composition of the normal vaginal microbiota. Lastly, interventions are discussed to restore and maintain a healthy vaginal environment. PMID:25389548

Buve, Anne; Jespers, Vicky; Crucitti, Tania; Fichorova, Raina N

2014-10-23

115

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

116

Development of an arid site closure plan  

SciTech Connect

This document describes the development of a prototype plan for the effective closure and stabilization of an arid low-level waste disposal site. This plan will provide demonstrated closure techniques for a trench in a disposal site at Los Alamos. The accuracy of modeling soil water storage by two hydrologic models, CREAMS and HELP, was tested by comparing simulation results with field measurements of soil moisture in eight experimental landfill cover systems having a range of well-defined soil profiles and vegetative covers. Regression analysis showed that CREAMS generally represented soil moisture more accurately than HELP simulations. Precautions for determining parameter values for model input and for interpreting simulation results are discussed. A specific example is presented showing how the field-validated hydrologic models can be used to develop a final prototype closure plan. 15 refs., 13 figs., 3 tabs.

Nyhan, J.W.; Barnes, F.J.

1987-01-01

117

50 CFR 648.141 - Closure.  

Code of Federal Regulations, 2011 CFR

...STATES Management Measures for the Black Sea Bass Fishery § 648.141 Closure...shall close the EEZ to fishing for black sea bass by commercial vessels issued...forth as follows: § 648.141 Black sea bass Annual Catch Target...

2011-10-01

118

Vaginal gel formulation based on theaflavin derivatives as a microbicide to prevent HIV sexual transmission.  

PubMed

We previously demonstrated that a commercially available natural product preparation with high content (>90%) of theaflavin derivatives (TFmix) exhibited potent anti-HIV activities. Here we developed a TFmix gel formulation as a topical microbicide candidate. The effect of TFmix on the amyloid fibril formation of semen-derived enhancer of virus infection (SEVI) peptide was detected by transmission electron microscopy. The toxicity of the TFmix gel was evaluated using human vaginal and cervical epithelial cell lines and rabbit vaginal irritation models, respectively. Levels of proinflammatory cytokines (IL-1?, IL-6, IL-8, and TNF-?) and immunoregulatory cytokines (IL-10 and GM-CSF) in cervicovaginal lavages (CVLs) were measured by ELISA kits. Proliferating cell nuclear antigen (PCNA) immunostaining was performed to evaluate inflammation in the vaginal tissues. TFmix gel could degrade SEVI-specific amyloid fibrils and showed low cytotoxicity to epithelial cells of the female reproductive tract. No apparent cervicovaginal toxicity was observed at any time point evaluated following the intravaginal administration of TFmix gel to rabbits, whereas application of N-9 gel resulted in damage to the vaginal epithelium. Neither proinflammatory nor immunoregulatory cytokine production was triggered by TFmix gel. Only low expression of PCNA was observed in vaginal tissues of TFmix gel-treated rabbits. The concentration of TFmix in plasma was very low (below the lower limit of quantitation) 1?h after a single vaginal administration of TFmix gel. However, TFmix was still detected in the cervicovaginal lavages (CVLs) 6?h after treatment, indicating that it could be retained in the vaginal cavity for a long period of time. With its potent anti-HIV-1 activity, marked stability at acidic condition, low mucosal toxicity, and lack of systemic absorption, TFmix gel can be considered as an inexpensive and safe microbicide candidate for the prevention of HIV sexual transmission. PMID:22867271

Yang, Jie; Li, Lin; Jin, Hong; Tan, Suiyi; Qiu, Jiayin; Yang, Lei; Ding, Yanqing; Jiang, Zhi-Hong; Jiang, Shibo; Liu, Shuwen

2012-11-01

119

Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) trial  

PubMed Central

Background Many women without preexisting stress urinary incontinence (SUI) who undergo vaginal surgery to correct pelvic organ prolapse will develop symptoms of SUI. A concomitant prophylactic anti-incontinence procedure may prevent SUI symptom development in women undergoing vaginal prolapse surgery. Purpose To present the rationale, design and methodology of a randomized controlled surgical trial (RCT), the Outcomes Following Vaginal Prolapse Repair and Mid Urethral Sling (OPUS) Trial. The primary aims of this RCT are to determine (1) whether the prevalence of post-operative urinary incontinence (UI) differs between stress continent women receiving vaginal prolapse repair with concomitant tension-free vaginal tape (TVT®; a sling procedure commonly used to treat SUI) and those with only sham incisions at 3 months post surgery (2) whether it is more cost-effective to place a TVT prophylactically than to treat the SUI symptoms postoperatively as they occur over a 12 month period after the index surgery.. The study also incorporates a patient preference trial (PPT). Methods Primary outcome, defined as signs (positive cough stress test), symptoms (per validated questionnaire) and/or need for treatment of SUI and its associated cost, at 3 and 12 months post-operatively. Secondary outcomes consist of group differences in lower urinary tract and prolapse symptoms, health related quality of life, measures of vaginal anatomy, and surgical complications. Limitations Given the invasive nature of surgical intervention trials, some individuals may be reluctant to agree with random assignment, potentially impacting result generalizability. To evaluate the magnitude and direction of non-participation bias, the PPT will enroll a sample of those who decline participation in the RCT but are otherwise eligible. Conclusion This sham-controlled RCT will provide important information for patients and surgeons regarding both the short- and long-term optimal treatment approach for stress continent women undergoing a vaginal surgery for prolapse. Non-participation bias will be estimated. PMID:19342469

Wei, John T.; Nygaard, Ingrid; Richter, Holly E.; Brown, Morton B; Barber, Matthew D.; Xu, Xiao; Kenton, Kim; Nager, Charles W.; Schaffer, Joseph; Visco, Anthony; Weber, Anne

2010-01-01

120

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

121

Transcatheter closure of atrial septal defect preserves right ventricular function  

PubMed Central

Objectives: To determine the effects of atrial septal defects (ASD) and their closure on systolic and diastolic right and left ventricular function; and by comparing surgical closure with transcatheter device closure, to establish differences attributable to cardiopulmonary bypass. Design: Cross sectionally guided M mode echocardiographic ventricular long axis function was measured prospectively before and within one week after ASD closure by device in 17 patients and by surgery in 12 patients, and compared with 18 normal subjects. Results: All indices of right ventricular function were impaired after surgery: mean total excursion, ?1.89 cm (95% confidence interval (CI), ?2.18 to ?1.59); peak shortening rate, ?9.09 cm/s (?10.82 to ?7.35); peak lengthening rate, ?9.26 cm/s (?11.09 to ?7.43). Total excursion and peak lengthening rate were preserved after device closure, at ?0.12 cm (?0.28 to 0.05) and 0.01 cm/s (?2.29 to 2.31), respectively. Left ventricular free wall function was unchanged after closure by either method, while all septal measurements were reduced after closure by either method (changes ranging from ?3.51 to ?0.32; 95% CI ranging from ?4.90 to ?0.13). Conclusions: Left ventricular free wall function is unaffected by ASD closure, whereas septal function is impaired, irrespective of the method of closure. Right ventricular function, both systolic and diastolic, is impaired by cardiopulmonary bypass but preserved after device closure. These findings support the transcatheter approach to ASD closure in anatomically suitable defects. PMID:11997422

Dhillon, R; Josen, M; Henein, M; Redington, A

2002-01-01

122

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-Antonio, 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

123

Feasibility of Histological Scoring and Colony Count for Evaluating Infective Severity in Mouse Vaginal Candidiasis  

PubMed Central

Qualitative measurement of the infective level is relatively difficult in experimental vaginal candidiasis. Female BALB/c mice aged 8 to 10 weeks were randomly divided into E1, E2 and E0 groups, which received subcutaneous injection of 0.05 mg, 0.1 mg of estradiol benzoate or 0.1 ml soybean oil 3 days before vaginal inoculation, respectively, and hormone treatment continued every other day thereafter. Each group was further divided into infected and noninfected subgroups. The infected mice were inoculated intravaginally with 10 µl (5 × 104 conidia) of Candida albicans suspension, while the noninfected mice were inoculated with 10 µl phosphate-buffered saline. Direct microscopic examination, colony count and vaginal histopathology including infection degree and inflammation extent were performed at 3, 7 and 14 days post inoculation. Estrogen treatment increased the vaginal fungal burden and extent of infection and inflammation compared with the control group, and 0.3 mg/week estrogen generally induced more severe infection and inflammation than 0.15 mg/week estrogen did. Colony count peaked on day 3 and decreased remarkably after 7 days. Infection score increased gradually during the first 7 days and decreased on day 14, while inflammation extent exacerbated progressively over the course of 14 days. This study demonstrates that the modified histological scoring system might be more feasible than colony count for evaluation of infectivity and dynamic change in experimental vaginal candidiasis. PMID:23903055

Zhang, Jin-E; Luo, Dan; Chen, Rong-Yi; Yang, Yan-Ping; Zhou, Ying; Fan, Yi-Ming

2013-01-01

124

Changes in the Vaginal Microenvironment with Metronidazole Treatment for Bacterial Vaginosis in Early Pregnancy  

PubMed Central

Abstract Objective Bacterial vaginosis (BV) is associated with preterm delivery, but there is little evidence that treatment improves pregnancy outcomes. We examined whether oral or vaginal metronidazole treatment for BV in early pregnancy was more effective in restoring the normal vaginal environment. Methods This was a randomized controlled trial comparing oral and intravaginal metronidazole for treatment of BV in early pregnancy (<20 weeks). Vaginal samples collected at baseline and 4 weeks after treatment were evaluated using gram stain, culture, colorimetric detection of sialidase, and immunoassay for measurement of proinflammatory cytokines interleukins-1?, -6, -8 (IL-1?, IL-6, IL-8) and secretory leukocyte protease inhibitor (SLPI). We compared the effect of treatment between groups (using chi-square and t test) and within individuals (McNemar's test). Results Of 126 subjects, 108 (86%) completed follow-up (55 oral, 53 intravaginal). Of the study population, 34% achieved therapeutic cure, and this was not different between treatment groups. BV-associated bacteria were significantly reduced in both groups, but few subjects regained colonization with protective lactobacilli. Among women who achieved therapeutic cure, the level of IL-1? dropped significantly (p?vaginal treatment group had undetectable sialidase after treatment (p?=?0.013). Conclusions Treatment with oral or intravaginal metronidazole in early pregnancy reduced colonization with BV-associated bacteria but was not effective in achieving therapeutic cure or in restoring healthy vaginal lactobacilli. PMID:19951217

Balkus, Jennifer; Agnew, Kathy; Lawler, Richard; Hitti, Jane

2009-01-01

125

Vaginal epithelial surface appearances in women using vaginal rings for contraception  

Microsoft Academic Search

Vaginal inspections using colposcopy before insertion of contraceptive vaginal rings and at 2-month intervals during ring use were conducted on 169 users of four different formulations. The rings studied released Nestorone® alone (50, 75, 100 ?g daily over 6 months); ethinyl estradiol: Nestorone (30:100 and 15:150 ?g daily over 6 months); ethinylestradiol:norethindrone acetate (20:1000 and 15:1000 ?g daily over 4

Ian S Fraser; Maria Lacarra; Daniel R Mishell Jr; Francisco Alvarez; Vivian Brache; Pekka Lähteenmäki; Kaisa Elomaa; Edith Weisberg; Harold A Nash

2000-01-01

126

Small intestinal submucosa patch for extensive vaginal endometriosis resection.  

PubMed

This case report describes use of a porcine small intestinal submucosa patch to prevent vaginal stiffness and retraction after extensive vaginal resection of an endometriosis nodule. A 32-year-old nulliparous woman was referred for surgical treatment of a large rectovaginal nodule that extended from the vaginal to the rectal mucosa. Surgical treatment was performed in 2 steps. Initially, a laparoscopic rectal resection was performed without opening the vagina to reduce the risk of fistula formation; 6 months later, the patient underwent a laparoscopic second-look combined with the vaginal approach to remove remaining disease. A small intestinal submucosa patch was successfully used to prevent vaginal shortening. PMID:19896606

Lemos, Nucélio Luiz de Barros Moreira; Kamergorodsky, Gil; Faria, Ana Luiza Antunes; Ribeiro, Paulo Augusto Ayroza Galvão; Auge, Antonio Pedro Flores; Aoki, Tsutomu

2009-01-01

127

Vaginal intraepithelial neoplasia III detected after hysterectomy for benign conditions.  

PubMed

Because primary vaginal cancer is rare, many experts discourage routine cytologic sampling of the vaginal vault following hysterectomy for benign circumstances. The following report describes a case of vaginal intraepithelial neoplasia III (VAIN III) detected by a vaginal vault Papanicolaou smear obtained from an asymptomatic 57-year-old woman 23 years after she had a total abdominal hysterectomy for a benign condition. As VAIN III is a true vaginal cancer precursor, the innocent disregard of recommended screening practices averted significant morbidity and possibility mortality for this otherwise healthy woman. PMID:7807042

Ferris, D G; Messing, M J; Crosby, J H

1995-01-01

128

Comparison of Frequency Vaginal and Cesarean Deliveries  

Microsoft Academic Search

Background: We investigated the rate of vaginal childbirth and Cesarean and its causes in maternity wards of Imam Khomeini Educational Hospital in Ahwaz the capital city of Khuzestan Province and Al- Hadi Hospital in Shoostar as a traditional city. Methods: In this comparative descriptive study data were obtained from medical records of birth deliveries in six months (March to September)

K Karami; M Najafian; P Shahri; S Faizi

2009-01-01

129

Clinical toxicology of clotrimazole when administered vaginally.  

PubMed

Clotrimazole, a tritylimidazole and a new antimicrobial agent, produced itching and irritation of the vulva and vaginal area in less than 1% of the population (N = 131) studied. No abdominal cramps, headache or lightheadedness, nausea, vomiting, and diarrhea were observed when 200 mg of clotrimazole was inserted deep in the vagina for several days. PMID:7009034

Wolfson, N; Riley, J; Samuels, B; Singh, J M

1981-01-01

130

Vaginal birth after C-section  

MedlinePLUS

... If your doctor says that you can have a VBAC, chances are good that you can have one with success. Around 3 out of 4 women who try VBAC are able to deliver vaginally. Keep in mind, you can try for a VBAC, but you may need a C-section ...

131

VAGINAL REPLACEMENT IN CHILDREN AND YOUNG ADULTS  

Microsoft Academic Search

PurposeAbsence of the vagina in the pediatric population most commonly results from congenital abnormalities, such as the Mayer-Rokitansky syndrome but it may also be seen after treatment for pelvic tumors, such as rhabdomyosarcoma, and in patients who have had previous gender reassignment. We review our experience using bowel for vaginal replacement in a group of children and young adults to

TERRY W. HENSLE; ELIZABETH A. REILEY

1998-01-01

132

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

133

Vaginal Douching and Intimate Partner Violence  

Microsoft Academic Search

Findings. Six percent of the sample reported experiencing any type of IPV in the past year, and 23% reported douching in the past year. IPV is significantly associated with douching after controlling for sociodemographic and health-related covariates. This finding holds for women with and without current reproductive capacity. Conclusions. This is the first study to identify an association between vaginal

Carol S. Weisman; Diane M. Grimley; Lucy Annang; Marianne M. Hillemeier; Gary A. Chase; Anne-Marie Dyer

2007-01-01

134

Orbiter door closure tools  

NASA Technical Reports Server (NTRS)

Safe reentry of the shuttle orbiter requires that the payload bay doors be closed and securely latched. Since a malfunction in the door drive or bulkhead latch systems could make safe reentry impossible, the requirement to provide tools to manually close and secure the doors was implemented. The tools would disconnect a disabled door or latch closure system and close and secure the doors if the normal system failed. The tools required to perform these tasks have evolved into a set that consists of a tubing cutter, a winch, a latching tool, and a bolt extractor. The design, fabrication, and performance tests of each tool are described.

Acres, W. R.

1980-01-01

135

50 CFR 654.23 - Southwest Florida seasonal trawl closure.  

Code of Federal Regulations, 2011 CFR

...AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE STONE CRAB FISHERY OF THE GULF OF MEXICO Management Measures § 654.23 Southwest Florida seasonal trawl closure. From January 1 to 1 hour...

2011-10-01

136

50 CFR 654.23 - Southwest Florida seasonal trawl closure.  

Code of Federal Regulations, 2010 CFR

...AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE STONE CRAB FISHERY OF THE GULF OF MEXICO Management Measures § 654.23 Southwest Florida seasonal trawl closure. From January 1 to 1 hour...

2010-10-01

137

Radiation therapy for primary vaginal carcinoma.  

PubMed

Brachytherapy plays a significant role in the management of cervical cancer, but the clinical significance of brachytherapy in the management of vaginal cancer remains to be defined. Thus, a single institutional experience in the treatment of primary invasive vaginal carcinoma was reviewed to define the role of brachytherapy. We retrospectively reviewed the charts of 36 patients with primary vaginal carcinoma who received definitive radiotherapy between 1992 and 2010. The treatment modalities included high-dose-rate intracavitary brachytherapy alone (HDR-ICBT; two patients), external beam radiation therapy alone (EBRT; 14 patients), a combination of EBRT and HDR-ICBT (10 patients), or high-dose-rate interstitial brachytherapy (HDR-ISBT; 10 patients). The median follow-up was 35.2 months. The 2-year local control rate (LCR), disease-free survival (DFS), and overall survival (OS) were 68.8%, 55.3% and 73.9%, respectively. The 2-year LCR for Stage I, II, III and IV was 100%, 87.5%, 51.5% and 0%, respectively (P = 0.007). In subgroup analysis consisting only of T2-T3 disease, the use of HDR-ISBT showed marginal significance for favorable 5-year LCR (88.9% vs 46.9%, P = 0.064). One patient each developed Grade 2 proctitis, Grade 2 cystitis, and a vaginal ulcer. We conclude that brachytherapy can play a central role in radiation therapy for primary vaginal cancer. Combining EBRT and HDR-ISBT for T2-T3 disease resulted in good local control. PMID:23559599

Murakami, N; Kasamatsu, T; Sumi, M; Yoshimura, R; Takahashi, K; Inaba, K; Morota, M; Mayahara, H; Ito, Y; Itami, J

2013-09-01

138

Vaginal masses: magnetic resonance imaging features with pathologic correlation.  

PubMed

The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution and multiplanar capabilities - is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation. PMID:17924224

Elsayes, K M; Narra, V R; Dillman, J R; Velcheti, V; Hameed, O; Tongdee, R; Menias, C O

2007-10-01

139

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

140

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

141

Nursing home closures: effects on capacity and reasons for closure  

Microsoft Academic Search

Objectives: to identify the rate of closure of nursing homes for older people, the types of homes closing and the reasons for closure. Design: mixed method study including a census and telephone survey of registration and inspection units and interviews with independent providers. Participants: 81 of 96 health authority and joint registration and inspection unit managers in England completed the

ANN NETTEN; R OBIN DARTON; J ACQUETTA WILLIAMS

2003-01-01

142

Breast Cancer, Aromatase Inhibitor Therapy, and Sexual Functioning: A Pilot Study of the Effects of Vaginal Testosterone Therapy  

PubMed Central

Introduction Women with breast cancer have better cancer-related outcomes with the use of aromatase inhibitors (AIs), but the physiological suppression of estradiol can negatively affect sexual functioning because of unpleasant urogenital and vaginal symptoms. Local health care practitioners have observed that the benefits of vaginal testosterone in allaying these unpleasant symptoms in women with breast cancer are similar to the benefits of vaginal estrogen in women without breast cancer. Aim The aim of this study was to evaluate the effects of using a daily vaginal testosterone cream on the reported sexual health quality of life in women with breast cancer taking AI therapy. Methods Thirteen postmenopausal women with breast cancer on AI therapy and experiencing symptoms of sexual dysfunction were recruited from an oncology practice. The women were prescribed a 300 ?g testosterone vaginal cream daily for 4 weeks. During the first study visit, a vaginal swab was obtained to rule out the presence of Candida species or Gardnerella vaginalis in participants. Women with positive vaginal swabs were treated prior to starting the vaginal testosterone therapy. Main Outcome Measure ?The Female Sexual Function Index (FSFI) survey, measuring female sexual health quality of life, was administered during the first study visit and at the final study visit, after completing testosterone therapy. Results Twelve patients completed 4 weeks of daily vaginal testosterone therapy. When compared with baseline FSFI scores, there was a statistically significant improvement for individual domain scores of desire (P = 0.000), arousal (P = 0.002), lubrication (P = 0.018), orgasm (P = 0.005), satisfaction (P = 0.001), and pain (P = 0.000). Total domain scores reflecting sexual health quality of life also improved when compared with baseline (P = 0.000). Conclusions The use of a compounded testosterone vaginal cream applied daily for 4 weeks improves reported sexual health quality of life in women with breast cancer taking AIs. Dahir M and Travers-Gustafson D. Breast cancer, aromatase inhibitor therapy, and sexual functioning: A pilot study of the effects of vaginal testosterone therapy. Sex Med 2014;2:8–15. PMID:25356296

Dahir, Melissa; Travers-Gustafson, Dianne

2014-01-01

143

COUNTER-CLOSURE Federico Luzzi  

E-print Network

to Closure, one that expresses a related and prima facie very plausible view: that knowledge obtained by the principle of Counter-Closure, that knowledge-yielding competent deductive inference must issue from known construct as exhibiting a justified, true belief to which none of the usual diagnoses of knowledge failure

Fitelson, Branden

144

Closure fixture and assembly cap  

Microsoft Academic Search

A closure fixture has a slide member or valve for radioactive and toxic media, a fixture housing, a housing cover connected to the housing via a first sealing surface and a closure device with a drive mechanism arranged on the housing cover. The housing fixture comprises an additional sealing surface and an assembly cap has an interior configured to receive

L. Grein; U. Reimpell; R. Reiter

1981-01-01

145

Closure plan for Solid Waste Storage Area 6: Volume 1, Closure plan  

SciTech Connect

This Closure Plan for Solid Waste Storage Area 6 (SWSA 6) a disposal area for low-level radioactive wastes and hazardous materials, of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) describes how portions of SWSA 6 will be closed under Resource Conservation and Recovery Act (RCRA) Interim Status per 40 CFR 265 Subpart G (TN Rule 1200-1-11-.05(7)). An overview is provided of activities necessary for final closure and corrective measures for all of SWSA 6. Results of surface waters and groundwater sampling are provided.

Not Available

1988-09-01

146

Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence  

PubMed Central

Objective To compare tension-free vaginal tape with colposuspension as primary treatment for stress incontinence. Design Multicentred randomised comparative trial. Setting Gynaecology or urology departments in 14 centres in the United Kingdom and Eire, including university teaching hospitals and district general hospitals. Participants 344 women with urodynamic stress incontinence; 175 randomised to tension-free vaginal tape and 169 to colposuspension Main outcome measures Assessment before treatment and at six months postoperatively with the SF-36, the Bristol female lower urinary tract symptoms questionnaire, the EQ-5D health questionnaire, a one week urinary diary, one hour perineal pad test, cystometry, and, in some centres, urethral profilometry. Results 23 women in the colposuspension group and 5 in the vaginal tape group withdrew before surgery. No significant difference was found between the groups for cure rates: 115 (66%) women in the vaginal tape group and 97 (57%) in the colposuspension group were objectively cured (95% confidence interval for difference in cure ?4.7% to 21.3%). Bladder injury was more common during the vaginal tape procedure; postoperative complications, in particular delayed resumption of micturition, were more common after colposuspension. Operation time, duration of hospital stay, and return to normal activity were all longer after colposuspension than after the vaginal tape procedure. Conclusion Surgery with tension-free vaginal tape is associated with more operative complications than colposuspension, but colposuspension is associated with more postoperative complications and longer recovery. Vaginal tape shows promise for the treatment of urodynamic stress incontinence because of minimal access and rapid recovery times; cure rates at six months were comparable with colposuspension. What is already known on this topicFew randomised trials exist on surgery for stress incontinenceSystematic reviews suggest that colposuspension is associated with cure rates of up to 90%Case series of tension-free vaginal tape suggest cure rates of about 85%, with rapid return to normal activityWhat this study addsAt six months the tension-free vaginal tape procedure is as effective as colposuspension for the primary treatment of stress incontinenceOperative complications were more common with vaginal tape, but duration of hospital stay and return to normal activity were shorter than with colposuspensionPostoperative complications were more common after colposuspension PMID:12114234

Ward, Karen; Hilton, Paul

2002-01-01

147

In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide  

PubMed Central

Background Hydrogen peroxide (H2O2) produced by vaginal lactobacilli is generally believed to protect against bacteria associated with bacterial vaginosis (BV), and strains of lactobacilli that can produce H2O2 are being developed as vaginal probiotics. However, evidence that led to this belief was based in part on non-physiological conditions, antioxidant-free aerobic conditions selected to maximize both production and microbicidal activity of H2O2. Here we used conditions more like those in vivo to compare the effects of physiologically plausible concentrations of H2O2 and lactic acid on a broad range of BV-associated bacteria and vaginal lactobacilli. Methods Anaerobic cultures of seventeen species of BV-associated bacteria and four species of vaginal lactobacilli were exposed to H2O2, lactic acid, or acetic acid at pH 7.0 and pH 4.5. After two hours, the remaining viable bacteria were enumerated by growth on agar media plates. The effect of vaginal fluid (VF) on the microbicidal activities of H2O2 and lactic acid was also measured. Results Physiological concentrations of H2O2 (< 100 ?M) failed to inactivate any of the BV-associated bacteria tested, even in the presence of human myeloperoxidase (MPO) that increases the microbicidal activity of H2O2. At 10 mM, H2O2 inactivated all four species of vaginal lactobacilli but only one of seventeen species of BV-associated bacteria. Moreover, the addition of just 1% vaginal fluid (VF) blocked the microbicidal activity of 1 M H2O2. In contrast, lactic acid at physiological concentrations (55-111 mM) and pH (4.5) inactivated all the BV-associated bacteria tested, and had no detectable effect on the vaginal lactobacilli. Also, the addition of 10% VF did not block the microbicidal activity of lactic acid. Conclusions Under optimal, anaerobic growth conditions, physiological concentrations of lactic acid inactivated BV-associated bacteria without affecting vaginal lactobacilli, whereas physiological concentrations of H2O2 produced no detectable inactivation of either BV-associated bacteria or vaginal lactobacilli. Moreover, at very high concentrations, H2O2 was more toxic to vaginal lactobacilli than to BV-associated bacteria. On the basis of these in vitro observations, we conclude that lactic acid, not H2O2, is likely to suppress BV-associated bacteria in vivo. PMID:21771337

2011-01-01

148

Wound closure and wound management  

PubMed Central

Wound closure and infection control are the primary goal of wound management. A variety of disinfectants and antimicrobial agents are widely available today and routinely achieve infection control. On the contrary, wound closure still remains a challenging goal. Cell adhesion, migration and contraction play significant roles in creating contractile force of patent wound margins and in contributing to wound closure. Modulations of these cellular behaviors have been investigated in the context of wound contraction; however, therapeutic strategy to achieve wound closure has not been established. Recently, we have reported that a previously unknown cytoskeleton molecule, wound inducible transcript-3.0 (wit3.0) also known as fibroblast growth factor receptor 1 oncogene partner 2 (FGFR1OP2), can significantly modulate fibroblast-driven wound closure in vitro and in vivo. The dynamic role of cytoskeleton in different experimental models may provide a novel platform for designing the therapeutic target of wound management. PMID:20448469

Lin, Audrey; Hokugo, Akishige

2010-01-01

149

Do changes in anal sphincter anatomy correlate with anal function in women with a history of vaginal delivery?  

PubMed

Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner's score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US) em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal. PMID:25296079

Murad-Regadas, Sthela Maria; Dealcanfreitas, Iris Daiana; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Pereira, Jacyara de Jesus Rosa

2014-09-01

150

Evaluation of Two Energy Balance Closure Parametrizations  

NASA Astrophysics Data System (ADS)

A general lack of energy balance closure indicates that tower-based eddy-covariance (EC) measurements underestimate turbulent heat fluxes, which calls for robust correction schemes. Two parametrization approaches that can be found in the literature were tested using data from the Canadian Twin Otter research aircraft and from tower-based measurements of the German Terrestrial Environmental Observatories (TERENO) programme. Our analysis shows that the approach of Huang et al. (Boundary-Layer Meteorol 127:273-292, 2008), based on large-eddy simulation, is not applicable to typical near-surface flux measurements because it was developed for heights above the surface layer and over homogeneous terrain. The biggest shortcoming of this parametrization is that the grid resolution of the model was too coarse so that the surface layer, where EC measurements are usually made, is not properly resolved. The empirical approach of Panin and Bernhofer (Izvestiya Atmos Oceanic Phys 44:701-716, 2008) considers landscape-level roughness heterogeneities that induce secondary circulations and at least gives a qualitative estimate of the energy balance closure. However, it does not consider any feature of landscape-scale heterogeneity other than surface roughness, such as surface temperature, surface moisture or topography. The failures of both approaches might indicate that the influence of mesoscale structures is not a sufficient explanation for the energy balance closure problem. However, our analysis of different wind-direction sectors shows that the upwind landscape-scale heterogeneity indeed influences the energy balance closure determined from tower flux data. We also analyzed the aircraft measurements with respect to the partitioning of the "missing energy" between sensible and latent heat fluxes and we could confirm the assumption of scalar similarity only for Bowen ratios 1.

Eder, Fabian; De Roo, Frederik; Kohnert, Katrin; Desjardins, Raymond L.; Schmid, Hans Peter; Mauder, Matthias

2014-05-01

151

Spectrum of vaginal discharge in a tertiary care setting  

PubMed Central

Introduction: Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. Materials and Methods: A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. Results: Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. Conclusion: The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies. PMID:24470998

Sivaranjini, R; Jaisankar, TJ; Thappa, Devinder Mohan; Kumari, Rashmi; Chandrasekhar, Laxmisha; Malathi, M; Parija, SC; Habeebullah, S

2013-01-01

152

The effects of a combined contraceptive vaginal ring releasing ethinyloestradiol and 3-ketodesogestrel on vaginal flora.  

PubMed

Fifty nine women with documented normal ovulatory cycles and with no symptoms of vaginal infection were divided into four groups. Each group used a combined contraceptive vaginal ring (CCVR) with a mean daily release rate of 0.015 mg of ethinyloestradiol (EE) and 0.120 mg of 3-ketodesogestrel (3-KDG) per day, for one cycle of either 21, 28, 42, or 56 days. Cultures from the posterior vaginal fornix and from the endocervical canal were obtained immediately before insertion of the ring and on removal of the ring. Changes in the numbers of vaginal cells, aerobic and anaerobic bacteria, Chlamydia trachomatis, Gardnerella vaginalis, yeasts and Trichomonas vaginalis were documented at the end of each treatment. Intra- and inter- group changes in the vaginal flora were assessed at the end of each treatment. The comparison between the number and type of flora showed no significant change between the pre-treatment population and the post-treatment population. The results of this study suggest that the use of this CCVR for 21, 28, 42 and 56 days is not associated with an increase in inflammatory cells or pathogenic bacteria. PMID:1623721

Davies, G C; Feng, L X; Newton, J R; Dieben, T O; Coelingh-Bennink, H J

1992-05-01

153

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

PubMed Central

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:25372005

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

2014-01-01

154

Can group B streptococci cause symptomatic vaginitis?  

PubMed Central

BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients. PMID:10449271

Honig, E; Mouton, J W; van der Meijden, W I

1999-01-01

155

[Morphogenesis of vaginal aplasia. Therapeutic deductions].  

PubMed

On the basis of the studies of the embryogenesis of the vagina, the authors consider that malformations classically described as being partial aplasia should not be separated from the total absence of the vagina. The important feature is the association of a functioning or non functioning uterus with the absence of the vagina. They believe that it is incorrect to describe the pouch of menstrual retention associated with a functioning uterus as "haematocolpos" and that is not justified to describe the cup-shaped vestibular depression as "hemi-vagina". According to the authors, although vaginal aplasia with a functioning uterus forming a pouch of menstrual retention constitutes an absolute indication for surgery, surgery is not justified in cases of vaginal aplasia with a non functioning uterus. If Frank's method fails in these cases, the patient or the couple should be referred to a sexologist, as women with this anomaly retain a perfect femininity, although unable to conceive. PMID:4059773

Minh, H N; Smadja, A; Belaisch, J

1985-01-01

156

The Vaginal Approach After Failed Previous Surgery  

Microsoft Academic Search

After any failed surgery for incontinence, or after any vaginal surgery complicated by incontinence for that matter, it is\\u000a essential to carry out a complete evaluation of the patient— both subjectively and objectively. Certainly recurrent incontinence\\u000a after previous surgery can usually be treated successfully, but it requires precise patient evaluation because it is imperative\\u000a that the exact functional derangement is

Christopher C. R. Chapple

157

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

158

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

159

Acr appropriateness Criteria management of vaginal cancer.  

PubMed

Due to its rarity, treatment guidelines for vaginal cancer are extrapolated from institutional reports and prospective studies of cervical and anal cancer. An expert panel was convened to reach consensus on the selection of imaging and therapeutic modalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) used by the panel to rate the appropriateness of imaging and treatment procedures. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Four variants were developed to represent clinical scenarios in vaginal cancer management. Group members reached consensus on the appropriateness of the pretreatment evaluation and therapeutic interventions. This article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management. PMID:24575547

Lee, Larissa J; Jhingran, Anuja; Kidd, Elizabeth; Cardenes, Higinia Rosa; Elshaikh, Mohamed A; Erickson, Beth; Mayr, Nina A; Moore, David; Puthawala, Ajmel A; Rao, Gautam G; Small, William; Varia, Mahesh A; Wahl, Andrew O; Wolfson, Aaron H; Yashar, Catheryn M; Yuh, William; Gaffney, David K

2013-11-01

160

Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis  

PubMed Central

Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effects of some antibiotics on Lactobacilli isolates. Materials and Methods: In this study (110) vaginal swabs were obtained from women suffering from vaginitis who admitted to Babylon Hospital of Maternity and Paediatrics in Babylon province, Iraq. The study involved the role of intrauterine device among married women with vaginitis and also involved isolation of opportunistic bacterial isolates among pregnant and non pregnant women. This study also involved studying probiotic role of Lactobacilli by production of some defense factors like hydrogen peroxide, bacteriocin, and lactic acid. Results: Results revealed that a total of 130 bacterial isolates were obtained. Intrauterine device was a predisposing factor for vaginitis. The most common opportunistic bacterial isolates were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Klebsiella pneumoniae. All Lactobacilli were hydrogen peroxide producers while some isolates were bacteriocin producers that inhibited some of opportunistic pathogens (S. aureus, E. coli). Lactobacilli were sensitive to erythromycin while 93.3% of them were resistant to ciprofloxacin and (40%, 53.3%) of them were resistant to amoxicillin and gentamycin respectively. Results revealed that there was an inverse relationship between Lactobacilli presence and organisms causing vaginitis. This may be attributed to the production of defense factors by Lactobacilli. Conclusion: The types of antibiotics used to treat vaginitis must be very selective in order not to kill the beneficial bacteria (Lactobacilli) that help in preservation of vaginal health and ecosystem as being one of the probiotic bacteria. PMID:22540089

Razzak, Mohammad Sabri A.; Al-Charrakh, Alaa H.; AL-Greitty, Bara Hamid

2011-01-01

161

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

162

The propeller flap concept used in vaginal wall reconstruction.  

PubMed

Most posterior vaginal wall defects are due to abdominoperineal resection for colorectal carcinoma involving the posterior vaginal wall or resection of local malignancies. The rectus abdominis myocutaneous flap, the modified Singapore flap and the gracilis myocutaneous flap remain workhorse solutions for this type of vaginal reconstruction. The introduction of the perforator concept has introduced new therapeutic options using the gluteal donor site region. Recently, perforator-based gluteal flaps have been described as a reliable solution for reconstruction of posterior vaginal wall defects, with low donor site morbidity. Here, we present a new technique to optimise results and minimise morbidity to the patient. PMID:22133384

Smeets, L; Hendrickx, B; Teo, T C

2012-05-01

163

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

164

Effects of endopeptidase inhibition on the contraction-relaxation response of isolated human vaginal tissue.  

PubMed

INTRODUCTION.: Vasoactive peptides, such as bradykinin, C-type natriuretic peptide (CNP), vasoactive intestinal polypeptide (VIP), and endothelin 1 (ET-1), are assumed to be involved in the control of female genital vascular and nonvascular smooth muscle. Tissue levels of said peptides are controlled by the activity of endopeptidase enzymes. Theoretically, in female genital tissues, inhibiting the degradation of bradykinin, CNP, and VIP, or the conversion of Big ET-1 into ET-1 should result in an enhancement in smooth muscle relaxation and, thus, an improvement in sexual response. AIM.: Elucidate the effects of the endopeptidase inhibitor KC 12615 on the contraction/relaxation response of isolated human vaginal smooth muscle to Big ET-1, bradykinin, CNP, or VIP. METHODS.: Tissue bath experiments were carried out to ascertain the responses of human vaginal tissue challenged by ET-1 (0.1??M) to increasing concentrations of bradykinin, CNP, and VIP (0.01??M, 0.1??M, and 1??M, respectively). The effects were also evaluated following preexposure to KC 12615 (10??M, for 20 minutes). MAIN OUTCOME MEASURES.: Measure the effects of KC 12615 on the relaxation of isolated human vaginal smooth muscle brought about by bradykinin, CNP, or VIP and the contraction mediated by Big ET-1. RESULTS.: The tension induced by ET-1 was reversed by bradykinin, CNP, or VIP (-25?±?6.6%, -13.3?±?2.2%, and -17.6?±?10%, respectively). Big ET-1 induced contraction of the vaginal tissue. Preexposure of the tissue to KC 12615 increased the relaxation exerted by bradykinin, CNP, or VIP (to -39.2?±?5.8%, -40.7?±?7.3%, and -44.6?±?19%, respectively). The contraction induced by Big ET-1 was attenuated in the presence of KC 12615 (to approximately 25% of the initial response). CONCLUSION.: Inhibition of endopeptidase activity can antagonize the contraction of human vaginal tissue induced by Big ET-1 and increase the relaxation induced by vasoactive endogenous peptides. PMID:23347427

Rahardjo, Harrina E; Uckert, Stefan; Taher, Akmal; Sonnenberg, Joachim E; Kauffels, Wolfgang; Rahardjo, Djoko; Kuczyk, Markus A

2013-04-01

165

The Conditional Moment Closure Model  

Microsoft Academic Search

\\u000a The relatively recent Conditional Moment Closure methods for turbulent reacting flows have advanced from application to relatively\\u000a well behaved, simple laboratory flames to complex flow geometries and flame conditions with intense turbulence-chemistry interactions.\\u000a The progress on second order closures, double conditioning approaches, two-phase and premixed CMC is reviewed in the first\\u000a part of this chapter, while the second part is

A. Kronenburg; E. Mastorakos

166

The base-closure waltz  

SciTech Connect

A desire to protect bases and weapons contracts in their representative districts and states unites almost all members of Congress, regardless of party affiliation. As described in this paper, this unity was especially evident in the latest round of proposed base closures -- the third in five years. The implications and schedule of these base closures and some remarks of Congressional representatives are provided in this article.

Isaacs, J. (Council for a Livable World, Washington, DC (United States))

1993-05-01

167

Design Factors and Socioeconomic Variables Associated with Ecological Responses to Fishery Closures in the Western Indian Ocean  

Microsoft Academic Search

We assessed the ability of socioeconomic variables (population size, perceived infringement, and community infrastructure) and design features (closure age and area) to predict ecological indicators of “success” in seventeen coral-reef fishery closures in the Western Indian Ocean. Success was measured as absolute fish biomass and coral cover in closures, and the response ratio of these variables indicating the level of

Tim M. Daw; Joshua E. Cinner; Timothy R. McClanahan; Nicholas A. J. Graham; Shaun K. Wilson

2011-01-01

168

Telemetric assessment of referred vaginal hyperalgesia and the effect of indomethacin in a rat model of endometriosis.  

PubMed

Symptoms of endometriosis (ENDO), among others, include pelvic/abdominal and muscle pain. Non-steroidal anti-inflammatory agents are first-line treatment for this pain. Similar to women, rats with surgically induced ENDO, but not its surgical control, exhibit vaginal hyperalgesia, which in rats is evidenced by a decreased threshold for the visceromotor response (VMR) induced by vaginal distention. Here we assess the VMR in rats with implanted probes that telemetrically transmit EMG activity from the abdominal muscle. The feasibility and sensitivity of this technique for monitoring the VMR threshold across the estrous cycle and the influence of Indomethacin on ENDO-induced vaginal hyperalgesia were evaluated. VMR thresholds in response to vaginal distention with an infusion pump were measured in different estrous stages. Indomethacin (5 or 10?mg/kg i.p. or s.c.) was injected in proestrus rats and 40-60?min later the VMR threshold was measured. The VMR threshold varied across the estrous cycle only in ENDO rats, being lowest in proestrus. Indomethacin increased this threshold in proestrus ENDO rats. These results show that telemetric assessment of the VMR is a sensitive tool, suitable for long-term studies in conscious rats. The results with this technique also suggest that ENDO-associated vaginal hyperalgesia involves COX activity, the feature that also underlies inflammatory pains. PMID:22969722

Dmitrieva, N; Faircloth, E K; Pyatok, S; Sacher, F; Patchev, V

2012-01-01

169

Microbiology of the lower genital tract in postmenarchal adolescent girls: differences by sexual activity, contraception, and presence of nonspecific vaginitis.  

PubMed

The prevalence of selected microorganisms in the lower genital tract in postmenarchal adolescent girls was assessed, including vaginal Gardnerella vaginalis, group B streptococcus, lactobacillus, Mycoplasma species, Ureaplasma urealyticum, Staphylococcus aureus, and yeast, and endocervical Mycoplasma species, U. urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Specific attention was focused on important sexually transmitted disease organisms, and differences in isolations by age, sexual activity, ethnicity, contraception, and the diagnosis of nonspecific vaginitis were measured. Sexually active subjects had a mean of 6.05 organisms (SD = 3.16), compared with 3.12 organisms (SD = 3.92) in non-sexually active subjects (P = 0.001). Sexually active subjects had significantly more vaginal G. vaginalis, lactobacilli, Mycoplasma species, and U. urealyticum, as well as endocervical Mycoplasma species and U. urealyticum, compared with non-sexually active subjects; C. trachomatis, N. gonorrhoea, and T. vaginalis were isolated exclusively from the sexually active group. Significant differences in isolation rates by ethnicity were found in vaginal Mycoplasma species and U. urealyticum, and endocervical Mycoplasma species, U. urealyticum, C. trachomatis, N. gonorrhoeae, and T. vaginalis. In general, organisms were isolated from blacks most frequently; N. gonorrhoea was isolated from blacks exclusively. Differences were found in microbiologic isolations by the presence or absence of nonspecific vaginitis. Vaginal G. vaginalis and Mycoplasma species and endocervical Mycoplasma species and U. urealyticum were found significantly more often in isolates from the group with nonspecific vaginitis. It is important to define the microbial flora of the lower genital tract in adolescent girls in order to understand its role in the pathogenesis of acute salpingitis. PMID:3877803

Shafer, M A; Sweet, R L; Ohm-Smith, M J; Shalwitz, J; Beck, A; Schachter, J

1985-12-01

170

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.; Mahood, L.; Manlucu, E. D.; Nath, Manju E.

2008-10-28

171

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.

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

2014-01-01

172

Vaginal mass following uncemented total hip arthroplasty.  

PubMed

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

2014-11-01

173

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

174

Predictive score for vaginal birth after cesarean section  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the relative weight of the different variables that may influence the chances of vaginal birth after one cesarean delivery, with the aim of developing a predictive score for success of such a trial. STUDY DESIGN: In this retrospective study, which covered a 10-year period (1981 to 1990), 471 women who attempted vaginal birth at

Daniel Weinstein; Abraham Benshushan; Vasilios Tanos; Ronit Zilberstein; Nathan Rojansky

1996-01-01

175

Vaginal birth after cesarean among women with gestational diabetes  

Microsoft Academic Search

Objective: We sought to determine the pregnancy and infant outcomes of women with gestational diabetes who attempted vaginal birth after previous cesarean delivery. Study Design: We conducted a retrospective cohort study to compare women with gestational diabetes with matched control subjects without diabetes who attempted vaginal birth after cesarean at Grady Memorial Hospital, Atlanta, from January 1, 1989, through December

Traci L. Coleman; Hugh Randall; William Graves; Michael Lindsay

2001-01-01

176

Estradiol-delivering vaginal rings for hormone replacement therapy  

Microsoft Academic Search

Objectives: This study was undertaken to determine the relief of climacteric symptoms by vaginal rings delivering estradiol and to monitor estrogen levels. Study Design: Rings releasing in vitro either 60 or 140 ?g\\/d estradiol were used by 35 women who had undergone hysterectomy for each dose level. Hot flash and night sweat incidences, vaginal conditions, and complaints were recorded at

Harold A. Nash; Francisco Alvarez-Sanchez; Daniel R. Mishell; Ian S. Fraser; Takeshi Maruo; Troy M. Harmon

1999-01-01

177

Immunological Characterization of Human Vaginal Xenografts in Immunocompromised Mice  

PubMed Central

A small animal model for the in vivo study of human immunodeficiency virus-1 and other fastidious infectious agents in human host target tissues is critical for the advancement of therapeutic and preventative strategies. Our laboratory has developed a human vaginal xenograft model that histologically recapitulates features of the human vaginal epithelial barrier. Vaginal xenografts were surgically implanted into C.B.-Igh-1b/IcrTac-Prkdcscid (SCID) and NOD/LtSz-scid/scid (NOD/SCID) mice, with and without human peripheral blood mononuclear cell reconstitution. Immunohistochemical staining of vaginal xenografts demonstrated that in the SCID strain healed vaginal xenografts did not retain intrinsic human immune cells at baseline levels, whereas the NOD/SCID strain supported retention of intrinsic human immune cell populations within the xenografts for at least 2 months after engraftment. In peripheral blood mononuclear cell-reconstituted NOD/SCID mice with vaginal xenografts, flow cytometric analyses detected human immune cell populations in the peripheral blood and immunohistochemical methods detected infiltration of human CD45+ cells in the mouse spleens and vaginal xenografts for at least 2 months after reconstitution. This optimized NOD/SCID human vaginal xenograft model may provide a unique small animal in vivo system for the study of human immunodeficiency virus-1 transmission and infection. PMID:11733382

Kish, Tina M.; Budgeon, Lynn R.; Welsh, Patricia A.; Howett, Mary K.

2001-01-01

178

Vaginal hygiene and douching: perspectives of Hispanic men  

Microsoft Academic Search

Vaginal douching is widely practised by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction and sexuality. Little previous research has addressed the beliefs and practices of Latina women and none has included the perspective of

Diane McKee; María Baquero; Matthew Anderson; Alison Karasz

2009-01-01

179

Variation in vaginal breech delivery rates by hospital type  

Microsoft Academic Search

Objective: To relate vaginal breech delivery rates to the following hospital types: public, health maintenance organization, private teaching, or private nonteaching.Methods: In a retrospective study using administrative discharge data from Los Angeles County, California, we calculated the vaginal breech delivery rates of singleton breech deliveries during calendar years 1988 and 1991.Results: Ten thousand four hundred breech deliveries were identified, 8988

Kimberly D Gregory; Lisa M Korst; Michael Krychman; Patricia Cane; Lawrence D Platt

2001-01-01

180

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

181

Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid  

PubMed Central

Background: Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor. Objective: The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values. Materials and Methods: A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve. Results: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively. Conclusion: This study demonstrates that of two markers investigated creatinine has the higher diagnostic power. PMID:24639733

Kariman, Nourossadat; Afrakhte, Maryam; Hedayati, Mehdi; Fallahian, Masoumeh; Alavi Majd, Hamid

2013-01-01

182

[Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics].  

PubMed

Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics is discussed. Optimal effect of school closure is observed when this measure is taken at the start of the epidemic or pandemic and for a sufficiently long time. School closure during high morbidity among schoolchildren, in the middle (at the peak) and by the end of epidemic or pandemic does not influence significantly the spread of influenza or morbidity. Significant economic losses and other negative consequences of school closure are noted. School closure may be the most appropriate during the emergence of influenza pandemic when the pandemic vaccine is not yet available, however timely mass immunization of schoolchildren against influenza may be a more appropriate measure than school closure for the reduction of influenza morbidity and spread during seasonal influenza epidemics. PMID:22830286

Gendon, Iu Z; Vasil'ev, Iu M

2012-01-01

183

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

184

Pap test--with or without vaginal smear?  

PubMed

The aim of this study was to evaluate medical and economic justification of vaginal smears as a part of primary screening for cervical carcinoma and its precursors. Study included 245.048 participants whose VCE (vaginal, cervical, endocervical) smears were examined at Department of clinical cytology of University Hospital Center Osijek from 2003 till 2008. There were 12.639 (5.2%) abnormal findings, and they were divided into three groups: abnormal cells found only in vaginal smear (V), abnormal cells found in vaginal and in at least one other smear (V+) and abnormal cells not found in vaginal smear (C/E). These three groups were analysed in respect to cytological differential diagnosis and age of participants. It was estimated how many women could be additionally included in the screening, if vaginal smear would be included in the Pap test only after 50 years of age. In 6.9% of cytologically diagnosed lesions abnormal cells were found exclusively in vaginal smears (0.35% of all findings). As for squamous cell lesions, 91.2% were mild lesions (ASC and LSIL). Invasive squamous cell carcinoma was not diagnosed exclusively by vaginal smear in either woman under 50 years of age, while in women over 50 years of age it was diagnosed in 2.3% of cases. Exclusively by vaginal smear was diagnosed 3.9% of all AGC and 6.3% of adenocarcinoma, while in 85.0% of glandular epithelium lesions abnormal cells were not found in vaginal smears. Two thirds of adenocarcinoma diagnosed exclusively by vaginal smears were endometrial adenocarcinoma, but that is only 10.3% of all endometrial carcinoma diagnosed by Pap test. Obtained results show that taking of vaginal smears along with cervical and endocervical smears as a part of primary screening for cervical carcinoma and its precursors in women under 50 years of age is not justifiable, since vaginal smear only has a role in detection of endometrial carcinoma that are extremely rare in younger age groups. If vaginal smear would be taken only in women over 50 years of age, additional 37.7% of women under 50, or 25.1% women over 50 years of age could be included in the screening. PMID:20437636

Milici?-Juhas, Valerija; Peri?, Marija; Pajtler, Marija; Prvulovi?, Ivana; Curzik, Darko

2010-03-01

185

Effectiveness of Cellulose Sulfate Vaginal Gel for the Prevention of HIV Infection: Results of a Phase III Trial in Nigeria  

PubMed Central

Background This trial evaluated the safety and effectiveness of 6% cellulose sulfate vaginal gel in preventing male-to-female vaginal transmission of HIV, gonorrhea and chlamydial infection. Methods This Phase III, double-blind, randomized, placebo-controlled trial was conducted between November 2004 and March 2007 in Lagos and Port Harcourt, Nigeria. We enrolled 1644 HIV-antibody negative women at high risk of HIV acquisition. Study participants were randomized 1?1 to cellulose sulfate or placebo and asked to use gel plus a condom for each act of vaginal intercourse over one year of follow-up. The participants were evaluated monthly for HIV, gonorrhea and chlamydial infection, and for adverse events. Results The trial was stopped prematurely after the data safety monitoring board of a parallel trial concluded that cellulose sulfate might be increasing the risk of HIV. In contrast, we observed fewer infections in the active arm (10) than on placebo (13), a difference that was nonetheless not statistically significant (HR?=?0.8, 95% CI 0.3–1.8; p?=?0.56). Rates of gonorrhea and chlamydial infection were lower in the CS group but the difference was likewise not statistically significant (HR?=?0.8, 95% CI 0.5–1.1; p?=?0.19 for the combined STI outcome). Rates of adverse events were similar across study arms. No serious adverse events related to cellulose sulfate use were reported. Conclusions Cellulose sulfate gel appeared to be safe in the evaluated study population but we found insufficient evidence that it prevented male-to-female vaginal transmission of HIV, gonorrhea or chlamydial infection. The early closure of the trial compromised the ability to draw definitive conclusions about the effectiveness of cellulose sulfate against HIV. Trial Registration ClinicalTrials.gov NCT00120770 PMID:19023429

Halpern, Vera; Ogunsola, Folasade; Obunge, Orikomaba; Wang, Chin-Hua; Onyejepu, Nneka; Oduyebo, Oyinola; Taylor, Doug; McNeil, Linda; Mehta, Neha; Umo-Otong, John; Otusanya, Sakiru; Crucitti, Tania; Abdellati, Said

2008-01-01

186

REPAIR OF VESICO-VAGINAL FISTULA  

PubMed Central

One hundred and thirteen patients with vesico-vaginal fistula were seen at the University of California Hospital from 1932 through 1959. The most common cause of fistula was trauma associated with pelvic operation, and the operation most often involved was total abdominal hysterectomy. Malignant disease of the pelvic organs was the second most common cause, while radiation therapy and obstetrical causes were next in the order of frequency. Three fistulas healed spontaneously. Twelve bladder by-pass operations were done and 54 repairs were carried out in 46 patients. Thirty-eight patients (82.6 per cent) were cured after one or more repair operations. A variety of operative approaches were used, selected in accordance with the needs of the individual case. Bladder distention postoperatively, due to a plugged catheter, was held responsible for failure of the repair in three cases, and this complication was considered preventable. Close attention to surgical technique, the recognition of bladder injury, and proper repair at the time of operation are prime factors in the prevention of vesico-vaginal fistula. PMID:13954511

Hill, Edward C.

1962-01-01

187

Vaginal microbial flora analysis by next generation sequencing and microarrays; can microbes indicate vaginal origin in a forensic context?  

PubMed

Forensic analysis of biological traces generally encompasses the investigation of both the person who contributed to the trace and the body site(s) from which the trace originates. For instance, for sexual assault cases, it can be beneficial to distinguish vaginal samples from skin or saliva samples. In this study, we explored the use of microbial flora to indicate vaginal origin. First, we explored the vaginal microbiome for a large set of clinical vaginal samples (n?=?240) by next generation sequencing (n?=?338,184 sequence reads) and found 1,619 different sequences. Next, we selected 389 candidate probes targeting genera or species and designed a microarray, with which we analysed a diverse set of samples; 43 DNA extracts from vaginal samples and 25 DNA extracts from samples from other body sites, including sites in close proximity of or in contact with the vagina. Finally, we used the microarray results and next generation sequencing dataset to assess the potential for a future approach that uses microbial markers to indicate vaginal origin. Since no candidate genera/species were found to positively identify all vaginal DNA extracts on their own, while excluding all non-vaginal DNA extracts, we deduce that a reliable statement about the cellular origin of a biological trace should be based on the detection of multiple species within various genera. Microarray analysis of a sample will then render a microbial flora pattern that is probably best analysed in a probabilistic approach. PMID:22282153

Benschop, Corina C G; Quaak, Frederike C A; Boon, Mathilde E; Sijen, Titia; Kuiper, Irene

2012-03-01

188

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

189

Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa  

PubMed Central

Background Bacterial vaginosis (BV) – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS) in The Gambia, West Africa. Methods We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp) cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire. Results BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202)-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 – 47.6) and anaerobes (P = 0.001 [OR] could not be calculated), but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 – 0.15), and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 – 0.28). Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12.8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting). Conclusion In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics. PMID:15757510

Demba, Edward; Morison, Linda; van der Loeff, Maarten Schim; Awasana, Akum A; Gooding, Euphemia; Bailey, Robin; Mayaud, Philippe; West, Beryl

2005-01-01

190

Mitigation of infectious disease at school: targeted class closure vs school closure  

E-print Network

School environments are thought to play an important role in the community spread of airborne infections (e.g., influenza) because of the high mixing rates of school children. The closure of schools has therefore been proposed as efficient mitigation strategy, with however high social and economic costs: alternative, less disruptive interventions are highly desirable. The recent availability of high-resolution contact networks in school environments provides an opportunity to design micro-interventions and compare the outcomes of alternative mitigation measures. We consider mitigation measures that involve the targeted closure of school classes or grades based on readily available information such as the number of symptomatic infectious children in a class. We focus on the case of a primary school for which we have high-resolution data on the close-range interactions of children and teachers. We simulate the spread of an influenza-like illness in this population by using an SEIR model with asymptomatics and c...

Gemmetto, Valerio; Cattuto, Ciro

2014-01-01

191

Arterial closure devices. A review.  

PubMed

The use of arterial closure devices in achieving haemostasis following arterial puncture has become increasingly popular. This review aims to provide an overview of the currently available closure devices, with an up-to-date summary of the supporting literature. The various devices have their advantages and disadvantages as well as differing mechanisms of actions. Technical aspects of deployment affect the learning curve and ease of use of individual devices. Some complications that arise are device specific where others are related to arterial punctures in general. When choosing a device, all these factors should be taken into account as well as differing clinical requirements and priorities. Most studies of arterial closure devices that are currently in use conclude that the safety profile of closure devices is comparable to manual compression. The literature does not show superiority of any particular device. Caution is advised in extrapolating evidence based on differing patient groups, as many of the study populations are heterogeneous. As physicians become more familiar with the use of closure devices, off-label applications of some devices have emerged, some of which need further evaluation. The ideal closure device should reduce complication rates compared to manual compression, be easy to use with a short learning curve, and have a high rate of deployment success. It should also be usable across a wide range of sheath sizes, not leave any permanent foreign body behind, reduce time to haemostasis and ambulation, allow immediate repuncture, improve patient comfort and be cost effective. In spite of the wide range of devices currently available there remains room for improvement. PMID:17989631

Madigan, J B; Ratnam, L A; Belli, A M

2007-10-01

192

Alarm sensor apparatus for closures  

DOEpatents

An alarm sensor apparatus for closures such as doors and windows, and particularly for closures having loose tolerances such as overhead doors, garage doors or the like, the sensor apparatus comprising a pair of cooperating bracket members, one being attached to the door facing or framework and the other to the door member, two magnetic sensor elements carried by said bracket members, the bracket members comprising a pair of cooperating orthogonal guide slots and plates and a stop member engageable with one of the sensors for aligning the sensors with respect to each other in all three orthogonal planes when the door is closed.

Carlson, J.A.; Stoddard, L.M.

1984-01-31

193

Explanation Closure, Action Closure, and the Sandewall Test Suite  

E-print Network

with action closure (AC) for reasoning about dynamic worlds, by way of Sandewall's test suite of 12-or room" problem, and were intended as a test and challenge for nonmonotonic logics of ac- tion. The EC/AC that are a matter of \\prac- tical certainty" (given our theory of the domain). In view of their potency

194

Development of an in vitro alternative assay method for vaginal irritation  

Microsoft Academic Search

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 (HSV-2). Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant

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

2011-01-01

195

The value of the vaginal pack test in large cystoceles.  

PubMed

To detect possible stress urinary incontinence associated with but masked by large cystoceles protruding through the vaginal orifice, a vaginal pack test was done in conjunction with video fluoro-urodynamic studies. Sixteen female patients with large cystoceles did not demonstrate stress urinary incontinence on clinical examination and were included in this study. Additionally, 10 healthy female volunteers underwent the same test to study the effect of a vaginal pack on urethral dynamics. The vaginal pack revealed the presence of stress urinary incontinence in 11 patients (69%): 3 (19%) with type II (vesicourethral hypermobility) and 8 (50%) with type III (internal sphincteric deficiency). After insertion of the vaginal pack, urodynamic studies showed that the closing proximal urethral pressure in patients with stress urinary incontinence was significantly lower than in continent patients (p < 0.05). No significant change in urethral pressures was noted in volunteer subjects after vaginal pack insertion. Fluoroscopy showed kinking of the posterior urethra and enlargement of the most dependent portion of the cystocele, that is the lower half of the hourglass image. Our study suggests that the mechanisms of continence in these patients are multifactorial, including urethral kinking, urethral compression and pressure dissipation. The vaginal pack test is easy to perform, increases visualization of the vesicourethral unit when used with fluoroscopy, and can aid in the selection of patients who would benefit from anti-incontinence surgery and/or cystocele repair. PMID:8051758

Ghoniem, G M; Walters, F; Lewis, V

1994-09-01

196

An investigation into the pathogenesis of vulvo-vaginal candidosis  

PubMed Central

Objective: To monitor yeasts isolated from women during and between episodes of recurrent vulvo-vaginal candidosis (VVC) to determine whether vaginal relapse or re-infection occurred. Methods: Women presenting at the genitourinary medicine clinic with signs and symptoms of VVC were recruited to the study (n = 121). A vaginal washing, high vaginal swab (HVS) and rectal swab were taken and the women treated with a single 500 mg clotrimazole pessary. Women were asked to re-attend after 1, 4, and 12 weeks, or when the VVC recurred, when vaginal washings and HVS were repeated. Candida isolates recovered were strain typed using the Ca3 probe and their similarity assessed. Antifungal susceptibility to fluconazole and clotrimazole were determined. Results: Of the women recruited, 47 completed the study, either returning for four visits or suffering a recurrence during the study period. Of the 22 women who experienced recurrence, the same strain was responsible for the initial and recurrent episode in 17 women. For the remaining five women, four had strain replacement and one had a change of species. None of the isolates recovered from the women demonstrated resistance to either clotrimazole or fluconazole. Conclusions: Our findings support the theory of vaginal relapse and thus may support the use of more prolonged courses of antifungal therapy initially to increase the chances of eradication of the yeast. Key Words: vaginal candidosis PMID:11402224

El-Din, S; Reynolds, M; Ashbee, H; Barton, R; Evans, E

2001-01-01

197

Comparative permeability of human vaginal and buccal mucosa to water.  

PubMed

There is currently a resurgence of interest in the oral mucosa as a route for drug delivery. The relative scarcity of human oral mucosa for in vitro permeability studies, and the fact that vaginal mucosa is histologically similar and more abundant than the former, caused us to compare these 2 tissues with respect to their barrier properties to water. Specimens of fresh, clinically-healthy human vaginal and buccal mucosa from non-smokers were taken from excised tissue obtained during vaginal hysterectomies and various oral surgical procedures. Biopsies from each specimen were mounted in flow-through diffusion cells and their permeability to tritiated water determined using a continuous flow-through perfusion system. Specimens were examined histologically before and after permeability experiments and similarities between vaginal and buccal tissues verified. No statistically significant differences between mean steady state flux values (10-16 h) for vaginal and buccal mucosa, respectively, were found. Human vaginal mucosa is therefore as permeable as buccal mucosa to water, and these results warrant further investigation with other compounds to establish whether vaginal mucosa may be a useful model for buccal mucosa for drug permeability studies. PMID:9469607

van der Bijl, P; Thompson, I O; Squier, C A

1997-12-01

198

Effects of estroprogestins containing natural estrogen on vaginal flora.  

PubMed

Abstract 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

199

Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification  

PubMed Central

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

2012-01-01

200

Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy  

PubMed Central

Vulvovaginal atrophy (VVA) and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms. PMID:21072280

Kingsberg, SA; Kellogg, S; Krychman, M

2010-01-01

201

[The use of mesh in vaginal prolapse].  

PubMed

More than 13,000 vaginal prolapse operations are performed in the Netherlands each year. Native tissue repair is associated with a re-operation risk of 20-30%. Randomized trials demonstrate that mesh reinforced repairs are anatomically and functionally more effective in the short and medium term. Sexual functioning is comparable after mesh or native tissue repair; there is no difference in dyspareunia. It is not clear whether, in the long term, mesh decreases the risk of recurrence without increasing the risk of complications. 'Exposure' is the most frequently reported complication (4-19%), but treatment is usually not difficult. Pain caused by 'shrinkage' of the mesh is rare, but can be serious and is difficult to treat. The frequency of this complication is not well known. Until long-term results are known, mesh should only be considered in case of recurrent prolapse. Mesh surgery should be performed after informed consent and by surgeons with proven experience only. PMID:23899707

Milani, A L Fred; Vollebregt, Astrid; Roovers, Jan Paul W R; Withagen, Mariella I J

2013-01-01

202

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

203

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective  

PubMed Central

Vaginal bacterial communities are thought to help prevent sexually transmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid–producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexually transmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states. PMID:22133886

Brotman, Rebecca M.

2011-01-01

204

Vaginal Septoplasty in Septate Uterus with Double Cervix  

PubMed Central

Fusion defects of the Müllerian ducts occur frequently and they have been described by the American Fertility Society. However, septate uterus with cervical duplication and longitudinal vaginal septum is not described by this classification and has suggested a change in the classical theory of fusion of the Müllerian ducts. This paper describes a rare case report of a patient with complete septate uterus with double cervix and longitudinal vaginal septum, submitted to the vaginal septoplasty for dyspareunia, progressing to clinical improvement. The description of this case is to contribute with all uncommon cases of Müllerian anomalies reports and clinical treatment protocols, which is not yet established. PMID:25136464

Chiamulera, Nara; Botelho, Beatriz

2014-01-01

205

Imperforate hymen and vaginal atresia and their associated anomalies.  

PubMed Central

The presenting features and associated abnormalities of imperforate hymen and vaginal atresia were studied in 24 girls under the age of 16 years. Hydrocolpos or hydrometrocolpos occurred in 8 infants, 13 older girls developed haematocolpos, but 3 of the girls had no distension of the genital tract. Seven of the older girls were diagnosed as having appendicitis. Anorectal anomalies were present in 9 of the children. Intravenous pyelography was performed on 16 girls and was normal in only one. Urinary tract investigations are indicated in all girls with vaginal outlet obstruction, and the vaginal orifice should be inspected in all girls with anorectal abnormalities. PMID:6876046

Shaw, L M; Jones, W A; Brereton, R J

1983-01-01

206

[Vaginal prolapse of the small intestine. A rare clinical presentation].  

PubMed

A spontaneous transvaginal evisceration is a rare clinical event. The case of a 61-year-old woman is described. It is often associated with previous vaginal surgery as well as postmenopausal hypoestrogenism and therefore atrophy of the vaginal vault. The primary treatment is characterized by laparotomy and reposition of the prolapsed bowel. After assessing the viability resection of compromised segments is indicated. However, the main surgical problem is the prophylaxis of recurrence. Beside the repair of the vaginal disruption a colpocleisis, colpectomy, sacropexia or obliteration of the Douglas cavity is necessary. PMID:11143514

Simanowski, J H; Grotz, M; Kauffels, W

2000-01-01

207

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective.  

PubMed

Vaginal bacterial communities are thought to help prevent sexually transmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid-producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexually transmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states. PMID:22133886

Brotman, Rebecca M

2011-12-01

208

Norepinephrine Potentiates Proinflammatory Responses of Human Vaginal Epithelial Cells  

PubMed Central

The vaginal epithelium provides a barrier to pathogens and recruits immune defenses through the secretion of cytokines and chemokines. Several studies have shown that mucosal sites are innervated by norepinephrine-containing nerve fibers. Here we report that norepinephrine potentiates the proinflammatory response of human vaginal epithelial cells to products produced by Staphylococcus aureus, a pathogen that causes menstrual toxic shock syndrome. The cells exhibit immunoreactivity for catecholamine synthesis enzymes and the norepinephrine transporter. Moreover, the cells secrete norepinephrine and dopamine at low concentrations. These results indicate that norepinephrine may serve as an autocrine modulator of proinflammatory responses in the vaginal epithelium. PMID:23571017

Brosnahan, Amanda J.; Vulchanova, Lucy; Witta, Samantha R.; Dai, Yuying; Jones, Bryan J.; Brown, David R.

2013-01-01

209

RECRUITMENT CLOSURE CHECKLIST [INTERVIEW DATA FORM  

E-print Network

Manager: TAM Requisition ID #: Position Title: Job Code: #12;RECRUITMENT CLOSURE CHECKLIST [INTERVIEW DATARECRUITMENT CLOSURE CHECKLIST [INTERVIEW DATA FORM] Instructions: The Interview Data Form (IDF) captures documentation of your recruitment process, and ensures uniform review standards were applied

Walker, Matthew P.

210

40 CFR 280.74 - Closure records.  

Code of Federal Regulations, 2011 CFR

...SOLID WASTES (CONTINUED) TECHNICAL STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and...

2011-07-01

211

40 CFR 280.70 - Temporary closure.  

Code of Federal Regulations, 2011 CFR

...SOLID WASTES (CONTINUED) TECHNICAL STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a)...

2011-07-01

212

Congenital vaginal obstructions: varied presentation and outcome.  

PubMed

Congenital obstructing lesions of vagina, hydrometrocolpos, and hematocolpos, present at a variable time during early childhood and adolescence to different medical and surgical specialties. Twenty-six cases presenting over an 18-years period (1987-2005) were divided into three groups; Group A: neonates (6), Group B: adolescents (18), and Group C: adults (2). Common presentations in neonates (Group A) were abdominal mass (5), neonatal sepsis (3), and respiratory distress (2); whereas abdominal pain (18), voiding dysfunctions (13), and backache (7) were prevalent in adolescents (Group B). Adults (Group C) presented with inability to consummate and infertility (2). Four patients received erroneous treatment; exploratory laparotomy (1) and appendectomy (3). Urinary symptoms and associated urinary abnormalities were present in more than 50% of cases, especially those with complex anomalies. Management included excision of imperforate hymen (16) and transverse vaginal septum (8) through perineal (20) and abdominoperineal approach (4). Patients with urogenital sinus (1) and cloacal malformation (1) had staged reconstruction at 2.5 years of age following preliminary vesicostomy and colostomy at birth. On follow up (range 1-15 years; mean 7) more than 60% patients have menstrual irregularity (11), endometriosis (5), and infertility (4). In conclusion, rarity and variable presentation of congenital vaginal obstructions can lead to delayed diagnosis and erroneous management. A high index of suspicion and cross-sectional imaging help in early diagnosis and associated renal anomalies. A comprehensive management is imperative to preserve the reproductive potentials, as significant proportion of patients may experience sexual difficulties, menstrual irregularity, and infertility. PMID:16871398

Nazir, Zafar; Rizvi, Raheela M; Qureshi, Rahat N; Khan, Zarrish Saeed; Khan, Zarak

2006-09-01

213

Panel Closure Redesign: August 2011  

E-print Network

represented in Performance Assessment · Salado Mass Concrete NMED Hazardous Waste Facility Permit (operational with construction wall. (NMED) 3. Replace freshwater grouting with salt-based grouting. (EPA/NMED) 4. Allow option;Interim Closure · 2003- To comply with the requirements of the Hazardous Waste Facility Permit, the DOE

214

CIRSE Vascular Closure Device Registry  

PubMed Central

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. PMID:20981425

Muller-Hulsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zelenak, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2010-01-01

215

Feedback Exchange: Managing Group Closure.  

ERIC Educational Resources Information Center

A common problem in an "experiential class" is the lack of attention devoted to group closure at the end of the course. Toward the end of the semester, students working in small groups in organizational behavior classes often experience anxiety over losing the support and identity that they enjoyed as members of a small learning group. A final…

Wagenheim, Gary; Gemmill, Gary

216

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

217

[Tension-free vaginal mesh repair for recurrence of pelvic organ prolapse after vaginal mesh procedures: a case report].  

PubMed

A 61-year-old woman presented with the chief complaint of a vaginal bulge for 2 years. She had undergone two operations for pelvic organ prolapse. The initial procedure was the Manchester procedure and posterior colporrhaphy, and the second was a vaginal repair with mesh for recurrent rectocele 3 years after the initial surgery. She noticed the vaginal bulge shortly after the second surgery. A gynecological examination revealed a stage III rectocele associated with a 2 cm, firm mass at the posterior vaginal wall. T2-weighted magnetic resonance imaging showed a 2 × 3 cm high-intensity mass located between the vaginal wall and rectum. The recurrent rectocele might have been caused by incomplete support from the mesh, which was not fixed in the vaginal wall, resulting in formation of a mass. The patient underwent complete mesh removal and tension-free vaginal mesh-posterior surgery for the rectocele. The excised mesh had shrunk from a 7 × 5 cm rectangle mesh preoperatively into a firm 2 × 2 × 3 cm mass. No recurrence has been seen for 18 months postoperatively. PMID:21412043

Takahi, Yuko; Kiuchi, Hiroshi; Kimura, Toshio; Kato, Chikako; Ichimaru, Naotsugu

2011-02-01

218

Vaginal Flora Alterations and Clinical Symptoms in Low-Risk Pregnant Women  

Microsoft Academic Search

Background:To evaluate associations between alterations in vaginal flora and clinical symptoms in low-risk pregnant women. Methods:Vaginal specimens from 245 pregnant women were analyzed by microscopy for vaginal flora. Signs and symptoms of vaginal infection were determined by patient interviews and gynecologic examinations. Results:Abnormal vaginal flora was identified in 45.7% of the subjects. The final clinical diagnoses were bacterial vaginosis (21.6%),

Fausto Gondo; Márcia G. da Silva; Jossimara Polettini; Andréa da R. Tristao; José C. Peracoli; Steven S. Witkin; Marilza V. C. Rudge

2011-01-01

219

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

220

ADDENDUM TO "EXISTENTIALLY COMPLETE CLOSURE ALGEBRAS"  

E-print Network

ADDENDUM TO "EXISTENTIALLY COMPLETE CLOSURE ALGEBRAS" Paolo Lipparini (14 maggio 1998) SOMMARIO. Si there is no closure algebra which is a model of the existential sentence ¬, that is, iff no extension of the two an arbitrary closure algebra A and an existential formula with constants from A, and we found necessary

Lipparini, Paolo

221

Comparison of Blood Loss in Induced vs. Spontaneous Vaginal Delivery Using Specialized Blood Collection Bag  

PubMed Central

Objective: To compare third stage blood loss in induced vs. spontaneous vaginal deliveries and to correlate the amount of blood loss with the decrease in haemoglobin following deliveries. Setting: Department of Obstetrics and Gynaecology, Kasturba Hospital Manipal, Karnataka, India. Materials and Methods: Blood loss following placental deliveries was measured by using special collection bags in 150 pregnant ladies who delivered vaginally by labour induction and it was compared with that of another 50 women who had spontaneous vaginal deliveries. Haemoglobin values were recorded for each patient prior to labour and after delivery of child. Results: The mean blood loss in induced group was 30 mL more than that in spontaneous group (202 ± 117 mL vs. 172 ± 114 mL), but this was not statistically significant (p=0.12). However, when different methods of induction were compared, oxytocin group was found to have significantly higher blood loss (327 ± 140 mL) as compared to that in other types of labour inductions as well as spontaneous deliveries. Labour induction using prostaglandins did not produce more blood loss as compared that produced by spontaneous deliveries. Both induced and spontaneous delivery groups showed statistically significant drops in post-delivery haemoglobin values, but the drop was relatively more in induced group as compared to that in spontaneous vaginal delivery group (0.96gm/dL vs. 0.56gm/dL), which appeared to be statistically significant (p=0.002). Conclusion: Labour induction using prostaglandins is safe as compared to oxytocin usage. Accurate estimation of blood loss is important in all types of deliveries, in order to detect postpartum haemorrhage early, so that appropriate measures can be undertaken. PMID:24959480

Rai, Lavanya; Mohan, Akshara

2014-01-01

222

Vaginitis: How Many Women Are Affected/at Risk?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How many women are affected/at risk? Skip sharing on social media links Share this: Page Content How many women are affected by vaginitis? Most women will have ...

223

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

224

Gynecologic bleeding revealing vaginal metastasis of renal cell carcinoma  

PubMed Central

Vaginal metastases of renal cell carcinoma have been rarely described. We report a case of a 75-year old woman, who underwent radical right nephrectomy for a renal cell carcinoma. Tumour was classified pT3bN0M0 and grade III of Furhmann grading. One year later, scanner discovered mediastinal and lombo-aortic lymph nodes. She received 2 months of immunotherapy associated with bevacizumab, but stopped because of intolerance. She was readmitted in our institute for vaginal bleeding. Clinical investigations showed a vaginal mass and biopsy revealed a renal cell carcinoma metastasis. This case suggests that retrograde venous dissemination may be at the origin of vaginal metastasis of renal cell carcinoma and emphasized the preventive value of early ligature of renal vein. PMID:23565309

Benbrahim, Zineb; Chouaib, Ali; Mazeron, Renaud; Leger-Ravet, Marie Benedicte; Lefort, Catherine; Lhomme, Catherine; El Mesbahi, Omar; Escudier, Bernard

2013-01-01

225

[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

226

Vaginal Estrogen Therapy for Patients with Breast Cancer  

PubMed Central

On account of the good prognosis for patients with breast cancer, improving or maintaining the quality of life in the aftercare period is becoming more and more important. In particular, the increasing usage of aromatase inhibitors in the past few years has led to an increased incidence of vaginal atrophy with symptoms such as vaginal dryness, petechial bleeding, dyspareunia and recurrent cystitis. And just these symptoms have a detrimental impact on the quality of life of breast cancer patients. Application of a topical estrogen therapy represents the most effective means to treat vaginal atrophy. The use of a systemic or, respectively, topical hormone therapy is, however, contraindicated for breast cancer patients. Further clinical trials are needed in order to assess the safety of vaginal estrogen therapy. PMID:24771890

Moegele, M.; Buchholz, S.; Seitz, S.; Lattrich, C.; Ortmann, O.

2013-01-01

227

Diversity of the vaginal microbiome correlates with preterm birth.  

PubMed

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

228

Robotic-Assisted Laparoscopic Sacrocolpopexy for Vaginal Vault Prolapse  

MedlinePLUS

... Medical Center will perform the state of the art procedure to surgically correct vaginal vault prolapse by ... webcast from Duke University. Today we will be performing a robotic sacrocolpopexy using the da Vinci S system. ...

229

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

230

Deglutitive laryngeal closure in stroke patients  

PubMed Central

Background Dysphagia has been reported in up to 70% of patients with stroke, predisposing them to aspiration and pneumonia. Despite this, the mechanism for aspiration remains unclear. Aims To determine the relationship between bolus flow and laryngeal closure during swallowing in patients with stroke and to examine the sensorimotor mechanisms leading to aspiration. Methods Measures of swallowing and bolus flow were taken from digital videofluoroscopic images in 90 patients with stroke and 50 healthy adults, after repeated volitional swallows of controlled volumes of thin liquid. Aspiration was assessed using a validated Penetration–Aspiration Scale. Oral sensation was also measured by electrical stimulation at the faucial pillars. Results After stroke, laryngeal ascent was delayed (mean (standard deviation (SD)) 0.31 (0.06)?s, p<0.001), resulting in prolongation of pharyngeal transit time (1.17 (0.07)?s, p<0.001) without a concomitant increase in laryngeal closure duration (0.84 (0.04)?s, p?=?0.9). The delay in laryngeal elevation correlated with both the severity of aspiration (r?=?0.5, p<0.001) and oral sensation (r?=?0.5, p<0.001). Conclusions After stroke, duration of laryngeal delay and degree of sensory deficit are associated with the severity of aspiration. These findings indicate a role for sensorimotor interactions in control of swallowing and have implications for the assessment and management of dysphagia after stroke. PMID:17012336

Power, M L; Hamdy, S; Singh, S; Tyrrell, P J; Turnbull, I; Thompson, D G

2007-01-01

231

Female sexual dysfunction following vaginal surgery: Myth or reality?  

Microsoft Academic Search

This article reviews the mechanisms by which vaginal surgery affects female sexual function and related pathophysiology to\\u000a potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed\\u000a as they apply to vaginal surgery. Methods to avoid neurovascular damage during pelvic floor surgery have been corroborated\\u000a by supporting literature. The incidence of female sexual

Hari S. G. R. Tunuguntla; Angelo E. Gousse

2004-01-01

232

An unusual cause of vaginal discharge following gender reassignment  

Microsoft Academic Search

Neovaginal reconstruction is an important part of gender reassignment surgery. We report a case of stone formation at the\\u000a apex of vaginal vault constructed with sigmoid colon segment. A 48-year-old woman presented with profuse vaginal discharge\\u000a for 1 year. She had a history of gender reassignment surgery (male to female) in 1994, and the neovagina had been constructed\\u000a with an isolated

S. Sukumaran; P. A. Moran; A. Makar

2009-01-01

233

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

234

Bioadhesive mini-tablets for vaginal drug delivery.  

PubMed

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

235

[Posthysterectomy vault prolapse of vaginal walls: choice of operating procedure].  

PubMed

Post-hysterectomy vaginal vault prolapse is a common complication following different types of hysterectomy with a negative impact on the woman's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanisms for the uterus and vagina is important in order to make the right choice of the corrective procedure and also to minimize the risk of posthysterectomy occurrence of vault prolapse. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced in hysterectomy to prevent vault prolapse. Vaginal vault repair can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures. The vaginal approach for vault prolapse is superior to the abdominal approach in terms of complication rates, blood loss, postoperative discomfort, length of hospital stay and cost-effectiveness. Moreover, it allows the simultaneous repair of all coexistent pelvic floor defects, such as cystocele, enterocele and rectocele. Abdominal sacrocolpopexy is associated with a lower rate of recurrent vault prolapse and dyspareunia than the vaginal sacrospinous colpopexy. Other less commonly performed procedures include uterosacral ligament suspension and illeococcygeal fixation with a high risk of ureteric injury. Surgical mesh of non-absorbent material is gaining in popularity and preliminary data from vaginal mesh procedures is encouraging. PMID:23289289

Argirovi?, Rajka

2012-01-01

236

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

237

Markers of local immunity in cervico-vaginal secretions of HIV infected women: implications for HIV shedding  

PubMed Central

Objectives: To link local proinflammatory cytokines with HIV related nucleic acids in cervico-vaginal secretions and the factors associated with them. Methods: An observational study on 60 HIV positive women attending the department of obstetrics and gynaecology, University of Pavia, Italy. HIV-1 RNA in plasma, proviral HIV-1-DNA, cell associated and cell free HIV-1 RNA in cervico-vaginal secretions were evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). IL-1ß, IL-6, and TNF-? were measured by ELISA in cervico-vaginal lavages. Multiple regression analysis on ordinal categorical variables was used to test for the simultaneous associations of clinical and microbiological variables on quartiles of cytokine concentrations in lavage samples. Results: Proviral HIV-1 DNA, cell associated and cell free HIV-1 RNA were detected in 76.7% (46/60), 70% (42/60), and 71.7% (43/60) of the patients, respectively. IL-1ß concentration was directly correlated with proviral HIV-DNA (Spearman rho = 0.35, p = 0.01) and cell associated HIV-RNA levels (Spearman rho = 0.263, p = 0.05). IL-1ß concentration (153.9 pg/ml) was higher (p<0.05) among women with cytological squamous intraepithelial lesion (SIL) than negative controls (73.4 pg/ml). In women with vaginal infection both IL-1ß (41.7 pg/ml) and IL-6 (10.2 pg/ml) were lower (p<0.05) in comparison to negative controls (144.9 pg/ml and 23.7 pg/ml, respectively). Women receiving stable antiretroviral therapy had significantly lower TNF-? (34.4 pg/ml versus 44.4 pg/ml, p = 0.04) and higher IL-6 (24.0 pg/ml versus 1.4 pg/ml, p = 0.004) levels in lavage samples compared to untreated women. The associations between the presence of SIL, antiretroviral treatment, vaginal infection and cytokine concentrations in cervico-vaginal secretions were confirmed in multiple regression analysis. Conclusions: Local immune activation may modulate HIV-1 shedding in cervico-vaginal secretion with possible influence on vaginal physiology and host defence. Pharmacological agents lowering HIV-1 replication cause a shift to a pattern of cytokine production which seems less favourable to the transmission of the disease. PMID:15054170

Zara, F; Nappi, R; Brerra, R; Migliavacca, R; Maserati, R; Spinillo, A

2004-01-01

238

Lactocin 160, a Bacteriocin Produced by Vaginal Lactobacillus rhamnosus, Targets Cytoplasmic Membranes of the Vaginal Pathogen, Gardnerella vaginalis.  

PubMed

Bacterial vaginosis (BV) is a commonly occurring vaginal infection that is associated with a variety of serious risks related to the reproductive health of women. Conventional antibiotic treatment for this condition is frequently ineffective because the antibiotics tend to inhibit healthy vaginal microflora along with the pathogens. Lactocin 160, a bacteriocin produced by healthy vaginal lactobacilli, is a promising alternative to antibiotics; this compound specifically inhibits the BV-associated vaginal pathogens such as Gardnerella vaginalis and Prevotella bivia without affecting the healthy microflora. This study investigates the molecular mechanism of action for lactocin 160 and reveals that this compound targets the cytoplasmic membrane of G. vaginalis, causing the efflux of ATP molecules and dissipation of the proton motive force. PMID:20445810

Turovskiy, Yevgeniy; Ludescher, Richard D; Aroutcheva, Alla A; Faro, Sebastian; Chikindas, Michael L

2009-01-20

239

Anatomical risk factors in primary angle-closure glaucoma  

Microsoft Academic Search

A population of 539 persons was examined in 1979, using LCD and ACD estimations acc. to van Herick et al. and by Haag Streit pachymetry, respectively. ACD had been measured already in 1969, due to a remarkable occurrence of primary angle-closure glaucoma (PACG) in the survey population of Greenland Eskimos (District of Uummannaq). The present follow up study in 1989

Foul Helge Alsbirk

1992-01-01

240

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...

241

What has Changed about Vaginal Douching among African American Mothers and Daughters?  

PubMed Central

Objectives To explore African American mothers’ and daughters’ practices and influences related to vaginal douching. Design and Sample Our overall study used a sequential mixed-method design with 3 phases. Phase 1, the focus of this report, used grounded theory methods and in-depth, semistructured individual interviews. Two generations of African American girls and women: 24 girls (“daughters”) aged 14–18 and 17 women (“mothers” or “mother figures”) aged 22–43, recruited from 1 adolescent health clinic in Baltimore, MD. Measures In-depth interviews were taped and transcribed and data analysis used the constant comparison method. Results Daughters were much less likely to douche or to have been exposed to douching information than mothers. Many mothers and daughters were influenced by health care providers and/or family members to not initiate, to decrease, or to stop douching. Women who currently douche often do so because of the perception of improved smell and cleanliness around menstruation and sexual intercourse. Conclusions These data indicate that although some women continue to believe that vaginal douching has therapeutic value, others have been influenced to stop or not start douching by family and health care providers. Health care providers should continue efforts to educate patients on the risks of vaginal douching. PMID:20840711

Mark, Hayley; Sherman, Susan G.; Nanda, Joy; Chambers-Thomas, Tracey; Barnes, Mathilda; Rompalo, Anne

2010-01-01

242

?-human chorionic gonadotropin assay in vaginal washing fluid for the accurate diagnosis of premature rupture of membranes during late pregnancy  

PubMed Central

Objective To determine whether the measurement of beta-human chorionic gonadotropin (?-hCG) levels in vaginal fluid is useful for the diagnosis of premature rupture of membranes (PROM). Material and Methods A total of 92 pregnant women between 24 and 40 weeks gestation participated in this study. The patients with fluid leaking from the vagina were designated Group 1, the patients with no fluid leaking from the vagina were Group 2, and those with a suspicion of fluid leaking from the vagina were classified as Group 3. Irrigating the posterior vaginal fornix with 5 mL sterile saline was used to measure ?-hCG levels of the patients. Receiver operator curve (ROC) analysis was used to determine the cut-off value for a positive diagnosis. Results The ?-hCG levels of vaginal fluid were measured as 20.5±25.0 mIU/mL, 254.6±346.8 mIU/mL, and 74.3±100.8 mIU/mL in Group 1, Group 2, and Group 3, respectively. Vaginal ?-hCG level was higher statistically significantly in Group 2 than Group 1 and 3 (p<0.001). 100 mIU/mL was accepted as a cut-off value by using the receiver operating characteristic curve. According to 100 mIU/mL, sensitivity, specificity, positive predictive and negative predictive values were calculated as 71.2, 100, 100, and 65.1%, respectively. Conclusion The study showed that the measurement of ?-hCG level in vaginal washing fluid is an efficient and easy diagnostic test for predicting the amount of fluid leaking from the vagina. However, due to the low negative predictive value of the test, it would not be convenient in daily practice. PMID:24592106

Temel, Orhan; Cogendez, Ebru; Selcuk, Selcuk; Asoglu, Mehmet Resit; Kaya, Erdal

2013-01-01

243

Preparation and Characterisation of Fluconazole Vaginal Films for the Treatment of Vaginal Candidiasis  

PubMed Central

Objective of the present study was to develop and evaluate vaginal films with essential in vitro studies. Films were developed using hydroxypropyl methylcellulose as a polymer and formulations were coded. The developed films were evaluated with Fourier transform infrared spectroscopy, drug content, viscosity, surface pH, thickness, mechanical characterisation and in vitro drug release study. Fourier transform infrared spectroscopy results confirmed that there is no chemical interaction between drug and stabilisers/excipients. The batch variation was not more than 5% for average thickness and weight of the films. The drug content for the prepared formulation was in the range of 72.32±0.18% to 94.48±0.54%. Viscosity of the formulations increased with the increase in concentration of polymer. Mechanical characterisation revealed that tensile strength and percentage elongation of the films improved as there is increase in degree of substitution of the polymer, but the values of modulus decreased which confirmed that all the prepared films are soft in nature. The in vitro study indicated that 1 and 2% concentrations of polymer are the least concentrations to control the release of drug whereas the 4% concentration of polymer is a good and more effective concentration to control the release. Only one prepared formulation released the drug by following anomalous transport whereas other film formulations released the fluconazole by following Fickian diffusion mechanism. Prepared vaginal films may be an important alternative for the treatment of vaginal candidiasis, because these prepared films suggest the benefits of controlled release of fluconazole at the site of absorption. PMID:24403660

Kumar, L.; Reddy, M. S.; Shirodkar, R. K.; Pai, G. K.; Krishna, V. T.; Verma, R.

2013-01-01

244

Closure plan for Solid Waste Storage Area 6: Volume 1, Closure plan. Remedial investigation/feasibility study  

SciTech Connect

This Closure Plan for Solid Waste Storage Area 6 (SWSA 6) a disposal area for low-level radioactive wastes and hazardous materials, of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) describes how portions of SWSA 6 will be closed under Resource Conservation and Recovery Act (RCRA) Interim Status per 40 CFR 265 Subpart G [TN Rule 1200-1-11-.05(7)]. An overview is provided of activities necessary for final closure and corrective measures for all of SWSA 6. Results of surface waters and groundwater sampling are provided.

Not Available

1988-09-01

245

Efficacy of Rifaximin Vaginal Tablets in Treatment of Bacterial Vaginosis: a Molecular Characterization of the Vaginal Microbiota  

PubMed Central

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV. PMID:22585228

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo

2012-01-01

246

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

247

Species-level classification of the vaginal microbiome  

PubMed Central

Background The application of next-generation sequencing to the study of the vaginal microbiome is revealing the spectrum of microbial communities that inhabit the human vagina. High-resolution identification of bacterial taxa, minimally to the species level, is necessary to fully understand the association of the vaginal microbiome with bacterial vaginosis, sexually transmitted infections, pregnancy complications, menopause, and other physiological and infectious conditions. However, most current taxonomic assignment strategies based on metagenomic 16S rDNA sequence analysis provide at best a genus-level resolution. While surveys of 16S rRNA gene sequences are common in microbiome studies, few well-curated, body-site-specific reference databases of 16S rRNA gene sequences are available, and no such resource is available for vaginal microbiome studies. Results We constructed the Vaginal 16S rDNA Reference Database, a comprehensive and non-redundant database of 16S rDNA reference sequences for bacterial taxa likely to be associated with vaginal health, and we developed STIRRUPS, a new method that employs the USEARCH algorithm with a curated reference database for rapid species-level classification of 16S rDNA partial sequences. The method was applied to two datasets of V1-V3 16S rDNA reads: one generated from a mock community containing DNA from six bacterial strains associated with vaginal health, and a second generated from over 1,000 mid-vaginal samples collected as part of the Vaginal Human Microbiome Project at Virginia Commonwealth University. In both datasets, STIRRUPS, used in conjunction with the Vaginal 16S rDNA Reference Database, classified more than 95% of processed reads to a species-level taxon using a 97% global identity threshold for assignment. Conclusions This database and method provide accurate species-level classifications of metagenomic 16S rDNA sequence reads that will be useful for analysis and comparison of microbiome profiles from vaginal samples. STIRRUPS can be used to classify 16S rDNA sequence reads from other ecological niches if an appropriate reference database of 16S rDNA sequences is available. PMID:23282177

2012-01-01

248

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

249

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

250

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

251

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; Hallen, Anders; Fredlund, Hans; Jensen, J?rgen S.; Engstrand, Lars; Unemo, Magnus

2013-01-01

252

Acid production by vaginal flora in vitro is consistent with the rate and extent of vaginal acidification.  

PubMed

Perinatally, and between menarche and menopause, increased levels of estrogen cause large amounts of glycogen to be deposited in the vaginal epithelium. During these times, the anaerobic metabolism of the glycogen, by the epithelial cells themselves and/or by vaginal flora, causes the vagina to become acidic (pH approximately 4). This study was designed to test whether the characteristics of acid production by vaginal flora in vitro can account for vaginal acidity. Eight vaginal Lactobacillus isolates from four species-L. gasseri, L. vaginalis, L. crispatus, and L. jensenii-acidified their growth medium to an asymptotic pH (3.2 to 4.8) that matches the range seen in the Lactobacillus-dominated human vagina (pH 3.6 to 4.5 in most women) (B. Andersch, L. Forssman, K. Lincoln, and P. Torstensson, Gynecol. Obstet. Investig. 21:19-25, 1986; L. Cohen, Br. J. Vener. Dis. 45:241-246, 1969; J. Paavonen, Scand. J. Infect. Dis. Suppl. 40:31-35, 1983; C. Tevi-Bénissan, L. Bélec, M. Lévy, V. Schneider-Fauveau, A. Si Mohamed, M.-C. Hallouin, M. Matta, and G. Grésenguet, Clin. Diagn. Lab. Immunol. 4:367-374, 1997). During exponential growth, all of these Lactobacillus species acidified their growth medium at rates on the order of 10(6) protons/bacterium/s. Such rates, combined with an estimate of the total number of lactobacilli in the vagina, suggest that vaginal lactobacilli could reacidify the vagina at the rate observed postcoitally following neutralization by the male ejaculate (W. H. Masters and V. E. Johnson, Human sexual response, p. 93, 1966). During bacterial vaginosis (BV), there is a loss of vaginal acidity, and the vaginal pH rises to >4.5. This correlates with a loss of lactobacilli and an overgrowth of diverse bacteria. Three BV-associated bacteria, Gardnerella vaginalis, Prevotella bivia, and Peptostreptococcus anaerobius, acidified their growth medium to an asymptotic pH (4.7 to 6.0) consistent with the characteristic elevated vaginal pH associated with BV. Together, these observations are consistent with vaginal flora, rather than epithelial cells, playing a primary role in creating the acidity of the vagina. PMID:10496892

Boskey, E R; Telsch, K M; Whaley, K J; Moench, T R; Cone, R A

1999-10-01

253

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

254

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

255

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

256

Oral microflora in infants delivered vaginally and by caesarean section.  

PubMed

BACKGROUND.? Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. AIM.? To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. DESIGN.? This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County Hospital in Halmstad, Sweden. Medically compromised and premature children (<32 weeks) were excluded. The mean age was 8.25 months (range 6-10 months), and parents were asked to complete a questionnaire on socioeconomic factors, lifestyle, and hygiene habits. Saliva was collected and analysed using checkerboard DNA-DNA hybridization. RESULTS.? A higher prevalence of salivary Streptococcus salivarius, Lactobacillus curvata, Lactobacillus salivarius, and Lactobacuillus casei was detected in infants delivered vaginally (P < 0.05). The caries-associated bacteria Streptococcus mutans and Streptococcus sobrinus were detected in 63% and 59% of all children, respectively. CONCLUSION.? A significantly higher prevalence of certain strains of health-related streptococci and lactobacilli was found in vaginally delivered infants compared with infants delivered by C-section. The possible long-term effects on oral health need to be further investigated. PMID:21702851

Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron; Blomqvist, Susanne; Dahlén, Gunnar; Twetman, Svante

2011-11-01

257

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

258

A ciliary body tumor preventing angle closure.  

PubMed

We present a case report of a 60-year-old white woman, found to have advanced angle closure glaucoma in the right eye and appositional closure for about half of the left eye and no glaucoma. The remaining angle of the left eye was open with localized heavy pigmentation of the ciliary body band and trabecular meshwork. Ultrasound biomicroscopy showed a ciliary body tumor displacing the iris root centripetally preventing angle closure. PMID:23117627

Mehanna, Chadi; Desjardins, Laurence; Puech, Michel; Cohn, Howard

2014-02-01

259

Air quality impacts of a scheduled 36-h closure of a major highway  

NASA Astrophysics Data System (ADS)

Elevated concentrations of ultrafine particles (UFPs, <0.1 ?m) are commonly found near roadways. On the July 16-17, 2011 weekend, a section of a major Los Angeles freeway, the I-405, was closed for 36 h. We measured UFPs and other pollutants at two fixed locations, one upwind and one downwind, and at various distances from I-405 using a mobile measurement platform (MMP) on Fridays, Saturdays, and Sundays before, during, and after closure. On the closure Saturday on July 16, I-405 traffic flow was reduced by ˜90% relative to non-closure Saturday observations. Downwind of I-405, fixed-site measurements showed the following reductions: 83% of particle number concentration (PNC), 36% of PM2.5, and 62% of black carbon. Fixed-site measurements showed daily average UFP size distributions were bimodal for non-closure conditions (nucleation modes ˜20 nm, accumulation modes ˜60 nm), but only showed an accumulation mode ˜50 nm during closure. Spatial measurements from the MMP confirmed no nucleation mode was detected at any location 0-300 m downwind during closure. In 2011, non-closure particle emission factors were 5.0, 2.7, and 3.4 × 1013 particles vehicle-1 km-1 for Friday through Sunday respectively. After accounting for instrumental and traffic flow differences, weekday PNC in 2011 was 60% lower than 2001 at the same study location. During the closure event, regional freeway traffic was reduced compared to four selected control Saturdays. Eight stationary monitoring stations throughout the South Coast Air Basin showed PM2.5 was reduced between 18 and 36% relative to the same control days. The outcome of this natural experiment during the I-405 closure confirms that substantial traffic reduction can improve local and regional air quality in sprawled urban regions such as Los Angeles, CA.

Quiros, David C.; Zhang, Qunfang; Choi, Wonsik; He, Meilu; Paulson, Suzanne E.; Winer, Arthur M.; Wang, Rui; Zhu, Yifang

2013-03-01

260

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2011 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...the closure and post-closure requirements that apply to landfills (§ 265.310). [47 FR 32368, July 26,...

2011-07-01

261

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...the closure and post-closure requirements that apply to landfills (§ 265.310). [47 FR 32368, July 26,...

2013-07-01

262

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2010 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...the closure and post-closure requirements that apply to landfills (§ 265.310). [47 FR 32368, July 26,...

2010-07-01

263

40 CFR 265.258 - Closure and post-closure care.  

Code of Federal Regulations, 2012 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...the closure and post-closure requirements that apply to landfills (§ 265.310). [47 FR 32368, July 26,...

2012-07-01

264

Closure Welding of Plutonium Bearing Storage Containers  

SciTech Connect

A key element in the Department of Energy (DOE) strategy for the stabilization, packaging and storage of plutonium-bearing materials involves closure welding of DOE-STD-3013 Outer Containers (3013 container). The 3013 container provides the primary barrier and pressure boundary preventing release of plutonium-bearing materials to the environment. The final closure (closure weld) of the 3013 container must be leaktight, structurally sound and meet DOE STD 3013 specified criteria. This paper focuses on the development, qualification and demonstration of the welding process for the closure welding of Hanford PFP 3013 outer containers.

Cannell, G.R.

2002-02-28

265

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

266

WAVELENGTH-DEPENDENT OPTICAL PROPERTIES, MASS ABSORPTION COEFFICIENTS, AND CLOSURE STUDIES FOR CARBONACEOUS AEROSOLS AT  

E-print Network

WAVELENGTH-DEPENDENT OPTICAL PROPERTIES, MASS ABSORPTION COEFFICIENTS, AND CLOSURE STUDIES Gorkowski and Claudio Mazzoleni, Michigan Technological University R. Subramanian, Droplet Measurement Technologies Arthur Sedlacek, Gunnar Senum, and Stephen Springston, Brookhaven National Laboratory Ari Setyan

267

Vaginal Birth After Cesarean Delivery: Deciding on a Trial of Labor After a Cesarean Delivery (TOLAC)  

MedlinePLUS

What is a vaginal birth after cesarean delivery (VBAC)? If you have had a previous cesarean delivery , you have two choices ... vaginal birth after cesarean delivery (VBAC). What is a trial of labor after cesarean delivery (TOLAC)? A ...

268

40 CFR 258.61 - Post-closure care requirements.  

...2014-07-01 2014-07-01 false Post-closure care requirements. 258.61 Section 258.61 ...SOLID WASTE LANDFILLS Closure and Post-Closure Care § 258.61 Post-closure care requirements. (a) Following closure of...

2014-07-01

269

A Vaginal Cyst Causing Dysuria and Dyschezia in a Bitch  

PubMed Central

ABSTRACT A 9-year-old female dog was referred to Azabu University Veterinary Teaching Hospital for dysuria and dyschezia after ovariohysterectomy. After a series of diagnostic imaging, vaginal obstruction was suspected by vaginal fluid retention. Surgical repair was attempted three times to establish patency through the vagina and the vestibule by episiotomy and laparotomy. Another laparotomy was performed to remove the entire vaginal mucosal layer to prevent recurrence, which resulted in favorable outcome. Histopathological examination revealed that the resected tissue was a cyst originated from mesonephric duct remnant. In the present case, the cyst was curable by the entire resection of the cyst lining membrane, which could eradicate all the secretory cells with least damage to the urethral vasculature and innervation. PMID:24646603

WATANABE, Toshifumi; MISHINA, Mika; SAKURAI, Yohei

2014-01-01

270

Large vesico-vaginal fistula caused by a foreign body.  

PubMed

Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications. PMID:24116334

Massinde, An; Kihunrwa, A

2013-07-01

271

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.

272

Study of the vaginal tolerance to acidform, an acid-buffering, bioadhesive gel  

Microsoft Academic Search

Vaginal tolerance tests were performed with a new potential microbicidal and spermicidal product, an acid-buffering vaginal gel (Acidform) without or with nonoxynol-9 (N-9). The potential advantages over other vaginal products include keeping a low pH, decrease of the irritating effect of N-9 on the cervix or vaginal mucosa associated with greater retention of the product after application, and decreasing “messiness”

Eliana Amaral; Anibal Faúndes; Lourens Zaneveld; Donald Waller; Sanjay Garg

1999-01-01

273

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

274

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

275

Evaluation of risk factors of vaginal cuff dehiscence after hysterectomy  

PubMed Central

Objective The purpose of this study was to evaluate risk factors of vaginal cuff dehiscence or evisceration according to the type of operation. Methods Medical records of 604 women who underwent hysterectomies at Korea University Anam Hospital between June 2007 and June 2011 were reviewed. They were allocated to six groups. The six types of hysterectomies included robotic hysterectomy (n = 7), robotic radical hysterectomy and node dissection (RRHND, n = 9), total laparoscopic hysterectomy (TLH, n = 274), laparoscopy assisted vaginal hysterectomy (LAVH, n = 238), laparoscopic radical hysterectomy and node dissection (n = 11), and abdominal radical hysterectomy (ARH, n = 63). The characteristics and outcomes of each groups were compared. Results There was no difference in the characteristics of patients between 6 groups. In total of 604 hysterectomies, 3 evisceration (0.49%) and 21 dehiscences (3.47%) occurred. Evisceration were found in RRHND (1/9, 11.1%), TLH (1/276, 0.36%), and ARH (1/63, 1.56%). Dehiscences occurred in TLH (15/274, 5.42%), LAVH (4/238, 1.68%), and ARH (2/63, 3.17%). In 169 cases of TLH with intra-corporeal continuous suture, 1 evisceration and 4 dehiscences occurred, whereas 11 dehiscences occurred in 105 TLH cases with vaginal continuous locking suture (2.96% vs. 10.47%, P = 0.02). Conclusion The incidence of vaginal cuff dehiscenceand eviscerationwas significantly higher in TLH than LAVH. The intra-corporeal cuff suture was superior to the vaginal suture to prevent the vaginal cuff complications in TLH. PMID:24678487

Kim, Myung Ji; Kim, Seongmin; Bae, Hyo Sook; Lee, Jae Kwan; Lee, Nak Woo

2014-01-01

276

Effects of feminine hygiene products on the vaginal mucosal biome  

PubMed Central

Background Over-the-counter (OTC) feminine hygiene products come with little warning about possible side effects. This study evaluates in-vitro their effects on Lactobacillus crispatus, which is dominant in the normal vaginal microbiota and helps maintain a healthy mucosal barrier essential for normal reproductive function and prevention of sexually transmitted infections and gynecologic cancer. Methods A feminine moisturizer (Vagisil), personal lubricant, and douche were purchased OTC. A topical spermicide (nonoxynol-9) known to alter the vaginal immune barrier was used as a control. L. crispatus was incubated with each product for 2 and 24h and then seeded on agar for colony forming units (CFU). Human vaginal epithelial cells were exposed to products in the presence or absence of L. crispatus for 24h, followed by epithelium-associated CFU enumeration. Interleukin-8 was immunoassayed and ANOVA was used for statistical evaluation. Results Nonoxynol-9 and Vagisil suppressed Lactobacillus growth at 2h and killed all bacteria at 24h. The lubricant decreased bacterial growth insignificantly at 2h but killed all at 24h. The douche did not have a significant effect. At full strength, all products suppressed epithelial viability and all, except the douche, suppressed epithelial-associated CFU. When applied at non-toxic dose in the absence of bacteria, the douche and moisturizer induced an increase of IL-8, suggesting a potential to initiate inflammatory reaction. In the presence of L. crispatus, the proinflammatory effects of the douche and moisturizer were countered, and IL-8 production was inhibited in the presence of the other products. Conclusion Some OTC vaginal products may be harmful to L. crispatus and alter the vaginal immune environment. Illustrated through these results, L. crispatus is essential in the preservation of the function of vaginal epithelial cells in the presence of some feminine hygiene products. More research should be invested toward these products before they are placed on the market. PMID:24009546

Fashemi, Bisiayo; Delaney, Mary L.; Onderdonk, Andrew B.; Fichorova, Raina N.

2013-01-01

277

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

278

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

279

Failed vaginal birth after a cesarean section: How risky is it?  

Microsoft Academic Search

Objective: Our purpose was to determine the maternal risks associated with failed attempt at vaginal birth after cesarean compared with elective repeat cesarean delivery or successful vaginal birth after cesarean. Study Design: From 1989 to 1998 all patients attempting vaginal birth after cesarean and all patients undergoing repeat cesarean deliveries were reviewed. Data were extracted from a computerized obstetric database

Judith U. Hibbard; Muhammed A. Ismail; Yantao Wang; Catherine Te; Theodore Karrison; Mahmoud A. Ismail

2001-01-01

280

Vaginal Microbiome and Epithelial Gene Array in PostMenopausal Women with Moderate to Severe Dryness  

Microsoft Academic Search

After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding

Ruben Hummelen; Jean M. Macklaim; Jordan E. Bisanz; Jo-Anne Hammond; Amy McMillan; Rebecca Vongsa; David Koenig; Gregory B. Gloor; Gregor Reid

2011-01-01

281

Non-surgical treatment of uterovaginal prolapse using double vaginal rings  

Microsoft Academic Search

A new technique of using double vaginal ring pessaries to treat uterovaginal prolapse in a group of elderly women is described. Eighteen women with a mean age of 82 years and advanced Stage III or IV uterovaginal prolapse had double vaginal rings inserted. All of them previously had used single vaginal ring pessaries or had undergone pelvic floor repair surgery.

K. Singh; W. M. N. Reid

2001-01-01

282

Molecular analysis of the diversity of vaginal microbiota associated with bacterial vaginosis  

Microsoft Academic Search

BACKGROUND: Bacterial vaginosis (BV) is an ecological disorder of the vaginal microbiota that affects millions of women annually, and is associated with numerous adverse health outcomes including pre-term birth and the acquisition of sexually transmitted infections. However, little is known about the overall structure and composition of vaginal microbial communities; most of the earlier studies focused on predominant vaginal bacteria

Zongxin Ling; Jianming Kong; Fang Liu; Haibin Zhu; Xiaoyi Chen; Yuezhu Wang; Lanjuan Li; Karen E Nelson; Yaxian Xia; Charlie Xiang

2010-01-01

283

Menstrual-like vaginal bleeding in prepubertal girls: an unexplained condition  

PubMed Central

Unexplained menstrual-like cyclic vaginal bleeding, lasting for several days and without any uterine and vaginal anomaly, is a rare condition in prepubertal girls. Only small series (containing four to eleven cases) have been described in literature. We report our in nine girls presenting with vaginal bleeding without any abnormality at gynaecological, hormonal and echographic examination. PMID:24753876

Merckx, M.; Weyers, S.; Santegoeds, R.; De Schepper, J.

2011-01-01

284

Vaginal hysterectomy for the woman with a moderately enlarged uterus weighing 200 to 700 grams  

Microsoft Academic Search

Objectives: The purpose of this study was to compare the surgical outcomes of women with moderately enlarged uteri undergoing vaginal hysterectomy with those of women with uteri of normal size undergoing vaginal hysterectomy. A secondary objective was to investigate the roles of uterine morcellation and laparoscopically assisted vaginal hysterectomy in the treatment of these women. Study Design: Thirty consecutive women

James B. Unger

1999-01-01

285

Long-term, controlled release of the HIV microbicide TMC120 from silicone elastomer vaginal rings  

Microsoft Academic Search

Objectives: The feasibility of providing prolonged and controlled release of the experimental non- nucleoside reverse transcriptase inhibitor TMC120 from a silicone vaginal ring in quantities sufficient to maintain a vaginal concentration offering protection against heterosexual HIV transmission was investigated. Methods: Core-type, silicone elastomer vaginal rings containing TMC120 were manufactured, and in vitro release studies performed under sink conditions. The experimental

R. Karl Malcolm; A. David Woolfson; Clare F. Toner; Ryan J. Morrow; Stephen D. McCullagh

2005-01-01

286

Geographic Concentration and Correlates of Nursing Home Closures: 1999-2008  

PubMed Central

Background While demographic shifts project an increased need for long-term care for an aging population, hundreds of nursing homes close each year. We examine whether nursing home closures are geographically concentrated and related to local community characteristics such as the racial and ethnic population mix and poverty. Methods National Online Survey Certification and Reporting data were used to document cumulative nursing facility closures over a decade, 1999 through 2008. Census 2000 zip code level demographics and poverty rates were matched to study facilities. The weighted Gini coefficient was used to measure geographic concentration of closures, and geographic information system maps to illustrate spatial clustering patterns of closures. Changes in bed supply due to closures were examined at various geographic levels. Results Between 1999 and 2008, a national total of 1776 freestanding nursing homes closed (11%), compared with 1126 closures of hospital-based facilities (nearly 50%). Combined, there was a net loss of over 5% of beds. The relative risk of closure was significantly higher in zip code areas with a higher proportion of blacks or Hispanics or a higher poverty rate. The weighted Gini coefficient for closures was 0.55 across all metropolitan statistical areas and 0.71 across zip codes. Closures tended to be spatially clustered in minority-concentrated zip codes around the urban core, often in pockets of concentrated poverty. Conclusions Nursing home closures are geographically concentrated in minority and poor communities. Since nursing home use among the minority elderly population is growing while it is declining among whites, these findings suggest that disparities in access will increase. PMID:21220642

Feng, Zhanlian; Lepore, Michael; Clark, Melissa A.; Tyler, Denise; Smith, David B.; Mor, Vincent; Fennell, Mary L.

2013-01-01

287

Base Closures Can Open New Opportunities.  

ERIC Educational Resources Information Center

Describes how public schools can develop plans for coping with decreased student enrollment and limited revenue due to military base closures. Describes how two school districts responded to the closure of two military bases (George Air Force Base and Norton Air Force Base) in San Bernadino County, California. Two figures are included. (LMI)

Pulliam, Barry

1996-01-01

288

50 CFR 635.28 - Closures.  

Code of Federal Regulations, 2011 CFR

...may be possessed in or from the Atlantic Ocean north of 5° N. lat. or landed...closure may be possessed in the Atlantic Ocean north of 5 N. lat. or landed...fishing after the closure in the Atlantic Ocean north of 5 N. lat., and...

2011-10-01

289

50 CFR 635.28 - Closures.  

Code of Federal Regulations, 2012 CFR

...may be possessed in or from the Atlantic Ocean north of 5° N. lat. or landed...closure may be possessed in the Atlantic Ocean north of 5 N. lat. or landed...fishing after the closure in the Atlantic Ocean north of 5 N. lat., and...

2012-10-01

290

50 CFR 635.28 - Closures.  

Code of Federal Regulations, 2010 CFR

...may be possessed in or from the Atlantic Ocean north of 5 N. lat. or landed...closure may be possessed in the Atlantic Ocean north of 5 N. lat. or landed...fishing after the closure in the Atlantic Ocean north of 5 N. lat., and...

2010-10-01

291

50 CFR 635.28 - Fishery closures.  

Code of Federal Regulations, 2013 CFR

...may be possessed in or from the Atlantic Ocean north of 5° N. lat. or landed...closure may be possessed in the Atlantic Ocean north of 5 N. lat. or landed...fishing after the closure in the Atlantic Ocean north of 5 N. lat., and...

2013-10-01

292

Hanford Patrol Academy Demolition Sites Closure Plan  

SciTech Connect

From 1975 to 1991 the Hanford Patrol Academy Demolition Sites (HPADS) were used for demolition events. These demolition events were a form of thermal treatment for spent or abandoned chemical waste. Because the HPADS will no longer be used for this thermal activity, the sites will be closed. Closure will be conducted pursuant to the requirements of the Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and 40 CFR 270.1. Closure also will satisfy closure requirements of WAC 173-303-680 and for the thermal treatment closure requirements of 40 CFR 265.381. This closure plan presents a description of the HPADS, the history of the waste treated, and the approach that will be followed to close the HPADS. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. Only dangerous constituents derived from HPADS operations will be addressed in this closure plan in accordance with WAC 173-303-610(2)(b)(i). The HPADS are actually two distinct soil closure areas within the Hanford Patrol Academy training area.

Not Available

1992-11-01

293

School Closures in Rural Finnish Communities  

ERIC Educational Resources Information Center

The network of small rural schools in Finland has been radically weakened since the global recession of the 1990s. This article focuses on the social role of rural schools and the phenomenon of school closures. Our aim is to look at rural schools from the viewpoint of local residents and examine how they experience school closures. We seek to hear…

Autti, Outi; Hyry-Beihammer, Eeva Kaisa

2014-01-01

294

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

295

Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial  

Microsoft Academic Search

Objective  To compare efficacy and safety of vaginal misoprostol (PGE1 analog) with dinoprostone (PGE2 analog) vaginal insert for labor induction in term pregnancies.\\u000a \\u000a \\u000a \\u000a Study design  A total of 112 women with singleton pregnancies of ?37 weeks of gestation, and low Bishop scores underwent labor induction.\\u000a The subjects were randomized to receive either 50 ?g misoprostol intravaginally every 4 h to a maximum of five doses

Sebiha Özkan; Eray Çal??kan; Emek Do?er; ?zzet Yücesoy; Semih Özeren; Birol Vural

2009-01-01

296

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

297

A randomized comparison of the effects on vaginal and cervical epithelium of a placebo vaginal ring with non-use of a ring  

Microsoft Academic Search

Little is known about the effects of contraceptive vaginal rings on the vaginal surface epithelium, although most studies have not demonstrated any significant deleterious effect. However, one study found that some medium-to-long-term levonorgestrel-releasing ring users developed chronic erythematous and ulcerative lesions in the posterior vaginal fornix. Subsequently, this ring was completely redesigned (IVR-2) with different dimensions and much greater flexibility.

E. Weisberg; I. S. Fraser; J. Baker; D. Archer; B.-M. Landgren; S. Killick; P. Soutter; T. Krause; C. d’Arcangues

2000-01-01

298

Changing Policies on Vaginal Birth after Cesarean: Impact on Access  

Microsoft Academic Search

Background: The issue of vaginal birth after cesarean (VBAC) has become highly visible and contentious. In 1999, the American College of Obstetricians and Gynecologists advocated a policy that surgical capability be ''immediately available'' for women in labor attempting VBAC. Methods: Every hospital in Colorado, Montana, Oregon, and Wisconsin was contacted by telephone at least once during the period 2003 to

Richard G. Roberts; Mark Deutchman; Valerie J. King; George E. Fryer; Thomas J. Miyoshi

2007-01-01

299

Laparoscopic assisted vaginal radical hysterectomy - evolution of a concept  

Microsoft Academic Search

The evolution of the laparoscopic techniques for the treatment of patients with early cervical cancer is presen- ted. The laparoscopic assistance makes the pelvic lymphade- nectomy and the removal of the lateral portion of the para- metrium feasible during radical vaginal hysterectomy without the need for the muscle-cutting vulvovaginal incision. The technique is also applicable to patients with early cervical

DANIEL DARGENT

300

Vaginal cancer: the role of infectious and environmental factors.  

PubMed

Primary cancers of the vagina are rare. They comprise 1% to 2% of all gynecologic malignancies and occur predominantly in older women. The diagnosis of primary carcinoma of the vagina requires that the cervix and vulva be intact and that no clinical evidence of other primary tumors exist. Approximately 90% of all vaginal tumors are squamous cell in type on histologic examination. Adenocarcinoma, which is much less common (2% to 4%), is seen primarily in younger women with in utero exposure to diethylstilbestrol. In addition to exposure to diethylstilbestrol, other environmental factors have been associated with the development of vaginal tumors, including chronic irritation from pessaries, previous hysterectomy for benign disease, immunosuppression therapy, cervical irradiation, and endometriosis. Infectious causes seem to play an even more pernicious role in vaginal cancer. The two agents most often implicated are herpes simplex virus and human papillomavirus. These viruses appear to serve as cofactors in the inducement of various genital cancers, working together or with environmental agents such as diethylstilbestrol and host-related genetic abnormalities. The prognosis of vaginal cancer depends on the stage of the disease, with an overall 5-year survival rate of 80% to 90% for early stages. PMID:1659200

Merino, M J

1991-10-01

301

Quantitation of Secretory Immonoglobulin A in Vaginal Secretions  

ERIC Educational Resources Information Center

The purpose of this study was to attempt to correlate vaginal levels of SIgA with variables including age, day of menstrual cycle, use of oral contraceptives, length of time oral contraceptives had been used, and presence of Candida albicans infection. (Author)

Grant, Tamara Dawn; Mace, Kenneth D.

1977-01-01

302

Attitudes of Singapore women toward cesarean and vaginal deliveries  

Microsoft Academic Search

Objectives: To assess the attitude, knowledge, and expectations of Asian pregnant women toward cesarean and vaginal deliveries. Methods: Written questionnaires were given to pregnant women attending the National University Hospital antenatal clinics, and 160 responses were tabulated and analyzed using SPSS software. Results: The participation rate was 65% and 50% of the respondents were Chinese, 20% Indian, 21% Malay, 2%

E. S. Y. Chong; M. Mongelli

2003-01-01

303

Vaginal evisceration during intraperitoneal chemotherapy for advanced ovarian cancer  

Microsoft Academic Search

Background.Recent studies have established that intraperitoneal chemotherapy is associated with improved outcomes compared with intravenous treatment in patients with advanced, optimally cytoreduced ovarian cancer, but at the expense of increased toxicity. We present a case of vaginal evisceration during intraperitoneal chemotherapy for advanced ovarian cancer.

Amy M. Burkett; David E. Cohn; Larry J. Copeland

2007-01-01

304

Vaginal birth after cesarean: an appraisal of fetal risk  

Microsoft Academic Search

Objective: To expand on prior investigations and further evaluate the fetal risk associated with vaginal birth after cesarean (VBAC) by examining the incidence not only of a depressed Apgar score at 5 minutes but also of fetal acidemia.Methods: Between January 1, 1991, and December 31, 1996, the following groups of patients who delivered a singleton fetus with birth weight greater

Michael L Socol; Alan M Peaceman

1999-01-01

305

Prognostic indicators for successful vaginal birth after cesarean delivery  

Microsoft Academic Search

Objective: To determine characteristics associated with successful trials of labor after cesarean delivery (TOLAC) and to determine the success of vaginal birth after cesarean delivery (VBAC) in a subset of patients with previous cesarean delivery for failure to progress at full dilatation.Methods: A retrospective chart review from January 1997 through April 1998 of patients undergoing TOLAC at our institution. Four

Jennifer D. Marshak; Brian S. Cooperman; Wendy B. Fried; Quihu Shi

2000-01-01

306

The making of a medical tradition: Vaginal birth after cesarean  

Microsoft Academic Search

By 1982, both the National Institutes of Health (NIH) and the American College of Obstetricians and Gynecologists had recommended that hospitals adopt policies favoring vaginal birth after cesarean (VBAC). Yet VBAC has since made only small inroads against repeat cesarean section and is primarily popular among progressive obstetricians and middle-class women wanting to experience natural childbirth and to avoid surgery.

Carol Shepherd McClain

1990-01-01

307

Vaginal birth after cesarean: To induce or not to induce  

Microsoft Academic Search

Objective: Our purpose was to determine the impact of labor induction on both the success and safety of a trial of labor in women who are candidates for vaginal birth after cesarean. Study Design: We performed a prospective observational analysis of 505 women consecutively presenting for delivery with a prior cesarean (September 1997–December 1999), of whom 236 (46.7%) underwent trial

Emma J. Sims; Roger B. Newman; Thomas C. Hulsey

2001-01-01

308

Vaginal birth after cesarean delivery in the twin gestation  

Microsoft Academic Search

Objective: The safety of vaginal birth after cesarean delivery (VBAC) in the singleton pregnancy has been known for many years. Despite this knowledge, most physicians feel the risk of VBAC in a twin pregnancy (TP) is too high despite the lack of documentation in the literature. We sought to determine if a VBAC for a TP carried greater risk than

Thomas D. Myles; Rory Miranda

2000-01-01

309

Vaginal birth after cesarean delivery: An historic cohort cost analysis  

Microsoft Academic Search

Objective: The purpose of this study was to evaluate the relative cost-effectiveness of attempted vaginal birth after cesarean delivery compared with elective repeat cesarean delivery. Study Design: We performed an historic cohort analysis of women with a single prior cesarean delivery who were delivered at our institution during 1999. Inclusion criteria were ?36 weeks' gestation and carrying a live, singleton

Heather DiMaio; Rodney K. Edwards; Tammy Y. Euliano; R. William Treloar; Amelia C. Cruz

2002-01-01

310

Vaginal birth after cesarean and uterine rupture rates in California  

Microsoft Academic Search

Objective: To describe attempted and successful vaginal birth after cesarean (VBAC) rates and uterine rupture rates for women with and without prior cesareans, and compare delivery outcomes in hospitals with different attempted VBAC rates.Methods: We used California hospital discharge summary data for 1995 to calculate attempted and successful VBAC rates and uterine rupture rates. We used multivariate logistic regression models

Kimberly D Gregory; Lisa M Korst; Patricia Cane; Lawrence D Platt; Katherine Kahn

1999-01-01

311

Vaginal Birth After Cesarean Delivery: An Admission Scoring System  

Microsoft Academic Search

Objective: To develop a scoring system to predict the likelihood of vaginal birth in patients undergoing a trial of labor after previous cesarean delivery using factors known at the time of hospital admission.Methods: Trial of labor was attempted in 5022 patients who were assigned randomly to score derivation and score testing groups. Multivariate logistic regression modeling was used in the

Bruce L Flamm; Ann M Geiger

1997-01-01

312

Vaginal birth after cesarean section in twin gestation  

Microsoft Academic Search

OBJECTIVE: We report a 10-year experience with vaginal birth after cesarean section in women with twins. STUDY DESIGN: Data were gathered from labor and delivery records and maternal and neonatal hospital charts. Women with a vertical uterine scar, a previous uterine rupture, an unrepaired dehiscence, or obstetric contraindications to labor were excluded from a trial of labor. Full-thickness uterine defects

David A. Miller; Patrick Mullin; Dennis Hou; Richard H. Paul

1996-01-01

313

The clinical platform for the 17?-estradiol vaginal releasing ring  

Microsoft Academic Search

All women, regardless of race, culture, or socioeconomic background, experience urogenital atrophy as a result of hypoestrogenism from the menopause. As women go through the aging cycle, their vaginal and urethral epithelium become progressively deprived of estrogen and the tissue loses epithelial thickness, rugation, moisture, vasculature, and elasticity. The pH increases to above 5, infections in the urinary tract and

Gloria Ann Bachmann

1998-01-01

314

Effects of ovarian steroids on vaginal smears in the rat.  

PubMed

A correspondence between the appearance of vaginal smears and the layers of the epithelium from which the cells had desquamated was established in untreated rats during the estrous cycle, in control ovariectomized rats and in spayed rats injected with either estrogen or progesterone. The technique for preparing and staining the smears (modified Shorr's staining procedure) is outlined. A simplified system of classification which allows the accurate identification of the various stages of the reproductive state in the rat is described. Standing estrus, as well as the influence of estrogen on spayed rats, is characterized by marked cornification of the cells and the disappearance of leukocytes. At the end of estrus, the cornified layer is sloughed off and invasion by leukocytes occurs. During diestrus, as well as in untreated ovariectomized rats, the vaginal contents consistently lack cornified cells whereas leukocytes are very plentiful. Proestrus follows diestrus: the vaginal smear is devoid of leukocytes and characterized by nucleated epithelial cells. Pregnancy, as well as the influence of progesterone on ovariectomized rats, is also characterized by epithelial growth and desquamation but at different rates, resulting in the presence of intermediate cells, and polymorphs and mucus forming a noticeable background to the smear. Since vaginal smears display cell pictures characteristic for each hormone after administration of estrogen or progesterone, exfoliate cytology is a good indicator of the stage of the reproductive state in the rat. PMID:3227778

Montes, G S; Luque, E H

1988-01-01

315

Effects of Ovarian Steroids on Vaginal Smears in the Rat  

Microsoft Academic Search

A correspondence between the appearance of vaginal smears and the layers of the epithelium from which the cells had desquamated was established in untreated rats during the estrous cycle, in control ovariectomized rats and in spayed rats injected with either estrogen or progesterone. The technique for preparing and staining the smears (modified Shorr’s staining procedure) is outlined. A simplified.system of

G. S. Monies; E. H. Luque

1988-01-01

316

Local Production of Chemokines during Experimental Vaginal Candidiasis  

Microsoft Academic Search

Recurrent vulvovaginal candidiasis, caused by Candida albicans, is a significant problem in women of child- bearing age. Although cell-mediated immunity (CMI) due to T cells and cytokines is the predominant host defense mechanism against C. albicans at mucosal tissue sites, host defense mechanisms against C. albicans at the vaginal mucosa are poorly understood. Based on an estrogen-dependent murine model of

MICHAEL SAAVEDRA; BRAD TAYLOR; NICHOLAS LUKACS; PAUL L. FIDEL

1999-01-01

317

Plasma prolactin concentrations after caesarean section or vaginal delivery  

Microsoft Academic Search

The umbilical venous plasma prolactin concentrations of three groups of term infants were compared immediately after birth. Samples were taken following seven vaginal deliveries, eight emergency caesarean sections performed during labour, and 12 elective caesarean sections before labour. Mean concentrations of prolactin were significantly lower in the elective caesarean section group compared with the labour groups. This result indicates that

Lindsay Heasman; John A D Spencer; Michael E Symonds

1997-01-01

318

Vaginal Stimulation: An Important Determinant of Maternal Bonding in Sheep  

Microsoft Academic Search

The immediate induction of the full complement of maternal behavior in nonpregnant ewes primed with estrogen and progesterone has been obtained after 5 minutes of vaginal-cervical stimulation. A similar period of such stimulation given to recently parturient ewes, after the development of selective bonding to their own lambs, reversed their rejection behavior of alien lambs and produced a state of

E. B. Keverne; F. Levy; P. Poindron; D. R. Lindsay

1983-01-01

319

A retrospective comparison of water births and conventional vaginal deliveries  

Microsoft Academic Search

The aim of this study was to document the practice of water births and compare their outcome and safety with normal vaginal deliveries. A retrospective case-control study was conducted over a five year period from 1989 to 1994 at the Maternity Unit, Rochford Hospital, Southend, UK. Three hundred and one women electing for water births were compared with the same

Chineze M. Otigbah; Mandish K. Dhanjal; Gloria Harmsworth; Tim Chard

2000-01-01

320

Energy balance closure for the LITFASS-2003 experiment  

Microsoft Academic Search

In the first part, this paper synthesises the main results from a series of previous studies on the closure of the local energy\\u000a balance at low-vegetation sites during the LITFASS-2003 experiment. A residual of up to 25% of the available energy has been\\u000a found which cannot be fully explained either by the measurement uncertainty of the single components of the

Thomas Foken; Matthias Mauder; Claudia Liebethal; Florian Wimmer; Frank Beyrich; Jens-Peter Leps; Siegfried Raasch; Henk A. R. DeBruin; Wouter M. L. Meijninger; Jens Bange

2010-01-01

321

AISLAMIENTO DE CEPAS DE ESCHERICHIA COLI DESDE CASOS CLÍNICOS DE INFECCIÓN VAGINAL: ASOCIACIÓN CON OTROS MICROORGANISMOS Y SUSCEPTIBILIDAD ANTIBACTERIANA  

Microsoft Academic Search

SUMMARY Objective: To determine the presence of Escherichia coli in vaginal fluids of women with vaginal infection and to study its antimicrobial susceptibility. Methods: 425 samples of women with clinical diagnosis of vaginal infection (cases) and 100 healthy women were studied (controls). The vaginal samples were studied by means of the criteria of Amsel and Nugent. Different methodologies were used

2007-01-01

322

Airway closure on imaging relates to airway hyperresponsiveness and peripheral airway disease in asthma  

PubMed Central

The regional pattern and extent of airway closure measured by three-dimensional ventilation imaging may relate to airway hyperresponsiveness (AHR) and peripheral airways disease in asthmatic subjects. We hypothesized that asthmatic airways are predisposed to closure during bronchoconstriction in the presence of ventilation heterogeneity and AHR. Fourteen asthmatic subjects (6 women) underwent combined ventilation single photon emission computed tomography/computed tomography scans before and after methacholine challenge. Regional airway closure was determined by complete loss of ventilation following methacholine challenge. Peripheral airway disease was measured by multiple-breath nitrogen washout from which Scond (index of peripheral conductive airway abnormality) was derived. Relationships between airway closure and lung function were examined by multiple-linear regression. Forced expiratory volume in 1 s was 87.5 ± 15.8% predicted, and seven subjects had AHR. Methacholine challenge decreased forced expiratory volume in 1 s by 23 ± 5% and increased nonventilated volume from 16 ± 4 to 29 ± 13% of computed tomography lung volume. The increase in airway closure measured by nonventilated volume correlated independently with both Scond (partial R2 = 0.22) and with AHR (partial R2 = 0.38). The extent of airway closure induced by methacholine inhalation in asthmatic subjects is greater with increasing peripheral airways disease, as measured by ventilation heterogeneity, and with worse AHR. PMID:22837168

Salome, Cheryl M.; Harris, Benjamin E.; Bailey, Dale L.; Bailey, Elizabeth; Berend, Norbert; Young, Iven H.; King, Gregory G.

2012-01-01

323

Analysis of Lactobacillus Products for Phages and Bacteriocins That Inhibit Vaginal Lactobacilli  

PubMed Central

Objective: Bacterial vaginosis is associated with an unexplained loss of vaginal lactobacilli. Previously, we have identified certain vaginal lactobacilli-released phages that can inhibit in vitro other vaginal lactobacilli. However, there is no apparent route for phages to be transmitted among women. The purpose of this study was to identify whether certain Lactobacillus products commonly used by women release phages or bacteriocins that can inhibit vaginal lactobacilli. Methods: From 26 Lactobacillus products (2 acidophilus milks, 20 yogurts, 3 Lactobacillus pills, and 1 vaginal douche mix), lactobacilli were isolated with Rogosa SL agar (Difco, Detroit, MI). From these lactobacilli, phages and bacteriocins were induced with mitomycin C and tested against a collection of vaginal Lactobacillus strains. Results: From the 26 products, 43 Lactobacillus strains were isolated. Strains from 11 yogurts released phages, among which 7 inhibited vaginal lactobacilli. Eleven strains released bacteriocins that inhibited vaginal lactobacilli. While about one-half of the vaginal strains were lysed by bacteriocins, less than 20% were lysed by phages. Conclusions: Some vaginal lactobacilli were inhibited in vitro by phages or bacteriocins released from Lactobacillus products used by women, implying that vaginal lactobacilli may be reduced naturally due to phages or bacteriocins from the environment. PMID:18476145

Pavlova, Sylvia I.; Mou, Susan M.; Ma, Wen-ge; Kilic, Ali O.

1997-01-01

324

Design of tenofovir-UC781 combination microbicide vaginal gels.  

PubMed

Tenofovir (TFV) is a proven microbicide when administered topically as a vaginal gel. To improve its efficacy, TFV was combined with the nonnucleoside reverse-transcriptase inhibitor UC781 in a vaginal gel. Mixture design of experiments theory was used to define a range of gel compositions with varying rheological properties and to assess in vitro drug release and tissue retention. Experiments and computations led to the specification of three different gels referred to as a spreading gel (SG), an intermediate spreading gel (ISG), and a bolus gel (BG). These three gels, all containing 1.0% TFV and 0.1% micronized UC781, were evaluated for in vitro release, in vitro tissue retention and safety, and in vivo pharmacokinetics in the rabbit. There were some differences in in vitro release rates of UC781 (the higher the gel viscosity, the slower the release rate) across gels, while release of TFV was independent of gel type. In an organotypic human vaginal-ectocervical (VEC) tissue model, the amounts of tissue-associated TFV and UC781 were several orders of magnitude higher than their in vitro half-maximal inhibitory concentration. There were no differences in VEC tissue concentrations of TFV or UC781 between the SG, ISG, and BG. All three gels were well tolerated in the VEC model as assessed by tissue viability, electrical resistance, histology, and cytokine (interleukin-8 and interleukin-1 beta) release. The local vaginal tissue concentrations in rabbits following a single dose or seven once-daily doses were variable and generally lower than those found in the VEC tissue model. The approach described herein provides a rational schema to design and evaluate vaginal gels for use as microbicides. PMID:22359356

Kiser, Patrick F; Mahalingam, Alamelu; Fabian, Judit; Smith, Eric; Damian, Festo R; Peters, Jennifer J; Katz, David F; Elgendy, Hoda; Clark, Meredith R; Friend, David R

2012-05-01

325

Comparison of Storage Conditions for Human Vaginal Microbiome Studies  

PubMed Central

Background The effect of storage conditions on the microbiome and metabolite composition of human biological samples has not been thoroughly investigated as a potential source of bias. We evaluated the effect of two common storage conditions used in clinical trials on the bacterial and metabolite composition of the vaginal microbiota using pyrosequencing of barcoded 16S rRNA gene sequencing and 1H-NMR analyses. Methodology/Principal Findings Eight women were enrolled and four mid-vaginal swabs were collected by a physician from each woman. The samples were either processed immediately, stored at ?80°C for 4 weeks or at ?20°C for 1 week followed by transfer to ?80°C for another 4 weeks prior to analysis. Statistical methods, including Kolmogorovo-Smirnov and Wilcoxon tests, were performed to evaluate the differences in vaginal bacterial community composition and metabolites between samples stored under different conditions. The results showed that there were no significant differences between samples processed immediately after collection or stored for varying durations. 1H-NMR analysis of the small molecule metabolites in vaginal secretions indicated that high levels of lactic acid were associated with Lactobacillus-dominated communities. Relative abundance of lactic acid did not appear to correlate with relative abundance of individual Lactobacillus sp. in this limited sample, although lower levels of lactic acid were observed when L. gasseri was dominant, indicating differences in metabolic output of seemingly similar communities. Conclusions/Significance These findings benefit large-scale, field-based microbiome and metabolomic studies of the vaginal microbiota. PMID:22655031

Bai, Guoyun; Gajer, Pawel; Nandy, Melissa; Ma, Bing; Yang, Hongqiu; Sakamoto, Joyce; Blanchard, May H.; Ravel, Jacques; Brotman, Rebecca M.

2012-01-01

326

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

327

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

328

Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer  

ClinicalTrials.gov

Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

2012-06-08

329

Efficacy of Clindamycin Vaginal Ovule (3-Day Treatment) vs. Clindamycin Vaginal Cream (7-Day Treatment) in Bacterial Vaginosis  

PubMed Central

Objective: To compare the efficacy and safety of a 3-day regimen of clindamycin vaginal ovules with a 7-day regimen of clindamycin vaginal cream for the treatment of bacterial vaginosis (BV) Methods: Women with a clinical diagnosis of BV were treated with a 3-day course of clindamycin ovules or a 7-day course of clindamycin cream administered intravaginally. Three hundred and eighty-four patients received study drug and were included in the evaluable patient population (ovule group, n = 204; cream group, n = 180). Assessments included pelvic examination and diagnostic testing. Primary efficacy endpoints were a resolution of two of three diagnostic criteria at the first follow-up visit and three of three diagnostic criteria at the second. Results: Cure rates in the evaluable patient population were similar between treatment groups: 53.7% (109/204) for the ovule group and 47.8% (85/180) for the cream group (p = 0.2471, 95% CI– 4.1–16.0%). The most commonly reported medical event, vulvovaginal pruritus, had similar incidence in both treatment groups. Conclusions: A 3-day course of clindamycin vaginal ovules is as effective and well-tolerated as a 7-day course of clindamycin vaginal cream in the treatment of BV. PMID:11368263

Peipert, Jeffrey F.; McGregor, James A.; Livengood, Charles; Martin, Maureen; Robbins, Jill; Wajszczuk, Charles P.

2001-01-01

330

Vaginal approach to vesicovaginal fistula and vaginal vault prolapse preserving sexual function by Latzko repair and sacrospinous suspension  

PubMed Central

The combination of vesicovaginal fistula and complete vaginal vault prolapse is rare. The only published treatment recommendations concern partial colpocleisis; an option that precludes intercourse. In this case report, we describe successful repair of this problem with a Latzko fistula repair and concomitant Michigan four-wall sacrospinous ligament suspension: curing the fistula, correcting the prolapse and preserving sexual function. PMID:22983277

Crosby, Erin C.; Berger, Mitchell B.; DeLancey, John O. L.

2014-01-01

331

Vaginal approach to vesicovaginal fistula and vaginal vault prolapse preserving sexual function by Latzko repair and sacrospinous suspension.  

PubMed

The combination of vesicovaginal fistula and complete vaginal vault prolapse is rare. The only published treatment recommendations concern partial colpocleisis, an option that precludes intercourse. In this case report, we describe successful repair of this problem with a Latzko fistula repair and a concomitant Michigan 4-wall sacrospinous ligament suspension: instead of curing the fistula, correcting the prolapse, and preserving sexual function. PMID:22983277

Crosby, Erin C; Berger, Mitchell B; Delancey, John O L

2012-01-01

332

Associations between Vaginal Pathogenic Community and Bacterial Vaginosis in Chinese Reproductive-Age Women  

PubMed Central

Background Bacterial vaginosis (BV) is one of the most common urogenital infections among women of reproductive age that represents shifts in microbiota from Lactobacillus spp. to diverse anaerobes. The aim of our study was to evalute the diagnostic values of Gardnerella, Atopobium, Eggerthella, Megasphaera typeI, Leptotrichia/Sneathia and Prevotella, defined as a vaginal pathogenic community for BV and their associations with vaginal pH and Nugent scores. Methods and Findings We investigated the vaginal pathogenic bacteria and Lactobacillus spp. with species-specific real-time quantitative PCR (qPCR) in 50 BV-positive and 50 BV-negative Chinese women of reproductive age. Relative to BV-negative subjects, a siginificant decline in Lactobacillus and an obvious increase in bacteria in the vaginal pathogenic community were observed in BV-postive subjects (P<0.05). With the exception of Megasphaera typeI, other vaginal pathogenic bacteria were highly predictable for BV with a better sensitivity and specificity. The vaginal pathogenic community was positively associated with vaginal pH and Nugent scores, while Lactobacillus spp., such as L. iners and L. crispatus was negatively associated with them (P<0.05). Conclusions Our data implied that the prevalance of vaginal pathogenic bacteria as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Vaginal microbiota shifts, especially the overgrowth of the vaginal pathogenic community, showed well diagnostic values in predicting BV. Postive correlations between those vaginal pathogenic bacteria and vaginal pH, Nugent score indicated the vaginal pathogenic community rather than a single vaginal microorganism, was participated in the onset of BV directly. PMID:24124575

Luo, Yueqiu; Wu, Xiaoxing; Yuan, Li; Tong, Xiaojuan; Li, Lanjuan; Xiang, Charlie

2013-01-01

333

Closure Evaluation of Laboratory Aerosols Optical and Hygroscopic Properties  

NASA Astrophysics Data System (ADS)

Closure analysis of the optical and hygroscopic properties of selected pure inorganic aerosol (e.g., ammonium sulfate and sodium chloride), pure organic aerosol (e.g., glutaric acid and succinic acid), and two inorganic and organic aerosol mixtures will be evaluated. Focus will be on the effect of particulate organic matter (POM) content on an aerosol's optical hygroscopicity. The Mie-Lorentz light scattering ("BHMIE") code is used to predict the total light scattering and backscattering coefficients (?sp and ?bsp, respectively) at given RH values. The "BHMIE" code uses measured aerosol particle number size distributions by Hygroscopic Tandem Differential Mobility Analyzer (H-TDMA), and refractive indices as major model inputs. As a subset of the optical closure study, another closure on the real refractive indices of the aerosols will also be completed by comparing results from the partial molar refraction (PMR) approach to the experimentally determined values using two independent optical devices - ellipsometer and refractometer at different sub-saturated solute mass concentrations. Meanwhile, a scanning relative humidity (RH) nephelometry system, humidograph, is used to measure ?bsp and ?bsp at controlled RH values between 35% and 85%. Comparisons of the extensive aerosol optical properties, ?sp and ?bsp, and intensive derived ones, such as hygroscopic response in ?sp (f?sp), single scattering albedo ( ?), Ångström exponent (å), and hemispheric backscatter fraction (b) at select RH values will be made to accomplish the closure evaluations. In addition, particle growth (g(RH)), effect of temperature (T) and RH uncertainties and sample heating on measurements of aerosol optical properties will also be quantified.

Wang, W.; Rood, M.

2006-12-01

334

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

335

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

336

Retrospective study of outcome on vaginal and abdominal delivery in twin pregnancy in which twin 1 is presenting by the breech  

Microsoft Academic Search

.   We retrospectively reviewed the perinatal outcome of twin pregnancies cohere the first baby was presenting by the breech.\\u000a 21 were delivered vaginally and 37 abdominally. Differences in perinatal outcome, as measured by Apgar score and mortality,\\u000a were not apparently different.

A. T. Abu-Heija; S. Ziadeh; F. Abukteish; A. Obeidat

1998-01-01

337

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

338

Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration  

PubMed Central

This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. PMID:25114497

Rajjoub, Lamise Z; Chadha, Nisha; Belyea, David A

2014-01-01

339

Genetic, epigenetic, and environmental contributions to neural tube closure.  

PubMed

The formation of the embryonic brain and spinal cord begins as the neural plate bends to form the neural folds, which meet and adhere to close the neural tube. The neural ectoderm and surrounding tissues also coordinate proliferation, differentiation, and patterning. This highly orchestrated process is susceptible to disruption, leading to neural tube defects (NTDs), a common birth defect. Here, we highlight genetic and epigenetic contributions to neural tube closure. We describe an online database we created as a resource for researchers, geneticists, and clinicians. Neural tube closure is sensitive to environmental influences, and we discuss disruptive causes, preventative measures, and possible mechanisms. New technologies will move beyond candidate genes in small cohort studies toward unbiased discoveries in sporadic NTD cases. This will uncover the genetic complexity of NTDs and critical gene-gene interactions. Animal models can reveal the causative nature of genetic variants, the genetic interrelationships, and the mechanisms underlying environmental influences. PMID:25292356

Wilde, Jonathan J; Petersen, Juliette R; Niswander, Lee

2014-11-23

340

Effect of forest canopy closure on incoming solar radiance  

SciTech Connect

In order to better understand the physical processes involved in defoliation assessment from remotely sensed data, a field study was designed to investigate the effect of forest canopy closure and other environmental variables on incoming solar radiation. Diffuse radiation measurements were recorded in red, infrared, and middle infrared wavelengths using the Mark 2 three band field radiometer. Results to date indicate that the percent canopy closure is the single most important variable affecting incoming solar radiation. In the visible and near infrared regions, interaction between time of day and date (defined later as solar zenith angle) also affect radiometric response. Aspect has only limited influence on radiance response. These same variables do not influence middle infrared response, however. Uniformity of the forest canopy appears to be more important. These results are compared to LANDSAT MSS classification results of gypsy moth defoliation.

Dottavio, C.L.

1981-04-01

341

Effect of forest canopy closure on incoming solar radiance  

NASA Technical Reports Server (NTRS)

In order to better understand the physical processes involved in defoliation assessment from remotely sensed data, a field study was designed to investigate the effect of forest canopy closure and other environmental variables on incoming solar radiation. Diffuse radiation measurements were recorded in red, infrared, and middle infrared wavelengths using the Mark 2 three band field radiometer. Results to date indicate that the percent canopy closure is the single most important variable affecting incoming solar radiation. In the visible and near infrared regions, interaction between time of day and date (defined later as solar zenith angle) also affect radiometric response. Aspect has only limited influence on radiance response. These same variables do not influence middle infrared response, however. Uniformity of the forest canopy appears to be more important. These results are compared to LANDSAT MSS classification results of gypsy moth defoliation.

Dottavio, C. L. (principal investigator)

1981-01-01

342

Longitudinal changes in vaginal microbiota composition assessed by Gram-stain among never sexually active pre- and postmenarcheal adolescents in Rakai, Uganda  

PubMed Central

Study Objective To describe changes in vaginal microbiota and pH over time among never sexually active adolescents at different menarcheal stages. Design A cohort of 49 sexually inexperienced Ugandan adolescents provided weekly self-collected vaginal swabs and behavioral/health information for up to two years. Menarcheal stage was classified as: not experiencing menarche during follow-up (premenarcheal, n=9), achieving menarche during follow-up (perimenarcheal, n=20), and being postmenarcheal (n=20) at enrollment. Vaginal microbiota were characterized as morphotypes of large Gram-positive rods, small Gram-negative or variable rods, and curved Gram-negative rods based on Nugent Gram-stain criteria. Baseline measures were compared using nonparametric tests. Mean changes (?) in morphotypes and pH over time were estimated using longitudinal mixed-effects models. Results The baseline median (IQR: interquartile range) Nugent score was 8 (7-8) in premenarcheal, 4.5 (1-8) in perimenarcheal, and 1 (0-3) in postmenarcheal girls (p=0.001). For each respective menarcheal stage, the median counts of (IQR) Gram-positive rods were 0 (0-0), 10 (0-30), and 30 (18-30) (p=0.002) and Gram-negative or variable rods were 30 (30-30), 16 (0.5-30), and 0.5 (0-2.5) (p=0.002) at enrollment. Counts of Gram-positive rods increased (? = 0.259, 95% CI: 0.156, 0.362) and Gram-negative or variable rods decreased (? = -0.201, 95% CI:-0.298,-0.103) significantly over time in premenarcheal girls, but not in other groups. Vaginal pH declined significantly in peri- and postmenarcheal girls only. Conclusion Vaginal microbiota composition varied by menarcheal stage at enrollment. Over time, significant changes in vaginal morphotypes occurred in premenarcheal girls, suggesting this may be an important period of transition. PMID:20709584

Thoma, Marie E.; Gray, Ronald H.; Kiwanuka, Noah; Aluma, Simon; Wang, Mei-Cheng; Sewankambo, Nelson; Wawer, Maria J.

2010-01-01

343

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

344

The TopClosure® 3S System, for skin stretching and a secure wound closure.  

PubMed

The principle of stretching wound margins for primary wound closure is commonly practiced and used for various skin defects, leading at times to excessive tension and complications during wound closure. Different surgical techniques, skin stretching devices and tissue expanders have been utilized to address this issue. Previously designed skin stretching devices resulted in considerable morbidity. They were invasive by nature and associated with relatively high localized tissue pressure, frequently leading to necrosis, damage and tearing of skin at the wound margins. To assess the clinical effectiveness and performance and, to determine the safety of TopClosure® for gradual, controlled, temporary, noninvasive and invasive applications for skin stretching and secure wound closing, the TopClosure® device was applied to 20 patients for preoperative skin lesion removal and to secure closure of a variety of wound sizes. TopClosure® was reinforced with adhesives, staples and/or surgical sutures, depending on the circumstances of the wound and the surgeon's judgment. TopClosure® was used prior to, during and/or after surgery to reduce tension across wound edges. No significant complications or adverse events were associated with its use. TopClosure® was effectively used for preoperative skin expansion in preparation for dermal resection (e.g., congenital nevi). It aided closure of large wounds involving significant loss of skin and soft tissue by mobilizing skin and subcutaneous tissue, thus avoiding the need for skin grafts or flaps. Following surgery, it was used to secure closure of wounds under tension, thus improving wound aesthetics. A sample case study will be presented. We designed TopClosure®, an innovative device, to modify the currently practiced concept of wound closure by applying minimal stress to the skin, away from damaged wound edges, with flexible force vectors and versatile methods of attachment to the skin, in a noninvasive or invasive manner. PMID:22719176

Topaz, Moris; Carmel, Narin-Nard; Silberman, Adi; Li, Ming Sen; Li, Yong Zhong

2012-07-01

345

Extender for securing a closure  

SciTech Connect

An apparatus for securing a closure such as door or a window that opens and closes by movement relative to a fixed structure such as a wall or a floor. Many embodiments provide a device for relocating a padlock from its normal location where it secures a fastener (such as a hasp) to a location for the padlock that is more accessible for locking and unlocking the padlock. Typically an extender is provided, where the extender has a hook at a first end that is disposed through the eye of the staple of the hasp, and at an opposing second end the extender has an annulus, such as a hole in the extender or a loop or ring affixed to the extender. The shackle of the padlock may be disposed through the annulus and may be disposed through the eye of a second staple to secure the door or window in a closed or open position. Some embodiments employ a rigid sheath to enclose at least a portion of the extender. Typically the rigid sheath has an open state where the hook is exposed outside the sheath and a closed state where the hook is disposed within the sheath.

Thomas, II, Patrick A.

2012-10-02

346

50 CFR 665.268 - Closures.  

Code of Federal Regulations, 2013 CFR

...CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii Fisheries § 665.268 Closures. (a) If the Regional Administrator determines that the...

2013-10-01

347

50 CFR 665.666 - Closures.  

Code of Federal Regulations, 2010 CFR

...NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Pacific Remote Island Area Fisheries § 665.666 Closures. (a) If the Regional Administrator determines that...

2010-10-01

348

[Functional disturbances after acute angle closure glaucoma].  

PubMed

This issue presents the results of a study on patients with acute angle closure glaucoma. We analyse the functional disturbances and their long term evolution, and we show some risk factors which lead to severe functional disturbances. PMID:15341106

Macarie, S; Macarie, Daniela

2004-01-01

349

Technical Aspects of Underground Storage Tank Closure.  

National Technical Information Service (NTIS)

The overall objective of the study was to develop a deeper understanding of UST residuals at closure: their quantities, origins, physical/chemical properties, ease of removal by various cleaning methods, and their environmental mobility and persistence. T...

A. N. Tafuri

1992-01-01

350

50 CFR 622.246 - Area closures.  

Code of Federal Regulations, 2013 CFR

...GULF OF MEXICO, AND SOUTH ATLANTIC Golden Crab Fishery of the South Atlantic Region § 622.246 Area closures. (a) Golden crab trap closed areas. In the golden crab northern zone, a golden crab trap may not...

2013-10-01

351

Reliability assessment of underground shaft closure  

SciTech Connect

The intent of the WIPP, being constructed in the bedded geologic salt deposits of Southeastern New Mexico, is to provide the technological basis for the safe disposal of radioactive Transuranic (TRU) wastes generated by the defense programs of the United States. In determining this technological basis, advanced reliability and structural analysis techniques are used to determine the probability of time-to-closure of a hypothetical underground shaft located in an argillaceous salt formation and filled with compacted crushed salt. Before being filled with crushed salt for sealing, the shaft provides access to an underground facility. Reliable closure of the shaft depends upon the sealing of the shaft through creep closure and recompaction of crushed backfill. Appropriate methods are demonstrated to calculate cumulative distribution functions of the closure based on laboratory determined random variable uncertainty in salt creep properties.

Fossum, A.F. [RE/SPEC, Inc., Rapid City, SD (United States); Munson, D.E. [Sandia National Labs., Albuquerque, NM (United States)

1994-12-31

352

40 CFR 265.381 - Closure.  

Code of Federal Regulations, 2010 CFR

...TREATMENT, STORAGE, AND DISPOSAL FACILITIES Thermal Treatment § 265.381 Closure. ...including, but not limited to, ash) from the thermal treatment process or equipment. [Comment...that any solid waste removed from his thermal treatment process or equipment is not...

2010-07-01

353

Occupancy estimation and the closure assumption  

USGS Publications Warehouse

1. Recent advances in occupancy estimation that adjust for imperfect detection have provided substantial improvements over traditional approaches and are receiving considerable use in applied ecology. To estimate and adjust for detectability, occupancy modelling requires multiple surveys at a site and requires the assumption of 'closure' between surveys, i.e. no changes in occupancy between surveys. Violations of this assumption could bias parameter estimates; however, little work has assessed model sensitivity to violations of this assumption or how commonly such violations occur in nature. 2. We apply a modelling procedure that can test for closure to two avian point-count data sets in Montana and New Hampshire, USA, that exemplify time-scales at which closure is often assumed. These data sets illustrate different sampling designs that allow testing for closure but are currently rarely employed in field investigations. Using a simulation study, we then evaluate the sensitivity of parameter estimates to changes in site occupancy and evaluate a power analysis developed for sampling designs that is aimed at limiting the likelihood of closure. 3. Application of our approach to point-count data indicates that habitats may frequently be open to changes in site occupancy at time-scales typical of many occupancy investigations, with 71% and 100% of species investigated in Montana and New Hampshire respectively, showing violation of closure across time periods of 3 weeks and 8 days respectively. 4. Simulations suggest that models assuming closure are sensitive to changes in occupancy. Power analyses further suggest that the modelling procedure we apply can effectively test for closure. 5. Synthesis and applications. Our demonstration that sites may be open to changes in site occupancy over time-scales typical of many occupancy investigations, combined with the sensitivity of models to violations of the closure assumption, highlights the importance of properly addressing the closure assumption in both sampling designs and analysis. Furthermore, inappropriately applying closed models could have negative consequences when monitoring rare or declining species for conservation and management decisions, because violations of closure typically lead to overestimates of the probability of occurrence.

Rota, Christopher T.; Fletcher, Robert J. Jr.; Dorazio, Robert M.; Betts, Matthew G.

2009-01-01

354

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

355

[Right patent ductus arteriosus with an ipsilateral aortic arch: percutaneous closure with amplatzer devices].  

PubMed

The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when there are no other intracardiac anomalies. We report three female patients aged 26, 35 and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In two patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in two patients and an Amplatzer muscular ventricular septal defect occluder, in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective. PMID:17394880

Santiago, Justo; Acuña, Manuel; Arispe, Elizabeth; Camargo, Ronaldo; Neves, Juliana; Arnoni, Daniel; Fontes, Valmir F; Pedra, Carlos A

2007-03-01

356

Right patent ductus arteriosus with an ipsilateral aortic arch: percutaneous closure with amplatzer devices.  

PubMed

The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when 3 are no other intracardiac anomalies. We report three female patients aged 26, 35, and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In 2 patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in 2 patients and an Amplatzer muscular ventricular septal defect occluder in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective. PMID:24774528

Santiago, Justo; Acuña, Manuel; Arispe, Elizabeth; Camargo, Ronaldo; Neves, Juliana; Arnoni, Daniel; Fontes, Valmir F; Pedra, Carlos A C

2007-01-01

357

Downbeat nystagmus elicited by eyelid closure.  

PubMed

: We describe a patient with downbeat nystagmus (DBN) evoked only by eye closure. Brain and spinal cord magnetic resonance imaging revealed a T2 paramedian lesion in the left lower basis pontis and other white matter lesions consistent with multiple sclerosis. One potential mechanism for DBN in this case involves transverse ephaptic spread of excitation from areas that subserve coordinated lid closure to the decussating ventral tegmental tract. PMID:24667774

Lemos, João; Pereira, Daniela; Amorim, Margarida; Santiago, Beatriz; Paiva, António; Cunha, Luís

2014-12-01

358

Conditional Moment Closure for Large Eddy Simulations  

Microsoft Academic Search

A conditional moment closure (CMC) based combustion model for large-eddy simulations (LES) of turbulent reacting flow is proposed\\u000a and evaluated. Transport equations for the conditionally filtered species are derived that are consistent with the LES formulation\\u000a and closures are suggested for the modelling of the conditional velocity, conditional scalar dissipation and the fluctuations\\u000a around the conditional mean. A conventional ?-probability

S. Navarro-Martinez; A. Kronenburg; F. Di Mare

2005-01-01

359

Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery  

Microsoft Academic Search

Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth)

Holly E. Richter; Cynthia G. Brumfield; Suzanne P. Cliver; Kathryn L. Burgio; Cherry L. Neely; R. Edward Varner

2002-01-01

360

Optical closure study on light-absorbing aerosols  

NASA Astrophysics Data System (ADS)

The in situ measurement of atmospheric aerosol optical properties is an important component of quantifying climate change. In particular, the in-situ measurement of the aerosol single-scattering albedo (SSA), which is the ratio of aerosol scattering to aerosol extinction, is identified as a key challenge in atmospheric sciences and climate change research. Ideally, the complete set of aerosol optical properties is measured through optical closure studies which simultaneous measure aerosol extinction, scattering and absorption coefficients. The recent development of new optical instruments have made real-time in situ optical closure studies attainable, however, many of these instruments are state-of-the-art but not practical for routine monitoring. In our studies we deployed a suit of well-established and recently developed instruments including the cavity attenuated phase shift (CAPS) method for aerosol light extinction, multi-angle absorption photometer (MAAP) and particle soot absorption photometer (PSAP) for aerosol light absorption, and an integrating nephelometer (NEPH) for aerosol light scattering measurements. From these directly measured optical properties we calculated light absorption from extinction minus scattering (difference method), light extinction from scattering plus absorption, and aerosol single-scattering albedo from combinations CAPS + MAAP, NEPH + PSAP, NEPH + MAAP, CAPS + NEPH. Closure studies were conducted for laboratory-generated aerosols composed of various mixtures of black carbon (Regal 400R pigment black, Cabot Corp.) and ammonium sulphate, urban aerosol (Billerica, MA), and background aerosol (Storm Peak Lab.). Key questions addressed in our closure studies are: (1) how well can we measure aerosol light absorption by various methods, and (2) how well can we measure the aerosol single-scattering albedo by various instrument combinations? In particular we investigated (3) whether the combination of a CAPS and NEPH provides a reasonable approach for determining aerosol absorption using the difference method, and (4) whether this comparison provides any indication that the PSAP and/or MAAP measurements of absorption have artifacts by organic condensation as suggested in the literature. The results presented here contribute to the ongoing efforts of assessing measurement methods suitable for the monitoring of aerosol optical properties.

Petzold, Andreas; Bundke, Ulrich; Freedman, Andrew; Onasch, Timothy B.; Massoli, Paola; Andrews, Elizabeth; Hallar, Anna G.

2014-05-01

361

Challenges for Lithuania: Ignalina NPP Early Closure  

SciTech Connect

As a condition of accession into the European Union (EU), Lithuania is committed to the closure and decommissioning of Ignalina NPP comprising two RBMK-1500 reactor units (Fig. 1). It was agreed in a special protocol to the Accession Treaty that, in return for adequate EU financial assistance, Unit 1 would be closed before 2005 and Unit 2 by the end of 2009. The first unit was duly shut down on December 31, 2004. Lithuania, which has borders with Russia (Kaliningrad territory), Poland, Latvia and Belarus, spent fifty years as part of the Soviet Union and was deeply integrated into its economy and electrical infrastructure. At the break-up of the USSR, Lithuania inherited electricity generating capacity designed to supply the north-west region including ownership of Ignalina NPP located in the north-east of the country. Ignalina NPP Unit 1 was commissioned in 1983, Unit 2 in 1987; the planned lifespan of each unit was 30 years. Construction of a third unit was started but never completed. Since Lithuania became independent in 1990, Ignalina NPP has typically contributed more than 70% of national power supply. The town of Visaginas (population approx. 30,000) was purpose built to serve the plant and staff were brought in from throughout the USSR. With 3200 direct employees, Ignalina NPP remains by far the largest employer. Although there are pockets of Russian-language speakers in communities throughout Lithuania, Visaginas is the only example on a whole-town scale. Thus closure of Ignalina NPP within the restricted timescale required by the EU Accession Treaty commitment set an exceptional challenge to Lithuania. However, since the preparatory phase of decommissioning started in 2000, notable progress has been made, experience gained and lessons learnt. At present Unit 1 remains partially fueled in a state of care and maintenance. Partly burnt fuel is being transferred from Unit 1 to Unit 2 for further irradiation in order to minimize the commitment of new fuel thereby reducing operating costs and the final quantity of spent fuel. Design and construction of the facilities for spent fuel storage, waste processing and free-release is ongoing. The siting of the Near Surface Repository is now in the final stages of approval and construction of the landfill facility is under tendering. In order to facilitate the approval process and minimize the transport of waste, both disposal facilities will be within the boundary of the NPP site. Approximately 450 staff are employed at the shutdown Unit 1 for the safe maintenance of essential systems. The total staffing level at the plant is currently being reduced by around 200 each year, with a larger release to take place at the closure of Unit 2. It is envisaged that 2000 staff will be required for the dismantling operations. Although Ignalina NPP is still in the early stages of closure and decommissioning, some important lessons have already been learnt: Firstly, the importance considering social and financial issues as well as technical factors in deciding the decommissioning strategy. This should be done before the preparation is started of the FDP. The same broad consideration should also be given to the economic restructuring of the local area. Consultation is necessary with local and national authorities, and other stakeholders up to ensure a common vision. At Ignalina NPP it was considered essential to staff morale and the maintenance of a strong safety culture to guarantee the special social and employment benefits to dismissed staff in law [9]. At the same time, measures were also adopted to encourage certain key personnel to remain at the plant until closure. The case of Lithuania, which at independence had no legislative framework or management infrastructure for radioactive waste, may be exceptional; however, for all decommissioning projects it is necessary to have, from the outset, a clear strategy on waste storage and disposal. Finally, coordination at all levels must be assured, especially with the involvement of the nuclear regulators and other regulatory authorities, t

Teskeviciene, Birute [Ministry of Economy, Gedimino pr. 38/2, Vilnius, LT-01104 (Lithuania); Harrison, Peter [Central Project Management Agency, S. Konarskio 13, Vilnius, LT-03109 (Lithuania)

2008-01-15

362

Aspects of psychosocial problems of patients with vesico-vaginal fistula.  

PubMed

Our objective was to evaluate psychosocial problems among patients presenting with vesico-vaginal fistula (VVF), and their close relatives. All patients presenting with VVF and their spouses or attendant close relatives were administered a structured questionnaire followed by an in-depth interview. A total of 20 patients and 10 attendant relatives were interviewed. The average age of patients was 24.7 years, range 16-38 years. A total of 11 patients (55%) had their first marriage between the ages of 15-20 years, with one nulliparous, unmarried patient, who acquired VVF following infertility treatment with herbs. Of the interviewed respondents, 19 affirmed that prolonged labour was the cause of VVF, while four patients developed VVF sequel to unsupervised vaginal birth after a previous caesarean section. Reported medical problems were dermatitis (20%), foul smell of urine (15%), recurrent UTI (10%), infertility (5%), amenorrhoea (5%), in that order. Socially, 45% felt ostracised and 50% were economically impoverished by job loss. The divorce rate was 25%, with one case of remarriage and childbirth with an unrepaired VVF. Some 56.6% respondents suggested hospital delivery was a preventive measure, while 33.3% felt avoidance of premarital sex and early marriage would prevent VVF. VVF is still a major social and reproductive health problem and most patients and relatives understand the place of difficult childbirth in VVF formation. The need to empower patients to timely access standard maternity and emergency obstetric care is recommended. PMID:19757273

Gharoro, E P; Agholor, K N

2009-10-01

363

Vaginal delivery after hemipelvectomy and pelvic radiotherapy for chondrosarcoma.  

PubMed

Chondosarcoma of the proximal femur is a rare malignant disorder in women of (pre-) childbearing age, for which a radical resection through a hemipelvectomy could be indicated. We describe a case of a 36-year-old primigravida with a hemipelvectomy (2004) who had a history of radiotherapy of the pelvic and uterine regions after an atypical cartilaginous tumour. After an uncomplicated pregnancy, she had a spontaneous rupture of the membranes at 41+2 weeks and an uncomplicated vaginal delivery with physiological development of the infant. On the basis of the literature review, vaginal delivery after hemipelvectomy should be advocated and discussed with the patient and involved care providers. Women with radiotherapy in the pelvic and uterine areas have an increased risk of stillbirth, placental attachment disorders, impaired fetal growth, fetal malposition and preterm labour, but no association with prolonged rupture of the membranes has been described. PMID:25257889

Browne, J L; Oudijk, M A; Holtslag, H R; Schreuder, H W R

2014-01-01

364

On the Biomechanics of Vaginal Birth and Common Sequelae  

PubMed Central

Approximately 11% of U.S. women undergo surgery for pelvic floor dysfunction, including genital organ prolapse and urinary and fecal incontinence. The major risk factor for developing these conditions is giving vaginal birth. Vaginal birth is a remarkable event about which little is known from a biomechanical perspective. We first review the functional anatomy of the female pelvic floor, the normal loads acting on the pelvic floor in activities of daily living, and the functional capacity of the pelvic floor muscles. Computer models show that the stretch ratio in the pelvic floor muscles can reach an extraordinary 3.26 by the end of the second stage of labor. Magnetic resonance images provide evidence that show that the pelvic floor regions experiencing the most stretch are at the greatest risk for injury, especially in forceps deliveries. A conceptual model suggests how these injuries may lead to the most common form of pelvic organ prolapse, a cystocele. PMID:19591614

Ashton-Miller, James A.; DeLancey, John O.L.

2010-01-01

365

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

366

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 Cell 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

2014-10-30

367

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

368

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

369

Induction of labor for vaginal birth after cesarean delivery  

Microsoft Academic Search

A recent population-based study of vaginal birth after cesarean delivery (VBAC) attempts observed uterine rupture rates of 24.5 per 1,000 with prostaglandin-induced labor, while the uterine rupture rates with spontaneous labor and labor induced without prostaglandins were lower (5.2\\/1,000 and 7.7\\/1,000 respectively). The authors did not confirm the diagnoses by examining individual medical records, so the actual incidence of uterine

2002-01-01

370

Ovarian function with a novel combined contraceptive vaginal ring  

Microsoft Academic Search

BACKGROUND: NuvaRing® is a combined contraceptive vaginal ring designed for 3 weeks continuous use followed by a 1 week ring-free period. The present study evaluated ovarian function in women who were instructed to either adhere to, or deviate from, the recommended regimen of use. METHODS: In this open-label, randomized study, 45 women aged between 18 and 35 years used NuvaRing

Titia M. T. Mulders; Thom O. M. Dieben; Herjan J. T. Coelingh Bennink

371

Contraceptive vaginal ring — a rising star on the contraceptive horizon  

Microsoft Academic Search

Two studies were carried out at AIIMS to judge efficacy, side-effects and acceptability of the contraceptive vaginal ring, a Silastic ring with an inner core containing 6.0 mg levonorgestrel mixed with Silastic and an outer core of Silastic only. It releases levonorgestrel at a constant rate of 20 µg\\/day and remains effective for 90 days. The first study of 50

K. Buckshee; S. Kumar; L. Sarava

1990-01-01

372

Accelerating cleanup: Paths to closure  

SciTech Connect

This report describes the status of Environmental Management`s (EM`s) cleanup program and a direction forward to complete achievement of the 2006 vision. Achieving the 2006 vision results in significant benefits related to accomplishing EM program objectives. As DOE sites accelerate cleanup activities, risks to public health, the environment, and worker safety and health are all reduced. Finding more efficient ways to conduct work can result in making compliance with applicable environmental requirements easier to achieve. Finally, as cleanup activities at sites are completed, the EM program can focus attention and resources on the small number of sites with more complex cleanup challenges. Chapter 1 describes the process by which this report has been developed and what it hopes to accomplish, its relationship to the EM decision-making process, and a general background of the EM mission and program. Chapter 2 describes how the site-by-site projections were constructed, and summarizes, for each of DOE`s 11 Operations/Field Offices, the projected costs and schedules for completing the cleanup mission. Chapter 3 presents summaries of the detailed cleanup projections from three of the 11 Operations/Field Offices: Rocky Flats (Colorado), Richland (Washington), and Savannah River (South Carolina). The remaining eight Operations/Field Office summaries are in Appendix E. Chapter 4 reviews the cost drivers, budgetary constraints, and performance enhancements underlying the detailed analysis of the 353 projects that comprise EM`s accelerated cleanup and closure effort. Chapter 5 describes a management system to support the EM program. Chapter 6 provides responses to the general comments received on the February draft of this document.

NONE

1998-06-01

373

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

374

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, Jose; das Neves, Jose; Palmeira-de-Oliveira, Rita

2014-01-01

375

Dorsal onlay vaginal graft urethroplasty for female urethral stricture  

PubMed Central

Introduction: Female urethral stricture is an underdiagnosed and overlooked cause of female bladder outlet obstruction. The possible etiologies may be infection, prior dilation, difficult catheterization with subsequent fibrosis, urethral surgery, trauma, or idiopathic. We present our technique and results of dorsal onlay full thickness vaginal graft urethroplasty for female urethral stricture. Materials and Methods: A retrospective review was performed on 16 female patients with mid-urethral stricture who underwent dorsal onlay vaginal graft urethroplasty from January 2007 to June 2011. Of these, 13 patients had previously undergone multiple Hegar dilatations, three had previous internal urethrotomies. The preoperative work up included detailed voiding history, local examination, uroflowmetry, calibration, and micturating cystourethrogram. Results: All patients had mid-urethral stricture. Mean age was 47.5 years. Mean Qmax improved from 6.2 to 27.6 ml/s. Mean residual volume decreased from 160 to 20 ml. Mean duration of follow-up was 24.5 months (6 months to 3 years). Only one patient required self-calibration for 6 months after which her stricture stabilized. None of the patient was incontinent. Conclusion: Dorsal vaginal onlay graft urethroplasty could be considered as an effective way to treat female urethral stricture. PMID:23956514

Singh, Manmeet; Kapoor, Rakesh; Kapoor, Deepa; Kapoor, Rohit; Srivastav, Alok; Chipde, Saurabh

2013-01-01

376

Development of dapivirine vaginal ring for HIV prevention.  

PubMed

In the continuing effort to develop effective HIV prevention methods for women, a vaginal ring containing the non-nucleoside reverse transcriptase inhibitor dapivirine is currently being tested in two safety and efficacy trials. This paper reviews dapivirine ring's pipeline development process, including efforts to determine safe and effective dosing levels as well as identify delivery platforms with the greatest likelihood of success for correct and consistent use. Dapivirine gel and other formulations were developed and tested in preclinical and clinical studies. Multiple vaginal ring prototypes were also tested, resulting in the current ring design as well as additional designs under consideration for future testing. Efficacy results from clinical trials are expected in 2015. Through ongoing consultations with national regulatory authorities, licensure requirements for dapivirine vaginal ring approval have been defined. This article is based on a presentation at the "Product Development Workshop 2013: HIV and Multipurpose Prevention Technologies," held in Arlington, Virginia on February 21-22, 2013. It forms part of a special supplement to Antiviral Research. PMID:24188702

Devlin, Bríd; Nuttall, Jeremy; Wilder, Susan; Woodsong, Cynthia; Rosenberg, Zeda

2013-12-01

377

Vaginal isolates of Staphylococcus aureus associated with toxic shock syndrome.  

PubMed Central

Staphylococcus aureus has been isolated from vaginal fluids of women with toxic shock syndrome (TSS), a multisystem disease with onset usually during menses. A total of 15 vaginal isolates of S. aureus from TSS patients were compared with 18 vaginal isolates from women without TSS. Phenotypic traits which were significantly more frequent in the TSS group of strains than in the non-TSS group were arsenate resistance, proteolysis of hemoglobin, reduced hemolysis of sheep blood in agar medium, and lack of lethality of culture filtrates for chicken embryos and rabbits. In addition, isoelectric focusing of ethanol extracts of culture filtrates showed differences between the two groups in the occurrence of two proteins. All hemolytic and chicken embryo-lethal strains (3 TSS strains and 14 non-TSS strains) produced an extracellular protein with an isoelectric point of 8.6. In contrast, all TSS strains, but only one-half of non-TSS strains, released a protein with an isoelectric point of 7.0 and an apparent subunit molecular weight of 22,000. Images PMID:6456228

Barbour, A G

1981-01-01

378

Optical and electrical investigations into cathode ignition and diode closure  

SciTech Connect

The temporal behavior of high-power diodes is closely related to the impedance collapse caused by the movement of the cathode and/or anode plasmas. This impedance collapse can be especially problematic when a constant power electron beam is required. This is the case for the very large area (square meters) diodes used to pump the amplifiers within the Aurora KrF laser system. The electron beam technology development program at Los Alamos utilizes the Electron Beam Test Facility (EGTF) to study diode physics in an attempt to better understand the basic phenomenology of ignition and closure. A combination of optical and electric diagnostics has been fielded on the Electron Beam Test Facility to study ignition and closure in large area electron beam diodes. A four-channel framing camera is used to observe the formation of microplasmas on the surface of the cathode and the subsequent movement of these plasmas toward the anode. Additionally, a perveance model is used to extract information about this plasma from voltage and current profiles. Results from the two diagnostics are compared. Closure velocity measurements are presented showing little dependence on applied magnetic field for both velvet and carbon felt emitters. We also report the first observation of the screening effect in large area cold cathode diodes. 13 refs., 11 figs.

Coogan, J.J.; Rose, E.A.; Shurter, R.P.

1991-01-01

379

Analysis of surface energy balance closure over heterogeneous surfaces  

NASA Astrophysics Data System (ADS)

Surface energy balance closure has been examined using eddy covariance measurements and other observations at one industrial and three agricultural sites near the Nakdong River during daytime. Energy balance closure was evaluated by calculating the long-term averaged energy balance ratio (EBR), the ratio of turbulent energy fluxes to available energy, and the statistical regression of turbulent energy fluxes against available energy using half-hourly data. The EBR of all sites ranges from 0.46 to 0.83 while the coefficient of determination (R 2) ranges from 0.37 to 0.77. The energy balance closure was relatively poor compared to homogeneous sites, indicating the influence of surface heterogeneity. Unmeasured heat storage terms also seem to play a role in the surface energy budget at the industrial and irrigated sites. The energy balance closure was better in conditions of high wind speed, low downward short wave radiation, and high friction velocity, which suggests the role of heat storage term and surface heterogeneity in surface energy balance at these sites. Spectrum analysis shows a sharp roll-off at the low frequency in co-spectrum, which indicates that low-frequency motions do not significantly contribute to turbulent fluxes. Both the spectra and co-spectra in unstable conditions show a broad peak indicating the influence of multiple sizes of large eddies over heterogeneous sites. Most of ogive curves for the kinematic latent and sensible heat fluxes reach an asymptote within 30 minutes regardless of the EBR value, indicating that low frequency motion is not a main factor for energy imbalance. However, stationary eddies due to landscape heterogeneity still remains as a possible cause for energy imbalance.

Kim, Soojin; Lee, Young-Hee; Kim, Kyu Rang; Park, Young-San

2014-10-01

380

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

381

The importance of the vaginal delivery route for antiretrovirals in HIV prevention  

PubMed Central

The HIV/AIDS pandemic continues to be a global health priority, with high rates of new HIV-1 infections persisting in young women. One HIV prevention strategy is topical pre-exposure prophylactics or microbicides, which are applied vaginally or rectally to protect the user from HIV and possibly other sexually transmitted infections. Vaginal microbicide delivery will be the focus of this review. Multiple nonspecific and specific antiretroviral microbicide products have been clinically evaluated, and many are in preclinical development. The events of HIV mucosal transmission and dynamics of the cervicovaginal environment should be considered for successful vaginal microbicide delivery. Beyond conventional vaginal formulations, intravaginal rings, tablets and films are employed as platforms in the hope to increase the likelihood of microbicide use. Furthermore, combining multiple antiretrovirals within a given formulation, combining a microbicide product with a vaginal device and integrating novel drug-delivery strategies within a microbicide product are approaches to successful vaginal-microbicide delivery. PMID:22468220

Ferguson, Lindsay M; Rohan, Lisa Cencia

2012-01-01

382

Closure of post-laryngectomy pharyngocutaneous fistulae  

PubMed Central

Background Closure of salvage laryngectomy defects with vascularized tissue remains controversial. Methods We evaluate outcomes in patients who required repair of a fistula after attempted primary closure of salvage laryngectomy defect and assess risk factors for persistent fistula. Between 2001 and 2010, 20 patients were treated for pharyngocutaneous fistulae after primary closure of a salvage laryngectomy. All patients required free flap repair for definitive fistula management. Results Patients presented with fistulae from one to 18 months in duration; median time to closure was seven days. Radial forearm free flap was used in 86% of patients. With free flap alone 50% of patients achieved fistula closure. Additional procedures improved closure rate to 85%. Recipient vessels were used in the neck in 54.5%, compared to internal mammary vessels in 45.5%. Hypothyroidism was identified as a risk factor for persistent fistula (p = 0.01). Chronic steroid use (p = 0.08) did not reach significance as a risk factor for fistula closure. Gastroesophageal reflux disease was newly diagnosed or noted as a comorbidity in 14 patients (70%) in this study. It did not reach statistical significance as a risk factor in refistulization (p = 0.12). Complications included leak, carotid blowout, infection, free flap loss, and late refistulization. Overall flap failure in this study was 4.5%. Conclusions Delayed secondary repair of pharygocutaneous fistulas after salvage laryngectomy is associated with a higher complication rate and poor success rates compared to use of vascularized tissue at the time of salvage laryngectomy. Prolonged wound healing in these patients is associated with hypothyroidism. PMID:21615952

2011-01-01

383

An eddy closure for potential vorticity  

SciTech Connect

The Gent-McWilliams (GM) parameterization is extended to include a direct influence in the momentum equation. The extension is carried out in two stages; an analysis of the inviscid system is followed by an analysis of the viscous system. In the inviscid analysis the momentum equation is modified such that potential vorticity is conserved along particle trajectories following a transport velocity that includes the Bolus velocity in a manner exactly analogous to the continuity and tracer equations. In addition (and in contrast to traditional GM closures), the new formulation of the inviscid momentum equation results in a conservative exchange between potential and kinetic forms of energy. The inviscid form of the eddy closure conserves total energy to within an error proportional to the time derivative of the Bolus velocity. The hypothesis that the viscous term in the momentum equation should give rise to potential vorticity being diffused along isopycnals in a manner analogous to other tracers is examined in detail. While the form of the momentum closure that follows from a strict adherence to this hypothesis is not immediately interpretable within the constructs of traditional momentum closures, three approximations to this hypothesis results in a form of dissipation that is consistent with traditional Laplacian diffusion. The first two approximations are that relative vorticity, not potential vorticity, is diffused along isopyncals and that the flow is in approximate geostrophic balance. An additional approximation to the Jacobian term is required when the dissipation coefficient varies in space. More importantly, the critique of this hypothesis results in the conclusion that the viscosity parameter in the momentum equation should be identical to the tradition GM closure parameter {Kappa}. Overall, we deem the viscous form of the eddy closure for potential vorticity as a viable closure for use in ocean circulation models.

Ringler, Todd D [Los Alamos National Laboratory

2009-01-01

384

40 CFR 264.310 - Closure and post-closure care.  

Code of Federal Regulations, 2012 CFR

...a) At final closure of the landfill or upon closure of any cell...or operator must cover the landfill or cell with a final cover...liquids through the closed landfill; (2) Function with minimum...2) Continue to operate the leachate collection and removal...

2012-07-01

385

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...closure and post-closure care requirements that apply to landfills (§ 264.310). (c)(1) The owner or operator of...

2013-07-01

386

40 CFR 264.310 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...a) At final closure of the landfill or upon closure of any cell...or operator must cover the landfill or cell with a final cover...liquids through the closed landfill; (2) Function with minimum...2) Continue to operate the leachate collection and removal...

2013-07-01

387

40 CFR 264.310 - Closure and post-closure care.  

Code of Federal Regulations, 2010 CFR

...a) At final closure of the landfill or upon closure of any cell...or operator must cover the landfill or cell with a final cover...liquids through the closed landfill; (2) Function with minimum...2) Continue to operate the leachate collection and removal...

2010-07-01

388

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2011 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...closure and post-closure care requirements that apply to landfills (§ 264.310). (c)(1) The owner or operator of...

2011-07-01

389

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2010 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...closure and post-closure care requirements that apply to landfills (§ 264.310). (c)(1) The owner or operator of...

2010-07-01

390

40 CFR 264.258 - Closure and post-closure care.  

Code of Federal Regulations, 2012 CFR

...and structures and equipment contaminated with waste and leachate, and manage them as hazardous waste unless § 261.3(d...closure and post-closure care requirements that apply to landfills (§ 264.310). (c)(1) The owner or operator of...

2012-07-01

391

40 CFR 264.310 - Closure and post-closure care.  

Code of Federal Regulations, 2011 CFR

...a) At final closure of the landfill or upon closure of any cell...or operator must cover the landfill or cell with a final cover...liquids through the closed landfill; (2) Function with minimum...2) Continue to operate the leachate collection and removal...

2011-07-01

392

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

393

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

394

In search of sexual pleasure and fidelity: vaginal practices in KwaZulu?Natal, South Africa  

Microsoft Academic Search

Vaginal practices, such as intra?vaginal cleansing, drying and tightening, are suspected of placing women at higher risk of acquiring HIV and STIs. Yet, there is limited understanding of what these practices entail, what motivates women to undertake them and what their socio?cultural and historical meanings are. This paper explores the range of vaginal practices used by women in KwaZulu?Natal, South

Fiona Scorgie; Busisiwe Kunene; Jennifer A. Smit; Ntsiki Manzini; Matthew F. Chersich

2009-01-01

395

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

Microsoft Academic Search

A 7-year-old girl with foul-smelling, bloody vaginal discharge for more than 2 years was initially suspected of suffering\\u000a from vaginal foreign bodies. Although plain radiography revealed no abnormal findings in the pelvis, magnetic resonance imaging\\u000a (MRI) showed multiple low intensity objects and an intact vaginal wall. Four plastic toys were removed with forceps under\\u000a general anesthesia. MRI is supposed to

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

2001-01-01

396

In vivo evaluation of an in-situ hydrogel system for vaginal administration.  

PubMed

The vaginal retention and local irritation of a carrageenan, poloxamer 407 and carbopol-based thermosensitive hydrogel system for vaginal drug delivery was assessed. Results showed that the residence of hydrogel in the mouse vagina following intravaginal administration was prolonged by carrageenan and further prolonged by the addition of a mucoadhesive component (carbopol). The optimal hydrogel formulation was proven to be safe for vaginal use in rabbits. PMID:24974582

Li, Chenxi; Han, Cong; Zhu, Yan; Lu, Weiyue; Li, Qiuhong; Liu, Yu

2014-06-01

397

Cloud condensation nuclei closure study on summer arctic aerosol  

NASA Astrophysics Data System (ADS)

We present an aerosol - cloud condensation nuclei (CCN) closure study on summer high Arctic aerosol based on measurements that were carried out in 2008 during the Arctic Summer Cloud Ocean Study (ASCOS) on board the Swedish ice breaker Oden. The data presented here were collected during a three-week time period in the pack ice (>85° N) when the icebreaker Oden was moored to an ice floe and drifted passively during the most biological active period into autumn freeze up conditions. CCN number concentrations were obtained using two CCN counters measuring at different supersaturations. The directly measured CCN number concentration was then compared with a CCN number concentration calculated using both bulk aerosol mass composition data from an aerosol mass spectrometer (AMS) and aerosol number size distributions obtained from a differential mobility particle sizer, assuming ?-Köhler theory, surface tension of water and an internally mixed aerosol. The last assumption was supported by measurements made with a hygroscopic tandem differential mobility analyzer (HTDMA) for particles >70 nm. For the two highest measured supersaturations, 0.73 and 0.41%, closure could not be achieved with the investigated settings concerning hygroscopicity and density. The calculated CCN number concentration was always higher than the measured one for those two supersaturations. This might be caused by a relative larger insoluble organic mass fraction of the smaller particles that activate at these supersaturations, which are thus less good CCN than the larger particles. On average, 36% of the mass measured with the AMS was organic mass. At 0.20, 0.15 and 0.10% supersaturation, closure could be achieved with different combinations of hygroscopic parameters and densities within the uncertainty range of the fit. The best agreement of the calculated CCN number concentration with the observed one was achieved when the organic fraction of the aerosol was treated as nearly water insoluble (?org=0.02), leading to a mean total ?, ?tot, of 0.33 ± 0.13. However, several settings led to closure and ?org=0.2 is found to be an upper limit at 0.1% supersaturation. ?org?0.2 leads to a ?tot range of 0.33 ± 013 to 0.50 ± 0.11. Thus, the organic material ranges from being sparingly soluble to effectively insoluble. These results suggest that an increase in organic mass fraction in particles of a certain size would lead to a suppression of the Arctic CCN activity.

Martin, M.; Chang, R. Y.-W.; Sierau, B.; Sjogren, S.; Swietlicki, E.; Abbatt, J. P. D.; Leck, C.; Lohmann, U.

2011-11-01

398

The Effects of School Closures on Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies  

PubMed Central

Background School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies. Objectives To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies. Methods We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns. Results School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number <2), and if attack rates were higher in children than in adults. The cumulative attack rate was expected to change less than the peak, but quantitative predictions varied (e.g. reductions in the peak were frequently 20–60% but some studies predicted >90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns. Conclusions Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions. PMID:24830407

Jackson, Charlotte; Mangtani, Punam; Hawker, Jeremy; Olowokure, Babatunde; Vynnycky, Emilia

2014-01-01

399

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

400

Early pregnancy diagnosis by vaginal pressures and cervical smears in the bovine  

E-print Network

- seminating catheter and a clean dry glass vaginal speculum. Care was exercised to avoid any mucous contamira tion from ths vaginal wall or the vulva. A head lamg was used in collecting the mucus to illuminate the cervt. cal opening and every precaution...- seminating catheter and a clean dry glass vaginal speculum. Care was exercised to avoid any mucous contamira tion from ths vaginal wall or the vulva. A head lamg was used in collecting the mucus to illuminate the cervt. cal opening and every precaution...

Ghannam, Samir A. M

2012-06-07

401

Bardet-Biedl syndrome associated with vaginal atresia: a case report.  

PubMed

This is a case report of Bardet-Biedl syndrome associated with vaginal atresia diagnosed in a 15-year-old girl. She had mild mental retardation; obesity; nistagmus, retinitis pigmentosa and optic atrophy in both eyes; accessory digit on the left hand; polydactyly in lower extremities; a mobile, painful, nonfixed mass of 6 cm in diameter in the pelvic region; a palpable cystic mass in front of the rectal wall; and no vaginal opening. Secondary sex characteristics were determined. The vaginal atresia was distinguished from vaginal agenesis by the presence of proximal vagina in radiological examination. PMID:14696812

U?uralp, Sema; Demircan, Mehmet; Cetin, Selma; Si?irci, Ahmet

2003-01-01

402

Taking Closure to the Next Level - 13030  

SciTech Connect

The River Corridor Closure Project (RCCP) is the Hanford Site's first closure project and when it is complete, in 2015, it will have cleaned up 220 mi{sup 2} of contaminated land adjacent to the Columbia River. Washington Closure Hanford (WCH) was selected by the DOE to manage the removal and cleanup of Hanford's nuclear legacy along the River Corridor. Work began in 2005 and is now more than 85% complete with more than 2 years left in the contract. A Closure Team was commissioned in December 2009 and has since issued a closure strategy and a disciplined three-phase approach to transition land parcels to DOE, Richland Operations Office (DOE-RL) as cleanup is completed. This process supports DOE-RL objectives for progressive footprint reduction based on the division of the River Corridor into geographical land parcels. It also allows for incremental area-by-area transition and turnover to the Long-Term Stewardship program. Several important milestones stand between now and the successful end of the RCCP. They include overall funding impacts, working with DOE-RL on new scope additions, meeting regulatory milestones, and maintaining a strong safety performance. (authors)

Feist, E.T. [Washington Closure Hanford, 2620 Fermi Avenue, Richland, WA, 99354 (United States)] [Washington Closure Hanford, 2620 Fermi Avenue, Richland, WA, 99354 (United States)

2013-07-01

403

Space Station evolution study oxygen loop closure  

NASA Technical Reports Server (NTRS)

In the current Space Station Freedom (SSF) Permanently Manned Configuration (PMC), physical scars for closing the oxygen loop by the addition of oxygen generation and carbon dioxide reduction hardware are not included. During station restructuring, the capability for oxygen loop closure was deferred to the B-modules. As such, the ability to close the oxygen loop in the U.S. Laboratory module (LAB A) and the Habitation A module (HAB A) is contingent on the presence of the B modules. To base oxygen loop closure of SSF on the funding of the B-modules may not be desirable. Therefore, this study was requested to evaluate the necessary hooks and scars in the A-modules to facilitate closure of the oxygen loop at or subsequent to PMC. The study defines the scars for oxygen loop closure with impacts to cost, weight and volume and assesses the effects of byproduct venting. In addition, the recommended scenarios for closure with regard to topology and packaging are presented.

Wood, M. G.; Delong, D.

1993-01-01

404

Hanford Patrol Academy demolition sites closure plan  

SciTech Connect

The Hanford Site is owned by the U.S. Government and operated by the U.S. Department of Energy, Richland Operations Office. Westinghouse Hanford Company is a major contractor to the U.S. Department of Energy, Richland Operations Office and serves as co-operator of the Hanford Patrol Academy Demolition Sites, the unit addressed in this paper. This document consists of a Hanford Facility Dangerous Waste Part A Permit Application, Form 3 (Revision 4), and a closure plan for the site. An explanation of the Part A Form 3 submitted with this closure plan is provided at the beginning of the Part A section. This Hanford Patrol Academy Demolition Sites Closure Plan submittal contains information current as of December 15, 1994.

Not Available

1993-09-30

405

Closure device for lead-acid batteries  

DOEpatents

A closure device for lead-acid batteries includes a filter of granulated activated carbon treated to be hydrophobic combined with means for preventing explosion of emitted hydrogen and oxygen gas. The explosion prevention means includes a vertical open-end tube within the closure housing for maintaining a liquid level above side wall openings in an adjacent closed end tube. Gases vent from the battery through a nozzle directed inside the closed end tube against an impingement surface to remove acid droplets. The gases then flow through the side wall openings and the liquid level to quench any possible ignition prior to entering the activated carbon filter. A wick in the activated carbon filter conducts condensed liquid back to the closure housing to replenish the liquid level limited by the open-end tube.

Ledjeff, Konstantin (Schwalbach, DE)

1983-01-01

406

Vaginal Extrusion of Transobturator Tape 6 Years after Procedure: How Long Should Be the Follow-Up Period after Vaginal Sling Surgeries?  

PubMed Central

A 77-year-old lady presented to the gynaecology outpatient clinic with vaginal extrusion (3C/T3/S1) six years after a transobturator suburethral sling procedure (TOT). The entire tape was spontaneously extruded vaginally and the vaginal erosion healed with conservative management. Midurethral tapes, currently the standard of care in the management of urodynamic stress incontinence (USI), are associated with a risk of erosion and extrusion of the synthetic material. The present case highlights the importance of the long-term followup after any sling procedure as erosion and/or extrusion may arise at any time following the procedure. PMID:23227380

Singh, Chanchal; Weng, Roy Ng Kwok

2012-01-01

407

The benefit of atrial septal defect closure in elderly patients*  

PubMed Central

Objective Closure of an atrial septal defect in elderly patients is controversial. The aim of the study was to evaluate the outcomes of transcatheter closure of secundum atrial septal defects (ASDs) in elderly patients. Patients and methods From a total of 488 patients with ASDs who underwent transcatheter closure, 75 patients aged over 60 years (45 female, 30 male) with a mean age of 65.3±15.7 (60–75) years were analyzed. All patients had an isolated secundum ASD with a mean pulmonary blood flow:systemic blood flow of 2.84±1.9 (1.5–3.9). Symptom-limited treadmill exercise tests with respiratory gas-exchange analysis and transthoracic color Doppler echocardiographic study, as well as quality of life measured using the Short Form (36) Health Survey (SF-36) were repeated in all patients before the procedure and after 12 months of follow-up. Results The atrial septal device was successfully implanted in all patients (procedure time 37.7±4.5 [13–59] minutes, fluoroscopy time 11.2±9.9 [6–40] minutes). There were no major complications. The defect echo diameter was 17.7±15.8 (12–30) mm. The mean balloon-stretched diameter of ASDs was 22.4±7.9 (14–34) mm. The diameter of the implanted devices ranged from 16 to 34 mm. Significant improvement of exercise capacity was noted at 6 and 12 months after the procedure. Exercise time within 6 months of ASD closure was longer (P<0.001) compared to baseline values, and also oxygen consumption increased (P<0.001). Seven quality-of-life parameters (except mental health) improved at 12-month follow-up compared to baseline data. The mean SF-36 scale increased significantly in 66 (88%) patients, with a mean of 46.2±19.1 (5–69). As early as 1 month after the procedure, a significant decrease of the right ventricular dimension and the right atrium dimension was observed (P<0.001). The right ventricular dimension decreased in 67 patients (89.3%). Conclusion Closure of ASDs in elderly patients caused significant clinical and hemodynamic improvement after percutaneous treatment, which was maintained during long-term follow-up, justifying this procedure in old age. PMID:25075179

Komar, Monika; Przewlocki, Tadeusz; Olszowska, Maria; Sobien, Bartosz; Podolec, Piotr

2014-01-01

408

Final Clean Closure Report Site 300 Surface Impoundments Closure Lawrence Livermore National Laboratory Livermore, California  

SciTech Connect

Lawrence Livermore National Laboratory operated two Class II surface impoundments that stored wastewater that was discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater was the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners were nearing the end of their service life. The purpose of this project was to clean close the surface impoundments and provide new wastewater storage using above ground storage tanks at six locations. The tanks were installed and put into service prior to closure of the impoundments. This Clean Closure Report (Closure Report) 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 Closure Report provides the following information: (1) a brief site description; (2) the regulatory requirements relevant to clean closure of the impoundments; (3) the closure procedures; and (4) the findings and documentation of clean closure.

Haskell, K

2006-02-14

409

Investigation of closure approximations for fiber orientation distribution in contracting turbulent flow  

Microsoft Academic Search

We have investigated the orientation state of a dilute fiber suspension flow in a planar contraction at high Reynolds numbers in turbulent flow. High speed imaging is used to directly measure the orientation distribution function at different downstream positions along the contraction centerline. The results from the direct measurement of the orientation distribution are used to evaluate the existing closure

Mehran Parsheh; Matthew L. Brown; Cyrus K. Aidun

2006-01-01

410

Pharmacokinetic and Safety Analyses of Tenofovir and Tenofovir-Emtricitabine Vaginal Tablets in Pigtailed Macaques  

PubMed Central

Vaginal rapidly disintegrating tablets (RDTs) containing tenofovir (TFV) or TFV and emtricitabine (FTC) were evaluated for safety and pharmacokinetics in pigtailed macaques. Two separate animal groups (n = 4) received TFV (10 mg) or TFV-FTC (10 mg each) RDTs, administered near the cervix. A third group (n = 4) received 1 ml TFV gel. Blood plasma, vaginal tissue biopsy specimens, and vaginal fluids were collected before and after product application at 0, 0.5, 1, 4, and 24 h. A disintegration time of <30 min following vaginal application of the RDTs was noted, with negligible effects on local inflammatory cytokines, vaginal pH, and microflora. TFV pharmacokinetics were generally similar for both RDTs and gel, with peak median concentrations in vaginal tissues and vaginal secretions being on the order of 104 to 105 ng/g (147 to 571 ?M) and 106 ng/g (12 to 34 mM), respectively, at 1 to 4 h postdose. At 24 h, however, TFV vaginal tissue levels were more sustained after RDT dosing, with median TFV concentrations being approximately 1 log higher than those with gel dosing. FTC pharmacokinetics after combination RDT dosing were similar to those of TFV, with peak median vaginal tissue and fluid levels being on the order of 104 ng/g (374 ?M) and 106 ng/g (32 mM), respectively, at 1 h postdose with levels in fluid remaining high at 24 h. RDTs are a promising alternative vaginal dosage form, delivering TFV and/or FTC at levels that would be considered inhibitory to simian-human immunodeficiency virus in the macaque vaginal microenvironment over a 24-h period. PMID:24566178

Pereira, Lara E.; Friend, David R.; Garber, David A.; McNicholl, Janet M.; Hendry, R. Michael; Doncel, Gustavo F.

2014-01-01

411

Now You Hear Me, Now You Don't: Eyelid Closures as an Indicator of Auditory Task Disengagement  

PubMed Central

Study Objectives: Eyelid closures in fatigued individuals signify task disengagement in attention-demanding visual tasks. Here, we studied how varying degrees of eyelid closure predict responses to auditory stimuli depending on whether a participant is well rested or sleep deprived. We also examined time-on-task effects and how more and less vulnerable individuals differed in frequency of eye closures and lapses. Design: Six repetitions of an auditory vigilance task were performed in each of two sessions: rested wakefulness (RW) and total sleep deprivation (TSD) (order counterbalanced). Setting: Sleep laboratory. Participants: Nineteen healthy young adults (mean age: 22 ± 2.8 y; 11 males). Intervention: Approximately 24 h of TSD. Measurements and Results: Eyelid closure was rated on a 9-point scale (1 = fully closed to 9 = fully opened) using video segments time-locked to the auditory event. Eyes-open trials predominated during RW, but different degrees of eye closure were uniformly distributed during TSD. The frequency of lapses (response time > 800 ms or nonresponses) to auditory stimuli increased dramatically with greater degrees of eye closure, but the association was strong only during TSD. There were significant within-run time-on-task effects on eye closure and auditory lapses that were exacerbated by TSD. Participants who had more auditory lapses during TSD (more vulnerable) had greater variability in their eyelid closures. Conclusions: Eyelid closures are a strong predictor of auditory task disengagement in the sleep-deprived state but are less relevant during rested wakefulness. Individuals relatively more impaired in this auditory vigilance task during total sleep deprivation display oculomotor evidence for greater state instability. Citation: Ong JL; Asplund CL; Chia TTY; Chee MWL. Now you hear me, now you don't: eyelid closures as an indicator of auditory task disengagement. SLEEP 2013;36(12):1867-1874. PMID:24293761

Ong, Ju Lynn; Asplund, Christopher L.; Chia, Tiffany T. Y.; Chee, Michael W. L.

2013-01-01

412

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

413

The Anti-HIV Microbicide Candidate RC-101 Inhibits Pathogenic Vaginal Bacteria Without Harming Endogenous Flora or Mucosa  

PubMed Central

Problem Vaginal microbicides represent a promising approach for preventing heterosexual HIV transmission. However, preclinical evaluation should be conducted to ensure that microbicides will be safe for human cells and healthy microflora of the female reproductive tract. One microbicide candidate, RC-101, has been effective and well-tolerated in preliminary cell culture and macaque models. However, the effect of RC-101 on primary vaginal tissues and resident vaginal microflora requires further evaluation. Method of Study We treated primary vaginal tissues and vaginal bacteria, both pathogenic and commensal, with RC-101 to investigate effects of this microbicide. Results RC-101 was well-tolerated by host tissues, and also by commensal vaginal bacteria. Simultaneously, pathogenic vaginal bacteria, which are known to increase susceptibility to HIV acquisition, were inhibited by RC-101. Conclusions By establishing vaginal microflora, the specific antibacterial activity of RC-101 may provide a dual mechanism of HIV protection. These findings support advancement of RC-101 to clinical trials. PMID:23167830

Eade, Colleen R.; Cole, Amy L.; Diaz, Camila; Rohan, Lisa C.; Parniak, Michael A.; Marx, Preston; Tarwater, Patrick M.; Gupta, Phalguni; Cole, Alexander M.

2012-01-01

414

Regulation of natural antimicrobial defences in human vaginal epithelial cells  

Microsoft Academic Search

BackgroundThe involvement of natural antimicrobial peptides in infection-associated preterm birth is unknown. Our aim was to assess regulation by granulocyte-macrophage colony-stimulating factor, monocyte-chemotactic-protein-1 (GM-CSF and MCP-1, interleukin-1 (IL) and lipopolysaccharide (LPS) in cultured human vaginal epithelial cells.MethodsVK2\\/E6E7 cells were treated with IL-1, MCP-1 and GM-CSF (20\\/100\\/200\\/500 pg\\/ml and 1 ng\\/ml) at 2 h, 4 h, 6 h and 24 h

C Foster; E Chin-Smith; R Tribe

2011-01-01

415

[Postpartum hemorrhage by vaginal laseration: new case and improved management].  

PubMed

We describe a case of uterine necrosis, following Gelitaspon(®) embolization for postpartum hemorrhage resulting from vaginal laceration. Previous cases published help to improve the safety of this effective method by showing the risk factors, as particles sizes, ultraselective embolization, prevention of infection. Controlling bleeding by surgery is the priority when hemorragy is due to laceration without uterin atony. In case of failure, embolization is an option which should be proposed without delay. Uterine necrosis should be suspected in case of postembolization septic syndrome. PMID:23706157

Gitz, L; Picone, O; Mas, A-E; Dagher, L; Deffieux, X

2014-05-01

416

Vaginal birth after cesarean section in grand multiparous women  

Microsoft Academic Search

Objective.  To determine the rate, delivery outcome and safety of attempted vaginal birth after cesarean section (VBAC) in grand multiparous\\u000a women (para 6 or more).\\u000a \\u000a \\u000a \\u000a Methods.  This is a retrospective case-control study, performed at King Abdulaziz university hospital, the charts of 405 grand multiparous\\u000a women with previous caesarean section were reviewed to determine rate and delivery outcome of attempted VBAC. The outcome

Tarik Y. Yamani Zamzami

2004-01-01

417

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

418

Vaginal Discharge: An Approach to Diagnosis and Management  

PubMed Central

Vaginal discharge is a frequent presenting complaint in an office practice. The authors of this article review the most common causes of this condition, namely Candidiasis, Trichimoniasis, and Bacterial Vaginosis (Gardnerella), as well as the more serious causes, namely gonorrhea, chlamydia, and Herpes simplex. Symptoms and physical signs are generally insufficient to distinguish specific etiologic agents and, as treatment for each is different, diagnostic examination of smears in the office is critical to the management of these patients. A clinical approach and method of office diagnosis is described. PMID:21263805

Watson, William J.; DeMarchi, Gregory

1987-01-01

419

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; Nath, Manju E.