Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction-secondary analysis of a randomised trial.

PubMed

Kolberg Tennfjord, M; Hilde, G; Staer-Jensen, J; Siafarikas, F; Engh, M Ellström; Bø, K

2016-03-01

Evaluate effect of pelvic floor muscle training (PFMT) on vaginal symptoms and sexual matters, dyspareunia and coital incontinence in primiparous women stratified by major or no defects of the levator ani muscle. Randomised controlled trial (RCT). Akershus University Hospital, Norway. About 175 primiparous women with a singleton vaginal delivery. Two-armed assessor blinded parallel group RCT from 6 weeks to 6 months postpartum comparing effect of PFMT versus control. International Consultation on Incontinence Modular Questionnaire-vaginal symptoms questionnaire (ICIQ-VS) and ICIQ sexual matters module (ICIQ-FLUTSsex). Overall, analysis (n = 175) showed no difference between training and control groups in women having vaginal symptoms or symptoms related to sexual dysfunction 6 months postpartum. The majority of women (88%) had intercourse and there was no difference between groups. Unadjusted subgroup analysis of women with a major defect of the levator ani muscle (n = 55) showed that women in the training group had 45% less risk of having the symptom 'vagina feels loose or lax' compared with the control group (relative risk 0.55, 95% confidence interval 0.31, 0.95; P = 0.03). Unadjusted analysis showed that in women with major defect of the levator ani muscle, significantly fewer in the training group had the symptom 'vagina feels loose or lax' compared with the control group. No difference was found between groups for symptoms related to sexual dysfunction. More studies are needed to explore effect of PFMT on vaginal symptoms and sexual dysfunction. Unadjusted analysis shows that PFMT might prevent symptoms of 'vagina feels loose or lax'. © 2015 Royal College of Obstetricians and Gynaecologists.

Coital incontinence and vaginal symptoms and the relationship to pelvic floor muscle function in primiparous women at 12 months postpartum: a cross-sectional study.

PubMed

Tennfjord, Merete Kolberg; Hilde, Gunvor; Stær-Jensen, Jette; Siafarikas, Franziska; Engh, Marie Ellström; Bø, Kari

2015-04-01

Symptoms related to sexual dysfunction postpartum are scarcely addressed in the literature, and the relationship to pelvic floor muscle (PFM) function is largely unknown. The aim of this study was to investigate primiparous women 12 months postpartum and study: (i) prevalence and bother of coital incontinence, vaginal symptoms, and sexual matters; and (ii) whether coital incontinence and vaginal symptoms were associated with vaginal resting pressure (VRP), PFM strength, and endurance. International Consultation on Incontinence Modular Questionnaire (ICIQ) sexual matters module and ICIQ-Vaginal Symptoms Questionnaire were used for questions on coital incontinence, vaginal symptoms, and sexual matters, respectively. PFM function was assessed by manometer (Camtech AS, Sandvika, Norway). Coital incontinence, vaginal symptoms, and PFM function were the main outcome measures. One hundred seventy-seven primiparous women, mean age 28.7 (standard deviation [SD] 4.3) participated. Of the 94% of women having sexual intercourse, coital incontinence was found for 1.2% whereas 34.5% reported at least one vaginal symptom interfering with the sexual life of primiparous women. Of the symptoms investigated, "vagina feels dry," "vagina feels sore," and "vagina feels loose or lax" were most prevalent, but the overall impact on the woman's sexual life was minimally bothersome, mean 1.4 out of 10 (SD 2.5). Women reporting "vagina feels loose or lax" had lower VRP, PFM strength, and endurance when compared with women without the symptom. Twelve-month postpartum coital incontinence was rare, whereas the prevalence of vaginal symptoms interfering with sexual life was more common. The large majority of primiparous women in our study had sexual intercourse at 12 months postpartum and the reported overall bother on sexual life was low. Women reporting "vagina feels loose or lax" had lower VRP, PFM strength, and endurance when compared with women without the symptom. © 2015 International

Visual improvements in vaginal mucosa correlate with symptoms of VVA: data from a double-blind, placebo-controlled trial.

PubMed

Simon, James A; Archer, David F; Kagan, Risa; Bernick, Brian; Graham, Shelli; Constantine, Ginger D; Mirkin, Sebastian

2017-09-01

To evaluate the response of the vaginal mucosa with TX-004HR and its correlation with vulvar and vaginal atrophy (VVA) symptoms, and whether visual examination is a useful measure for assessing VVA. REJOICE was a 12-week, phase 3, multicenter, randomized, double-blind, placebo-controlled study of a vaginal, muco-adhesive, 17β-estradiol softgel capsule (TX-004HR 4, 10, and 25 μg) in postmenopausal women with VVA and moderate-to-severe dyspareunia. Treatments were self-administered vaginally once per day for 2 weeks, then twice per week for 10 weeks. The vagina was visually examined at baseline and at weeks 2, 6, 8, and 12; changes were evaluated using a 4-item scale for vaginal color, vaginal epithelial integrity, vaginal epithelial surface thickness, and vaginal secretions. Significant improvements were observed with all three TX-004HR doses versus placebo in vaginal color (least square mean score changes of -0.96 to -1.06 for TX-004HR doses vs -0.60 for placebo at week 12), epithelial integrity (-0.97 to -1.07 vs -0.60), epithelial surface thickness (-0.94 to -1.03 vs -0.61), and secretions (-1.01 to -1.06 vs -0.64) (P < 0.001 for all comparisons at all time points). Both Pearson's correlations and logistic regression receiver-operating characteristic curve analyses significantly correlated the sum of the individual visual assessment scores with dyspareunia (P < 0.0001) and vaginal dryness (P < 0.0001) at 12 weeks. Greater improvements in the vaginal mucosa of postmenopausal women with VVA and moderate-to-severe dyspareunia were observed with TX-004HR versus placebo, and vaginal mucosa assessment scores correlated with vaginal symptoms of dyspareunia and dryness. Visual vaginal assessment by healthcare professionals is a useful measure for diagnosing VVA and assessing response to treatment.

Menopause and the vaginal microbiome.

PubMed

Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

2016-09-01

For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Formation of Galactic Bulges

NASA Astrophysics Data System (ADS)

Carollo, C. Marcella; Ferguson, Henry C.; Wyse, Rosemary F. G.

2000-03-01

Part I. Introduction: What are galactic bulges?; Part II. The Epoch of Bulge Formation: Origin of bulges; Deep sub-mm surveys: High-z ULIRGs and the formation of spheroids; Ages and metallicities for stars in the galactic bulge; Integrated stellar populations of bulges: First results; HST-NICMOS observations of galactic bulges: Ages and dust; Inside-out bulge formation and the origin of the Hubble sequence; Part III. The Timescales of Bulge Formation: Constraints on the bulge formation timescale from stellar populations; Bulge building with mergers and winds; Role of winds, starbursts, and activity in bulge formation; Dynamical timescales of bulge formation; Part IV. Physical Processes in Bulge Formation: the role of bars for secular bulge formation; Bars and boxy/peanut-shaped bulges: an observational point of view; Boxy- and peanut-shaped bulges; A new class of bulges; The role of secondary bars in bulge formation; Radial transport of molecular gas to the nuclei of spiral galaxies; Dynamical evolution of bulge shapes; Two-component stellar systems: Phase-space constraints; Central NGC 2146 - a firehose-type bending instability?; Bulge formation: the role of the multi-phase ISM; Global evolution of a self-gravitating multi-phase ISM in the central kpc region of galaxies; Part V. Bulge Phenomenology: Bulge-disk decomposition of spiral galaxies in the near-infrared; The triaxial bulge of NGC 1371; The bulge-disk orthogonal decoupling in galaxies: NGC 4698 and NGC 4672; The kinematics and the origin of the ionized gas in NGC 4036; Optically thin thermal plasma in the galactic bulge; X-ray properties of bulges; The host galaxies of radio-loud AGN; The centers of radio-loud early-type galaxies with HST; Central UV spikes in two galactic spheroids; Conference summary: where do we stand?

The most bothersome symptom of vaginal atrophy: Evidence from the observational AGATA study.

PubMed

Palma, Federica; Xholli, Anjeza; Cagnacci, Angelo

2018-02-01

Vaginal atrophy (VA) is a chronic medical condition. It is managed unsatisfactorily, despite its high prevalence and negative impact on female quality of life. In order to meet their needs, it would be useful to know what women perceive to be the most bothersome symptom (MBS) of VA. Cross-sectional, multicenter study of 913 postmenopausal women consulting 22 gynecological outpatient services. Prevalence of the MBS perceived by postmenopausal women of different age and vaginal condition. Vaginal dryness was the most prevalent MBS (54.4%), followed by dyspareunia (17.6%), itching (7.8%), dysuria (5.9%) and burning (2.0%). The prevalence of vaginal dryness as the MBS increased with years since menopause, while that of itching, dysuria and burning remained approximately constant over time. The prevalence of dyspareunia as the MBS was 26.2% in the first 6 years after menopause and declined thereafter, to 8.8%. Among all postmenopausal women vaginal dryness per se, independent of dyspareunia, is the most commonly reported MBS. In each woman, the identification of the MBS may help to define more appropriate VA management. Copyright © 2017. Published by Elsevier B.V.

Yeast Infection (Vaginal)

MedlinePlus

Yeast infection (vaginal) Overview A vaginal yeast infection is a fungal infection that causes irritation, discharge and intense itchiness ... symptoms Causes The fungus candida causes a vaginal yeast infection. Your vagina naturally contains a balanced mix of yeast, including ...

Clothing factors and vaginitis.

PubMed

Heidrich, F E; Berg, A O; Bergman, J J

1984-10-01

Associations of clothing factors and vulvovaginal symptoms, signs, and microbiology were sought in 203 women seeking care at a university family medicine clinic. Clothing factors studied were use of panty hose, underwear for sleep, cotton lining panels, and pants vs skirts. Women wearing and not wearing panty hose had similar rates of vaginitis symptoms and signs, but yeast vaginitis was about three times more common among wearers. Relationships of other clothing factors to vaginitis were not found. Nonspecific vaginitis was not found to be related to clothing.

Comparing Serum Follicle-Stimulating Hormone (FSH) Level with Vaginal PH in Women with Menopausal Symptoms.

PubMed

Vahidroodsari, Fatemeh; Ayati, Seddigheh; Yousefi, Zohreh; Saeed, Shohreh

2010-01-01

Despite the important implication for women's health and reproduction, very few studies have focused on vaginal PH for menopausal diagnosis. Recent studies have suggested vaginal PH as a simple, noninvasive and inexpensive method for this purpose. The aim of this study is to compare serum FSH level with vaginal PH in menopause. This is a cross-sectional, descriptive study, conducted on 103 women (aged 31-95 yrs) with menopausal symptoms who were referred to the Menopausal Clinic at Ghaem Hospital during 2006. Vaginal pH was measured using pH meter strips and serum FSH levels were measured using immunoassay methods. The data was analyzed using SPSS software (version 11.5) and results were evaluated statistically by the Chi-square and Kappa tests. p≤0.05 was considered statistically significant. According to this study, in the absence of vaginal infection, the average vaginal pH in these 103 menopausal women was 5.33±0.53. If the menopausal hallmark was considered as vaginal pH>4.5, and serum FSH as ≥20 mIU/ml, then the sensitivity of vaginal pH for menopausal diagnosis was 97%. The mean of FSH levels in this population was 80.79 mIU/ml. Vaginal pH is a simple, accurate, and cost effective tool that can be suggested as a suitable alternative to serum FSH measurement for the diagnosis of menopause.

Management of vaginal extrusion after tension-free vaginal tape procedure for urodynamic stress incontinence.

PubMed

Giri, Subhasis K; Sil, Debasri; Narasimhulu, Girish; Flood, Hugh D; Skehan, Mark; Drumm, John

2007-06-01

To report our experience in the management of vaginal extrusion after the tension-free vaginal tape (TVT) procedure for urodynamic stress incontinence. Five patients diagnosed with vaginal extrusion after a TVT procedure performed at our institution were identified. We reviewed the patients' records retrospectively. The interval from TVT placement to diagnosis, presenting symptoms and signs, duration of symptoms, diagnostic test findings, treatment, and postoperative results were recorded. Patients were followed up for at least 12 months. From January 2001 to June 2004, a total of 166 patients underwent the TVT procedure. Of these, 5 patients (3%) were diagnosed with isolated vaginal extrusion 4 to 40 months postoperatively. No cases of urethral or bladder erosion occurred in this series. The symptoms included vaginal discharge, pain, bleeding, and dyspareunia. The eroded margin of the vaginal mucosa was trimmed, mobilized, and closed over the tape with interrupted vertical mattress sutures in a single layer using 2-0 polyglactin 910 to avoid mucosal inversion. All patients remained symptom free without any evidence of defective healing or additional extrusion at a minimal follow-up of 12 months. Primary reclosure of the vaginal mucosa over the TVT tape is an effective first-line treatment option for vaginal extrusion without compromising continence. Patients undergoing the TVT procedure should be adequately counseled about the possibility of this complication and the available treatment options.

Evaluation of vaginal complaints.

PubMed

Anderson, Matthew R; Klink, Kathleen; Cohrssen, Andreas

2004-03-17

Vaginal symptoms are one of the most common reasons for gynecological consultation. Clinicians have traditionally diagnosed vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis using some combination of physical examination, pH, the wet mount, and the whiff test. To evaluate the role of the clinical examination and determine the positive and negative likelihood ratios (LRs) for the diagnosis of vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis. Using a structured literature review, we abstracted information on sensitivity and specificity for symptoms, signs, and office laboratory procedures. We chose published (1966 to April 2003) articles that appeared in the MEDLINE database and were indexed under the combined search terms of diagnosis with vaginitis, vaginal discharge, candidiasis, bacterial vaginosis, and trichomoniasis. Included studies of symptomatic premenopausal women seen in primary care settings. Tests were evaluated only if they would provide diagnostic information during the office visit and were compared with an acceptable criterion standard. All 3 authors extracted the data and computed sensitivity and specificity from each article independently. The absence of standard definitions for symptoms and signs made it impossible to combine results across studies. Symptoms alone do not allow clinicians to distinguish confidently between the causes of vaginitis. However, a patient's lack of itching makes candidiasis less likely (range of LRs, 0.18 [95% confidence interval [CI], 0.05-0.70] to 0.79 [95% CI, 0.72-0.87]) and lack of perceived odor makes bacterial vaginosis unlikely (LR, 0.07 [95% CI, 0.01-0.51]). Similarly, physical examination signs are limited in their diagnostic power. The presence of inflammatory signs is associated with candidiasis (range of LRs, 2.1 [95% CI, 1.5-2.8] to 8.4 [95% CI, 2.3-31]). Presence of a "high cheese" odor on examination is predictive of bacterial vaginosis (LR, 3.2 [95% CI, 2

Resolution of Rectal Prolapse by Vaginal Reconstruction.

PubMed

Devakumar, Hemikaa; Chandrasekaran, Neeraja; Alas, Alexandriah; Martin, Laura; Davila, G Willy; Hurtado, Eric

Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone. We present a novel case of rectal prolapse that resolved by correction of the vaginal defect. A 53-year-old female with prior history of abdominal hysterectomy, presented to the urogynecology clinic with complaints of vaginal bulge, urge urinary incontinence, and rectal bulge on straining with no fecal incontinence for several years. On physical examination, she was found to have stage 2 anterior, posterior, and apical vaginal prolapse and reducible rectal prolapse. Colorectal surgery (CRS) evaluation was requested, which revealed minimal anterior mucosal prolapse on Valsalva with no full-thickness prolapse. Magnetic resonance imaging (MRI) defecogram was performed, which demonstrated a large rectocele, enterocele, and small bowel prolapsing between the rectum and vagina during the evacuation phase, with no rectal prolapse. The decision to proceed with vaginal prolapse surgery without concomitant rectal prolapse repair was made, as the patient had no fecal incontinence, and the degree of rectal prolapse was minimal. On the day of surgery, which was 2 months later, she presented with a 2-cm anterior rectal prolapse with no incontinence. Colorectal surgery was consulted again, but unavailable. After counseling, the patient wished to proceed with her planned surgery. It was felt that correcting the anterior rectocele and enterocele, thereby eliminating the descent of the bowel on the anterior rectal wall, might cause

BULGES OF NEARBY GALAXIES WITH SPITZER: SCALING RELATIONS IN PSEUDOBULGES AND CLASSICAL BULGES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, David B.; Drory, Niv, E-mail: dbfisher@astro.as.utexas.ed

2010-06-20

We investigate scaling relations of bulges using bulge-disk decompositions at 3.6 {mu}m and present bulge classifications for 173 E-Sd galaxies within 20 Mpc. Pseudobulges and classical bulges are identified using Sersic index, Hubble Space Telescope morphology, and star formation activity (traced by 8 {mu}m emission). In the near-IR pseudobulges have n{sub b} < 2 and classical bulges have n{sub b} >2, as found in the optical. Sersic index and morphology are essentially equivalent properties for bulge classification purposes. We confirm, using a much more robust sample, that the Sersic index of pseudobulges is uncorrelated with other bulge structural properties, unlikemore » for classical bulges and elliptical galaxies. Also, the half-light radius of pseudobulges is not correlated with any other bulge property. We also find a new correlation between surface brightness and pseudobulge luminosity; pseudobulges become more luminous as they become more dense. Classical bulges follow the well-known scaling relations between surface brightness, luminosity, and half-light radius that are established by elliptical galaxies. We show that those pseudobulges (as indicated by Sersic index and nuclear morphology) that have low specific star formation rates are very similar to models of galaxies in which both a pseudobulge and classical bulge exist. Therefore, pseudobulge identification that relies only on structural indicators is incomplete. Our results, especially those on scaling relations, imply that pseudobulges are very different types of objects than elliptical galaxies.« less

Iliococcygeus fixation for the treatment of apical vaginal prolapse: efficacy and safety at 5 years of follow-up.

PubMed

Serati, Maurizio; Braga, Andrea; Bogani, Giorgio; Leone Roberti Maggiore, Umberto; Sorice, Paola; Ghezzi, Fabio; Salvatore, Stefano

2015-07-01

Sacrocolpopexy is considered the gold standard treatment for vaginal vault prolapse. However, the vaginal approach is very common, with 80-90 % of procedures being performed via this route. The aim of this study was to evaluate the safety and efficacy of iliococcygeus (ICG) fixation in the treatment of vaginal vault prolapse, with a minimum follow-up of 5 years. We prospectively enrolled women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥2) who were treated with ICG fixation. Subjective success was defined in the case of Patient Global Impression of Improvement ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse < 2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse < 2, and no need for other surgery. All women filled in the Prolapse Quality of Life (P-QOL) questionnaire both at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP. After a median (range) follow-up of 68.8 (60-92) months the subjective, objective, and overall cure rates were 88.6 % (39 out of 44), 84.1 % (37 out of 44), and 84.1 % (37 out of 44) respectively. Only preoperative stage IV vault descensus independently predicted POP recurrence after iliococcygeus fixation (OR: 8.78 [95 % CI: 1.31-9.42]; p < 0.001). Iliococcygeus fixation is a safe and effective surgical technique for the treatment of vaginal vault prolapse with long-lasting effectiveness.

Ablative dual-phase Erbium:YAG laser treatment of atrophy-related vaginal symptoms in post-menopausal breast cancer survivors omitting hormonal treatment.

PubMed

Mothes, A R; Runnebaum, M; Runnebaum, I B

2018-05-01

First evaluation of dual-phase vaginal Er:YAG laser to omit hormonal treatment for atrophy-related symptoms in post-menopausal breast cancer survivors following prolapse surgery. Patients with a history of breast cancer at the time of surgery for pelvic organ prolapse were offered non-hormonal vaginal Er:YAG laser treatment when complaining of atrophy-related genitourinary syndrome of menopause. A single 10-min course of dual-phase protocol of pulsed Er:YAG laser (2940 nm, fractional ablative and thermal mode, fluence according to tissue thickness). Follow-up included subjective satisfaction, vaginal pH, vaginal health index (VHI), and complications after 6 weeks. A total of 16 breast cancer survivors (age 71 years, SD 7) had been seeking treatment for pelvic floor symptoms related to vaginal atrophy at follow-up visits after prolapse surgery. All ablative vaginal Er:YAG laser outpatient procedures were successfully completed, all patients returned to daily activities without a need for analgetic medication. Evaluation was performed after 8.3 (SD 2.5) weeks. Pre-laser VHI scored 16 (SD 4.6) and post-laser VHI 20 (SD 3) with p = 0.01. Patients were satisfied in 94% (n = 15) regarding symptom relief. Breast cancer survivors with atrophy-related complaints after pelvic floor surgery may benefit from vaginal application of this innovative dual protocol of Er:YAG laser technology as a non-hormonal treatment approach.

KINEMATIC SIGNATURES OF BULGES CORRELATE WITH BULGE MORPHOLOGIES AND SERSIC INDEX

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fabricius, Maximilian H.; Saglia, Roberto P.; Bender, Ralf

2012-07-20

We use the Marcario Low Resolution Spectrograph at the Hobby-Eberly Telescope to study the kinematics of pseudobulges and classical bulges in the nearby universe. We present major axis rotational velocities, velocity dispersions, and h{sub 3} and h{sub 4} moments derived from high-resolution ({sigma}{sub inst} Almost-Equal-To 39 km s{sup -1}) spectra for 45 S0 to Sc galaxies; for 27 of the galaxies we also present minor axis data. We combine our kinematics with bulge-to-disk decompositions. We demonstrate for the first time that purely kinematic diagnostics of the bulge dichotomy agree systematically with those based on Sersic index. Low Sersic index bulgesmore » have both increased rotational support (higher v/{sigma} values) and on average lower central velocity dispersions. Furthermore, we confirm that the same correlation also holds when visual morphologies are used to diagnose bulge type. The previously noted trend of photometrically flattened bulges to have shallower velocity dispersion profiles turns out to be significant and systematic if the Sersic index is used to distinguish between pseudobulges and classical bulges. The anti-correlation between h{sub 3} and v/{sigma} observed in elliptical galaxies is also observed in intermediate-type galaxies, irrespective of bulge type. Finally, we present evidence for formerly undetected counter-rotation in the two systems NGC 3945 and NGC 4736.« less

Association of pregnancy and Candida vaginal colonization in women with or without symptoms of vulvovaginitis.

PubMed

Leli, C; Mencacci, A; Meucci, M; Bietolini, C; Vitali, M; Farinelli, S; D' Alò, F; Bombaci, J C; Perito, S; Bistoni, F

2013-06-01

Candida infection is one of the main causes of vulvovaginitis. The experience of symptoms of vulvovaginitis during pregnancy changes in relation to clinical, behavioral, and demographic factors. Candidiasis is associated with an increased risk of delivery complications. In some studies pregnant women are found more symptomatic than non-pregnant women, but in others a higher prevalence of asymptomatic infections is described during pregnancy. The aims of this study were to evaluate the prevalence of Candida vaginal colonization in pregnant women, and investigate if the occurrence of symptoms is influenced by pregnancy, in a population of Italian native and immigrant women. A total of 344 outpatients, who visited the laboratory for routine genital examination, independently of pregnancy or presence or absence of symptoms of vulvovaginitis, were evaluated. Colonization by Candida spp. was significantly higher in pregnant than non-pregnant patients (31.4% vs. 19.9%; χ2=5.59; P=0.018), nevertheless pregnant women were significantly more often asymptomatic compared to non-pregnant (46.5% vs. 16%; χ2=42.31; P<0.0001). In the sub-group of women colonized by Candida spp., pregnancy resulted significantly associated to asymptomatic infection (58.1% vs. 30.8%; χ2 =6.18; P=0.013). A binary logistic regression analysis showed pregnancy or lactobacilli colonization independently associated to a lower probability of experiencing symptoms of vulvovaginitis (respectively: P<0.0001 and P=0.008). Pregnancy seems to be independently associated to Candida spp. asymptomatic vaginal infection. Given that candidiasis has been associated with possible delivery complications, these results suggest to screen for Candida spp. vaginal colonization asymptomatic women during pregnancy.

Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

PubMed Central

Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

2015-01-01

Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors. PMID:25815692

Atrophic vaginitis in breast cancer survivors: a difficult survivorship issue.

PubMed

Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

2015-03-25

Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

Amine content of vaginal fluid from untreated and treated patients with nonspecific vaginitis.

PubMed Central

Chen, K C; Forsyth, P S; Buchanan, T M; Holmes, K K

1979-01-01

We examined the vaginal washings from patients with nonspecific vaginitis (NSV) to seek biochemical markers and possible explanations for the signs and symptoms of this syndrome. Seven amines were identified including methylamine, isobutylamine, putrescine, cadaverine, histamine, tyramine, and phenethylamine. These amines may contribute to the symptoms of NSV and may contribute to the elevated pH of the vaginal discharge. They may also be partly responsible for the "fishy" odor that is characteristic of vaginal discharges from these patients. Among the seven amines, putrescine and cadaverine were the most abundant and were present in all vaginal discharges from each of ten patients before treatment. These amines are produced in vitro during growth of mixed vaginal bacteria in chemically defined medium, presumably by decarboxylation of the corresponding amino acids. We hypothesize the anaerobic vaginal organisms, previously shown to be quantitatively increased in NSV, are responsible for the amine production, because metronidazole inhibited the production of amines by vaginal bacteria in vitro, and Haemophilus vaginalis did not produce amines. H. vaginalis did release high concentrations of pyruvic acid and of amino acids during growth in peptone-starch-dextrose medium, whereas, other vaginal flora consumed both pyruvic acid and amino acids in the same medium during growth. These findings suggest that a symbiotic relationship may exist between H. vaginalis and other vaginal flora in patients with NSV. Images PMID:447831

The effect of vaginal cream containing ginger in users of clotrimazole vaginal cream on vaginal candidiasis.

PubMed

Shabanian, Sheida; Khalili, Sima; Lorigooini, Zahra; Malekpour, Afsaneh; Heidari-Soureshjani, Saeid

2017-01-01

Vulvovaginal candidiasis is one of the most common infections of the genital tract in women that causes many complications. Therefore, we examined the clinical effect of ginger cream along with clotrimazole compared to vaginal clotrimazole alone in this study. This double-blind clinical trial was conducted on 67 women admitted to the Gynecology Clinic of Hajar Hospital with vaginal candidiasis. The patients were divided randomly into two groups of 33 and 34 people. The diagnosis was made according to clinical symptoms, wet smear, and culture. Ginger-clotrimazole vaginal cream 1% and clotrimazole vaginal cream 1% were administered to groups 1 and 2, respectively, once a day for 7 days and therapeutic effects and symptoms were evaluated in readmission. Data analysis was performed using SPSS version 22, t -test and Chi-square. The mean value of variables itching ( P > 0.05), burning ( P > 0.05), and cheesy secretion ( P < 0.05) in users of ginger-clotrimazole was less than the other group after the treatment. Recurrence in clotrimazole group was 48.5% and in ginger-clotrimazole group 51.2% during the 1-month follow-up with no significant difference. Study results showed that cream containing ginger and clotrimazole 1% was more effective and may be more useful than the clotrimazole to treat vaginal candidiasis.

Emphysematous vaginitis.

PubMed

Lima-Silva, Joana; Vieira-Baptista, Pedro; Cavaco-Gomes, João; Maia, Tiago; Beires, Jorge

2015-04-01

Emphysematous vaginitis is a rare condition, characterized by the presence of multiple gas-filled cysts in the vaginal and/or exocervical mucosa. Although its etiology is not completely understood, it is self-limited, with a benign clinical course. Vaginal discharge, sometimes bloody, and pruritus are the most common symptoms. Chronic and acute inflammation can be found, and diseases that impair the immune system and pregnancy have been associated with this condition. A 48-year-old postmenopausal woman, with a history of hysterectomy with several comorbidities, presented with a 4-month history of bloody discharge and vulvar pruritus. Examination showed multiple cystic lesions, 1 to 5 mm, occupying the posterior and right lateral vaginal walls. Speculum examination produced crepitus. Vaginal wet mount was normal, except for diminished lactobacilli; results of Trichomonas vaginalis DNA test and vaginal cultures were negative. Lugol's iodine applied to the vagina was taken up by the intact lesions. Biopsy result showed typical features of emphysematous vaginitis. This is an unusual entity, presenting with common gynecological complaints, and both physicians and pathologists should be aware to prevent misdiagnosis and overtreatment.

Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial.

PubMed

Jelovsek, J Eric; Barber, Matthew D; Brubaker, Linda; Norton, Peggy; Gantz, Marie; Richter, Holly E; Weidner, Alison; Menefee, Shawn; Schaffer, Joseph; Pugh, Norma; Meikle, Susan

2018-04-17

Uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) are commonly performed pelvic organ prolapse procedures despite a lack of long-term efficacy data. To compare outcomes in women randomized to (1) ULS or SSLF and (2) usual care or perioperative behavioral therapy and pelvic floor muscle training (BPMT) for vaginal apical prolapse. This 2 × 2 factorial randomized clinical trial was conducted at 9 US medical centers. Eligible participants who completed the Operations and Pelvic Muscle Training in the Management of Apical Support Loss Trial enrolled between January 2008 and March 2011 and were followed up 5 years after their index surgery from April 2011 through June 2016. Two randomizations: (1) BPMT (n = 186) or usual care (n = 188) and (2) surgical intervention (ULS: n = 188 or SSLF: n = 186). The primary surgical outcome was time to surgical failure. Surgical failure was defined as (1) apical descent greater than one-third of total vaginal length or anterior or posterior vaginal wall beyond the hymen or retreatment for prolapse (anatomic failure), or (2) bothersome bulge symptoms. The primary behavioral outcomes were time to anatomic failure and Pelvic Organ Prolapse Distress Inventory scores (range, 0-300). The original study randomized 374 patients, of whom 309 were eligible for this extended trial. For this study, 285 enrolled (mean age, 57.2 years), of whom 244 (86%) completed the extended trial. By year 5, the estimated surgical failure rate was 61.5% in the ULS group and 70.3% in the SSLF group (adjusted difference, -8.8% [95% CI, -24.2 to 6.6]). The estimated anatomic failure rate was 45.6% in the BPMT group and 47.2% in the usual care group (adjusted difference, -1.6% [95% CI, -21.2 to 17.9]). Improvements in Pelvic Organ Prolapse Distress Inventory scores were -59.4 in the BPMT group and -61.8 in the usual care group (adjusted mean difference, 2.4 [95% CI, -13.7 to 18.4]). Among women who had undergone

Validation of the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) in two south- Asian languages.

PubMed

Ekanayake, Chanil D; Pathmeswaran, Arunasalam; Herath, Rasika P; Perera, H Suharshi S; Patabendige, Malitha; Wijesinghe, Prasantha S

2017-12-01

The multifaceted nature of pelvic floor disorders means that a systematic evaluation is required for optimal treatment outcome. It is also generally acknowledged that a valid tool is necessary to objectively assess symptoms reported by affected women. The International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) questionnaire was translated to Sinhala and Tamil and a validation study carried out among women attending gynecology clinics at North Colombo Teaching Hospital, Ragama, and the district general hospitals Mannar and Vavuniya. Content validity was assessed by the level of missing answers, which was < 4% and 2% for each item in Sinhala and Tamil, respectively. Construct validity was assessed by the ability of the questionnaire to differentiate between patients and controls. Both differentiated patients from controls on vaginal symptoms score (VSS) (p < 0.001), sexual symptoms score (SSS) (p < 0.01), and quality of life (QoL) (p < 0.001). There was a strong positive correlation between Pelvic Organ Prolapse Quantification (POP-Q) scores and VSS (Sinhala r s  = 0.64, p < 0.001, Tamil r s  = 0.65, p < 0.001), and QoL (Sinhala r s  = 0.49, p < 0.001, Tamil r s  = 0.60, p < 0.001). Internal consistency as assessed using Cronbach's coefficient alpha: 0.78 (0.76-0.78) and 0.83 (0.80-0.84) in Sinhala and Tamil, respectively. Test-retest reliability was assessed by weighted kappa scores (Sinhala 0.58-0.88 and Tamil 0.76-0.90). Both questionnaires were sensitive to change and showed that VSS and QoL improved following surgery (Wilcoxon matched-pairs signed-rank test p < 0.001). The validated Sinhala and Tamil translations of ICIQ-VS will be useful for assessing vaginal and sexual symptoms among women speaking Sinhala and Tamil.

[Clinical characteristics of aerobic vaginitis and its mixed infections].

PubMed

Fan, Ai-Ping; Xue, Feng-Xia

2010-12-01

To investigate clinical characteristics of aerobic vaginitis (AV) and its mixed infections for diagnosis efficiently. From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonal vaginitis (TV), and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. Among 516 cases, AV cases were found in 14.7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30%, 13/44), and mixed with TV (25%, 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4.5 (84%, 27/32). Vaginal cleanliness mainly was grade III - IV (88%, 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV.

[Bacterial flora and mycosis of the vagina in women with symptoms of vaginal inflammation].

PubMed

Dybaś, Irena; Sidor-Wójtowicz, Anna; Kozioł-Montewka, Maria

2005-05-01

To estimate the microbiological profile of vaginal flora in 30 women with gynecologic problems and 20 pregnant women complaining about pathological symptoms {pruritus, burning, vaginal discharge}. The discharge from posterior vaginal vault was examined microbiologically on the Columbia Agar with sheep blood, MacConkey and Sabourand cultures incubated of 48 hours in the temperature of 37 degrees C. Bacterial infections were detected in 33 cases (66%), 12 of these women (24%) lived in urban, 21 (42%) in rural environment. From bacteria isolated from the vagina, most often because at 14 women stepped out Streptococcus agalactiae, at 11 Enterococcus faecalis at 8 Escherichia coli. In 5 cases bacterial inflammation was caused by two kinds of bacterium. At two women stepped out both Enterococcus faecalis and Escherichia coli. In single cases it was Klebsiella pneumoniae and Proteus vulgaris, Escherichia coli and Streptococcus agalactiae. In all cases of inflammation mycosis was called out by from Candida albicans. One ascertained it at 14 among all given an examination women. Mixed inflammations called out both by mycosis and bacterial stepped out in 3 cases in age of 21-30. At two women it was Candida albicans and Streptococcus agalactiae, at one inflammation mycosis accompanied Enterococcus faecalis. The common reason of vaginitis are bacterial infections caused by Streptococcus agalactiae, Enterococcus faecalis, E coli. Both, place of living and women' s age influence the type of etiological factor.

Vaginal symptoms and bacterial vaginosis (BV): how useful is self-report? Development of a screening tool for predicting BV status.

PubMed

Nelson, D B; Bellamy, S; Odibo, A; Nachamkin, I; Ness, R B; Allen-Taylor, L

2007-11-01

Vaginal complaints compel an evaluation of bacterial vaginosis (BV), however, many cases of BV are asymptomatic. We evaluated the sensitivity and specificity of vaginal symptoms in the diagnosis of BV and examined the utility of creating a BV screening tool using clinical, behavioural and demographic characteristics. A total of 1916 pregnant women were included in this analysis. In total, 757 women screened positive for BV and over one third of BV-positive women presented without any lower genital tract symptoms (39.4%). African American race, abnormal vaginal odour, and smoking were independently related to BV positivity. A BV screening tool including these three factors was fairly predictive of BV status with the area under the ROC curve equal to 0.669. This three-item prediction rule may be useful in identifying high- risk pregnant women in need of BV screening and, given the high specificity, accurately identify the group of BV-negative pregnant women.

Bright compact bulges at intermediate redshifts

NASA Astrophysics Data System (ADS)

Sachdeva, Sonali; Saha, Kanak

2018-07-01

Studying bright (MB < -20), intermediate-redshift (0.4 < z< 1.0), disc-dominated (nB < 2.5) galaxies from Hubble Space Telescope/Advanced Camera for Surveys and Wide Field Camera 3 in Chandra Deep Field-South, in rest-frame B and I band, we found a new class of bulges that is brighter and more compact than ellipticals. We refer to them as `bright, compact bulges' (BCBs) - they resemble neither classical nor pseudo-bulges and constitute ˜12 per cent of the total bulge population at these redshifts. Examining free-bulge + disc decomposition sample and elliptical galaxy sample from Simard et al., we find that only ˜0.2 per cent of the bulges can be classified as BCBs in the local Universe. Bulge to total light ratio of disc galaxies with BCBs is (at ˜0.4) a factor of ˜2 and ˜4 larger than for those with classical and pseudo-bulges. BCBs are ˜2.5 and ˜6 times more massive than classical and pseudo-bulges. Although disc galaxies with BCBs host the most massive and dominant bulge type, their specific star formation rate is 1.5-2 times higher than other disc galaxies. This is contrary to the expectations that a massive compact bulge would lead to lower star formation rates. We speculate that our BCB host disc galaxies are descendant of massive, compact, and passive elliptical galaxies observed at higher redshifts. Those high-redshift ellipticals lack local counterparts and possibly evolved by acquiring a compact disc around them. The overall properties of BCBs support a picture of galaxy assembly in which younger discs are being accreted around massive pre-existing spheroids.

Does vaginal irrigation with saline solution in women with infectious vaginitis contribute to the clinical and microbiological results of antibiotic therapy?

PubMed

Derbent, Aysel Uysal; Ulukanlıgil, Mustafa; Keskin, Esra Aktepe; Soylu, Gül; Kafalı, Hasan

2012-01-01

To compare the clinical and microbiological results between patients with infectious vaginitis receiving vaginal irrigation with saline or no irrigation before standard antibiotic therapy. Women with vaginitis (n = 109) were randomized to receive vaginal irrigation with saline or no irrigation before standard antibiotic therapy. The vaginal symptoms perceived by subjects and clinical findings were assessed with a standardized scale during four follow-up visits, and Gram stain Nugent scores and vaginal fluid cultures were analyzed at each visit. Vaginal discharge (z = 7.159; p < 0.001), pruritus (z = 5.169; p < 0.001), itching (z = 2.969; p < 0.003) and odor scores (z = 2.303; p < 0.021) were significantly reduced in the study group compared to the control group between the first visit and 3-5 days after irrigation, before the start of antibiotic therapy. The second and third visits (15 and 30-45 days after antibiotic therapy) showed that the patients' symptoms and amounts of visible vaginal discharge did not differ between the two groups. Moreover, the microbiological cures of patients in each group did not differ at these visits (z = 0.447; p = 0.655). Vaginal irrigation with saline significantly reduces self-reported symptoms in the short term but has no effect on long-term clinical and laboratory results in women with infectious vaginitis. Copyright © 2012 S. Karger AG, Basel.

Velocity Dispersions Across Bulge Types

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fabricius, Maximilian; Bender, Ralf; Hopp, Ulrich

2010-06-08

We present first results from a long-slit spectroscopic survey of bulge kinematics in local spiral galaxies. Our optical spectra were obtained at the Hobby-Eberly Telescope with the LRS spectrograph and have a velocity resolution of 45 km/s (sigma*), which allows us to resolve the velocity dispersions in the bulge regions of most objects in our sample. We find that the velocity dispersion profiles in morphological classical bulge galaxies are always centrally peaked while the velocity dispersion of morphologically disk-like bulges stays relatively flat towards the center--once strongly barred galaxies are discarded.

Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.

PubMed

de la Torre, Sarah; Miller, Larry E

2017-08-01

Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints. Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events. Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p < 0.001) and IIQ-7 score improved by 69% (p < 0.001). Sexual function quality of life improved by 54% for FSDS-R and 15% for FSFI (both p < 0.001). Pelvic floor muscle strength significantly improved (p < 0.001). Patient satisfaction with therapy was reported in 83% of patients. In the safety population, 2 (3.6%) adverse events were reported-1 urinary tract infection and 1 report of discomfort due to excessive warmth. Multimodal vaginal toning therapy yields clinically meaningful improvements in bladder symptoms, pelvic floor muscle strength, and quality of life in women with SUI.

The stimulation of the vaginal immune system with short-term administration of a vaginal gel containing fraction of Propionibacterium acnes, hyaluronic acid and polycarbophil is efficacious in vaginal infections dependent on disorders in the vaginal ecosystem.

PubMed

Melis, Gian Benedetto; Piras, Bruno; Marotto, Maria Francesca; Neri, Manuela; Corda, Valentina; Vallerino, Valerio; Saba, Alessandra; Lello, Stefano; Pilloni, Monica; Zedda, Pierina; Paoletti, Anna Maria; Mais, Valerio

2018-04-12

The vaginal immune system (VIS) is the first defense against antigens recognized as foreign. Substances capable of locally activating the VIS could be a valid strategy to treat vulvo-vaginal infections (VVI), caused by changes in the vaginal ecosystem, such as bacterial vaginosis (BV), vulvo-vaginal candidiasis (CA), and mixed vaginitis (MV). Bacterial lysates, obtained by crushing bacterial cultures, exert immuno-modulatory activities. The parietal fraction from Propionibacterium acnes is a patent of Depofarma (MoglianoVeneto, Italy). The preparation that associates such fraction to hyaluronic acid and polycarbophil is a registered trademark, commercially available in Italy as vaginal gel, Immunovag ® . The study aimed to evaluate whether a 5-day-treatment with Immunovag ® improves the symptoms and signs of VVI, in 60 women with Gardnerella vaginalis (GV), 154 with CA, 95 with MV, diagnosed with vulvar vaginal swab (VVS), and in 283 with BV, diagnosed with the Amsel criteria. At the end of the treatment (visit 2), the symptoms and signs of VVI disappeared in a significant number of subjects (χ 2 p < .02 vs pre-treatment) in all VVI groups, and their intensity was significantly (p < .0002) reduced in the subjects in which they were still present. Immunovag ® represents a valid treatment of VVI induced by changes in the vaginal ecosystem.

Vaginal foreign body presenting as bleeding with defecation in a child.

PubMed

Abdessamad, Hasan M; Greenfield, Marjorie

2009-04-01

Symptoms secondary to a vaginal foreign body are responsible for approximately 4% of pediatric gynecologic outpatient visits.(1) The classic symptom is vaginal bleeding, but vaginal discharge, foul odor, irritation, abdominal pain, and hematuria have been described. We are reporting a case of a microscopic vaginal foreign body presenting as hematochezia in a preadolescent girl. This case is unique in that the patient presented with bleeding with defecation, without vaginal bleeding. Vaginal foreign bodies can present with diverse symptomatology. Physicians should consider the diagnosis of vaginal foreign body when presented with a young female patient with unexplained hematochezia.

Vaginal Discharge

MedlinePlus

... also be on the lookout for symptoms of yeast infections, bacterial vaginosis and trichomoniasis, 3 infections that ... cause changes in your vaginal discharge. Signs of yeast infections White, cottage cheese-like discharge Swelling and ...

Bright Compact Bulges (BCBs) at intermediate redshifts

NASA Astrophysics Data System (ADS)

Sachdeva, Sonali; Saha, Kanak

2018-04-01

Studying bright (MB < -20), intermediate-redshift (0.4 < z < 1.0), disc dominated (nB < 2.5) galaxies from HST/ACS and WFC3 in Chandra Deep Field South, in rest-frame B and I-band, we found a new class of bulges which is brighter and more compact than ellipticals. We refer to them as "Bright, Compact Bulges" (BCBs) - they resemble neither classical nor pseudo-bulges and constitute ˜12% of the total bulge population at these redshifts. Examining free-bulge + disc decomposition sample and elliptical galaxy sample from Simard et al. (2011), we find that only ˜0.2% of the bulges can be classified as BCBs in the local Universe. Bulge to total ratio (B/T) of disc galaxies with BCBs is (at ˜0.4) a factor of ˜2 and ˜4 larger than for those with classical and pseudo bulges. BCBs are ˜2.5 and ˜6 times more massive than classical and pseudo bulges. Although disc galaxies with BCBs host the most massive and dominant bulge type, their specific star formation rate is 1.5-2 times higher than other disc galaxies. This is contrary to the expectations that a massive compact bulge would lead to lower star formation rates. We speculate that our BCB host disc galaxies are descendant of massive, compact and passive elliptical galaxies observed at higher redshifts. Those high redshift ellipticals lack local counterparts and possibly evolved by acquiring a compact disc around them. The overall properties of BCBs supports a picture of galaxy assembly in which younger discs are being accreted around massive pre-existing spheroids.

Qualitative cross-cultural exploration of vaginal bleeding/spotting symptoms and impacts associated with hormone therapy in post-menopausal women to inform the development of new patient-reported measurement tools.

PubMed

Arbuckle, Rob; Humphrey, Louise; Abraham, Lucy; Dennerstein, Lorraine; Simon, James A; Mirkin, Sebastian; Bonner, Nicola; Walmsley, Steven; Tatlock, Sophi; Symonds, Tara

2014-07-01

To understand the vaginal bleeding/spotting experiences of postmenopausal (PM) women taking estrogen plus progestin therapies (EPT) and develop measures to assess these symptoms and their impact on women's daily lives in four countries. (1) Concept elicitation interviews were conducted with PM women in the US (n=14), Italy (n=15), Mexico (n=15) and China (n=15) to explore vaginal bleeding/spotting symptoms associated with EPT. The Post-Menopausal Bleeding Questionnaire (PMBQ) was also debriefed to evaluate understanding and comprehensiveness. (2) Based on concept elicitation, a single item electronic daily diary was developed and the PMBQ modified to form a 12-item impact measure. (3) The measures were pilot-tested and then cognitively debriefed with US women receiving EPT. All qualitative data was subject to thematic analysis. The Vaginal Bleeding/Spotting Daily Diary, (VBS-DD) and Post-Menopausal Bleeding Impact Questionnaire (PMBIQ) were developed in this study. Concept elicitation identified vaginal bleeding and spotting as important symptoms for women taking EPT, impacting their emotional wellbeing, social life, ability to move freely, clothing and sexual activity. Based on pilot testing and cognitive debriefing, women demonstrated good understanding of the VBS-DD and the PMBQ was reduced to 10 items due to conceptual redundancy. Women taking EPT in the US, China, Mexico and Italy reported vaginal bleeding/spotting symptoms that have a detrimental impact on their quality of life. Two new measures were developed to assess the severity and impact of vaginal bleeding/spotting specific to EPT. This work highlights the need for EPT-related symptoms to be a part of treatment decision-making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Synthetic vaginal mesh for pelvic organ prolapse.

PubMed

Iglesia, Cheryl B

2011-10-01

The purpose of this review is to summarize recently published comparative trials on synthetic vaginal mesh versus traditional native tissue repairs for pelvic organ prolapse. Although studies suggest benefit from the use of synthetic vaginal mesh for anterior compartment prolapse, data are limited on the use of mesh for posterior and apical prolapse when compared with native tissue repair. The benefits of a more durable repair must be weighed against risks such as the development of de-novo stress incontinence, visceral injury, dyspareunia, pelvic pain and mesh contraction, exposure and extrusion requiring reoperation. Furthermore, the success rates of native tissue repairs are higher than previously considered using updated validated composite outcomes that incorporate both subjective relief of bulge and objective cure defined as prolapse above the hymenal ring. Surgeons placing synthetic mesh for pelvic organ prolapse should counsel patients regarding the potential benefits, risks, and alternatives including native tissue repairs. Level 1 evidence suggests anterior synthetic mesh may be superior to anterior repair. Expert opinion suggests potential benefit of vaginal mesh for recurrences, hysteropexy, and advanced prolapse in patients with medical co-morbidities precluding invasive open and endoscopic sacrocolpopexies; however, comparative clinical trials with long-term data are needed. (C) 2011 Lippincott Williams & Wilkins, Inc.

Mapping a stellar disk into a boxy bulge: The outside-in part of the Milky Way bulge formation

NASA Astrophysics Data System (ADS)

Di Matteo, P.; Haywood, M.; Gómez, A.; van Damme, L.; Combes, F.; Hallé, A.; Semelin, B.; Lehnert, M. D.; Katz, D.

2014-07-01

By means of idealized, dissipationless N-body simulations that follow the formation and subsequent buckling of a stellar bar, we study the characteristics of boxy/peanut-shaped bulges and compare them with the properties of the stellar populations in the Milky Way (MW) bulge. The main results of our modeling, valid for the general family of boxy/peanut shaped bulges, are the following: (i) Because of the spatial redistribution in the disk initiated at the epoch of bar formation, stars from the innermost regions to the outer Lindblad resonance (OLR) of the stellar bar are mapped into a boxy bulge. (ii) The contribution of stars to the local bulge density depends on their birth radius: stars born in the innermost disk tend to dominate the innermost regions of the boxy bulge, while stars originating closer to the OLR are preferably found in the outer regions of the boxy/peanut structure. (iii) Stellar birth radii are imprinted in the bulge kinematics: the larger the birth radii of stars ending up in the bulge, the greater their rotational support and the higher their line-of-sight velocity dispersions (but note that this last trend depends on the bar viewing angle). (iv) The higher the classical bulge-over-disk ratio, the larger its fractional contribution of stars at large vertical distance from the galaxy midplane. Comparing these results with the properties of the stellar populations of the MW bulge recently revealed by the ARGOS survey, we conclude that (I) the two most metal-rich populations of the MW bulge, labeled A and B in the ARGOS survey, originate in the disk, with the population of A having formed on average closer to the Galaxy center than the population of component B; (II) a massive (B/D ~ 0.25) classical spheroid can be excluded for the MW, thus confirming previous findings that the MW bulge is composed of populations that mostly have a disk origin. On the basis of their chemical and kinematic characteristics, the results of our modeling suggest that

Management of Vaginal Atrophy: Implications from the REVIVE Survey

PubMed Central

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

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

Management of Vaginal Atrophy: Implications from the REVIVE Survey.

PubMed

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

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

The Galactic Bulge Radial Velocity/Abundance Assay

NASA Astrophysics Data System (ADS)

Rich, R. M.

2012-08-01

The Bulge Radial Velocity Assay (BRAVA) measured radial velocities for ˜ 9500 late-type giants in the Galactic bulge, predominantly from -10° < l < +10° and -2° < b < -10°. The project has discovered that the bulge exhibits cylindrical rotation characteristic of bars, and two studies of dynamics (Shen et al. 2010; Wang et al. 2012 MNRAS sub.) find that bar models- either N-body formed from an instability in a preexisting disk, or a self-consistent model- can account for the observed kinematics. Studies of the Plaut field at (l,b) = 0°, -8° show that alpha enhancement is found in bulge giants even 1 kpc from the nucleus. New infrared studies extending to within 0.25° = 35 pc of the Galactic Center find no iron or alpha gradient from Baade's Window (l,b) = 0.9°, -3.9° to our innermost field, in contrast to the marked gradient observed in the outer bulge. We consider the case of the remarkable globular cluster Terzan 5, which has a strongly bimodal iron and rm [α/Fe] within its members, and we consider evidence pro and con that the bulge was assembled from dissolved clusters. The Subaru telescope has the potential to contribute to study of the Galactic bulge, especially using the Hyper Superime-Cam and planned spectroscopic modes, as well as the high resolution spectrograph. The planned Jasmine satellite series may deliver a comprehensive survey of distances and proper motions of bulge stars, and insight into the origin and importance of the X-shaped bulge.

[Efficiency of fenticonazole for the treatment of vaginal candidiasis].

PubMed

2012-01-01

Uncomplicated vulvovaginal candidiasis appears in 75% women of reproductive age. The most frequent causes are Candida albicans (85-95%) or C. glabrata, and infrequently C. krusei, C. tropicalis, C. parapsilosis, C. pseudotropicalis, etc. The aim of the study was to investigate efficiency and safety of fenticonazole for vaginal candidiasis treatment. Therapeutic effect of a single 600 mg fenticonasole vaginal capsule was observed in 417 women, aged 16-67, in five centers in Serbia. In all women, before the treatment, vaginal candidiasis was confirmed by testing of vaginal smear. Based on smear findings and associated symptoms observed on the 7th and 28th day after therapy administration, treatment results were evaluated. On the next day after drug application the patients recorded by using a questionnaire their own feelings on withdrawal symptoms and possible side effects in the period prior to the first control. Control after seven days showed a statistically significant decrease of symptoms. In 385 women, vaginal smear was found negative to yeast and yeast blastospores. Within the first seven days after treatment 84 women had to repeat therapy due to the persistence of symptoms or positive vaginal smear. After 28 days we recorded full recovery in 392 patients, clinical improvement in eight, no change in 16, and deterioration in one patient only. Side effects were very seldom, mostly in the form of a slight redness of the vulva and vagina, and mild itching during several days. Our observations confirmed good efficacy and safety of fenticonazole in the treatment of vaginal candidiasis.

Comparison of the Hyaluronic Acid Vaginal Cream and Conjugated Estrogen Used in Treatment of Vaginal Atrophy of Menopause Women: A Randomized Controlled Clinical Trial

PubMed Central

Jokar, Azam; Davari, Tayebe; Asadi, Nasrin; Ahmadi, Fateme; Foruhari, Sedighe

2016-01-01

Background: Vaginal atrophy is a common complication in menopause which does not improve with time and, if untreated, can affect the quality of life for women. The aim of this study was to compare the effectiveness of the vaginal cream of hyaluronic acid and conjugated estrogen (Premarin) in treatment of vaginal atrophy. Methods: This study was a randomized controlled clinical trial on 56 menopausal women with symptoms of vaginal atrophy; they were randomly allocated to two groups (recipient conjugated estrogen and hyaluronic acid). The severity of each sign of atrophy was evaluated by visual analog signals (VAS) and on the basis of a four point scale. Also to recognize the cellular maturation with pap smear and the maturation degree were calculated according to the formula and scores 0-100. As to the vaginal PH, we used PH marker band, the rate of which was divided into 4 degrees. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of this study showed that the symptoms of vaginal atrophy compared with the baseline level were relieved significantly in both groups. Dryness, itching, maturation index, PH and composite score of the vaginal symptoms were relieved significantly in both groups (P<0.001). Dyspareunia in Premarin (P<0.05) and hyaluronic acid (P<0.001) decreased compared with pre-treatment. Urinary incontinence only showed improvement in the hyaluronic acid group (P<0.05). Improvement in urinary incontinence, dryness, maturation index (P<0.05) and composite score of vaginal symptoms (P<0.001) in the hyaluronic acid group was better than those in the Premarin group. Conclusion: According to the results of the present study, hyaluronic acid and conjugated estrogen improved the symptoms of vaginal atrophy. But hyaluronic acid was more effective and this drug is suggested for those who do not want to or cannot take local hormone treatment. Trial Registration Number: IRCT2013022712644N1 PMID:26793732

Comparison of the Hyaluronic Acid Vaginal Cream and Conjugated Estrogen Used in Treatment of Vaginal Atrophy of Menopause Women: A Randomized Controlled Clinical Trial.

PubMed

Jokar, Azam; Davari, Tayebe; Asadi, Nasrin; Ahmadi, Fateme; Foruhari, Sedighe

2016-01-01

Vaginal atrophy is a common complication in menopause which does not improve with time and, if untreated, can affect the quality of life for women. The aim of this study was to compare the effectiveness of the vaginal cream of hyaluronic acid and conjugated estrogen (Premarin) in treatment of vaginal atrophy. This study was a randomized controlled clinical trial on 56 menopausal women with symptoms of vaginal atrophy; they were randomly allocated to two groups (recipient conjugated estrogen and hyaluronic acid). The severity of each sign of atrophy was evaluated by visual analog signals (VAS) and on the basis of a four point scale. Also to recognize the cellular maturation with pap smear and the maturation degree were calculated according to the formula and scores 0-100. As to the vaginal PH, we used PH marker band, the rate of which was divided into 4 degrees. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. The results of this study showed that the symptoms of vaginal atrophy compared with the baseline level were relieved significantly in both groups. Dryness, itching, maturation index, PH and composite score of the vaginal symptoms were relieved significantly in both groups (P<0.001). Dyspareunia in Premarin (P<0.05) and hyaluronic acid (P<0.001) decreased compared with pre-treatment. Urinary incontinence only showed improvement in the hyaluronic acid group (P<0.05). Improvement in urinary incontinence, dryness, maturation index (P<0.05) and composite score of vaginal symptoms (P<0.001) in the hyaluronic acid group was better than those in the Premarin group. According to the results of the present study, hyaluronic acid and conjugated estrogen improved the symptoms of vaginal atrophy. But hyaluronic acid was more effective and this drug is suggested for those who do not want to or cannot take local hormone treatment. IRCT2013022712644N1.

Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey.

PubMed

Kingsberg, Sheryl A; Wysocki, Susan; Magnus, Leslie; Krychman, Michael L

2013-07-01

Vulvar and vaginal atrophy (VVA) is a chronic medical condition experienced by many postmenopausal women. Symptoms include dyspareunia (pain with intercourse), vaginal dryness, and irritation and may affect sexual activities, relationships, and activities of daily life. The aim of this study is to characterize postmenopausal women's experience with and perception of VVA symptoms, interactions with healthcare professionals (HCPs), and available treatment options. An online survey was conducted in the United States in women from KnowledgePanel(®) , a 56,000-member probability-selected Internet panel projectable to the overall US population. Altogether, 3,046 postmenopausal women with VVA symptoms (the largest US cohort of recent surveys) responded to questions about their knowledge of VVA, impact of symptoms on their activities, communication with HCPs, and use of available treatments. Percent is calculated as the ratio of response over total responding for each question for all and stratified participants. The most common VVA symptoms were dryness (55% of participants), dyspareunia (44%), and irritation (37%). VVA symptoms affected enjoyment of sex in 59% of participants. Additionally, interference with sleep, general enjoyment of life, and temperament were reported by 24%, 23%, and 23% of participants, respectively. Few women attributed symptoms to menopause (24%) or hormonal changes (12%). Of all participants, 56% had ever discussed VVA symptoms with an HCP and 40% currently used VVA-specific topical treatments (vaginal over-the-counter [OTC] products [29%] and vaginal prescription therapies [11%]). Of those who had discussed symptoms with an HCP, 62% used OTC products. Insufficient symptom relief and inconvenience were cited as major limitations of OTC products and concerns about side effects and cancer risk limited use of topical vaginal prescription therapies. VVA symptoms are common in postmenopausal women. Significant barriers to treatment include lack of

The intrinsic shape of bulges in the CALIFA survey

NASA Astrophysics Data System (ADS)

Costantin, L.; Méndez-Abreu, J.; Corsini, E. M.; Eliche-Moral, M. C.; Tapia, T.; Morelli, L.; Dalla Bontà, E.; Pizzella, A.

2018-02-01

Context. The intrinsic shape of galactic bulges in nearby galaxies provides crucial information to separate bulge types. Aims: We aim to derive accurate constraints to the intrinsic shape of bulges to provide new clues on their formation mechanisms and set new limitations for future simulations. Methods: We retrieved the intrinsic shape of a sample of CALIFA bulges using a statistical approach. Taking advantage of GalMer numerical simulations of binary mergers we estimated the reliability of the procedure. Analyzing the i-band mock images of resulting lenticular remnants, we studied the intrinsic shape of their bulges at different galaxy inclinations. Finally, we introduced a new (B/A, C/A) diagram to analyze possible correlations between the intrinsic shape and the properties of bulges. Results: We tested the method on simulated lenticular remnants, finding that for galaxies with inclinations of 25° ≤ θ ≤ 65° we can safely derive the intrinsic shape of their bulges. We found that our CALIFA bulges tend to be nearly oblate systems (66%), with a smaller fraction of prolate spheroids (19%), and triaxial ellipsoids (15%). The majority of triaxial bulges are in barred galaxies (75%). Moreover, we found that bulges with low Sérsic indices or in galaxies with low bulge-to-total luminosity ratios form a heterogeneous class of objects; additionally, bulges in late-type galaxies or in less massive galaxies have no preference for being oblate, prolate, or triaxial. On the contrary, bulges with high Sérsic index, in early-type galaxies, or in more massive galaxies are mostly oblate systems. Conclusions: We concluded that various evolutionary pathways may coexist in galaxies, with merging events and dissipative collapse being the main mechanisms driving the formation of the most massive oblate bulges and bar evolution reshaping the less massive triaxial bulges.

Perceptions of dyspareunia in postmenopausal women with vulvar and vaginal atrophy: findings from the REVIVE survey.

PubMed

Freedman, Murray A

2014-07-01

Symptoms of vulvar and vaginal atrophy (VVA), including dyspareunia and vaginal dryness, have a distinct negative impact on a woman's quality of life. The REVIVE survey highlighted the lack of awareness of VVA symptoms among postmenopausal women with vaginal symptoms, with many women reluctant to initiate discussions with their healthcare professionals despite the presence of vaginal symptoms. The REVIVE survey also provided insights into women's views of VVA treatments. Women reported displeasure with the vaginal administration route, lack of symptom relief with over-the-counter products, and concerns about the safety of estrogen therapies. With the high prevalence of VVA, obstetricians/gynecologists should become vigilant in identifying women with VVA by implementing screening and discussion of symptoms during routine office visits - providing patients with information about appropriate therapies based on the severity and impact of symptoms, keeping in mind individual preferences and perceptions.

Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device.

PubMed

Sayer, T; Lim, J; Gauld, J M; Hinoul, P; Jones, P; Franco, N; Van Drie, D; Slack, M

2012-04-01

This study was designed to evaluate clinical outcomes ≥2 years following surgery with polypropylene mesh and vaginal support device (VSD) in women with vaginal prolapse, in a prospective, multi-center setting. Patients re-consented for this extended follow-up (n = 110), with anatomic evaluation using Pelvic Organ Prolapse Quantification (POP-Q) and validated questionnaires to assess pelvic symptoms and sexual function. Complications were recorded (safety set; n = 121). Median length of follow-up was 29 months (range 24-34 months). The primary anatomic success, defined as POP-Q 0-I, was 69.1%; however, in 84.5% of the cases, the leading vaginal edge was above the hymen. Pelvic symptoms and sexual function improved significantly from baseline (p < 0.01). Mesh exposure rate was 9.1%. Five percent reported stress urinary incontinence and 3.3% required further prolapse surgery. These results indicate this non-anchored mesh repair is a safe and effective treatment for women with symptomatic vaginal prolapse in the medium term.

Vaginitis: diagnosis and management.

PubMed

Faro, S

1996-01-01

The various conditions that give rise to vaginitis include specific and nonspecific entities, such as candidiasis, trichomoniasis, bacterial vaginosis, group B streptococcal vaginitis, purulent vaginitis, volvodynia, and vestibulitis. The patient with chronic vaginitis usually develops this condition because of a misdiagnosis. It is critical that patients who have chronic vaginitis be thoroughly evaluated to determine if there is a specific etiology and whether their condition is recurrent or persistent, or is a reinfection. This also must include obtaining a detailed history, beginning with the patient's best recollection of when she felt perfectly normal. The physician must have an understanding of a healthy vaginal ecosystem and what mechanisms are in place to maintain the equilibrium. The vaginal ecosystem is a complex system of micro-organisms interacting with host factors to maintain its equilibrium. The endogenous microflora consists of a variety of bacteria, which include aerobic, facultative and obligate anaerobic bacteria. These organisms exist in a commensal, synergistic or antagonistic relationship. Therefore, it is important to understand what factors control the delicate equilibrium of the vaginal ecosystem, and which factors, both endogenous and exogenous, can disrupt this system. It is also important for the physician to understand that when a patient has symptoms of vaginitis it is not always due to an infectious etiology. There are situations in which an inflammatory reaction occurs but the specific etiology may not be determined. Thus, it is important that the physician not rush through the history or the examination.

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS).

PubMed

Giarenis, Ilias; Musonda, Patrick; Mastoroudes, Heleni; Robinson, Dudley; Cardozo, Linda

2016-10-01

Traditionally, urodynamic studies (UDS) have been used to assess lower urinary tract symptoms (LUTS), but their routine use is now discouraged. While urodynamic stress incontinence is strongly associated with the symptom of stress urinary incontinence (SUI) and a positive cough test, there is a weak relationship between symptoms of overactive bladder and detrusor overactivity (DO). The aim of our study was to develop a model to predict DO in women with LUTS. This prospective study included consecutive women with LUTS attending a urodynamic clinic. All women underwent a comprehensive clinical and urodynamic assessment. The effect of each variable on the odds of DO was estimated both by univariate analysis and adjusted analysis using logistic regression. 1006 women with LUTS were included in the study with 374 patients (37%) diagnosed with DO. The factors considered to be the best predictors of DO were urgency urinary incontinence, urge rating/void and parity (p-value<0.01). The absence of SUI, vaginal bulging and previous continence surgery were also good predictors of DO (p-value<0.01). We have created a prediction model for DO based on our best predictors. In our scoring system, presence of UUI scores 5; mean urge rating/void≥3 scores 3; parity≥2 scores 2; previous continence surgery scores -1; presence of SUI scores -1; and the complaint of vaginal bulging scores -1. If a criterion is absent, then the score is 0 and the total score can vary from a value of -3 to +10. The Receiver Operating Characteristic (ROC) analysis for the overall cut-off points revealed an area under the curve of 0.748 (95%CI 0.741, 0.755). This model is able to predict DO more accurately than a symptomatic diagnosis alone, in women with LUTS. The introduction of this scoring system as a screening tool into clinical practice may reduce the need for expensive and invasive tests to diagnose DO, but cannot replace UDS completely. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Jupiter's hydrogen bulge: A Cassini perspective

NASA Astrophysics Data System (ADS)

Melin, Henrik; Stallard, T. S.

2016-11-01

We present observations of H Ly-α and H2 emissions on the body of Jupiter obtained during the Cassini flyby in late 2000 and early 2001. The H Ly-α emission is highly organised by System III longitude and latitude, peaking at a brightness of 22 kR between 90 and 120° longitude. This is known as the H Ly-α 'bulge'. These observations add to a number of previous studies, showing that the feature is very long-lived, present over several decades. We show that there is a strong correlation between the prevailing solar H Ly-α flux (measured at Earth) and the peak brightness of the H Ly-α bulge at Jupiter, which supports the notion that it is primarily driven by solar resonance scatter. The H Ly-α brightness distribution is not aligned with the jovigraphic equator, but is approximately aligned with the particle drift equator of some, but not all, major Jupiter magnetic field models. On the time scale of days, the bulge region appears twice as variable as the non-bulge region. We propose that the electron recombination of H3+ is an important reaction for the generation of the H Ly-α bulge, which requires an enhancement of soft electrons at the location of the bulge. We derive an equatorial H3+ lifetime of 1.6 ± 0.4 h and a corresponding column averaged electron density of 1.7 × 109 m-3.

Recognition of DNA/RNA bulges by antimicrobial and antitumor metallohelices.

PubMed

Malina, Jaroslav; Scott, Peter; Brabec, Viktor

2015-09-07

Bulged structures have been identified in nucleic acids and have been shown to be linked to biomolecular processes involved in numerous diseases. Thus, chemical agents with affinity for bulged nucleic acids are of general biological significance. Herein, the mechanism of specific recognition and stabilization of bulged DNA and RNA by helical bimetallic species was established through detailed molecular biophysics and biochemistry assays. These agents, known as 'flexicates', are potential mimetics of α-helical peptides in cancer treatment, exhibiting antimicrobial and antitumor effects. The flexicates have positive impacts on the thermal stability of DNA duplexes containing bulges, which means that the flexicates interact with the duplexes containing bulges, and that these interactions stabilize the secondary structures of these duplexes. Notably, the stabilising effect of the flexicates increases with the size of the bulge, the maximal stabilization is observed for the duplexes containing a bulge composed of at least three bases. The flexicates bind most preferentially to the bulges composed of pyrimidines flanked on both sides also by pyrimidines. It is suggested that it is so because these bulges exhibit greatest conformational variability in comparison with other combinations of bases in the bulge loop and bases flanking the bulge. Finally, the results indicate that there is only one dominant binding site for the flexicates on the DNA and RNA bulges and that the flexicates bind directly to the bulge or in its close proximity. It is also shown that the flexicates effectively bind to RNA duplexes containing the bulged region of HIV-1 TAR RNA.

Vaginal para-urethral myxoid leiomyoma: case report and review of the literature.

PubMed

Costantini, Elisabetta; Cochetti, Giovanni; Porena, Massimo

2008-08-01

Vaginal leiomyoma is a rare solid tumour of unknown aetiology, which usually develops in women between the ages of 35 and 50. As it presents with a wide range of symptoms, diagnosis is based on histological findings. Here we present the case of a 27-year-old white woman with a painless vaginal mass associated with dyspareunia, dysmenorrhea and foul-smelling vaginal discharge. She underwent surgery by vaginal route, and the histological findings confirmed a myxoid leiomyoma. After 17 months, the patient was disease-free, and symptoms disappeared. Vaginal leiomyomas are rare, local recurrence and transformation into sarcoma are rare, and complete surgical excision as soon as possible is recommended.

Comparison between vaginal royal jelly and vaginal estrogen effects on quality of life and vaginal atrophy in postmenopausal women: a clinical trial study.

PubMed

Seyyedi, Fatemeh; Kopaei, Mahmoud Rafiean; Miraj, Sepideh

2016-11-01

This study was conducted to evaluate the therapeutic effects of vaginal royal jelly and vaginal estrogen on quality of life and vaginal atrophy in postmenopausal women. This double-blind randomized controlled clinical trial was carried out at gynecology and obstetrics clinics of Hajar Hospital of Shahrekord University of Medical Sciences (Iran) from January 2013 to January 2014. The study was conducted on married postmenopausal women between 50 and 65 years old. Of 120 patients, 30 individuals were excluded based on the exclusion criteria, and 90 women were randomly distributed into three groups of 30 royal jelly vaginal cream 15%, vaginal Premarin, and placebo (lubricant), for three months. At the beginning and the end of the study, quality of life and vaginal cytology assay were evaluated. Data were analyzed by SPSS Version 11. Vaginal cream of royal jelly is significantly more effective than vaginal cream of Premarin and lubricant in improvement of quality of life in postmenopausal women (p<0.05). Moreover, Pap smear results showed that vaginal atrophy in vaginal Premarin group was lower than the other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89). Administration of vaginal royal jelly was effective in quality-of-life improvement of postmenopausal women. Given to the various properties of royal jelly and its effectiveness on quality of life and vaginal atrophy in postmenopausal women, further studies are recommended for using =royal jelly in improving menopausal symptoms. The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT code: 2014112220043n1. Shahrekord University of Medical Sciences supported this research (project no. 1440).

Kinematic Evaluation of Association between Disc Bulge Migration, Lumbar Segmental Mobility, and Disc Degeneration in the Lumbar Spine Using Positional Magnetic Resonance Imaging

PubMed Central

Hu, Jonathan K.; Morishita, Yuichiro; Montgomery, Scott R.; Hymanson, Henry; Taghavi, Cyrus E.; Do, Duc; Wang, Jeff C.

2011-01-01

Degenerative disc disease and disc bulge in the lumbar spine are common sources of lower back pain. Little is known regarding disc bulge migration and lumbar segmental mobility as the lumbar spine moves from flexion to extension. In this study, 329 symptomatic (low back pain with or without neurological symptoms) patients with an average age of 43.5 years with varying degrees of disc degeneration were examined to characterize the kinematics of the lumbar intervertebral discs through flexion, neutral, and extension weight-bearing positions. In this population, disc bulge migration associated with dynamic motion of the lumbar spine significantly increased with increased grade of disk degeneration. Although no obvious trends relating the migration of disc bulge and angular segmental mobility were seen, translational segmental mobility tended to increase with disc bulge migration in all of the degenerative disc states. It appears that many factors, both static (intervertebral disc degeneration or disc height) and dynamic (lumbar segmental mobility), affect the mechanisms of lumbar disc bulge migration. PMID:24353937

Long term subjective cure rate, urinary tract symptoms and dyspareunia following mesh augmented anterior vaginal wall prolapse repair.

PubMed

Weintraub, A Y; Friedman, T; Baumfeld, Y; Neuman, M; Krissi, H

2015-12-01

The aim of this study was to assess patient-centered long term outcomes following anterior vaginal repair with mesh. In January 2015, we identified 124 women who underwent anterior pelvic floor repair with mesh between January 2006 and February 2009. Patient records were reviewed and demographic, clinical, intra-operative and post-operative follow-up data retrieved. Telephone interviews were conducted to access information on clinical outcomes. Associations between baseline characteristics and long term symptoms were assessed by multivariable logistic regression models. Seventy-nine women were reached and consented to participate. Patients were interviewed 79-104 months after surgery. Their mean age at the time of surgery was 62.48 ± 9.53 years; all had stage III cystocele with a mean POP Q point Ba of 5.32 ± 1.47. Twenty-four (30%) had a previous hysterectomy and 26 (33%) had a previous pelvic organ prolapse or stress urinary incontinence operation. At telephone interviews, recurrence of prolapse symptoms was reported by 11 (13.9%) patients, mostly in the posterior compartment. Only 6 needed a corrective procedure. One patient had her mesh removed due to dyspareunia. Eleven (13.9%) reported lower urinary tract symptoms other than prolapse, as follows: stress urinary incontinence (1), overactive bladder (8) and dyspareunia (2). Long term rates of recurrent prolapse, dyspareunia and lower urinary tract symptoms were low for patients who underwent anterior vaginal wall mesh augmentation surgery for symptomatic cystoceles. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

"Shotgun" versus sequential testing. Cost-effectiveness of diagnostic strategies for vaginitis.

PubMed

Carr, Phyllis L; Rothberg, Michael B; Friedman, Robert H; Felsenstein, Donna; Pliskin, Joseph S

2005-09-01

Although vaginitis is a common outpatient problem, only 60% of patients can be diagnosed at the initial office visit of a primary care provider using the office procedures of pH testing, whiff tests, normal saline, and potassium hydroxide preps. To determine the most cost-effective diagnostic and treatment approach for the medical management of vaginitis. Decision and cost-effectiveness analyses. Healthy women with symptoms of vaginitis undiagnosed after an initial pelvic exam, wet mount preparations, pH, and the four criteria to diagnose bacterial vaginosis. General office practice. We evaluated 28 diagnostic strategies comprised of combinations of pH testing, vaginal cultures for yeast and Trichomonas vaginalis, Gram's stain for bacterial vaginosis, and DNA probes for Neisseria gonorrhoeae and Chlamydia. Data sources for the study were confined to English language literature. The outcome measures were symptom-days and costs. The least expensive strategy was to perform yeast culture, gonorrhoeae and Chlamydia probes at the initial visit, and Gram's stain and Trichomonas culture only when the vaginal pH exceeded 4.9 (330 dollars, 7.30 symptom days). Other strategies cost 8 dollars to 76 dollars more and increased duration of symptoms by up to 1.3 days. In probabilistic sensitivity analysis, this strategy was always the most effective strategy and was also least expensive 58% of the time. For patients with vaginitis symptoms undiagnosed by pelvic examination, wet mount preparations and related office tests, a comprehensive, pH-guided testing strategy at the initial office visit is less expensive and more effective than ordering tests sequentially.

Recognition of DNA bulges by dinuclear iron(II) metallosupramolecular helicates.

PubMed

Malina, Jaroslav; Hannon, Michael J; Brabec, Viktor

2014-02-01

Bulged DNA structures are of general biological significance because of their important roles in a number of biochemical processes. Compounds capable of targeting bulged DNA sequences can be used as probes for studying their role in nucleic acid function, or could even have significant therapeutic potential. The interaction of [Fe(2)L(3)](4+) metallosupramolecular helicates (L = C(25)H(20)N(4)) with DNA duplexes containing bulges has been studied by measurement of the DNA melting temperature and gel electrophoresis. This study was aimed at exploring binding affinities of the helicates for DNA bulges of various sizes and nucleotide sequences. The studies reported herein reveal that both enantiomers of [Fe(2)L(3)](4+) bind to DNA bulges containing at least two unpaired nucleotides. In addition, these helicates show considerably enhanced affinity for duplexes containing unpaired pyrimidines in the bulge and/or pyrimidines flanking the bulge on both sides. We suggest that the bulge creates the structural motif, such as the triangular prismatic pocket formed by the unpaired bulge bases, to accommodate the [Fe(2)L(3)](4+) helicate molecule, and is probably responsible for the affinity for duplexes with a varying number of bulge bases. Our results reveal that DNA bulges represent another example of unusual DNA structures recognized by dinuclear iron(II) ([Fe(2)L(3)](4+)) supramolecular helicates. © 2013 FEBS.

Comparison between vaginal royal jelly and vaginal estrogen effects on quality of life and vaginal atrophy in postmenopausal women: a clinical trial study

PubMed Central

Seyyedi, Fatemeh; Kopaei, Mahmoud Rafiean; Miraj, Sepideh

2016-01-01

Objective This study was conducted to evaluate the therapeutic effects of vaginal royal jelly and vaginal estrogen on quality of life and vaginal atrophy in postmenopausal women. Methods This double-blind randomized controlled clinical trial was carried out at gynecology and obstetrics clinics of Hajar Hospital of Shahrekord University of Medical Sciences (Iran) from January 2013 to January 2014. The study was conducted on married postmenopausal women between 50 and 65 years old. Of 120 patients, 30 individuals were excluded based on the exclusion criteria, and 90 women were randomly distributed into three groups of 30 royal jelly vaginal cream 15%, vaginal Premarin, and placebo (lubricant), for three months. At the beginning and the end of the study, quality of life and vaginal cytology assay were evaluated. Data were analyzed by SPSS Version 11. Results Vaginal cream of royal jelly is significantly more effective than vaginal cream of Premarin and lubricant in improvement of quality of life in postmenopausal women (p<0.05). Moreover, Pap smear results showed that vaginal atrophy in vaginal Premarin group was lower than the other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89). Conclusion Administration of vaginal royal jelly was effective in quality-of-life improvement of postmenopausal women. Given to the various properties of royal jelly and its effectiveness on quality of life and vaginal atrophy in postmenopausal women, further studies are recommended for using =royal jelly in improving menopausal symptoms. Clinical trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT code: 2014112220043n1. Funding Shahrekord University of Medical Sciences supported this research (project no. 1440). PMID:28070251

Comparison of the Effect of Vaginal Zataria multiflora Cream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age.

PubMed

Abdali, Khadijeh; Jahed, Leila; Amooee, Sedigheh; Zarshenas, Mahnaz; Tabatabaee, Hamidreza; Bekhradi, Reza

2015-01-01

Effect of Zataria multiflora on bacterial vaginosis and Trichomonas vaginalis is shown in vivo and in vitro. We compare the effectiveness of Zataria multiflora cream and oral metronidazole pill on results of treatment for vaginal infections including Trichomonas and bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis, Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. Vaginal Zataria multiflora cream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginal Zataria multiflora cream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p = 0.001 and p = 0.01). Vaginal Zataria multiflora cream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms of Trichomonas vaginitis.

Comparison of the Effect of Vaginal Zataria multiflora Cream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age

PubMed Central

Abdali, Khadijeh; Jahed, Leila; Amooee, Sedigheh; Zarshenas, Mahnaz; Tabatabaee, Hamidreza; Bekhradi, Reza

2015-01-01

Effect of Zataria multiflora on bacterial vaginosis and Trichomonas vaginalis is shown in vivo and in vitro. We compare the effectiveness of Zataria multiflora cream and oral metronidazole pill on results of treatment for vaginal infections including Trichomonas and bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis, Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. Vaginal Zataria multiflora cream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginal Zataria multiflora cream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p = 0.001 and p = 0.01). Vaginal Zataria multiflora cream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms of Trichomonas vaginitis. PMID:26266260

THE X-SHAPED BULGE OF THE MILKY WAY REVEALED BY WISE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ness, Melissa; Lang, Dustin, E-mail: ness@mpia-hd.mpg.de

2016-07-01

The Milky Way bulge has a boxy/peanut morphology and an X-shaped structure. This X-shape has been revealed by the “split in the red clump” from star counts along the line of sight toward the bulge, measured from photometric surveys. This boxy, X-shaped bulge morphology is not unique to the Milky Way and such bulges are observed in other barred spiral galaxies. N -body simulations show that boxy and X-shaped bulges are formed from the disk via dynamical instabilities. It has also been proposed that the Milky Way bulge is not X-shaped, but rather, the apparent split in the red clumpmore » stars is a consequence of different stellar populations, in an old classical spheroidal bulge. We present a Wide-Field Infrared Survey Explorer ( WISE ) image of the Milky Way bulge, produced by downsampling the publicly available “unWISE” coadds. The WISE image of the Milky Way bulge shows that the X-shaped nature of the Milky Way bulge is self-evident and irrefutable. The X-shape morphology of the bulge in itself and the fraction of bulge stars that comprise orbits within this structure has important implications for the formation history of the Milky Way, and, given the ubiquity of boxy X-shaped bulges, spiral galaxies in general.« less

Nuclear starburst activity induced by elongated bulges in spiral galaxies

NASA Astrophysics Data System (ADS)

Kim, Eunbin; Kim, Sungsoo S.; Choi, Yun-Young; Lee, Gwang-Ho; de Grijs, Richard; Lee, Myung Gyoon; Hwang, Ho Seong

2018-06-01

We study the effects of bulge elongation on the star formation activity in the centres of spiral galaxies using the data from the Sloan Digital Sky Survey Data Release 7. We construct a volume-limited sample of face-on spiral galaxies with Mr < -19.5 mag at 0.02 ≤z< 0.055 by excluding barred galaxies, where the aperture of the SDSS spectroscopic fibre covers the bulges of the galaxies. We adopt the ellipticity of bulges measured by Simard et al. (2011) who performed two-dimensional bulge+disc decompositions using the SDSS images of galaxies, and identify nuclear starbursts using the fibre specific star formation rates derived from the SDSS spectra. We find a statistically significant correlation between bulge elongation and nuclear starbursts in the sense that the fraction of nuclear starbursts increases with bulge elongation. This correlation is more prominent for fainter and redder galaxies, which exhibit higher ratios of elongated bulges. We find no significant environmental dependence of the correlation between bulge elongation and nuclear starbursts. These results suggest that non-axisymmetric bulges can efficiently feed the gas into the centre of galaxies to trigger nuclear starburst activity.

Stages of Vaginal Cancer

MedlinePlus

... stage of the cancer being treated. External and internal radiation therapy are used to treat vaginal cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life . Chemotherapy Chemotherapy is a cancer treatment ...

One-year clinical outcomes after prolapse surgery with nonanchored mesh and vaginal support device.

PubMed

Zyczynski, Halina M; Carey, Marcus P; Smith, Anthony R B; Gauld, Judi M; Robinson, David; Sikirica, Vanja; Reisenauer, Christl; Slack, Mark

2010-12-01

The purpose of this study was to evaluate outcomes after standardized transvaginal prolapse repair with nonanchored mesh and a vaginal support device. Postoperative vaginal support was assessed by pelvic organ prolapse quantitative examination after repair of symptomatic stage II/III prolapse. Validated questionnaires assessed pelvic symptoms and sexual function. Visual analog scales quantified experience with the vaginal support device. One hundred thirty-six women received the planned surgery; 95.6% of the women returned for the 1-year assessment: 76.9% of the cases were stage 0/I; however, in 86.9% of the cases, the leading vaginal edge was above the hymen. Pelvic symptoms, quality of life, and sexual function improved significantly from baseline (P < .05). Median visual analog scale scores for vaginal support device awareness and discomfort were 2.6 and 1.2, respectively (0 = none; 10 = worst possible). Vaginal support, pelvic symptoms, and sexual function improved at 1 year, compared with baseline, after trocar-free prolapse repair with nonanchored mesh and a vaginal support device. Copyright © 2010 Mosby, Inc. All rights reserved.

A New Population of Galactic Bulge Planetary Nebulas

NASA Astrophysics Data System (ADS)

Stenborg, T. N.

A new population of Galactic bulge planetary nebulas is presented. Nebula candidates were discovered by systematically reviewing archival [OIII] on/off band survey imaging of the central -5° ≤ l ≤ 5°, -5° ≤ b ≤ 5° region around the Galactic centre. An image segmentation and interleaving scheme was developed to facilitate this review. The resultant candidates (> 200) were then double checked against complementary archival Hα sky survey data to screen for obvious planetary nebula (PN) mimics or spurious image artefacts. Confirmatory spectroscopy of the PN candidates was pursued with thin slit, fibre multiobject and wide field spectrographs. Custom software was built to streamline interfacing with third-party spectroscopic management tools and a parallel greedy set cover algorithm implemented for efficient field selection in constrained multi-object observations. The combined imaging and spectroscopic evidence yielded true (4), probable (31) and possible (83) PNs toward the bulge. Secondary discoveries such as new PN mimics and late type stars were by-products of the confirmatory spectroscopy. Instances of literature PN duplication encountered during the investigation were noticed and documented. Spectral analysis of new PNs, including those obtained with a new optimised sky subtraction technique devised and demonstrated here, provided diagnostic data allowing radial velocity and Balmer decrement determination. Using a combined diameter and radial velocity criterion, bona fide bulge PNs were distinguished from new foreground PNs. Where Balmer decrements were available for new bulge PNs, differential aperture photometry was used to provide a modest data increment to Galactic bulge planetary nebula luminosity function (PNLF). The PNLF was revised with data from some new bulge PNs, but more significantly, by a series of corrections to the data derived from previously known bulge PNs (~225), such as improved filter transmission effects, statistically

[Sulphurous vaginal douching and vulvovaginal atrophy].

PubMed

Costantino, M; Conti, V; Marongiu, M B; Napolano, G; Filippelli, A

2017-01-01

During climacteric the reduction or interruption of estrogenic stimulus determines a gradual atrophy of the tissues of the urogenital tract.Vulvovaginal atrophy can be cause of dryness, itch, burning, and dyspareunia. Vulvovaginal atrophy is associated also with depression. Hence the importance of an appropriate treatment of the vulvovaginal atrophy. Between therapeutic options we can add, particularly for women who suffer only from vaginal symptoms, the spa therapy that uses mineral waters with benefic effects on vaginal tissue wellness and health. On the basis of considerations described above and on the insufficient literature data, the objective of our single-arm pilot study has been to evaluate, in women suffering from vulvovaginal atrophy, the effects and safety of a vaginal douching cycle with sulphurous mineral water and impact on depression disorder frequently observed. The study was conducted on 24 women affected by vulvovaginal atrophy; mean age:57±11 years; age range:42-81 years. The subjects were treated, for 2 weeks, with sulphurous vaginal douching from Terme of Telese S.p.A. (Benevento-Italy). At the beginning and at the end of the SPA treatment the following symptoms were evaluated: dryness, burning, itch, dyspareunia and leucorrhoea (using VAS scale); the impact on psychological distress (using S.D.S. Zung-test). At the end of the spa treatment, the mean values±SD, compared to baseline, have showed a significant (p<0.05) reduction in leucorrhoea (-88%), in vulvar itch (-79%), in vaginal burning (-71%), in vaginal dryness (-65%) with an improvement of psichological distress as demonstrated by S.D.S. Zung-test. The data of this single-arm pilot clinical trial show that the sulphurous vaginal douching cycle can be considered very useful in women suffering from vulvovaginal atrophy with improving of the quality of life and social relationship.

Local oestrogen for vaginal atrophy in postmenopausal women.

PubMed

Suckling, J; Lethaby, A; Kennedy, R

2003-01-01

Vaginal atrophy is a frequent complaint of postmenopausal women; symptoms include vaginal dryness, itching, discomfort and painful intercourse. Systemic treatment for these symptoms in the form of oral hormone replacement therapy is not always necessary. An alternative choice is oestrogenic preparations administered vaginally (in the form of creams, pessaries, tablets and the estradiol releasing ring). The objective of this review is to compare the effectiveness, safety and acceptability of oestrogenic preparations for women who suffer from vaginal atrophy. We searched the Cochrane Menstrual Disorders and Subfertility Group register of trials (searched January 2003), The Cochrane Library (Issue 2, 2003), MEDLINE (1966-January 2003), EMBASE (1980-January 2003), Current Contents (1993-January 2003), Biological Abstracts (1969-2002), Social Sciences Index (1980-January 2003), PsycINFO (1972-February 2003), CINAHL (1982-January 2003) and reference list of articles. We also contacted manufacturers and researchers in the field. The inclusion criteria were randomised comparisons of oestrogenic preparations administered intravaginally in postmenopausal women for the treatment of symptoms resulting from vaginal atrophy or vaginitis. Twenty nine trials were identified, of these 13 were excluded. Trials were assessed for quality and two reviewers extracted data independently. Ratios for dichotomous and means for continuous outcomes were estimated. Outcomes analysed were included under the headings of efficacy, safety and acceptability. Sixteen trials with 2129 women were included in this review. The overall quality of the studies was good, although not all trials measured the same outcomes. All trials measured efficacy with various outcome measures. When comparing efficacy of oestrogenic preparations (in the form of creams, pessaries, tablets and the estradiol releasing vaginal ring) with each other in relieving the symptoms of vaginal atrophy, results indicated significant

Local oestrogen for vaginal atrophy in postmenopausal women.

PubMed

Suckling, J; Lethaby, A; Kennedy, R

2006-10-18

Vaginal atrophy is a frequent complaint of postmenopausal women; symptoms include vaginal dryness, itching, discomfort and painful intercourse. Systemic treatment for these symptoms in the form of oral hormone replacement therapy is not always necessary. An alternative choice is oestrogenic preparations administered vaginally (in the form of creams, pessaries, tablets and the oestradiol-releasing ring). The objective of this review was to compare the effectiveness, safety and acceptability of oestrogenic preparations for women who suffer from vaginal atrophy. We searched the Cochrane Menstrual Disorders and Subfertility Group Register of trials (searched January 2006), The Cochrane Library (2006,Issue 2), MEDLINE (1966 to January 2006), EMBASE (1980 to January 2006), Current Contents (1993 to January 2006, Biological Abstracts (1969 to 2006), Social Sciences Index (1980 to January 2006), PsycINFO (1972 to February 2006), CINAHL (1982 to January 2006) and reference list of articles. We also contacted manufacturers and researchers in the field. The inclusion criteria were randomised comparisons of oestrogenic preparations administered intravaginally in postmenopausal women for the treatment of symptoms resulting from vaginal atrophy or vaginitis. Thirty-seven trials were identified: of these 18 were excluded. Included trials were assessed for quality and two reviewer authors extracted data independently. The ratios for dichotomous outcomes and means for continuous outcomes were calculated. The outcomes analysed were categorised under the headings of: efficacy, safety and acceptability. Nineteen trials with 4162 women were included in this review. The overall quality of the studies was good, although not all trials measured the same outcomes. All trials measured efficacy, with various outcome measures. When comparing the efficacy of different oestrogenic preparations (in the form of creams, pessaries, tablets and the oestradiol-releasing vaginal ring) in relieving the

The continuous rise of bulges out of galactic disks

NASA Astrophysics Data System (ADS)

Breda, Iris; Papaderos, Polychronis

2018-06-01

Context. A key subject in extragalactic astronomy concerns the chronology and driving mechanisms of bulge formation in late-type galaxies (LTGs). The standard scenario distinguishes between classical bulges and pseudo-bulges (CBs and PBs, respectively), the first thought to form monolithically prior to disks and the second gradually out of disks. These two bulge formation routes obviously yield antipodal predictions on the bulge age and bulge-to-disk age contrast, both expected to be high (low) in CBs (PBs). Aims: Our main goal is to explore whether bulges in present-day LTGs segregate into two evolutionary distinct classes, as expected from the standard scenario. Other questions motivating this study center on evolutionary relations between LTG bulges and their hosting disks, and the occurrence of accretion-powered nuclear activity as a function of bulge stellar mass ℳ⋆ and stellar surface density Σ⋆. Methods: In this study, we have combined three techniques - surface photometry, spectral modeling of integral field spectroscopy data and suppression of stellar populations younger than an adjustable age cutoff with the code REMOVEYOUNG (ℛ𝒴) - toward a systematic analysis of the physical and evolutionary properties (e.g., ℳ⋆, Σ⋆ and mass-weighted stellar age ℳ and metallicity ℳ, respectively) of a representative sample of 135 nearby (≤ 130 Mpc) LTGs from the CALIFA survey that cover a range between 108.9 M⊙ and 1011.5 M⊙ in total stellar mass ℳ⋆,T. In particular, the analysis here revolves around ⟨δμ9G⟩, a new distance- and formally extinction-independent measure of the contribution by stellar populations of age ≥ 9 Gyr to the mean r-band surface brightness of the bulge. We argue that ⟨δμ9G⟩ offers a handy semi-empirical tracer of the physical and evolutionary properties of LTG bulges and a promising means for their characterization. Results: The essential insight from this study is that LTG bulges form

Trajectories of Cepheid variable stars in the Galactic nuclear bulge

NASA Astrophysics Data System (ADS)

Matsunaga, Noriyuki

2012-06-01

The central region of our Galaxy provides us with a good opportunity to study the evolution of galactic nuclei and bulges because we can observe various phenomena in detail at the proximity of 8 kpc. There is a hierarchical alignment of stellar systems with different sizes; from the extended bulge, the nuclear bulge, down to the compact cluster around the central supermassive blackhole. The nuclear bulge contains stars as young as a few Myr, and even hosts the ongoing star formation. These are in contrast to the more extended bulge which are dominated by old stars, 10Gyr. It is considered that the star formation in the nuclear bulge is caused by fresh gas provided from the inner disk. In this picture, the nuclear bulge plays an important role as the interface between the gas supplier, the inner disk, and the galactic nucleus. Kinematics of young stars in the nuclear bulge is important to discuss the star forming process and the gas circulation in the Galactic Center. We here propose spectroscopic observations of Cepheid variable stars, 25 Myr, which we recently discovered in the nuclear bulge. The spectra taken in this proposal will allow timely estimates of the systemic velocities of the variable stars.

Tube Bulge Process : Theoretical Analysis and Finite Element Simulations

NASA Astrophysics Data System (ADS)

Velasco, Raphael; Boudeau, Nathalie

2007-05-01

This paper is focused on the determination of mechanics characteristics for tubular materials, using tube bulge process. A comparative study is made between two different models: theoretical model and finite element analysis. The theoretical model is completely developed, based first on a geometrical analysis of the tube profile during bulging, which is assumed to strain in arc of circles. Strain and stress analysis complete the theoretical model, which allows to evaluate tube thickness and state of stress, at any point of the free bulge region. Free bulging of a 304L stainless steel is simulated using Ls-Dyna 970. To validate FE simulations approach, a comparison between theoretical and finite elements models is led on several parameters such as: thickness variation at the free bulge region pole with bulge height, tube thickness variation with z axial coordinate, and von Mises stress variation with plastic strain. Finally, the influence of geometrical parameters deviations on flow stress curve is observed using analytical model: deviations of the tube outer diameter, its initial thickness and the bulge height measurement are taken into account to obtain a resulting error on plastic strain and von Mises stress.

Revisiting the Stellar Mass–Angular Momentum–Morphology Relation: Extension to Higher Bulge Fraction and the Effect of Bulge Type

NASA Astrophysics Data System (ADS)

Sweet, Sarah M.; Fisher, David; Glazebrook, Karl; Obreschkow, Danail; Lagos, Claudia; Wang, Liang

2018-06-01

We present the relation between stellar specific angular momentum j *, stellar mass M *, and bulge-to-total light ratio β for The H I Nearby Galaxy Survey, the Calar Alto Legacy Integral Field Area Survey, and Romanowsky & Fall data sets, exploring the existence of a fundamental plane between these parameters, as first suggested by Obreschkow & Glazebrook. Our best-fit M *–j * relation yields a slope of α = 1.03 ± 0.11 with a trivariate fit including β. When ignoring the effect of β, the exponent α = 0.56 ± 0.06 is consistent with α = 2/3 that is predicted for dark matter halos. There is a linear β–j */M * relation for β ≲ 0.4, exhibiting a general trend of increasing β with decreasing j */M *. Galaxies with β ≳ 0.4 have higher j * than predicted by the relation. Pseudobulge galaxies have preferentially lower β for a given j */M * than galaxies that contain classical bulges. Pseudobulge galaxies follow a well-defined track in β–j */M * space, consistent with Obreschkow & Glazebrook, while galaxies with classical bulges do not. These results are consistent with the hypothesis that while growth in either bulge type is linked to a decrease in j */M *, the mechanisms that build pseudobulges seem to be less efficient at increasing bulge mass per decrease in specific angular momentum than those that build classical bulges.

Does the Galactic Bulge Have Fewer Planets?

NASA Astrophysics Data System (ADS)

Kohler, Susanna

2016-12-01

The Milky Ways dense central bulge is a very different environment than the surrounding galactic disk in which we live. Do the differences affect the ability of planets to form in the bulge?Exploring Galactic PlanetsSchematic illustrating how gravitational microlensing by an extrasolar planet works. [NASA]Planet formation is a complex process with many aspects that we dont yet understand. Do environmental properties like host star metallicity, the density of nearby stars, or the intensity of the ambient radiation field affect the ability of planets to form? To answer these questions, we will ultimately need to search for planets around stars in a large variety of different environments in our galaxy.One way to detect recently formed, distant planets is by gravitational microlensing. In this process, light from a distant source star is bent by a lens star that is briefly located between us and the source. As the Earth moves, this momentary alignment causes a blip in the sources light curve that we can detect and planets hosted by the lens star can cause an additional observable bump.Artists impression of the Milky Way galaxy. The central bulge is much denserthan the surroundingdisk. [ESO/NASA/JPL-Caltech/M. Kornmesser/R. Hurt]Relative AbundancesMost source stars reside in the galactic bulge, so microlensing events can probe planetary systems at any distance between the Earth and the galactic bulge. This means that planet detections from microlensing could potentially be used to measure the relative abundances of exoplanets in different parts of our galaxy.A team of scientists led by Matthew Penny, a Sagan postdoctoral fellow at Ohio State University, set out to do just that. The group considered a sample of 31 exoplanetary systems detected by microlensing and asked the following question: are the planet abundances in the galactic bulge and the galactic disk the same?A Paucity of PlanetsTo answer this question, Penny and collaborators derived the expected

Chemical evolution of the Galactic bulge as traced by microlensed dwarf and subgiant stars. IV. Two bulge populations

NASA Astrophysics Data System (ADS)

Bensby, T.; Adén, D.; Meléndez, J.; Gould, A.; Feltzing, S.; Asplund, M.; Johnson, J. A.; Lucatello, S.; Yee, J. C.; Ramírez, I.; Cohen, J. G.; Thompson, I.; Bond, I. A.; Gal-Yam, A.; Han, C.; Sumi, T.; Suzuki, D.; Wada, K.; Miyake, N.; Furusawa, K.; Ohmori, K.; Saito, To.; Tristram, P.; Bennett, D.

2011-09-01

Based on high-resolution (R ≈ 42 000 to 48 000) and high signal-to-noise (S/N ≈ 50 to 150) spectra obtained with UVES/VLT, we present detailed elemental abundances (O, Na, Mg, Al, Si, Ca, Ti, Cr, Fe, Ni, Zn, Y, and Ba) and stellar ages for 12 new microlensed dwarf and subgiant stars in the Galactic bulge. Including previous microlensing events, the sample of homogeneously analysed bulge dwarfs has now grown to 26. The analysis is based on equivalent width measurements and standard 1-D LTE MARCS model stellar atmospheres. We also present NLTE Li abundances based on line synthesis of the 7Li line at 670.8 nm. The results from the 26 microlensed dwarf and subgiant stars show that the bulge metallicity distribution (MDF) is double-peaked; one peak at [Fe/H] ≈ -0.6 and one at [Fe/H] ≈ + 0.3, and with a dearth of stars around solar metallicity. This is in contrast to the MDF derived from red giants in Baade's window, which peaks at this exact value. A simple significance test shows that it is extremely unlikely to have such a gap in the microlensed dwarf star MDF if the dwarf stars are drawn from the giant star MDF. To resolve this issue we discuss several possibilities, but we can not settle on a conclusive solution for the observed differences. We further find that the metal-poor bulge dwarf stars arepredominantly old with ages greater than 10 Gyr, while the metal-rich bulge dwarf stars show a wide range of ages. The metal-poor bulge sample is very similar to the Galactic thick disk in terms of average metallicity, elemental abundance trends, and stellar ages. Speculatively, the metal-rich bulge population might be the manifestation of the inner thin disk. If so, the two bulge populations could support the recent findings, based on kinematics, that there are no signatures of a classical bulge and that the Milky Way is a pure-disk galaxy. Also, recent claims of a flat IMF in the bulge based on the MDF of giant stars may have to be revised based on the MDF and

The Heavy Ion Afternoon Bulge: Structure and Formation Mechanisms

NASA Astrophysics Data System (ADS)

Fernandes, P. A.; Larsen, B.; Skoug, R. M.; Reeves, G. D.; Denton, M.; Engel, M.; Ferradas, C.; Funsten, H. O.; Henderson, M. G.; Jahn, J. M.; Morley, S.; Thomsen, M. F.

2017-12-01

Recent observations of near-equatorial inner magnetosphere plasma composition indicate the presence of an "afternoon bulge" plasma population at low L-shell. A detailed statistical survey using HOPE data characterized this afternoon bulge as an enhancement in 10 keV O+ and He+ ions extending from 1100-2200 MLT and 2 ≤ L ≤ 4 during quiet/moderate geomagnetic activity (Kp < 5). This statistical HOPE study postulated that formation of the bulge is caused by variations in Kp: 10 keV particles have access to low L-shells during geomagnetically active times and become trapped during the transition to quiet times. In this study, we expand on previous observations of the afternoon bulge by examining individual transits of this feature by the Van Allen Probes. We analyze periods with optimal spacecraft transits of the afternoon bulge region, including: May - Oct. 2013, Feb. - June 2014, and Apr. - Aug. 2015. We determine the presence and duration of the bulge during case studies representing three categories of geomagnetic activity: 1) extended quiet geomagnetic conditions; 2) sharp transitions of Kp from active to quiet conditions; and 3) rises and falls in Kp on the time scales of spacecraft orbits to days. We thoroughly characterize the energy structure of the bulge as a function of Kp. We also analyze these transits of the bulge in the context of plasma access using both drift path modeling and UBK-derived energy access maps.

Abundances of disk and bulge giants from high-resolution optical spectra. II. O, Mg, Ca, and Ti in the bulge sample

NASA Astrophysics Data System (ADS)

Jönsson, H.; Ryde, N.; Schultheis, M.; Zoccali, M.

2017-02-01

Context. Determining elemental abundances of bulge stars can, via chemical evolution modeling, help to understand the formation and evolution of the bulge. Recently there have been claims both for and against the bulge having a different [α/Fe] versus [Fe/H] trend as compared to the local thick disk. This could possibly indicate a faster, or at least different, formation timescale of the bulge as compared to the local thick disk. Aims: We aim to determine the abundances of oxygen, magnesium, calcium, and titanium in a sample of 46 bulge K giants, 35 of which have been analyzed for oxygen and magnesium in previous works, and compare this sample to homogeneously determined elemental abundances of a local disk sample of 291 K giants. Methods: We used spectral synthesis to determine both the stellar parameters and elemental abundances of the bulge stars analyzed here. We used the exact same method that we used to analyze the comparison sample of 291 local K giants in Paper I of this series. Results: Compared to the previous analysis of the 35 stars in our sample, we find lower [Mg/Fe] for [Fe/H] >-0.5, and therefore contradict the conclusion about a declining [O/Mg] for increasing [Fe/H]. We instead see a constant [O/Mg] over all the observed [Fe/H] in the bulge. Furthermore, we find no evidence for a different behavior of the alpha-iron trends in the bulge as compared to the local thick disk from our two samples. Note to the reader: following the publication of the corrigendum, the subtitle of the article was corrected on April 6, 2017. "O, Mg, Co, and Ti" has been replaced by "O, Mg, Ca, and Ti".Based on observations collected at the European Southern Observatory, Chile (ESO programs 71.B-0617(A), 073.B-0074(A), and 085.B-0552(A)).

Vaginal Gene Expression During Treatment With Aromatase Inhibitors.

PubMed

Kallak, Theodora Kunovac; Baumgart, Juliane; Nilsson, Kerstin; Åkerud, Helena; Poromaa, Inger Sundström; Stavreus-Evers, Anneli

2015-12-01

Aromatase inhibitor (AI) treatment suppresses estrogen biosynthesis and causes genitourinary symptoms of menopause such as vaginal symptoms, ultimately affecting the quality of life for many postmenopausal women with breast cancer. Thus, the aim of this study was to examine vaginal gene expression in women during treatment with AIs compared with estrogen-treated women. The secondary aim was to study the presence and localization of vaginal aromatase. Vaginal biopsies were collected from postmenopausal women treated with AIs and from age-matched control women treated with vaginal estrogen therapy. Differential gene expression was studied with the Affymetrix Gene Chip Gene 1.0 ST Array (Affymetrix Inc, Santa Clara, CA) system, Ingenuity pathway analysis, quantitative real-time polymerase chain reaction, and immunohistochemistry. The expression of 279 genes differed between the 2 groups; AI-treated women had low expression of genes involved in cell differentiation, proliferation, and cell adhesion. Some differentially expressed genes were found to interact indirectly with the estrogen receptor alpha. In addition, aromatase protein staining was evident in the basal and the intermediate vaginal epithelium layers, and also in stromal cells with a slightly stronger staining intensity found in AI-treated women. In this study, we demonstrated that genes involved in cell differentiation, proliferation, and cell adhesion are differentially expressed in AI-treated women. The expression of vaginal aromatase suggests that this could be the result of local and systemic inhibition of aromatase. Our results emphasize the role of estrogen for vaginal cell differentiation and proliferation and future drug candidates should be aimed at improving cell differentiation and proliferation. Copyright © 2015 Elsevier Inc. All rights reserved.

Recurrent vaginal discharge in children.

PubMed

McGreal, Sharon; Wood, Paul

2013-08-01

Childhood vaginal discharge remains a frequent reason for referral from primary to secondary care. The Pediatric and Adolescent Gynecology (PAG) service at Kettering General Hospital was established in 1993 and provides a specialized service that meets the needs of children with gynaecological conditions. To investigate recurrent vaginal discharge noting symptomatology, defining pathogens, common and rarer causes, exploring management regimes, and any changes in practice over time. Retrospective review spanning 15 years identifying prepubertal children attending the outpatient PAG clinic with recurrent vaginal discharge. We reviewed the medical notes individually. 110 patients were identified; 85% were referred from primary care. The age distribution was bimodal at four and eight years. Thirty-five percent of our patients were discharged after the initial consultation. The commonest cause of discharge was vulvovaginitis (82%). Other important causes included suspected sexual abuse (5%), foreign body (3%), labial adhesions (3%), vaginal agenesis (2%). 35% of patients were admitted for vaginoscopy. Vaginal discharge is the most common gynecological symptom in prepubertal girls and can cause repeated clinical episodes. Vulvovaginitis is the most common cause and often responds to simple hygiene measures. Awareness of the less common causes of vaginal discharge is essential. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Vaginal rings for delivery of HIV microbicides

PubMed Central

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

2012-01-01

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

Vaginal rings for delivery of HIV microbicides.

PubMed

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

2012-01-01

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

Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study.

PubMed

Nygaard, Ingrid E; Clark, Erin; Clark, Lauren; Egger, Marlene J; Hitchcock, Robert; Hsu, Yvonne; Norton, Peggy; Sanchez-Birkhead, Ana; Shaw, Janet; Sheng, Xiaoming; Varner, Michael

2017-01-10

Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes. Using quantitative methods, we will evaluate whether pelvic floor support and symptoms 1 year after the first vaginal delivery are affected by biologically plausible factors that may impact muscle, nerve and connective tissue healing during recovery (first 8 weeks postpartum) and strengthening (remainder of the first postpartum year). Using qualitative methods, we will examine cultural aspects of perceptions, explanations of changes in pelvic floor support, and actions taken by Mexican-American and Euro-American primipara, emphasising early changes after childbirth. We will summarise project results in a resource toolkit that will enhance opportunities for dialogue between women, their families and providers, and across lay and medical discourses. We anticipate enrolling up to 1530 nulliparous women into the prospective cohort study during the third trimester, following those who deliver vaginally 1 year postpartum. Participants will be drawn from this cohort to meet the project's aims. The University of Utah and Intermountain Healthcare Institutional Review Boards approved this study. Data are stored in a

Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study

PubMed Central

Nygaard, Ingrid E; Clark, Erin; Clark, Lauren; Egger, Marlene J; Hitchcock, Robert; Hsu, Yvonne; Norton, Peggy; Sanchez-Birkhead, Ana; Shaw, Janet; Sheng, Xiaoming; Varner, Michael

2017-01-01

Introduction Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, ‘Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery’, uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes. Methods and analysis Using quantitative methods, we will evaluate whether pelvic floor support and symptoms 1 year after the first vaginal delivery are affected by biologically plausible factors that may impact muscle, nerve and connective tissue healing during recovery (first 8 weeks postpartum) and strengthening (remainder of the first postpartum year). Using qualitative methods, we will examine cultural aspects of perceptions, explanations of changes in pelvic floor support, and actions taken by Mexican-American and Euro-American primipara, emphasising early changes after childbirth. We will summarise project results in a resource toolkit that will enhance opportunities for dialogue between women, their families and providers, and across lay and medical discourses. We anticipate enrolling up to 1530 nulliparous women into the prospective cohort study during the third trimester, following those who deliver vaginally 1 year postpartum. Participants will be drawn from this cohort to meet the project's aims. Ethics and dissemination The University of Utah and Intermountain Healthcare

Nd:YAG laser therapy for rectal and vaginal venous malformations.

PubMed

Gurien, Lori A; Jackson, Richard J; Kiser, Michelle M; Richter, Gresham T

2017-08-01

Limited therapeutic options exist for rectal and vaginal venous malformations (VM). We describe our center's experience using Nd:YAG laser for targeted ablation of abnormal veins to treat mucosally involved pelvic VM. Records of patients undergoing non-contact Nd:YAG laser therapy of pelvic VM at a tertiary children's hospital were reviewed. Symptoms, operative findings and details, complications, and outcomes were evaluated. Nine patients (age 0-24) underwent Nd:YAG laser therapy of rectal and/or vaginal VM. Rectal bleeding was present in all patients and vaginal bleeding in all females (n = 5). 5/7 patients had extensive pelvic involvement on MRI. Typical settings were 30 (rectum) and 20-25 W (vagina), with 0.5-1.0 s pulse duration. Patients underwent the same-day discharge. Treatment intervals ranged from 14 to 180 (average = 56) weeks, with 6.1-year mean follow-up. Five patients experienced symptom relief with a single treatment. Serial treatments managed recurrent bleeding successfully in all patients, with complete resolution of vaginal lesions in 40% of cases. No complications occurred. Nd:YAG laser treatment of rectal and vaginal VM results in substantial improvement and symptom control, with low complication risk. Given the high morbidity of surgical resection, Nd:YAG laser treatment of pelvic VM should be considered as first line therapy.

Treatment Option Overview (Vaginal Cancer)

MedlinePlus

... stage of the cancer being treated. External and internal radiation therapy are used to treat vaginal cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life . Chemotherapy Chemotherapy is a cancer treatment ...

Diagnostic Value of Vaginal Discharge, Wet Mount and Vaginal pH – An Update on the Basics of Gynecologic Infectiology

PubMed Central

Frobenius, W.; Bogdan, C.

2015-01-01

The majority of uncomplicated vulvovaginal complaints (e.g. bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis) can be detected with uncomplicated basic infectiological tests and can usually be treated effectively without requiring further diagnostic procedures. Tests include measurement of vaginal pH, preparation and assessment of wet mount slides prepared from vaginal or cervical discharge, and the correct clinical and microbiological classification of findings. In Germany, at least in recent years, this has not been sufficiently taught or practiced. As new regulations on specialist gynecologic training in Germany are currently being drawn up, this overview provides basic information on gynecologic infectiology and summarizes clinically relevant aspects of recent microbiological findings on the physiology and pathology of vaginal flora. The clinical signs and symptoms of aerobic vaginitis, the pathogenesis of which is still not completely understood, are also reviewed. Finally, the symptoms, indications and risk factors for pelvic inflammatory disease (PID) are presented. In contrast to the above-listed infections, PID requires immediate culture of the pathogen from samples (e.g. obtained by laparoscopy) with microbiological diagnostic procedures carried out by specialist laboratories. A schematic summary of all pathologies discussed here is presented. PMID:26028693

Vaginal Changes Due to Varying Degrees of Rectocele Prolapse: A Computational Study.

PubMed

Chanda, Arnab; Meyer, Isuzu; Richter, Holly E; Lockhart, Mark E; Moraes, Fabia R D; Unnikrishnan, Vinu

2017-10-01

Pelvic organ prolapse (POP), downward descent of the pelvic organs resulting in a protrusion of the vagina, is a highly prevalent condition, responsible for 300,000 surgeries in the U.S. annually. Rectocele, a posterior vaginal wall (PVW) prolapse of the rectum, is the second most common type of POP after cystocele. A rectocele usually manifests itself along with other types of prolapse with multicompartment pelvic floor defects. To date, the specific mechanics of rectocele formation are poorly understood, which does not allow its early stage detection and progression prediction over time. Recently, with the advancement of imaging and computational modeling techniques, a plethora of finite element (FE) models have been developed to study vaginal prolapse from different perspectives and allow a better understanding of dynamic interactions of pelvic organs and their supporting structures. So far, most studies have focused on anterior vaginal prolapse (AVP) (or cystocele) and limited data exist on the role of pelvic muscles and ligaments on the development and progression of rectocele. In this work, a full-scale magnetic resonance imaging (MRI) based three-dimensional (3D) computational model of the female pelvic anatomy, comprising the vaginal canal, uterus, and rectum, was developed to study the effect of varying degrees (or sizes) of rectocele prolapse on the vaginal canal for the first time. Vaginal wall displacements and stresses generated due to the varying rectocele size and average abdominal pressures were estimated. Considering the direction pointing from anterior to posterior side of the pelvic system as the positive Y-direction, it was found that rectocele leads to negative Y-direction displacements, causing the vaginal cross section to shrink significantly at the lower half of the vaginal canal. Besides the negative Y displacements, the rectocele bulging was observed to push the PVW downward toward the vaginal hiatus, exhibiting the well-known "kneeling

Efficacy and safety of vitamin C vaginal tablets in the treatment of non-specific vaginitis. A randomised, double blind, placebo-controlled study.

PubMed

Petersen, E Eiko; Magnani, Paola

2004-11-10

This was a randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of Vitamin C vaginal tablets (250 mg) given once a day in patients suffering from non-specific vaginitis. The total length of the study was 20 days, including a treatment phase of 6 days. The primary end-point was the presence in the two groups of non-specific vaginitis 1 and 2 weeks after the end of treatment, as assessed by at least 3 out of the 4 characteristic symptoms: discharge, fishy odour, vaginal pH >/= 4.7, and presence of clue cells. Secondary end-points were the individual symptoms and signs, above reported, and pruritus, fever, superinfections, microscopic findings on vaginal smear, and colposcopy. One hundred female patients aged 18 years or older and suffering from non-specific vaginitis were included in the study after giving their informed consent. Fifty were randomised to the active treatment and 50 to placebo. Seven patients, three in the Vitamin C group and four in the placebo group, were lost to follow-up and did not complete the treatment period. Two patients in the active group showed protocol deviations (age under 18 years and HIV-positive, respectively). The two groups resulted comparable for demographics, history and baseline clinical picture. A cluster analysis of the four main symptoms showed a statistically significant difference between the active group and the placebo group; significantly more patients were still affected by non-specific vaginitis after placebo (35.7%) compared to patients treated with Vitamin C tablets (14.0%). The meaningful secondary variable, referring to the microscopic examination of vaginal smear, supported the trend for efficacy in the Vitamin C treated group. The clue cells disappeared in 79% of patients treated with the drug and in 53% of patients on placebo. Similarly, bacteria disappeared in 77 and 54%, respectively, while lactobacilli reappeared in 79.1 and 53.3%, respectively. Vaginal pH values decreased

Discovery of carbon-rich Miras in the Galactic bulge

NASA Astrophysics Data System (ADS)

Matsunaga, Noriyuki; Menzies, John W.; Feast, Michael W.; Whitelock, Patricia A.; Onozato, Hiroki; Barway, Sudhanshu; Aydi, Elias

2017-08-01

Only one carbon-rich (C-rich, hereinafter) Mira variable has so far been suggested as a member of the Galactic bulge and this is in a symbiotic system. Here we describe a method for selecting C-rich candidates from an infrared colour-colour diagram, (J - Ks) versus ([9] - [18]). Follow-up low-resolution spectroscopy resulted in the detection of eight C-rich Mira variables from a sample of 36 candidates towards the Galactic bulge. Our near-infrared photometry indicates that two of these, including the known symbiotic, are closer than the main body of the bulge while a third is a known foreground object. Of the five bulge members, one shows He I and [O II] emission and is possibly another symbiotic star. Our method is useful for identifying rare C-rich stars in the Galactic bulge and elsewhere. The age of these C-rich stars and the evolutionary process which produced them remain uncertain. They could be old and the products of either binary mass transfer or mergers, I.e. the descendants of blue stragglers, but we cannot rule out the possibility that they belong to a small in situ population of metal-poor intermediate age (<5 Gyr) stars in the bulge or that they have been accreted from a dwarf galaxy.

Giant primary vaginal calculus secondary to vesicovaginal fistula with partial vaginal outlet obstruction in a 12-year-old girl.

PubMed

Chen, Shushang; Ge, Rong; Zhu, Lingfeng; Yang, Shunliang; Wu, Weizhen; Yang, Yin; Tan, Jianming

2011-10-01

A vesicovaginal fistula with vagina obstruction associated with vaginal calculi is an extremely rare medical condition. We report a giant primary vaginal calculus resulting from vesicovaginal fistula with partial vaginal outlet obstruction secondary to perineum trauma and surgery in a 12-year-old girl. Episiotomy was performed and the adhesive labia minora was split. After the removal of a giant calculus in the vagina, approximately 8 cm in diameter, the fistula tract was completely excised, followed by the repair of the vesicovagina fistula and the vagina. The patient was symptom-free at 6-month follow-up examination. Copyright © 2011 Elsevier Inc. All rights reserved.

Bulge Growth Through Disc Instabilities in High-Redshift Galaxies

NASA Astrophysics Data System (ADS)

Bournaud, Frédéric

The role of disc instabilities, such as bars and spiral arms, and the associated resonances, in growing bulges in the inner regions of disc galaxies have long been studied in the low-redshift nearby Universe. There it has long been probed observationally, in particular through peanut-shaped bulges (Chap. 14 10.1007/978-3-319-19378-6_14"). This secular growth of bulges in modern disc galaxies is driven by weak, non-axisymmetric instabilities: it mostly produces pseudobulges at slow rates and with long star-formation timescales. Disc instabilities at high redshift (z > 1) in moderate-mass to massive galaxies (1010 to a few 1011 M⊙ of stars) are very different from those found in modern spiral galaxies. High-redshift discs are globally unstable and fragment into giant clumps containing 108-9 M⊙ of gas and stars each, which results in highly irregular galaxy morphologies. The clumps and other features associated to the violent instability drive disc evolution and bulge growth through various mechanisms on short timescales. The giant clumps can migrate inward and coalesce into the bulge in a few 108 years. The instability in the very turbulent media drives intense gas inflows toward the bulge and nuclear region. Thick discs and supermassive black holes can grow concurrently as a result of the violent instability. This chapter reviews the properties of high-redshift disc instabilities, the evolution of giant clumps and other features associated to the instability, and the resulting growth of bulges and associated sub-galactic components.

Stellar populations in the bulges of isolated galaxies

NASA Astrophysics Data System (ADS)

Morelli, L.; Parmiggiani, M.; Corsini, E. M.; Costantin, L.; Dalla Bontà, E.; Méndez-Abreu, J.; Pizzella, A.

2016-12-01

We present photometry and long-slit spectroscopy for 12 S0 and spiral galaxies selected from the Catalogue of Isolated Galaxies. The structural parameters of the sample galaxies are derived from the Sloan Digital Sky Survey I-band images by performing a two-dimensional photometric decomposition of the surface brightness distribution. This is assumed to be the sum of the contribution of a Sérsic bulge, an exponential disc, and a Ferrers bar characterized by elliptical and concentric isophotes with constant ellipticity and position angles. The rotation curves and velocity dispersion profiles of the stellar component are measured from the spectra obtained along the major axis of galaxies. The radial profiles of the Hβ, Mg and Fe line-strength indices are derived too. Correlations between the central values of the Mg2 and line-strength indices and the velocity dispersion are found. The mean age, total metallicity and total α/Fe enhancement of the stellar population in the centre and at the radius, where the bulge gives the same contribution to the total surface brightness as the remaining components, are obtained using stellar population models with variable element abundance ratios. We identify intermediate-age bulges with solar metallicity and old bulges with a large spread in metallicity. Most of the sample bulges display supersolar α/Fe enhancement, no gradient in age and negative gradients of metallicity and α/Fe enhancement. These findings support a formation scenario via dissipative collapse where environmental effects are remarkably less important than in the assembly of bulges of galaxies in groups and clusters.

Streptococcus agalactiae: a vaginal pathogen?

PubMed

Maniatis, A N; Palermos, J; Kantzanou, M; Maniatis, N A; Christodoulou, C; Legakis, N J

1996-03-01

The significance of Streptococcus agalactiae as an aetiological agent in vaginitis was evaluated. A total of 6226 samples from women who presented with vaginal symptoms was examined. The presence of >10 leucocytes/high-power field (h.p.f.) was taken to be the criterion of active infection. S. agalactiae was isolated from 10.1% of these samples. The isolation rates of other common pathogens such as Candida spp., Gardnerella vaginalis and Trichomonas spp. were 54.1%, 27.2% and 4.2%, respectively, in the same group of patients. In contrast, the isolation rates of these micro-organisms in the group of patients who had no infection (<10 leucocytes/h.p.f.) were 4.2%, 38.3%, 33% and 0.5%, respectively. In the majority of samples from which S. agalactiae was isolated, it was the sole pathogen isolated (83%) and its presence was associated with an inflammatory response in 80% of patients. Furthermore, the relative risk of vaginal infection with S. agalactiae (2.38) in patients with purulent vaginal discharge was greater than that of Candida spp. infection (1.41) and lower than that of Trichomonas spp. infection (8.32). These data suggest that S. agalactiae in symptomatic women with microscopic evidence of inflammation should be considered a causative agent of vaginitis.

Anterior vaginal introitoplasty for an acquired sensation of wide vagina: a case report and new surgical intervention.

PubMed

Ostrzenski, Adam

2014-01-01

A vaginal introital defect case and its symptomatology have never been published before. The objective of this presentation was to describe symptoms associated with an acquired sensation of wide vagina and to present a new surgical treatment for anterior vaginal introital defects. A 42-year-old, Caucasian woman, G4P4013, presented with a sensation of wide vagina at the vaginal opening and a history of colpoperineoplasty, without mesh, for the same condition 4 years prior. Clinical evaluation documented anterior vaginal introital defects and the absence of vaginal site-specific defects. Reconstruction of a vaginal introital defect was completed without complications. Surgical resolution of symptoms and signs of this condition were noted. Anterior vaginal introitoplasty can assist in the management of an acquired sensation of wide vagina.

Age bimodality in the central region of pseudo-bulges in S0 galaxies

NASA Astrophysics Data System (ADS)

Mishra, Preetish K.; Barway, Sudhanshu; Wadadekar, Yogesh

2017-11-01

We present evidence for bimodal stellar age distribution of pseudo-bulges of S0 galaxies as probed by the Dn(4000) index. We do not observe any bimodality in age distribution for pseudo-bulges in spiral galaxies. Our sample is flux limited and contains 2067 S0 and 2630 spiral galaxies drawn from the Sloan Digital Sky Survey. We identify pseudo-bulges in S0 and spiral galaxies, based on the position of the bulge on the Kormendy diagram and their central velocity dispersion. Dividing the pseudo-bulges of S0 galaxies into those containing old and young stellar populations, we study the connection between global star formation and pseudo-bulge age on the u - r colour-mass diagram. We find that most old pseudo-bulges are hosted by passive galaxies while majority of young bulges are hosted by galaxies that are star forming. Dividing our sample of S0 galaxies into early-type S0s and S0/a galaxies, we find that old pseudo-bulges are mainly hosted by early-type S0 galaxies while most of the pseudo-bulges in S0/a galaxies are young. We speculate that morphology plays a strong role in quenching of star formation in the disc of these S0 galaxies, which stops the growth of pseudo-bulges, giving rise to old pseudo-bulges and the observed age bimodality.

Galaxies Grow Their Bulges and Black Holes in Diverse Ways

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bell, Eric F.; Harmsen, Benjamin; D’Souza, Richard

Galaxies with Milky Way–like stellar masses have a wide range of bulge and black hole masses; in turn, these correlate with other properties such as star formation history. While many processes may drive bulge formation, major and minor mergers are expected to play a crucial role. Stellar halos offer a novel and robust measurement of galactic merger history; cosmologically motivated models predict that mergers with larger satellites produce more massive, higher-metallicity stellar halos, reproducing the recently observed stellar halo metallicity–mass relation. We quantify the relationship between stellar halo mass and bulge or black hole prominence using a sample of 18more » Milky Way-mass galaxies with newly available measurements of (or limits on) stellar halo properties. There is an order of magnitude range in bulge mass, and two orders of magnitude in black hole mass, at a given stellar halo mass (or, equivalently, merger history). Galaxies with low-mass bulges show a wide range of quiet merger histories, implying formation mechanisms that do not require intense merging activity. Galaxies with massive “classical” bulges and central black holes also show a wide range of merger histories. While three of these galaxies have massive stellar halos consistent with a merger origin, two do not—merging appears to have had little impact on making these two massive “classical” bulges. Such galaxies may be ideal laboratories to study massive bulge formation through pathways such as early gas-rich accretion, violent disk instabilities, or misaligned infall of gas throughout cosmic time.« less

Galaxies Grow Their Bulges and Black Holes in Diverse Ways

NASA Astrophysics Data System (ADS)

Bell, Eric F.; Monachesi, Antonela; Harmsen, Benjamin; de Jong, Roelof S.; Bailin, Jeremy; Radburn-Smith, David J.; D'Souza, Richard; Holwerda, Benne W.

2017-03-01

Galaxies with Milky Way-like stellar masses have a wide range of bulge and black hole masses; in turn, these correlate with other properties such as star formation history. While many processes may drive bulge formation, major and minor mergers are expected to play a crucial role. Stellar halos offer a novel and robust measurement of galactic merger history; cosmologically motivated models predict that mergers with larger satellites produce more massive, higher-metallicity stellar halos, reproducing the recently observed stellar halo metallicity-mass relation. We quantify the relationship between stellar halo mass and bulge or black hole prominence using a sample of 18 Milky Way-mass galaxies with newly available measurements of (or limits on) stellar halo properties. There is an order of magnitude range in bulge mass, and two orders of magnitude in black hole mass, at a given stellar halo mass (or, equivalently, merger history). Galaxies with low-mass bulges show a wide range of quiet merger histories, implying formation mechanisms that do not require intense merging activity. Galaxies with massive “classical” bulges and central black holes also show a wide range of merger histories. While three of these galaxies have massive stellar halos consistent with a merger origin, two do not—merging appears to have had little impact on making these two massive “classical” bulges. Such galaxies may be ideal laboratories to study massive bulge formation through pathways such as early gas-rich accretion, violent disk instabilities, or misaligned infall of gas throughout cosmic time.

[Progress in research of relationship between vaginal Lactobacillus and preterm delivery].

PubMed

He, Y N; Xiong, H Y; Zheng, Y J

2017-03-10

The vaginal flora in most healthy women is dominated by Lactobacillus species. The absence of Lactobacillus species in vaginal flora might lead to a series of symptoms, especially in pregnant women causing adverse pregnancy outcomes, such as preterm delivery. This review focuses on the progress in the research of the relationship between vaginal Lactobacillus and preterm delivery, providing reference for the reduction of the incidence of preterm delivery.

Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse.

PubMed

Sung, Vivian W; Rogers, Rebecca G; Barber, Matthew D; Clark, Melissa A

2014-04-01

To develop a comprehensive conceptual framework representing the most important outcomes for women seeking treatment for pelvic organ prolapse (POP). Twenty-five women with POP were recruited and participated in four semi-structured focus groups to refine and assess the content validity of a conceptual framework representing patient-important outcomes for POP. Specifically, the focus groups addressed the following three aims: (1) to evaluate the content and appropriateness of domains in our framework; (2) to identify gaps in the framework; and (3) to determine the relative importance of our framework domains from the patient perspective. Sessions were transcribed, coded, and qualitatively and quantitatively analyzed using analytic induction and deductive analysis to identify themes and domains relevant to women with POP. Our focus groups confirmed the importance of vaginal bulge symptoms (discomfort, bother, and adaptation), and the overarching domains and subdomains of physical (physical function and participation), social (social function, relationships, and sexual function), and mental health (emotional distress, preoccupation, and body image). Patients ranked outcomes in the following order of importance: (1) the resolution of vaginal bulge symptoms, (2) improvement in physical function; (3) improvement in sexual function; (4) improvement in body image perception; and (5) improvement in social function. We developed a conceptual framework for patient important outcomes of women seeking treatment for POP. This framework can improve the transparency and interpretation of POP study findings from the patient perspective. Vaginal bulge and its associated discomfort are most important for the definition of POP treatment success from the patient perspective. © 2013 Wiley Periodicals, Inc.

[Vaginal infections in a Family Health Clinic in the Metropolitan Region, Chile].

PubMed

Villaseca, Rodrigo; Ovalle, Alfredo; Amaya, Fernando; Labra, Bayron; Escalona, Natalia; Lizana, Paola; Montoya, M José; Lillo, Eduardo; Martínez, M Angélica

2015-02-01

Vaginal infections are a frequent cause for consultation, but their prevalence and etiology vary in different populations. To determine the prevalence and etiologies of vaginal infection in women attending a family health center in the Metropolitan Region of Chile. The microbiological diagnosis was made by wet mount and Gram stain. Diagnosis of trichomoniasis was performed by wet mount, culture and polymerase chain reaction. 101 women aged 15-54, not selected by signs or symptoms of vaginal infection, 46 of them pregnant were included. In 47 women (46.5%), vaginal infections were diagnosed. An association was observed between age and frequency of vaginal infection. The proportion of infections among pregnant and non-pregnant women was similar. The most frequent infections were bacterial vaginosis (16.8%), vulvovaginal candidiasis (11.9%) and co-infections (6.9%). We found 5.9% of intermediate microbiota cases, 3% of trichomoniasis and 2% of aerobic vaginitis. Symptoms of vaginal infection had poor agreement with microbiological findings. Otherwise physical signs had good agreement with the presence of infection, but low to moderate concordance with a specific etiology. We found a high prevalence of vaginal infections in the study population. It is necessary to improve the definitions and criteria of microbiological diagnosis of co-infections and intermediate microbiota, for them to be diagnosed in the clinical practice. More descriptive questionnaires are recommended to enhance the usefulness of clinical examination.

Effects of De-spinning and Lithosphere Thickening on the Lunar Fossil Bulge

NASA Astrophysics Data System (ADS)

Zhong, S.; Qin, C.; Phillips, R. J.

2016-12-01

The Moon has abnormally large degree-2 anomalies in gravity and shape (or bulge). The degree-2 gravity coefficients C20 and C22 are, respectively, 22 and 7 times greater than expected from the Moon's current orbital and rotational states. One prevalent hypothesis, called the fossil bulge hypothesis, interprets the current degree-2 shape as a remnant of the bulge that froze in when the Moon was closer to the Earth with stronger tidal and rotational potentials. However, the dynamic feasibility of the freeze-in process has never been quantitatively examined. In this study, we explore, using numerical models of viscoelastic deformation with time-dependent rotational potential and lithospheric rheology, how the degree-2 bulge would evolve with time as the early Moon cools and migrates away from the Earth. Our model includes two competing effects: 1) a thickening lithosphere with time through cooling, which helps maintain the bulge, and 2) de-spinning through tidal locking, which tends to reduce the bulge. In our model, a strong lithosphere is represented by the topmost layer that is orders of magnitude more viscous than the mantle. The benchmark results show that our numerical model can compute the bulge size accurately. Our calculations start with a bulge size that is in hydrostatic equilibrium with the initial rotational rate. The bulge reduces with time as the Moon spins down, while the lithosphere can support certain amount of bulge as it thickens. We find that the final size of the bulge is controlled by the relative time scales of the two processes. At limiting cases, if the time scale of de-spinning were much larger than that of lithosphere thickening, the bulge size would be largely maintained. Conversely, the bulge size would be reduced significantly. We will consider more realistic time scales for these two processes, as well as effects of other subsequent processes after lunar magma ocean crystallization, such as large impacts and mare volcanism.

Vaginal Testosterone for Management of Aromatase Inhibitor-Related Sexual Dysfunction: An Integrative Review.

PubMed

Lemke, Emily A; Madsen, Lydia T; Dains, Joyce E

2017-05-01

Women taking aromatase inhibitors (AIs) as part of the management of hormone receptor-positive breast cancer experience more symptoms of sexual dysfunction, including vaginal atrophy, as opposed to postmenopausal women and women treated with tamoxifen (Nolvadex®). Vaginal testosterone could be an alternative to estrogen, which is contraindicated in this population.
. A systematic review was completed by searching PubMed and Scopus databases.
. 64 search results were reduced to a final sample of 3 articles after applying inclusion and exclusion criteria.
. Published results suggest that vaginally applied testosterone doses of 150 mcg and 300 mcg improve symptoms of sexual dysfunction in women taking AIs. Minimal side effects are observed, and estradiol levels are not affected by vaginally applied testosterone. Additional research is needed to evaluate vaginal testosterone in women taking AIs.
. Vaginal testosterone shows preliminary promise as an option to manage sexual side effects of AI therapy in postmenopausal cancer survivors; however, available data are too limited to draw practice-changing conclusions.
. Large-scale randomized, controlled trials need to be completed to evaluate the efficacy and safety of vaginal testosterone in women taking AIs.

[Application of sumamed in treatment of bacterial vaginal infections during pregnancy].

PubMed

Nikolov, A; Shopova, E; Nashar, S; Dimitrov, A

2008-01-01

To study the efficacy of Sumamed in cases of endogenous bacterial vaginal infections during third trimester of pregnancy. 34 women in last trimester of pregnancy with Streptococcus group B, Streptococcus group A, alpha hemolytic Streptococci, S. aureus infections and intermediate state of vaginal ecosystem (Nugent score 4-6) were treated with Sumamed (Azithromycin, 500 mg. p.o. for 3 days). Patients were separated in two groups. First group included 19 women with symptomatic and microbiologically proven recurrent vaginal infection during last 6 months. Second group included 15 symptom free pregnant women, in whom, pathogenic bacteria were found on vaginal swab and culture. Culture revealed 2 cases of Streptococcus group A infection in the second study group. Streptococcus group B was isolated in 19 patients--11 group 1 and 8--group 2. S. aureus was found in 6 patients from group 1 and 3 patients from group 2. Alpha hemolytic streptococci were cultured in 4 cases--2 from group 1 and 2 from group 2. Isolated microorganisms showed in vitro sensibility toward Sumamed. After treatment completion, control swab and culture was performed in 26 cases (14 group 1 and 12 group 2 patients). In group 1 in 12 (85,7%) patients no pathological microorganisms were cultured, Nugent scores were between 0-3 and no subjective symptoms were reported. 2 (14,3%) patients had Candida infection. In the second group 10 patients (83,5%) had normal vaginal microbiology, 2(16,5%) remained with intermediate vaginal microflora state. No newborn infections and cases of endometritis were found in both study groups. Sumamed is an efficacious treatment in cases of streptococcal and staphylococcal vaginal infections during pregnancy. Application of Sumamed results in alleviation of clinical symptoms and in sanitation of birth canal.

Treatment Options by Stage (Vaginal Cancer)

MedlinePlus

... stage of the cancer being treated. External and internal radiation therapy are used to treat vaginal cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life . Chemotherapy Chemotherapy is a cancer treatment ...

Oxytocin stimulates cell proliferation in vaginal cell line Vk2E6E7.

PubMed

Kallak, Theodora K; Uvnäs-Moberg, Kerstin

2017-03-01

Objective During and after menopause, the symptoms of vaginal atrophy cause great discomfort and necessitate effective treatment options. Currently, vaginally applied oxytocin is being investigated as a treatment for the symptoms of vaginal atrophy in postmenopausal women. To clarify the mechanisms behind oxytocins effects on vaginal atrophy, the present study investigated the effects of oxytocin on cell proliferation in the cells of the Vk2E6E7 line, a non-tumour vaginal cell line. The study also compared the effects of oxytocin with those of estradiol (E2). Study design The effects of both oxytocin and E2 on the proliferation of Vk2E6E7 cells were investigated using Cell Proliferation ELISA BrdU Colorimetric Assay. The expression of both oxytocin and oxytocin receptor was studied in Vk2E6E7 cells using quantitative real-time polymerase chain reaction and immunofluorescent staining. Main outcome measures Cell proliferation and gene expression. Results Oxytocin increased cell proliferation both time dependently and dose dependently. This differed from the effect pattern observed in cells treated with E2. In addition, in oxytocin-treated cells, the oxytocin receptor was found to be co-localized with caveolin-1, indicating pro-proliferative signalling within the cell. Conclusions Oxytocin stimulates cell proliferation and the co-localization of oxytocin receptor with caveolin-1 in oxytocin-treated cells, supporting the role of oxytocin signalling in cell proliferation. In addition, these findings suggest that increased cell proliferation is one mechanism by which local vaginal oxytocin treatment increases vaginal thickness and relieves vaginal symptoms in postmenopausal women with vaginal atrophy.

Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard.

PubMed

Lowe, Nancy K; Neal, Jeremy L; Ryan-Wenger, Nancy A

2009-01-01

To estimate the accuracy of the clinical diagnosis of the three most common causes of acute vulvovaginal symptoms (bacterial vaginosis, candidiasis vaginitis, and trichomoniasis vaginalis) using a traditional, standardized clinical diagnostic protocol compared with a DNA probe laboratory standard. This prospective clinical comparative study had a sample of 535 active-duty United States military women presenting with vulvovaginal symptoms. Clinical diagnoses were made by research staff using a standardized protocol of history, physical examination including pelvic examination, determination of vaginal pH, vaginal fluid amines test, and wet-prep microscopy. Vaginal fluid samples were obtained for DNA analysis. The research clinicians were blinded to the DNA results. The participants described a presenting symptom of abnormal discharge (50%), itching/irritation (33%), malodor (10%), burning (4%), or others such as vulvar pain and vaginal discomfort. According to laboratory standard, there were 225 cases (42%) of bacterial vaginosis, 76 cases (14%) of candidiasis vaginitis, 8 cases (1.5%) of trichomoniasis vaginalis, 87 cases of mixed infections (16%), and 139 negative cases (26%). For each single infection, the clinical diagnosis had a sensitivity and specificity of 80.8% and 70.0% for bacterial vaginosis, 83.8% and 84.8% for candidiasis vaginitis, and 84.6% and 99.6% for trichomoniasis vaginalis when compared with the DNA probe standard. Compared with a DNA probe standard, clinical diagnosis is 81-85% sensitive and 70-99% specific for bacterial vaginosis, Candida vaginitis, and trichomoniasis. Even under research conditions that provided clinicians with sufficient time and materials to conduct a thorough and standardized clinical evaluation, the diagnosis and, therefore, subsequent treatment of these common vaginal problems remains difficult. II.

[Management of vaginal infection following failure of a probabilistic treatment: is the vaginal swab really useful?].

PubMed

Bretelle, F; Chiarelli, P; Palmer, I; Glatt, N

2015-02-01

The aim of this observational national multi-centre study was to describe medical care of vaginal infections resisting a primary probabilistic treatment. Two hundred and seventy female patients were included during a 9-month period (from 2013, March 20th to 2013, December 7th) by 155 gynaecologists located throughout France. All patients were presenting a vulvo-vaginitis episode which started about three weeks ago and which was characterized by leucorrhea (93 % cases), itching (88 % cases) and/or vulvar and/or vaginal irritation (88 % cases). In most cases, this episode was previously treated by a short course of an azole antifungal medication. This treatment was initiated by the patient herself without any doctor's prescription in six out of 10 cases and had no influence on the evolution of the original clinical symptoms. Second line treatments included azole antifungal medications (56 % cases), local fixed combinations (antifungal agent and bactericidal antibiotic) (29 %), metronidazole (9 %), oral antibiotics (7.4 %). At the end of the treatment, 85 % patients recovered from vaginitis symptoms. The recovery rate was 82.6 % for patients who got a bacteriological examination and 87.6 % for patients who were treated without any bacteriological examination. The difference is not statistically significant. These results seem to show that a probabilistic medical care is as effective as (but probably more economical than) a therapeutic strategy guided by the results of further examinations in case of failure of a primary treatment. This conclusion should be confirmed by a medico-economic comparison after randomization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

How Do Health Care Providers Diagnose Vaginitis?

MedlinePlus

... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose vaginitis? To find out the cause of a woman's symptoms, her health care provider will Examine the vagina, the vulva, and ...

A Comparison of Galaxy Bulge+Disk Decomposition Between Pan-STARRS and SDSS

NASA Astrophysics Data System (ADS)

Lokken, Martine Elena; McPartland, Conor; Sanders, David B.

2018-01-01

Measurements of the size and shape of bulges in galaxies provide key constraints for models of galaxy evolution. A comprehensive catalog of bulge measurements for Sloan Digital Sky Survey (SDSS) DR7 galaxies is currently available to the public. However, the Pan-STARRS1 (PS1) 3π survey now covers the same region with ~1-2 mag deeper photometry, a ~10-30% smaller PSF, and additional coverage in y-band. To test how much improvement in galaxy parameter measurements (e.g. bulge + disk) can be achieved using the new PS1 data, we make use of ultra-deep imaging data from the Hyper Suprime-Cam (HSC) Subaru Strategic Program (SSP). We fit bulge+disk models to images of 372 bright (mi < 18.5) galaxies detected in all three surveys. Comparison of galaxy parameters derived from SDSS and PS1 images with those measured from HSC-SSP images shows a tighter correlation between PS1 and SSP measurements for both bulge and disk parameters. Bulge parameters, such as bulge-to-total fraction and bulge radius, show the strongest improvement. However, measurements of all parameters degrade for galaxies with total r-band magnitude below the SDSS spectroscopic limit, mr = 17.7. We plan to use the PS1 3π survey data to produce an updated catalog of bulge+disk decomposition measurements for the entire SDSS DR7 spectroscopic galaxy sample.

Why are classical bulges more common in S0 galaxies than in spiral galaxies?

NASA Astrophysics Data System (ADS)

Mishra, Preetish K.; Wadadekar, Yogesh; Barway, Sudhanshu

2018-07-01

In this paper, we try to understand why the classical bulge fraction observed in S0 galaxies is significantly higher than that in spiral galaxies. We carry out a comparative study of the bulge and global properties of a sample of spiral and S0 galaxies in a fixed environment. Our sample is flux limited and contains 262 spiral and 155 S0 galaxies drawn from the Sloan Digital Sky Survey. We have classified bulges into classical and pseudo-bulge categories based on their position on the Kormendy diagram. Dividing our sample into bins of galaxy stellar mass, we find that the fraction of S0 galaxies hosting a classical bulge is significantly higher than the classical bulge fraction seen in spirals even at fixed stellar mass. We have compared the bulge and the global properties of spirals and S0 galaxies in our sample and find indications that spiral galaxies which host a classical bulge, preferentially get converted into S0 population as compared to pseudo-bulge hosting spirals. By studying the star formation properties of our galaxies in the NUV-r colour-mass diagram, we find that the pseudo-bulge hosting spirals are mostly star forming while the majority of classical bulge host spirals are in the green valley or in the passive sequence. We suggest that some internal process, such as AGN feedback or morphological quenching due to the massive bulge, quenches these classical bulge hosting spirals and transforms them into S0 galaxies, thus resulting in the observed predominance of the classical bulge in S0 galaxies.

Mapping the X-shaped Milky Way Bulge

NASA Astrophysics Data System (ADS)

Saito, R. K.; Zoccali, M.; McWilliam, A.; Minniti, D.; Gonzalez, O. A.; Hill, V.

2011-09-01

We analyzed the distribution of the red clump (RC) stars throughout the Galactic bulge using Two Micron All Sky Survey data. We mapped the position of the RC in 1 deg2 fields within the area |l| <= 8fdg5 and 3fdg5 <= |b| <= 8fdg5, for a total of 170 deg2. The single RC seen in the central area splits into two components at high Galactic longitudes in both hemispheres, produced by two structures at different distances along the same line of sight. The X-shape is clearly visible in the Z-X plane for longitudes close to the l = 0° axis. Crude measurements of the space densities of RC stars in the bright and faint RC populations are consistent with the adopted RC distances, providing further supporting evidence that the X-structure is real, and that there is approximate front-back symmetry in our bulge fields. We conclude that the Milky Way bulge has an X-shaped structure within |l| <~ 2°, seen almost edge-on with respect to the line of sight. Additional deep near-infrared photometry extending into the innermost bulge regions combined with spectroscopic data is needed in order to discriminate among the different possibilities that can cause the observed X-shaped structure.

Process optimization of joining by upset bulging with local heating

NASA Astrophysics Data System (ADS)

Rusch, Michael; Almohallami, Amer; Sviridov, Alexander; Bonk, Christian; Behrens, Bernd-Arno; Bambach, Markus

2017-10-01

Joining by upset bulging is a mechanical joining method where axial load is applied to a tube to form two revolving bulges, which clamp the parts to be joined and create a force and form fit. It can be used to join tubes with other structures such as sheets, plates, tubes or profiles of the same or different materials. Other processes such as welding are often limited in joining multi-material assemblies or high-strength materials. With joining by upset bulging at room temperature, the main drawback is the possible initiation of damage (cracks) in the inner buckling zone because of high local stresses and strains. In this paper, a method to avoid the formation of cracks is introduced. Before forming the bulge the tube is locally heated by an induction coil. For the construction steel (E235+N) a maximum temperature of 700 °C was used to avoid phase transformation. For the numerical study of the process the mechanical properties of the tube material were examined at different temperatures and strain rates to determine its flow curves. A parametrical FE model was developed to simulate the bulging process with local heating. Experiments with local heating were executed and metallographic studies of the bulging area were conducted. While specimens heated to 500 °C showed small cracks left, damage-free flanges could be created at 600 and 700 °C. Static testing of damage-free bulges showed improvements in tensile strength and torsion strength compared to bulges formed at room-temperature, while bending and compression behavior remained nearly unchanged. In cyclic testing the locally heated specimens underwent about 3.7 times as many cycles before failure as the specimens formed at room temperature.

Assessment of hot flushes and vaginal dryness among obese women undergoing bariatric surgery.

PubMed

Goughnour, S L; Thurston, R C; Althouse, A D; Freese, K E; Edwards, R P; Hamad, G G; McCloskey, C; Ramanathan, R; Bovbjerg, D H; Linkov, F

2016-01-01

Menopausal symptoms are associated with a negative impact on the quality of life, leading women to seek medical treatment. Obesity has been linked to higher levels of menopausal symptoms such as hot flushes. This assessment will explore whether the prevalence and bother of hot flushes and vaginal dryness change from pre- to post-bariatric surgery among obese midlife women. This study is a longitudinal analysis of data from 69 women (ages 35-72 years) undergoing bariatric surgery with reported reproductive histories and menopausal symptoms at preoperative and 6-month postoperative visits. Prevalence of and degree of bother of hot flushes and vaginal dryness at pre- and post-surgery were compared using McNemar's test and Wilcoxon signed-rank test. The reported degree of bother of symptoms associated with hot flushes decreased from pre- to post-surgery (p < 0.01). There was no significant change in the prevalence of hot flushes or vaginal dryness in the overall study sample. The degree of bother of symptoms associated with hot flushes among midlife women may decrease after bariatric surgery. These results highlight important secondary gains, including less bothersome menopausal symptoms, for women who choose bariatric surgery for weight loss.

Metallicity-dependent kinematics and morphology of the Milky Way bulge

NASA Astrophysics Data System (ADS)

Athanassoula, E.; Rodionov, S. A.; Prantzos, N.

2017-05-01

We use N-body chemo-dynamic simulations to study the coupling between morphology, kinematics and metallicity of the bar/bulge region of our Galaxy. We make qualitative comparisons of our results with available observations and find very good agreement. We conclude that this region is complex, since it comprises several stellar components with different properties - I.e. a boxy/peanut bulge, thin and thick disc components, and, to lesser extents, a disky pseudo-bulge, a stellar halo and a small classical bulge - all cohabiting in dynamical equilibrium. Our models show strong links between kinematics and metallicity, or morphology and metallicity, as already suggested by a number of recent observations. We discuss and explain these links.

JASMINE: constructor of the dynamical structure of the Galactic bulge

NASA Astrophysics Data System (ADS)

Gouda, N.; Kobayashi, Y.; Yamada, Y.; Yano, T.; Tsujimoto, T.; Suganuma, M.; Niwa, Y.; Yamauchi, M.

2008-07-01

We introduce a Japanese space astrometry project which is called JASMINE. JASMINE (Japan Astrometry Satellite Mission for INfrared Exploration) will measure distances and tangential motions of stars in the Galactic bulge with yet unprecedented precision. JASMINE will operate in z-band whose central wavelength is 0.9 micron. It will measure parallaxes, positions with accuracy of about 10 micro-arcsec and proper motions with accuracy of about 10 micro- arcsec/year for the stars brighter than z=14 mag. The number of stars observed by JASMINE with high accuracy of parallaxes in the Galactic bulge is much larger than that observed in other space astrometry projects operating in optical bands. With the completely new “map of the Galactic bulge” including motions of bulge stars, we expect that many new exciting scientific results will be obtained in studies of the Galactic bulge. One of them is the construction of the dynamical structure of the Galactic bulge. Kinematics and distance data given by JASMINE are the closest approach to a view of the exact dynamical structure of the Galactic bulge. Presently, JASMINE is in a development phase, with a target launch date around 2016. We comment on the outline of JASMINE mission, scientific targets and a preliminary design of JASMINE in this paper.

Effect of tension-free vaginal tape and TVT-obturator on lower urinary tract symptoms other than stress urinary incontinence.

PubMed

Ballert, Katie N; Kanofsky, Jamie A; Nitti, Victor W

2008-03-01

Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively. Total scores (TS), storage scores (SS), and voiding scores (VS) were compared overall and among patients with SUI vs mixed urinary incontinence (MUI) and those who underwent TVT vs TVT-obturator (TVT-O). The mean change in TS and SS was -3.6 and -3.0. Mean reductions in TS and SS were significant in all patient subsets with no change in VS. There was no significant difference in the mean changes in TS between patients with SUI vs MUI or those undergoing TVT vs TVT-O. LUTS are improved after TVT in most patients. In general, voiding symptoms were not adversely affected.

A study of the effect of bulges on bar formation in disc galaxies

NASA Astrophysics Data System (ADS)

Kataria, Sandeep Kumar; Das, Mousumi

2018-04-01

We use N-body simulations of bar formation in isolated galaxies to study the effect of bulge mass and bulge concentration on bar formation. Bars are global disc instabilities that evolve by transferring angular momentum from the inner to outer discs and to the dark matter halo. It is well known that a massive spherical component such as halo in a disc galaxy can make it bar stable. In this study, we explore the effect of another spherical component, the bulge, on bar formation in disc galaxies. In our models, we vary both the bulge mass and concentration. We have used two sets of models: one that has a dense bulge and high surface density disc, and the other model has a less concentrated bulge and a lighter disc. In both models, we vary the bulge to disc mass fraction from 0 to 0.7. Simulations of both the models show that there is an upper cut-off in bulge-to-disc mass ratio Mb/Md above which bars cannot form; the cut-off is smaller for denser bulges (Mb/Md = 0.2) compared to less denser ones (Mb/Md = 0.5). We define a new criterion for bar formation in terms of the ratio of bulge to total radial force (Fb/Ftot) at the disc scale lengths above which bars cannot form. We find that if Fb/Ftot > 0.35, a disc is stable and a bar cannot form. Our results indicate that early-type disc galaxies can still form strong bars in spite of having massive bulges.

How do clinicians manage vaginal complaints? An Internet survey.

PubMed

Anderson, Matthew R; Karasz, Alison

2005-06-21

Although vaginal symptoms are among the most common presentations in primary care, little is known about how clinicians manage them. We undertook an Internet survey to determine how clinicians decided what was normal, how they evaluated vaginal complaints, and what happened when a diagnosis could not be reached. A 27-question anonymous survey was conducted using the Medscape Internet publication platform and Medscape General Medicine , an online, peer-reviewed, open-access general medical journal. The study was targeted at physicians and nurse practitioners. There were 556 nurse practitioner and 608 physician respondents. Clinicians generally agreed that a midcycle increase in discharge and discharge seen at the introitus were normal; itching/irritation, odor, and a green discharge were not. There was less agreement concerning the value of a yellow discharge and "self-diagnosis" of abnormality. Eighty-two percent of MDs and 77% of NPs reported examining patients prior to treatment always or often. Only about 30% performed pH testing always or often. Ninety percent of NPs and 92% of MDs reported not making a diagnosis rarely or sometimes. When offered 4 different management strategies for patients in whom no diagnosis was made (watch and wait, symptomatic therapy, empiric antibiotics, referral), there was no clear preference. There was a weak correlation between performance of a wet mount and reports of less non-diagnosis. There was no correlation between pH and whiff testing and reports of less non-diagnosis. Clinicians do not always agree about what constitutes a vaginal symptom. Although most providers usually examine patients with vaginal complaints, pH and whiff testing are performed less frequently. Our data suggest the latter 2 maneuvers are not diagnostically helpful. There is no consensus regarding what to do when no diagnosis is made. Our findings suggest that the traditional approach to the evaluation of vaginal symptoms may have limited relevance for

The Star Formation History in the M31 Bulge

NASA Astrophysics Data System (ADS)

Dong, Hui; Olsen, Knut; Lauer, Tod; Saha, Abhijit; Li, Zhiyuan; García-Benito, Ruben; Schödel, Rainer

2018-05-01

We present the study of stellar populations in the central 5.5' (˜1.2 kpc) of the M31 bulge by using the optical color magnitude diagram derived from HST ACS WFC/HRC observations. In order to enhance image quality and then obtain deeper photometry, we construct Nyquist-sampled images and use a deconvolution method to detect sources and measure their photometry. We demonstrate that our method performs better than DOLPHOT in the extremely crowded region. The resolved stars in the M31 bulge have been divided into nine annuli and the color magnitude diagram fitting is performed for each of them. We confirm that the majority of stars (>70%) in the M31 bulge are indeed very old (> 5 Gyr) and metal-rich ([Fe/H]˜0.3). At later times, the star formation rate decreased and then experienced a significant rise around 1 Gyr ago, which pervaded the entire M31 bulge. After that, stars formed at less than 500 Myr ago in the central 130" . Through simulation, we find that these intermediate-age stars cannot be the artifacts introduced by the blending effect. Our results suggest that although the majority of the M31 bulge are very old, the secular evolutionary process still continuously builds up the M31 bulge slowly. We compare our star formation history with an older analysis derived from the spectral energy distribution fitting, which suggests that the latter one is still a reasonable tool for the study of stellar populations in remote galaxies.

Bulge Region as a Putative Hair Follicle Stem Cells Niche: A Brief Review

PubMed Central

JOULAI VEIJOUYE, Sanaz; YARI, Abazar; HEIDARI, Fatemeh; SAJEDI, Nayereh; GHOROGHI MOGHANI, Fatemeh; NOBAKHT, Maliheh

2017-01-01

Background: Hair follicle stem cells exist in different sites. Most of the hair follicle stem cells are reside in niche called bulge. Bulge region is located between the opening of sebaceous gland and the attachment site of the arrector pili muscle. Methods: Data were collected using databases and resources of PubMed, Web of Science, Science Direct, Scopus, MEDLINE and their references from the earliest available published to identify English observational studies on hair follicle bulge region. Results: Bulge stem cells are pluripotent with high proliferative capacity. Specific markers allow the bulge cells to be isolated from mouse or human hair follicle. Stem cells isolated from bulge region are label retaining and slow cycling hence these cells are defined as label-retaining cells. Bulge cell populations, due to their plasticity nature are able to differentiate into distinct linage and could contribute in tissue regeneration. Conclusion: The current review discuss about bulge stem cells characteristics and biology including their cycle, location, plasticity, specific markers and regenerative nature. Also the differences between mouse and human hair follicles are investigated. PMID:29026781

Military women's risk factors for and symptoms of genitourinary infections during deployment.

PubMed

Lowe, Nancy K; Ryan-Wenger, Nancy A

2003-07-01

Symptoms of vaginitis and urinary tract infections are miserable, distracting, and significantly affect women's quality of life. Among civilian women, these symptoms account for 10.5 million office visits per year. To examine the scope of the problem for military women during deployment situations, surveys were sent to randomly selected Army and Navy units. Of 841 women who completed the anonymous survey and had been deployed, vaginal infections were experienced by 30.1% and urinary tract infections by 18.4% of them during deployment. Vaginal symptoms were consistent with symptoms associated with the three most common vaginal infections (candida, bacterial, and trichomonas vaginitis). A variety of risk factors, both behavioral and situational, significantly differentiated women with and without infections. Urinary tract infections and vaginal infections are common during deployment situations where resources for self-care and appropriate primary health care for women are scarce or unavailable. One solution is a self-diagnosis and treatment kit for deployed military women.

Recognition of thymine in DNA bulges by a Zn(II) macrocyclic complex.

PubMed

del Mundo, Imee Marie A; Fountain, Matthew A; Morrow, Janet R

2011-08-14

A Zn(II) macrocyclic complex with appended quinoline is a bifunctional recognition agent that uses both the Zn(II) center and the pendent aromatic group to bind to thymine in bulges with good selectivity over DNA containing G, C or A bulges. Spectroscopic studies show that the stem containing the bulge stays largely intact in a DNA hairpin with the Zn(II) complex bound to the thymine bulge. This journal is © The Royal Society of Chemistry 2011

Determination of Material Strengths by Hydraulic Bulge Test.

PubMed

Wang, Hankui; Xu, Tong; Shou, Binan

2016-12-30

The hydraulic bulge test (HBT) method is proposed to determine material tensile strengths. The basic idea of HBT is similar to the small punch test (SPT), but inspired by the manufacturing process of rupture discs-high-pressure hydraulic oil is used instead of punch to cause specimen deformation. Compared with SPT method, the HBT method can avoid some of influence factors, such as punch dimension, punch material, and the friction between punch and specimen. A calculation procedure that is entirely based on theoretical derivation is proposed for estimate yield strength and ultimate tensile strength. Both conventional tensile tests and hydraulic bulge tests were carried out for several ferrous alloys, and the results showed that hydraulic bulge test results are reliable and accurate.

Structural basis for bifunctional zinc(II) macrocyclic complex recognition of thymine bulges in DNA.

PubMed

del Mundo, Imee Marie A; Siters, Kevin E; Fountain, Matthew A; Morrow, Janet R

2012-05-07

The zinc(II) complex of 1-(4-quinoylyl)methyl-1,4,7,10-tetraazacyclododecane (cy4q) binds selectively to thymine bulges in DNA and to a uracil bulge in RNA. Binding constants are in the low-micromolar range for thymine bulges in the stems of hairpins, for a thymine bulge in a DNA duplex, and for a uracil bulge in an RNA hairpin. Binding studies of Zn(cy4q) to a series of hairpins containing thymine bulges with different flanking bases showed that the complex had a moderate selectivity for thymine bulges with neighboring purines. The dissociation constants of the most strongly bound Zn(cy4q)-DNA thymine bulge adducts were 100-fold tighter than similar sequences with fully complementary stems or than bulges containing cytosine, guanine, or adenine. In order to probe the role of the pendent group, three additional zinc(II) complexes containing 1,4,7,10-tetraazacyclododecane (cyclen) with aromatic pendent groups were studied for binding to DNA including 1-(2-quinolyl)methyl-1,4,7,10-tetraazacyclododecane (cy2q), 1-(4-biphenyl)methyl-1,4,7,10-tetraazacyclododecane (cybp), and 5-(1,4,7,10-tetraazacyclododecan-1-ylsulfonyl)-N,N-dimethylnaphthalen-1-amine (dsc). The Zn(cybp) complex binds with moderate affinity but little selectivity to DNA hairpins with thymine bulges and to DNA lacking bulges. Similarly, Zn(dsc) binds weakly both to thymine bulges and hairpins with fully complementary stems. The zinc(II) complex of cy2q has the 2-quinolyl moiety bound to the Zn(II) center, as shown by (1)H NMR spectroscopy and pH-potentiometric titrations. As a consequence, only weak (500 μM) binding is observed to DNA with no appreciable selectivity. An NMR structure of a thymine-bulge-containing hairpin shows that the thymine is extrahelical but rotated toward the major groove. NMR data for Zn(cy4q) bound to DNA containing a thymine bulge is consistent with binding of the zinc(II) complex to the thymine N3(-) and stacking of the quinoline on top of the thymine. The thymine-bulge bound

The gravitational self-interaction of the Earth's tidal bulge

NASA Astrophysics Data System (ADS)

Norsen, Travis; Dreese, Mackenzie; West, Christopher

2017-09-01

According to a standard, idealized analysis, the Moon would produce a 54 cm equilibrium tidal bulge in the Earth's oceans. This analysis omits many factors (beyond the scope of the simple idealized model) that dramatically influence the actual height and timing of the tides at different locations, but it is nevertheless an important foundation for more detailed studies. Here, we show that the standard analysis also omits another factor—the gravitational interaction of the tidal bulge with itself—which is entirely compatible with the simple, idealized equilibrium model and which produces a surprisingly non-trivial correction to the predicted size of the tidal bulge. Our analysis uses ideas and techniques that are familiar from electrostatics, and should thus be of interest to teachers and students of undergraduate E&M, Classical Mechanics (and/or other courses that cover the tides), and geophysics courses that cover the closely related topic of Earth's equatorial bulge.

Vaginal disorders.

PubMed

Soderberg, S F

1986-05-01

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

Searching for fossil fragments of the Galactic bulge formation process

NASA Astrophysics Data System (ADS)

Ferraro, Francesco

2017-08-01

We have discovered that the stellar system Terzan5 (Ter5) in the Galactic bulge harbors stellar populations with very different IRON content (delta[Fe/H] 1 dex, Ferraro+09, Nature 462, 483) and AGES (12 Gyr and 4.5 Gyr for the sub-solar and super-solar metallicity populations, respectively, Ferraro+16, ApJ,828,75). This evidence demonstrates that Ter5 is not a globular cluster, and identifies it as (1) a site in the Galactic bulge where recent star formation occurred, and (2) the remnant of a massive system able to retain the iron-enriched gas ejected by violent supernova explosions. The striking chemical similarity between Ter5 and the bulge opens the fascinating possibility that we discovered the fossil remnant of a pristine massive structure that could have contributed to the Galactic bulge assembly.Prompted by this finding, here we propose to secure deep HST optical observations for the bulge stellar system Liller1, that shows a similar complexity as Ter5, with evidence of two stellar populations with different iron content. The immediate goal is to properly explore the main sequence turnoff region of the system for unveiling possible splits due to stellar populations of different ages. As demonstrated by our experience with Ter5, the requested HST observations, in combination with the K-band diffraction limited images that we already secured with GeMS-Gemini, are essential to achieve this goal.The project will allow us to establish if other fossil remnants of the bulge formation epoch do exist, thus probing that the merging of pre-evolved massive structures has been an important channel for the formation of the Galactic bulge.

Fractional CO2 Laser: From Skin Rejuvenation to Vulvo-Vaginal Reshaping.

PubMed

Filippini, Maurizio; Del Duca, Ester; Negosanti, Francesca; Bonciani, Diletta; Negosanti, Luca; Sannino, Mario; Cannarozzo, Giovanni; Nisticò, Steven Paul

2017-03-01

The CO 2 laser has become the gold standard treatment in dermatologic surgery for the treatment of a large number of skin and mucosal lesions. The introduction of the fractional micro-ablative technology represented an integration to the ablative resurfacing technique, reducing the healing time and the side effects. Vaginal rejuvenation performed with this technique is a minimally invasive procedure that stimulates internal tissues of the female lower genital tract to regenerate the mucosa, improving tissue trophism and restoring the correct functionality. In our experience, 386 menopausal women affected with vulvo-vaginal atrophy (VVA) were treated with three section of fractional micro-ablative CO 2 laser. After three treatments, patients reported a complete improvement of the symptoms (59.94% dryness, 56.26% burn, sensation, 48.75% dyspareunia, 56.37% itch, 73.15% soreness, and 48.79% vaginal introitus pain). Fractional micro-ablative CO 2 laser seems to reduce symptoms related to vaginal atrophy. The beneficial effects were reported just after the first session and confirmed 12 months after the last session.

Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings.

PubMed

Fan, Aiping; Yue, Yingli; Geng, Nv; Zhang, Huiying; Wang, Yingmei; Xue, Fengxia

2013-02-01

To investigate the clinical features of aerobic vaginitis (AV) and mixed infections with AV to achieve efficient diagnosis. From April 2008 to August 2009, 657 consecutive outpatients with vaginal symptoms in gynecology clinic in the General Hospital of Tianjin Medical University were investigated. Samples were taken for examination of vaginal discharge and fresh wet mount microscopy. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonal vaginitis (TV) were diagnosed according to standardized definitions. Sixty patients with single AV were randomly selected over the same period. Each patient accepted moxifloxacin therapy. Two kinds of treatment course (400 mg qd, 6 days or 400 mg qd, 12 days) were given. Clinical features and laboratory test results in the first visit and follow-ups were recorded and statistically analyzed. Among the 657 cases, AV was found in 23.74 % of the cases (156/657). AV mixed infections were diagnosed in 53.85 % (84/156): the mixed infections included VVC (32/84, 38.10 %), BV (31/84, 36.90 %), and TV (21/84, 25.00 %). Common symptoms of AV were a change in the characteristics of the discharge (44/72, 61.11 %) and increased discharge (30/72, 41.67 %). Vaginal pH was usually higher than 4.5 (63/72, 87.50 %). Enterococcus faecalis, Streptococcus viridans, Escherichia coli, and Staphylococcus epidermidis were frequently isolated. There is no statistically significant difference between two moxifloxacin treatment groups (p > 0.05). Cure rate was 89.7 % in 6-day group, and 71.4 % in 12-day group. AV is a common vaginal infection, and it is often mixed with other infections, especially VVC, BV and TV. The symptoms and signs of AV mixed infections are atypical. If a patient has vaginal complaints, it is necessary to determine whether AV or mixed infections are present. Oral moxifloxacin is effective in treating AV, and an appropriate course should be selected taking the severity of AV into consideration.

Saccharomyces cerevisiae vaginitis: transmission from yeast used in baking.

PubMed

Nyirjesy, P; Vazquez, J A; Ufberg, D D; Sobel, J D; Boikov, D A; Buckley, H R

1995-09-01

To determine whether vaginitis due to Saccharomyces cerevisiae can be caused by exposure to exogenous sources of baker's yeast. Eight women with S cerevisiae vaginitis were identified from a cohort of women referred for the evaluation of chronic vaginal symptoms. In those with high-level exposure to exogenous sources of S cerevisiae, isolates from the vagina and those sources were sent in a blinded fashion for contour-clamped homogeneous electric-field electrophoresis. Four women from a cohort of approximately 750 referred patients had high-level exposures to S cerevisiae. In one of these patients, electrophoresis analysis revealed similarities between the strains isolated from her vagina, her husband's fingers, and the yeast he used in his pizza shop. Saccharomyces cerevisiae vaginitis can be the result of the inoculation of this yeast from exogenous sources.

Foreign Body in Vagina: An Uncommon Cause of Vaginitis in Children

PubMed Central

Chinawa, JM; Obu, HA; Uwaezuoke, SN

2013-01-01

Vaginal discharge in children may result from a variety of causes. A long-standing intra-vaginal foreign body can pose both diagnostic and therapeutic challenges in children. Treatment failure may occur because of alteration of the normal vaginal flora. A 6-year-old girl, who lived with her parents, presented with a foul-smelling, blood-stained vaginal discharge as well as dysuria for 2 years. There was no history of sexual abuse. Initial evaluation that excluded gynecologic examination revealed lower abdominal tenderness. Vaginal swab and urine cultures yielded Staphylococcus aureus sensitive to ceftriaxone only. She was commenced on this antibiotic for 2 weeks, but the discharge persisted, necessitating referral to the gynecologist. Examination under anesthesia by the gynecologist revealed shreds of toilet tissue paper extracted from the vagina and slight excoriations on the wall of the vagina. Vaginal foreign body can present with diverse symptoms. It should be considered in any young female patient presenting with recurrent or persistent vaginal discharge. PMID:23634340

Gauging the Helium Abundance of the Galactic Bulge RR Lyrae Stars

NASA Astrophysics Data System (ADS)

Marconi, Marcella; Minniti, Dante

2018-02-01

We report the first estimate of the He abundance of the population of RR Lyrae stars in the Galactic bulge. This is done by comparing the recent observational data with the latest models. We use the large samples of ab-type RR Lyrae stars found by OGLE IV in the inner bulge and by the VVV survey in the outer bulge. We present the result from the new models computed by Marconi et al., showing that the minimum period for fundamental RR Lyrae pulsators depends on the He content. By comparing these models with the observations in a period versus effective temperature plane, we find that the bulk of the bulge ab-type RR Lyrae are consistent with primordial He abundance Y = 0.245, ruling out a significant He-enriched population. This work demonstrates that the He content of the bulge RR Lyrae is different from that of the bulk of the bulge population as traced by the red clump giants that appear to be significantly more He-rich. Based on observations collected at the European Organisation for Astronomical Research in the Southern Hemisphere under ESO programmes 179.B-2002 and 298.D-5048.

Nonlinear bulging factor based on R-curve data

NASA Technical Reports Server (NTRS)

Jeong, David Y.; Tong, Pin

1994-01-01

In this paper, a nonlinear bulging factor is derived using a strain energy approach combined with dimensional analysis. The functional form of the bulging factor contains an empirical constant that is determined using R-curve data from unstiffened flat and curved panel tests. The determination of this empirical constant is based on the assumption that the R-curve is the same for both flat and curved panels.

The effect of a vaginal suppository formulation of dill (Anethum graveolens) in comparison to clotrimazole vaginal tablet on the treatment of vulvovaginal candidiasis.

PubMed

Saghafi, Nafiseh; Karjalian, Maryam; Ghazanfarpour, Masumeh; Khorsand, Imaneh; Rakhshandeh, Hassan; Mirteimouri, Masumeh; Babakhanian, Masoudeh; Khadivzadeh, Talat; Najafzadeh, Mohammad Javad; Ghorbani, Ahmad; Pourali, Leila; Bahman, Sara

2018-03-19

The goal of this study was to compare the effect of Anethum graveolens (dill) vaginal suppositories and 100 mg clotrimazole vaginal tablets on vulvovaginal Candidiasis. This study was a single centre, single-blind, randomised, placebo-controlled trial, in which 60 women with microbiology-confirmed vulvovaginal candidiasis were randomly assigned to dill and clotrimazole groups. At the end of the study, the estimated prevalence of leucorrhoea, burning, and itching was 23%, 23% and 20% in dill users, respectively. This figure was 20%, 10% and 16.7% for the clotrimazole group, respectively. The difference between the two groups was not significant. 13% of suppository patients, compared with 10% of clotrimazole-treatment patients, had a positive culture, which was not significant (p = .68). According to findings, 2% dill vaginal suppositories were as effective as clotrimazole vaginal tablets in reducing both clinical and microbiological symptoms of Candidiasis. Studies with larger sample sizes are required to confirm current findings. Impact statement What is already known on the subject? Based on results from in vivo and in vitro animal studies, dill (Anethum graveolens) has anti-candida activity. What do the results of this study add? It appears that 2% dill vaginal suppositories were as effective as 100 mg clotrimazole vaginal tablets in reducing both the clinical and microbiological symptoms. What are the implications of these findings for clinical practice and further research? Obstetricians and gynaecologists can offer dill as a useful alternative to chemical drugs, especially in women who are often interested in herbal medicine, or in women who are resistant or are not allowed to use antifungal drugs.

THE MOLECULAR GAS DENSITY IN GALAXY CENTERS AND HOW IT CONNECTS TO BULGES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, David B.; Bolatto, Alberto; Drory, Niv

2013-02-20

In this paper we present gas density, star formation rate (SFR), stellar masses, and bulge-disk decompositions for a sample of 60 galaxies. Our sample is the combined sample of the BIMA SONG, CARMA STING, and PdBI NUGA surveys. We study the effect of using CO-to-H{sub 2} conversion factors that depend on the CO surface brightness, and also that of correcting SFRs for diffuse emission from old stellar populations. We estimate that SFRs in bulges are typically lower by 20% when correcting for diffuse emission. Using the surface brightness dependent conversion factor, we find that over half of the galaxies inmore » our sample have {Sigma}{sub mol} > 100 M {sub Sun} pc{sup -2}. Though our sample is not complete in any sense, our results are enough to rule out the assumption that bulges are uniformly gas-poor systems. We find a trend between gas density of bulges and bulge Sersic index; bulges with lower Sersic index have higher gas density. Those bulges with low Sersic index (pseudobulges) have gas fractions that are similar to that of disks. Conversely, the typical molecular gas fraction in classical bulges is more similar to that of an elliptical galaxy. We also find that there is a strong correlation between bulges with the highest gas surface density and the galaxy being barred. However, we also find that classical bulges with low gas surface density can be barred as well. Our results suggest that understanding the connection between the central surface density of gas in disk galaxies and the presence of bars should also take into account the total gas content of the galaxy. Finally, we show that when using the corrected SFRs and gas densities, the correlation between SFR surface density and gas surface density of bulges is similar to that of disks. This implies that at the scale of the bulges the timescale for converting gas into stars is comparable to those results found in disks.« less

Morpho-kinematic properties of field S0 bulges in the CALIFA survey

NASA Astrophysics Data System (ADS)

Méndez-Abreu, J.; Aguerri, J. A. L.; Falcón-Barroso, J.; Ruiz-Lara, T.; Sánchez-Menguiano, L.; de Lorenzo-Cáceres, A.; Costantin, L.; Catalán-Torrecilla, C.; Zhu, L.; Sánchez-Blazquez, P.; Florido, E.; Corsini, E. M.; Wild, V.; Lyubenova, M.; van de Ven, G.; Sánchez, S. F.; Bland-Hawthorn, J.; Galbany, L.; García-Benito, R.; García-Lorenzo, B.; González Delgado, R. M.; López-Sánchez, A. R.; Marino, R. A.; Márquez, I.; Ziegler, B.; Califa Collaboration

2018-02-01

We study a sample of 28 S0 galaxies extracted from the integral field spectroscopic (IFS) survey Calar Alto Legacy Integral Field Area. We combine an accurate two-dimensional (2D) multicomponent photometric decomposition with the IFS kinematic properties of their bulges to understand their formation scenario. Our final sample is representative of S0s with high stellar masses (M⋆/M⊙ > 1010). They lay mainly on the red sequence and live in relatively isolated environments similar to that of the field and loose groups. We use our 2D photometric decomposition to define the size and photometric properties of the bulges, as well as their location within the galaxies. We perform mock spectroscopic simulations mimicking our observed galaxies to quantify the impact of the underlying disc on our bulge kinematic measurements (λ and v/σ). We compare our bulge corrected kinematic measurements with the results from Schwarzschild dynamical modelling. The good agreement confirms the robustness of our results and allows us to use bulge deprojected values of λ and v/σ. We find that the photometric (n and B/T) and kinematic (v/σ and λ) properties of our field S0 bulges are not correlated. We demonstrate that this morpho-kinematic decoupling is intrinsic to the bulges and it is not due to projection effects. We conclude that photometric diagnostics to separate different types of bulges (disc-like versus classical) might not be useful for S0 galaxies. The morpho-kinematics properties of S0 bulges derived in this paper suggest that they are mainly formed by dissipational processes happening at high redshift, but dedicated high-resolution simulations are necessary to better identify their origin.

Stellar populations of bulges in galaxies with a low surface-brightness disc

NASA Astrophysics Data System (ADS)

Morelli, L.; Corsini, E. M.; Pizzella, A.; Dalla Bontà, E.; Coccato, L.; Méndez-Abreu, J.

2015-03-01

The radial profiles of the Hβ, Mg, and Fe line-strength indices are presented for a sample of eight spiral galaxies with a low surface-brightness stellar disc and a bulge. The correlations between the central values of the line-strength indices and velocity dispersion are consistent to those known for early-type galaxies and bulges of high surface-brightness galaxies. The age, metallicity, and α/Fe enhancement of the stellar populations in the bulge-dominated region are obtained using stellar population models with variable element abundance ratios. Almost all the sample bulges are characterized by a young stellar population, on-going star formation, and a solar α/Fe enhancement. Their metallicity spans from high to sub-solar values. No significant gradient in age and α/Fe enhancement is measured, whereas only in a few cases a negative metallicity gradient is found. These properties suggest that a pure dissipative collapse is not able to explain formation of all the sample bulges and that other phenomena, like mergers or acquisition events, need to be invoked. Such a picture is also supported by the lack of a correlation between the central value and gradient of the metallicity in bulges with very low metallicity. The stellar populations of the bulges hosted by low surface-brightness discs share many properties with those of high surface-brightness galaxies. Therefore, they are likely to have common formation scenarios and evolution histories. A strong interplay between bulges and discs is ruled out by the fact that in spite of being hosted by discs with extremely different properties, the bulges of low and high surface-brightness discs are remarkably similar.

Vaginal toxic shock reaction triggering desquamative inflammatory vaginitis.

PubMed

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

2013-01-01

The study aimed to report 2 cases of desquamative inflammatory vaginitis associated with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus strains. Case report of 2 patients, 1 with an acute and 1 with a chronic presentation, diagnosed with desquamative inflammatory vaginitis on the basis of clinical findings and wet mount microscopy. Pretreatment and posttreatment vaginal bacterial and yeast cultures were obtained. Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial culture results after oral antibiotic therapy were negative. Desquamative inflammatory vaginitis may be triggered through TSST-1-mediated vaginal toxic shock reaction.

Hysteroscopic Resection of the Vaginal Septum in Uterus Didelphys with Obstructed Hemivagina: A Case Report

PubMed Central

Kim, Tae Eun; Lee, Gyoung Hoon; Jee, Byung Chul; Ku, Seung-Yup; Suh, Chang Suk; Kim, Seok Hyun; Kim, Jung Gu; Moon, Shin Yong

2007-01-01

Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Excision of the obstructed vaginal septum is the treatment of choice for symptom relief and the preservation of reproductive capability. A 14-yr-old girl complained of persistent vaginal spotting following each menstruation. Pelvic magnetic resonance imaging revealed a uterus didelphys with left hematocolpos and ipsilateral renal agenesis. Instead of conventional transvaginal excision of the vaginal septum, we used hysteroscopic excision under transabdominal ultrasonographic guidance to preserve the integrity of the hymen. The postoperative course was uneventful, and clinical symptoms were completely resolved after this intervention. Resectoscopic excision of the vaginal septum was found to be easy, safe, effective, and appropriate for young women as it preserved hymen integrity. We believe that this is the first Korean report on the use of a hysteroscopy for vaginal septum resection in a patient with uterus didelphys with obstructed hemivagina. PMID:17728527

The vaginal microbiota, host defence and reproductive physiology.

PubMed

Smith, Steven B; Ravel, Jacques

2017-01-15

The interaction between the human host and the vaginal microbiota is highly dynamic. Major changes in the vaginal physiology and microbiota over a woman's lifetime are largely shaped by transitional periods such as puberty, menopause and pregnancy, while daily fluctuations in microbial composition observed through culture-independent studies are more likely to be the results of daily life activities and behaviours. The vaginal microbiota of reproductive-aged women is largely made up of at least five different community state types. Four of these community state types are dominated by lactic-acid producing Lactobacillus spp. while the fifth is commonly composed of anaerobes and strict anaerobes and is sometimes associated with vaginal symptoms. The production of lactic acid has been associated with contributing to the overall health of the vagina due to its direct and indirect effects on pathogens and host defence. Some species associated with non-Lactobacillus vaginal microbiota may trigger immune responses as well as degrade the host mucosa, processes that ultimately increase susceptibility to infections and contribute to negative reproductive outcomes such as infertility and preterm birth. Further studies are needed to better understand the functional underpinnings of how the vaginal microbiota affect host physiology but also how host physiology affects the vaginal microbiota. Understanding this fine-tuned interaction is key to maintaining women's reproductive health. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

The vaginal microbiota, host defence and reproductive physiology

PubMed Central

Smith, Steven B

2016-01-01

Abstract The interaction between the human host and the vaginal microbiota is highly dynamic. Major changes in the vaginal physiology and microbiota over a woman's lifetime are largely shaped by transitional periods such as puberty, menopause and pregnancy, while daily fluctuations in microbial composition observed through culture‐independent studies are more likely to be the results of daily life activities and behaviours. The vaginal microbiota of reproductive‐aged women is largely made up of at least five different community state types. Four of these community state types are dominated by lactic‐acid producing Lactobacillus spp. while the fifth is commonly composed of anaerobes and strict anaerobes and is sometimes associated with vaginal symptoms. The production of lactic acid has been associated with contributing to the overall health of the vagina due to its direct and indirect effects on pathogens and host defence. Some species associated with non‐Lactobacillus vaginal microbiota may trigger immune responses as well as degrade the host mucosa, processes that ultimately increase susceptibility to infections and contribute to negative reproductive outcomes such as infertility and preterm birth. Further studies are needed to better understand the functional underpinnings of how the vaginal microbiota affect host physiology but also how host physiology affects the vaginal microbiota. Understanding this fine‐tuned interaction is key to maintaining women's reproductive health. PMID:27373840

Why are classical bulges more common in S0 galaxies than in spiral galaxies?

NASA Astrophysics Data System (ADS)

Mishra, Preetish K.; Wadadekar, Yogesh; Barway, Sudhanshu

2018-05-01

In this paper, we try to understand why the classical bulge fraction observed in S0 galaxies is significantly higher than that in spiral galaxies. We carry out a comparative study of the bulge and global properties of a sample of spiral and S0 galaxies in a fixed environment. Our sample is flux limited and contains 262 spiral and 155 S0 galaxies drawn from the Sloan Digital Sky Survey. We have classified bulges into classical and pseudobulge categories based on their position on the Kormendy diagram. Dividing our sample into bins of galaxy stellar mass, we find that the fraction of S0 galaxies hosting a classical bulge is significantly higher than the classical bulge fraction seen in spirals even at fixed stellar mass. We have compared the bulge and the global properties of spirals and S0 galaxies in our sample and find indications that spiral galaxies which host a classical bulge, preferentially get converted into S0 population as compared to pseudobulge hosting spirals. By studying the star formation properties of our galaxies in the NUV - r color-mass diagram, we find that the pseudobulge hosting spirals are mostly star forming while the majority of classical bulge host spirals are in the green valley or in the passive sequence. We suggest that some internal process, such as AGN feedback or morphological quenching due to the massive bulge, quenches these classical bulge hosting spirals and transforms them into S0 galaxies, thus resulting in the observed predominance of the classical bulge in S0 galaxies.

Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey

PubMed Central

Nappi, R. E.; Palacios, S.; Panay, N.; Particco, M.; Krychman, M. L.

2016-01-01

Abstract Objectives The aim of the European REVIVE survey was to achieve a better understanding of vulvovaginal atrophy (VVA), a chronic and progressive condition after menopause. We investigated perceptions, experiences and needs in terms of sexual and vaginal health in a sample of European postmenopausal women. Methods An online internet based survey was conducted in Italy, Germany, Spain and the UK with a total surveyed sample of 3768 postmenopausal women (age: 45–75 years). Results The most common VVA symptom was vaginal dryness (70%). VVA has a significant impact on the ability to be intimate (62%), to enjoy sexual intercourse (72%) and to feel sexual spontaneity (66%). Postmenopausal women with VVA are sexually active (51%), but their sexual drive is reduced. Health-care professionals (HCPs) have discussed VVA with postmenopausal women (62%), but they initiated the conversation only in 10% of the cases. The most common treatments for VVA are over-the-counter, non-hormonal, local vaginal products. Thirty-two per cent of postmenopausal women were naïve to any kind of treatment, whereas discussion with the HCP was relevant to be on current treatment (60% of postmenopausal women that discussed VVA with a HCP vs. 23% who did not). The top reasons for poor compliance with vaginal treatments were: not bothersome enough symptoms (18%); vaginal changes not therapeutically reversed (18%); relief from VVA symptoms (17%). Approximately 45% were satisfied with treatment. The most frequent disliked aspects of treatment were the route of administration or the messiness. The fear of hormones was common in postmenopausal women using vaginal prescription products. Conclusions The European REVIVE survey confirmed that VVA symptoms are frequent in postmenopausal women and demonstrates a significant impact on quality of life and sexual life. However, the condition is still under-diagnosed and under-treated, with a high rate of dissatisfaction for actual available treatments in

Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey.

PubMed

Nappi, R E; Palacios, S; Panay, N; Particco, M; Krychman, M L

2016-04-01

The aim of the European REVIVE survey was to achieve a better understanding of vulvovaginal atrophy (VVA), a chronic and progressive condition after menopause. We investigated perceptions, experiences and needs in terms of sexual and vaginal health in a sample of European postmenopausal women. An online internet based survey was conducted in Italy, Germany, Spain and the UK with a total surveyed sample of 3768 postmenopausal women (age: 45-75 years). The most common VVA symptom was vaginal dryness (70%). VVA has a significant impact on the ability to be intimate (62%), to enjoy sexual intercourse (72%) and to feel sexual spontaneity (66%). Postmenopausal women with VVA are sexually active (51%), but their sexual drive is reduced. Health-care professionals (HCPs) have discussed VVA with postmenopausal women (62%), but they initiated the conversation only in 10% of the cases. The most common treatments for VVA are over-the-counter, non-hormonal, local vaginal products. Thirty-two per cent of postmenopausal women were naïve to any kind of treatment, whereas discussion with the HCP was relevant to be on current treatment (60% of postmenopausal women that discussed VVA with a HCP vs. 23% who did not). The top reasons for poor compliance with vaginal treatments were: not bothersome enough symptoms (18%); vaginal changes not therapeutically reversed (18%); relief from VVA symptoms (17%). Approximately 45% were satisfied with treatment. The most frequent disliked aspects of treatment were the route of administration or the messiness. The fear of hormones was common in postmenopausal women using vaginal prescription products. The European REVIVE survey confirmed that VVA symptoms are frequent in postmenopausal women and demonstrates a significant impact on quality of life and sexual life. However, the condition is still under-diagnosed and under-treated, with a high rate of dissatisfaction for actual available treatments in the four European countries surveyed. The

Technique and outcomes of laparoscopic bulge repair after abdominal free flap reconstruction.

PubMed

Lee, Johnson C; Whipple, Lauren A; Binetti, Brian; Singh, T Paul; Agag, Richard

2016-01-21

Bulges and hernias after abdominal free flap surgery are uncommon with rates ranging from as low as 0-36%. In the free flap breast reconstruction population, there are no clear guidelines or optimal strategies to treating postoperative bulges. We describe our minimally invasive technique and outcomes in managing bulge complications in abdominal free flap breast reconstruction patients. A retrospective review was performed on all abdominal free flap breast reconstruction patients at Albany Medical Center from 2011 to 2014. All patients with bulges on clinical exam underwent abdominal CT imaging prior to consultation with a minimally invasive surgeon. Confirmed symptomatic bulges were repaired laparoscopically and patients were monitored regularly in the outpatient setting. Sixty-two patients received a total of 80 abdominal free flap breast reconstructions. Flap types included 41 deep inferior epigastric perforator (DIEP), 36 muscle-sparing transverse rectus abdominus myocutaneous (msTRAM), 2 superficial inferior epigastric artery, and 1 transverse rectus abdominus myocutaneous flap. There were a total of 9 (14.5%) bulge complications, with the majority of patients having undergone msTRAM or DIEP reconstruction. There were no complications, revisions, or recurrences from laparoscopic bulge repair after an average follow-up of 181 days. Although uncommon, bulge formation after abdominal free flap reconstruction can create significant morbidity to patients. Laproscopic hernia repair using composite mesh underlay offers an alternative to traditional open hernia repair and can be successfully used to minimize scarring, infection, and pain to free flap patients who have already undergone significant reconstructive procedures. © 2016 Wiley Periodicals, Inc. Microsurgery, 2016. © 2016 Wiley Periodicals, Inc.

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article

PubMed Central

Park, Yoo Jin

2017-01-01

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC. PMID:29354612

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

PubMed

Kim, Jun-Mo; Park, Yoo Jin

2017-12-01

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter , Escherichia coli , Candida , and Gardnerella ). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

Non-specific vaginitis or vaginitis of undetermined aetiology.

PubMed

Faro, S; Phillips, L E

1987-01-01

Vaginitis is a complex syndrome that is probably the most common outpatient disease seen by the gynaecologist. The specific aetiologies of vaginitis are many. One of the most common entities, however, is "non-specific vaginitis" which can be subdivided into: Gardnerella vaginitis, anaerobic vaginosis, and vaginitis of undetermined aetiology. The role of Gardnerella as a causative agent for vaginitis has been studied in depth but its specific role remains controversial. Anaerobic vaginosis can be diagnosed by noting on microscopic examination the presence of clue cells, free-floating bacteria and numerous white blood cells (WBC's). Culturing an aliquot of the vaginal discharge reveals a high number of anaerobes. In addition, this condition responds to antibiotics effective against anaerobes, e.g., metronidazole. Vaginitis of undetermined aetiology is more complex and is characterized by a purulent vaginal discharge, a pH of 4.0-4.6, numerous WBC's, and a high concentration of bacteria. The microbiology of this vaginitis includes many facultative Gram-negative rods and Gram-positive cocci. Anaerobes may be present but do not make up a large component of the endogenous microflora. This condition does not respond to the usual antibiotic therapies employed in treating bacterial vaginitis. Since this condition appears to be primarily an inflammatory reaction, it may be responsive to topical antiinflammatory agents such as benzydamine.

Vaginal cancer

MedlinePlus

Vaginal cancer; Cancer - vagina; Tumor - vaginal ... Most vaginal cancers occur when another cancer, such as cervical or endometrial cancer , spreads. This is called secondary vaginal cancer. Cancer ...

Clinical Trials with Agents Currently Used in the Management of Vaginitis

PubMed Central

O'Brien, J. R.

1964-01-01

Results of treatment of 151 cases of vaginitis in patients attending a leukorrhea clinic were studied. The incidence of each type of vaginitis is recorded. Analysis of results of treatment with six compounds currently used in the therapy of vaginitis indicated that acetarsol or pimaricin compounds, with their broader spectra of activity, appeared to be most useful, prior to establishment of a definite diagnosis by means of cultures. Chlordantoin is an effective antifungal agent and is associated with a high percentage of “culture cures”. Resistant cases should be investigated for diabetes mellitus, and many are aided by a low carbohydrate diet. Metronidazole was used only for resistant cases of trichomoniasis, with a cure rate of over 80% when both partners were treated simultaneously. Triple-sulfa vaginal cream was effective in over 80% of patients with nonspecific vaginitis; no cases of resistant bacterial infections were encountered. Dienestrol cream was effective in relieving the symptoms of atrophic vaginitis. PMID:14144540

EXPLORING THE UNUSUALLY HIGH BLACK-HOLE-TO-BULGE MASS RATIOS IN NGC 4342 AND NGC 4291: THE ASYNCHRONOUS GROWTH OF BULGES AND BLACK HOLES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bogdan, Akos; Forman, William R.; Kraft, Ralph P.

2012-07-10

We study two nearby early-type galaxies, NGC 4342 and NGC 4291, that host unusually massive black holes relative to their low stellar mass. The observed black-hole-to-bulge mass ratios of NGC 4342 and NGC 4291 are 6.9{sup +3.8}{sub -2.3}% and 1.9% {+-} 0.6%, respectively, which significantly exceed the typical observed ratio of {approx}0.2%. As a consequence of the exceedingly large black-hole-to-bulge mass ratios, NGC 4342 and NGC 4291 are Almost-Equal-To 5.1{sigma} and Almost-Equal-To 3.4{sigma} outliers from the M{sub .}-M{sub bulge} scaling relation, respectively. In this paper, we explore the origin of the unusually high black-hole-to-bulge mass ratio. Based on Chandra X-raymore » observations of the hot gas content of NGC 4342 and NGC 4291, we compute gravitating mass profiles, and conclude that both galaxies reside in massive dark matter halos, which extend well beyond the stellar light. The presence of dark matter halos around NGC 4342 and NGC 4291 and a deep optical image of the environment of NGC 4342 indicate that tidal stripping, in which {approx}> 90% of the stellar mass was lost, cannot explain the observed high black-hole-to-bulge mass ratios. Therefore, we conclude that these galaxies formed with low stellar masses, implying that the bulge and black hole did not grow in tandem. We also find that the black hole mass correlates well with the properties of the dark matter halo, suggesting that dark matter halos may play a major role in regulating the growth of the supermassive black holes.« less

[EPIDEMIOLOGICAL, CLINICAL AND MICROBIOLOGICAL FINDINGS IN WOMEN WITH AEROBIC VAGINITIS].

PubMed

Dermendjiev, T; Pehlivanov, B; Hadjieva, K; Stanev, S

2015-01-01

Aerobic vaginitis (AV) is an alterarion of the normal lactobacillic flora accompanied by signs of inflammation, presence of mainly aerobic microorganisms from intestinal commensals or other aerobic pathogens. Clinical symptoms may vary by type and intensity and are marked by a high tendency for recurrence and chronification. Inflammation and ulcerations in AV could increase the risk of contracting HIV or other sexually transmitted infections. The aim is to study some epidemiological, clinical and microbiological features of the aerobic vaginitis in patients of the specialized Obstetric and Gynecological Clinic in Plovdiv, Bulgaria. In a retrospective research 4687 vaginal smears have been gathered in Microbiological laboratory at "St. George" Hospital - Plovdiv. We used clinical, microbiological and statistical methods. Information processing is performed by variation, alternative, correlation and graphical analysis using specialized package SPSS v13.0. The overall prevalence rate of AV in the studied population is 11.77%. The levels of prevalence of AV in pregnant and non-pregnant women are respectively 13.08% and 4.34%. The highest frequency of AV is in the age group 21-30 years (32.3%). The results show a marked association between Escherichia coli and the cases of AV (p < 0.001). AV is a common cause of vaginal symptoms in patients of specialized ambulatory outpatient. One in ten women with vaginal complaints suffers from AV Streptococcus agalactiae and Escherichia coli are most often isolated aerobic microorganisms.

The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women.

PubMed

Athanasiou, S; Pitsouni, E; Antonopoulou, S; Zacharakis, D; Salvatore, S; Falagas, M E; Grigoriadis, T

2016-10-01

To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women. Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora. Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant. MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.

Postpartum pelvic floor muscle training and pelvic organ prolapse--a randomized trial of primiparous women.

PubMed

Bø, Kari; Hilde, Gunvor; Stær-Jensen, Jette; Siafarikas, Franziska; Tennfjord, Merete Kolberg; Engh, Marie Ellstrøm

2015-01-01

Pelvic organ prolapse (POP) is a common and distressing condition. The aim of the present study was to evaluate the effect of pelvic floor muscle training (PFMT) on prevention and treatment of symptoms and signs of POP in primiparous postpartum women. This was a parallel group assessor blind randomized controlled trial. One hundred seventy-five primiparous postpartum women, mean age 29.8 years (standard deviation 4.1), stratified on major levator ani defects or no defect diagnosed by 3-/4-dimensional ultrasound, participated in a 4-month PFMT starting at 6-8 weeks' postpartum or control. All participants had thorough individual instruction and assessment of ability to perform correct pelvic floor muscle contractions. The PFMT group followed a supervised, weekly group training program and performed 3 sets of 8-12 daily maximal contractions at home. Main outcome was POP stage II or greater assessed by POP quantification and bladder neck position assessed by 3-/4- dimensional transperineal ultrasonography. Secondary outcome was symptoms of vaginal bulge using International Consultation on Incontinence Vaginal Symptoms questionnaire. Ninety-six percent of the intervention group adhered to ≥80% of both group and home training sessions. At postintervention, there was no significant risk difference in POP (rational ratio, 1.62; 95% confidence interval, 0.55-4.75), bladder neck position or symptoms of vaginal bulging. No effect was found of postpartum PFMT on POP in primiparous women. More randomized controlled trials are needed before strong conclusions can be drawn on the effect of PFMT on POP in the particular population. Copyright © 2015 Elsevier Inc. All rights reserved.

The Chemical Composition of the Galactic Bulge and Implications for its Evolution

NASA Astrophysics Data System (ADS)

McWilliam, Andrew

2016-08-01

At a bulge latitude of b = -4°, the average [Fe/H] and [Mg/H] values are +0.06 and +0.17 dex, roughly 0.2 and 0.7 dex higher than the local thin and thick disk values, respectively, suggesting a large bulge effective yield, perhaps due to efficient retention of supernova ejecta. The bulge vertical [Fe/H] gradient, at ∼0.5 dex/kpc, appears to be due to a changing mixture of sub-populations (near +0.3 dex and -0.3 dex and one possibly near -0.7 dex) with latitude. At solar [Fe/H], the bulge [Al/Fe] and [α/Fe] ratios are ∼ +0.15 dex. Below [Fe/H] ∼ -0.5 dex, the bulge and local thick disk compositions are very similar; but the measured [Mg/Fe], [/Fe], [La/Eu] and dramatic [Cu/Fe] ratios suggest higher SFR in the bulge. However, these composition differences with the thick disk could be due to measurement errors and non-LTE effects. Unusual zig-zag trends of [Cu/Fe] and [Na/Fe] suggest metallicity-dependent nucleosynthesis by core-collapse supernovae in the Type Ia supernova time-delay scenario. The bulge sub-population compositions resemble the local thin and thick disks, but at higher [Fe/H], suggesting a radial [Fe/H] gradient of -0.04 to -0.05 dex/kpc for both the thin and thick disks. If the bulge formed through accretion of inner thin and thick disk stars, it appears that these stars retained vertical scale heights characteristic of their kinematic origin, resulting in the vertical [Fe/H] gradient and [α/Fe] trends seen today.

Quantitative analysis of the extensional tectonics of Tharsis bulge, Mars - Geodynamic implications

NASA Astrophysics Data System (ADS)

Thomas, P. G.; Allemand, P.

1993-07-01

The amount of horizontal strain on the Martian Tharsis bulge is quantified in order to provide further information on the tectonic evolution of this province. About 10 percent of the Tharsis surface bulge exhibits elliptical impact craters, which are the largest strain markers in the solar system. It is shown that these strain ellipses indicate more strain than could be due to the bulge building alone. The existence of such intensely deformed areas, the direction of the extensive strain, the localization of these areas on the bulge crest or on the top of topographic slopes, and the evidence of nonthinned crust under these areas may all be explained by gravitational slidings of the bulge surface over the topographic slope. This sliding would be possible because of the presence of a decollement level two kilometers below the surface, and because of the prefracturation which have made the detachment possible.

Topical kanamycin: an effective therapeutic option in aerobic vaginitis.

PubMed

Tempera, G; Abbadessa, G; Bonfiglio, G; Cammarata, E; Cianci, A; Corsello, S; Raimondi, A; Ettore, G; Nicolosi, D; Furneri, P M

2006-08-01

Eighty-one patients with clinical diagnosis of aerobic vaginitis (AV) were included in the study. The patients were randomized for treatment, 45 with kanamycin (100 mg vaginal ovules for 6 days, consecutively) and 36 with meclocycline (35 mg vaginal ovules for 6 days, consecutively). The patients were examined before starting the study, 1-2 days after treatment and 30 days after the end of the study. At the first follow-up the patients showed different levels of symptom reduction. Reduction in the presence of leukocytes, vaginal mucosa burning and itching were statistically significant in the group treated with kanamycin with respect to the group treated with meclocycline. Moreover, there was also reduced isolation of Enterobacteriaeae (97%) in the group treated with kanamycin versus those treated with meclocycline (76%). At the second follow-up, vaginal homeostasis (normalization of pH and presence of lactobacilli) was more evident in the kanamycin-treated group. In conclusion, our data suggest that the topical use of kanamycin could be considered a specific antibiotic for the therapy of this new pathology.

Vaginal Atrophy

MedlinePlus

... an Endocrinologist Search Featured Resource Menopause Map™ View Vaginal Atrophy October 2017 Download PDFs English Editors Christine ... during this time, including vaginal dryness. What is vaginal atrophy? Vaginal atrophy (also referred to as vulvovaginal ...

Chronic vaginal discharge and left leg edema after a transobturator tape procedure.

PubMed

Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo

2014-05-01

We report on a patient who underwent total vaginal hysterectomy for urinary incontinence 8 years previously with a sling operation using transobturator tape (TOT). She was admitted to our hospital after complaints of vaginal discharge, foul odor, and bleeding, left thigh pain, and edema. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a fistula tract from the vagina or urethra with remnant sling tape. We removed the remnant tape using intraoperative ultrasonography. This case exemplifies the rare occurrence of a vaginal fistula extending to the obturator, adductor, and pectineus muscles combined with myositis after TOT placement. It is important that urogynecologists recognize that TOT procedures may result in complications accompanied by common recurrent vaginal symptoms, such as vaginal odor and spotting, which can be identified by MRI or CT.

Vaginal health in contraceptive vaginal ring users - A review.

PubMed

Lete, Iñaki; Cuesta, María C; Marín, Juan M; Guerra, Sandra

2013-08-01

To provide an overview of the available data from clinical studies of vaginal conditions in women who use a vaginal ring as a contraceptive. A systematic review of the literature. Millions of women have already used the ethylene vinyl acetate vaginal ring that releases ethinylestradiol and etonogestrel for contraception. Because of its small size, more than four out of five women using the ring report that they do not feel it, even during sexual intercourse. No colposcopic or cytological changes have been observed in users, although approximately 10% have increased vaginal discharge. While in vitro studies have shown adhesion of Candida yeasts to the vaginal ring surface, clinical studies have not demonstrated a greater incidence of Candida infections compared to users of equivalent oral contraceptives. Some clinical studies suggest a lower incidence of bacterial vaginosis. No interaction exists between concomitant use of the vaginal ring and other drugs or products for vaginal use. The use of a contraceptive vaginal ring does not alter the vaginal ecosystem and therefore does not substantially affect vaginal health.

One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires.

PubMed

Lone, Farah; Thakar, Ranee; Sultan, Abdul H

2015-09-01

Vaginal pessaries, pelvic floor exercises and surgery are treatment options for women with symptomatic pelvic organ prolapse (POP). The aim of this study was to compare the outcomes of pessaries and surgery in women with symptomatic POP using the validated International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) and Urinary Incontinence (ICIQ-UI) Short Form (SF). Women attending the Urogynecology clinics with symptomatic POP were recruited. All women were treated using either a vaginal pessary or surgery. Outcomes were evaluated and then compared at 1 year using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires. A total of 287 women with symptomatic prolapse were recruited. 269 women completed the questionnaires at baseline and 183 at 1 year. At 1 year, improvement was noted in quality of life (QOL), frequency of urinary leak and vaginal symptoms in both groups except for the symptom of vaginal soreness in the pessary group and the symptom of a tight vagina in the surgery group. However, both these symptoms were not bothersome. Women who underwent surgery demonstrated an improvement in faecal evacuation and sex life. There was an overall statistically significant improvement in vaginal, sex, QOL and urinary symptom scores in both groups. No statistically significant difference was noted between the surgery and the pessary groups. Using validated questionnaires 1 year after treatment, women with symptomatic POP report improvement in vaginal, bowel, urinary and quality of life scores when treated with either pessary use or surgery. No statistically significant difference was noted in the two groups.

An asymmetric mesoscopic model for single bulges in RNA

NASA Astrophysics Data System (ADS)

de Oliveira Martins, Erik; Weber, Gerald

2017-10-01

Simple one-dimensional DNA or RNA mesoscopic models are of interest for their computational efficiency while retaining the key elements of the molecular interactions. However, they only deal with perfectly formed DNA or RNA double helices and consider the intra-strand interactions to be the same on both strands. This makes it difficult to describe highly asymmetric structures such as bulges and loops and, for instance, prevents the application of mesoscopic models to determine RNA secondary structures. Here we derived the conditions for the Peyrard-Bishop mesoscopic model to overcome these limitations and applied it to the calculation of single bulges, the smallest and simplest of these asymmetric structures. We found that these theoretical conditions can indeed be applied to any situation where stacking asymmetry needs to be considered. The full set of parameters for group I RNA bulges was determined from experimental melting temperatures using an optimization procedure, and we also calculated average opening profiles for several RNA sequences. We found that guanosine bulges show the strongest perturbation on their neighboring base pairs, considerably reducing the on-site interactions of their neighboring base pairs.

Tracing the evolution of the Galactic bulge with chemodynamical modelling of alpha-elements

NASA Astrophysics Data System (ADS)

Friaça, A. C. S.; Barbuy, B.

2017-02-01

Context. Galactic bulge abundances can be best understood as indicators of bulge formation and nucleosynthesis processes by comparing them with chemo-dynamical evolution models. Aims: The aim of this work is to study the abundances of alpha-elements in the Galactic bulge, including a revision of the oxygen abundance in a sample of 56 bulge red giants. Methods: Literature abundances for O, Mg, Si, Ca and Ti in Galactic bulge stars are compared with chemical evolution models. For oxygen in particular, we reanalysed high-resolution spectra obtained using FLAMES+UVES on the Very Large Telescope, now taking each star's carbon abundances, derived from CI and C2 lines, into account simultaneously. Results: We present a chemical evolution model of alpha-element enrichment in a massive spheroid that represents a typical classical bulge evolution. The code includes multi-zone chemical evolution coupled with hydrodynamics of the gas. Comparisons between the model predictions and the abundance data suggest a typical bulge formation timescale of 1-2 Gyr. The main constraint on the bulge evolution is provided by the O data from analyses that have taken the C abundance and dissociative equilibrium into account. Mg, Si, Ca and Ti trends are well reproduced, whereas the level of overabundance critically depends on the adopted nucleosynthesis prescriptions. Observations collected both at the European Southern Observatory, Paranal, Chile (ESO programmes 71.B-0617A, 73.B0074A, and GTO 71.B-0196)

Odorous vaginal discharge - a case study for thorough investigation.

PubMed

Cernat, Geta; Leung, Lawrence

2011-08-01

Odorous vaginal discharge is a common presentation to general practitioners, and a frequent presentation for bacterial infections and sexually transmissible diseases. Busy GPs may be tempted to make a diagnosis from the clinical history and symptoms, and prescribe antibiotics as a first line treatment. This case highlights an unusual cause of persistent odorous vaginal discharge. If a thorough examination had not been conducted, the cause would have been overlooked, first line antibiotics would most likely have been ineffective, and potentially life threatening consequences may have occurred.

A HIGH-VELOCITY BULGE RR LYRAE VARIABLE ON A HALO-LIKE ORBIT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kunder, Andrea; Storm, J.; Rich, R. M.

2015-07-20

We report on the RR Lyrae variable star, MACHO 176.18833.411, located toward the Galactic bulge and observed within the data from the ongoing Bulge RR Lyrae Radial Velocity Assay, which has the unusual radial velocity of −372 ± 8 km s{sup −1} and true space velocity of −482 ± 22 km s{sup −1} relative to the Galactic rest frame. Located less than 1 kpc from the Galactic center and toward a field at (l, b) = (3, −2.5), this pulsating star has properties suggesting it belongs to the bulge RR Lyrae star population, yet a velocity indicating it is abnormal,more » at least with respect to bulge giants and red clump stars. We show that this star is most likely a halo interloper and therefore suggest that halo contamination is not insignificant when studying metal-poor stars found within the bulge area, even for stars within 1 kpc of the Galactic center. We discuss the possibility that MACHO 176.18833.411 is on the extreme edge of the bulge RR Lyrae radial velocity distribution, and also consider a more exotic scenario in which it is a runaway star moving through the Galaxy.« less

[Intravaginal treatment of colpitis maculosa with an oestriol-containing vaginal cream (author's transl)].

PubMed

Schröck, A; Kofler, K; Baumgarten, K; Endl, J; Schmidt, J; Tatschl, S

1981-12-11

43 patients with colpitis maculosa (average age 60.2 years) were selected for an open control therapeutic study with Ortho-Gynest vaginal cream (Ortho-Cilag). The cream contains 0.5 mg of oestriol per single applicator filling. The treatment lasted from 3 to 4 weeks, success being evaluated by clinical documentation and cytological evaluation of vaginal smears before and after treatment. 10 patients (23.3%) were treated successfully, 29 (67.4%) showed a distinct improvement both clinically and cytologically, whilst the remaining 4 (9.3%) showed only moderate improvement. Hence, 39 patients (90.7%) were classified as having been successfully or partly successfully treated. Severe symptoms disappeared completely or were greatly alleviated in 91.4% cases. Moderate symptoms vanished in 59.7%. 58.1% showed a complete normalisation of the former atrophic vaginal skin. Blood spotting and reddening of the vaginal wall vanished completely. A change from dry to moist vagina occurred in 77.3% patients. Discharge vanished completely in 80.6% cases. No untoward side effects were recorded.

Analysis of Vaginal Cell Populations during Experimental Vaginal Candidiasis

PubMed Central

Fidel, Paul L.; Luo, Wei; Steele, Chad; Chabain, Joseph; Baker, Marc; Wormley, Floyd

1999-01-01

Studies with an estrogen-dependent murine model of vaginal candidiasis suggest that local cell-mediated immunity (CMI) is more important than systemic CMI for protection against vaginitis. The present study, however, showed that, compared to uninfected mice, little to no change in the percentage or types of vaginal T cells occurred during a primary vaginal infection or during a secondary vaginal infection where partial protection was observed. Furthermore, depletion of polymorphonuclear leukocytes (PMN) had no effect on infection in the presence or absence of pseudoestrus. These results indicate a lack of demonstrable effects by systemic CMI or PMN against vaginitis and suggest that if local T cells are important, they are functioning without showing significant increases in numbers within the vaginal mucosa during infection. PMID:10338532

Numerical Simulation of Bulging Deformation for Wide-Thick Slab Under Uneven Cooling Conditions

NASA Astrophysics Data System (ADS)

Wu, Chenhui; Ji, Cheng; Zhu, Miaoyong

2018-06-01

In the present work, the bulging deformation of a wide-thick slab under uneven cooling conditions was studied using finite element method. The non-uniform solidification was first calculated using a 2D heat transfer model. The thermal material properties were derived based on a microsegregation model, and the water flux distribution was measured and applied to calculate the cooling boundary conditions. Based on the solidification results, a 3D bulging model was established. The 2D heat transfer model was verified by the measured shell thickness and the slab surface temperature, and the 3D bulging model was verified by the calculated maximum bulging deflections using formulas. The bulging deformation behavior of the wide-thick slab under uneven cooling condition was then determined, and the effect of uneven solidification, casting speed, and roll misalignment were investigated.

Numerical Simulation of Bulging Deformation for Wide-Thick Slab Under Uneven Cooling Conditions

NASA Astrophysics Data System (ADS)

Wu, Chenhui; Ji, Cheng; Zhu, Miaoyong

2018-02-01

In the present work, the bulging deformation of a wide-thick slab under uneven cooling conditions was studied using finite element method. The non-uniform solidification was first calculated using a 2D heat transfer model. The thermal material properties were derived based on a microsegregation model, and the water flux distribution was measured and applied to calculate the cooling boundary conditions. Based on the solidification results, a 3D bulging model was established. The 2D heat transfer model was verified by the measured shell thickness and the slab surface temperature, and the 3D bulging model was verified by the calculated maximum bulging deflections using formulas. The bulging deformation behavior of the wide-thick slab under uneven cooling condition was then determined, and the effect of uneven solidification, casting speed, and roll misalignment were investigated.

Two Populations of SiO Masers in the Galactic Bulge

NASA Astrophysics Data System (ADS)

Trapp, Adam; Rich, Robert Michael; Morris, Mark; Pihlstrom, Ylva; Sjouwerman, Lorant; Claussen, Mark J.; Stroh, Michael

2017-01-01

We present a summary of the kinematics of stellar SiO masers observed in the direction of the galactic bulge with ALMA (885 sources), and the JVLA (2,479 sources). These objects are selected by color from the MSX point source catalog, which has given an SiO detection rate of ~70%. The presented sample, along with the ~24,000 sources still being observed and reduced, enable radial velocity measurements even in regions with extreme optical extinction. These maser stars are compared to the known bulge surveys: APOGEE (~25,000 sources), BRAVA (~8000 sources), and GIBS (~6,400 sources). We have found that BAaDE stars in the direction of the bulge exist in two subpopulations: (1) A kinematically hot population exhibiting cylindrical rotation consistent with the other bulge surveys, and (2) a kinematically cold population more consistent with a disk population. In the ALMA data, we find evidence for a -200 km/s feature at (l,b) = (-9,0), possibly the symmetric complement to a previously proposed +200 km/s feature (Nidever 2012), that we do not confirm with our data.

Vaginal Toxic Shock Reaction Triggering Desquamative Inflammatory Vaginitis

PubMed Central

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

2012-01-01

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

METALLICITY GRADIENTS THROUGH DISK INSTABILITY: A SIMPLE MODEL FOR THE MILKY WAY'S BOXY BULGE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martinez-Valpuesta, Inma; Gerhard, Ortwin, E-mail: imv@mpe.mpg.de, E-mail: gerhard@mpe.mpg.de

2013-03-20

Observations show a clear vertical metallicity gradient in the Galactic bulge, which is often taken as a signature of dissipative processes in the formation of a classical bulge. Various evidence shows, however, that the Milky Way is a barred galaxy with a boxy bulge representing the inner three-dimensional part of the bar. Here we show with a secular evolution N-body model that a boxy bulge formed through bar and buckling instabilities can show vertical metallicity gradients similar to the observed gradient if the initial axisymmetric disk had a comparable radial metallicity gradient. In this framework, the range of metallicities inmore » bulge fields constrains the chemical structure of the Galactic disk at early times before bar formation. Our secular evolution model was previously shown to reproduce inner Galaxy star counts and we show here that it also has cylindrical rotation. We use it to predict a full mean metallicity map across the Galactic bulge from a simple metallicity model for the initial disk. This map shows a general outward gradient on the sky as well as longitudinal perspective asymmetries. We also briefly comment on interpreting metallicity gradient observations in external boxy bulges.« less

The Women's EMPOWER Survey: Women's Knowledge and Awareness of Treatment Options for Vulvar and Vaginal Atrophy Remains Inadequate.

PubMed

Krychman, Michael; Graham, Shelli; Bernick, Brian; Mirkin, Sebastian; Kingsberg, Sheryl A

2017-03-01

Postmenopausal women's knowledge about vulvar and vaginal atrophy (VVA) and available treatment options has historically been inadequate. Recent direct-to-consumer marketing and educational efforts would have been expected to increase awareness and treatment options. To compare results of the Women's EMPOWER survey with other available VVA surveys to assess progress in women's understanding and approaches to treatment of VVA. The Women's EMPOWER survey, an internet-based survey of US women with VVA symptoms, assessed women's awareness of VVA and their behaviors and attitudes associated with symptom treatment. These survey results were compared with previously published results of the Revealing Vaginal Effects at Mid-Life (REVEAL), Women's Voices in Menopause (WVM), Vaginal Health: Insight, Views, & Attitudes (VIVA), Clarifying Vaginal Atrophy's Impact on Sex and Relationship (CLOSER), and Real Women's Views of Treatment Options for Menopausal Vaginal Changes (REVIVE) surveys. Results of the Women's EMPOWER survey were consistent with those of past VVA surveys and showed that postmenopausal women generally failed to recognize VVA and its chronic, progressive process and that they were reluctant to discuss vaginal or sexual symptoms with their health care professionals (HCPs). However, women indicated a strong desire for accurate medical information about VVA from their health care professionals and a willingness to learn if HCPs would initiate the conversation. Most women believed that vaginal symptoms are a normal part of aging and they just need to cope with the symptoms. In the United States, women were most concerned with safety-related issues, including increased risk of breast cancer, side effects, and systemic absorption. The Women's EMPOWER survey demonstrates and reinforces that even with multimedia marketing and educational strategies in the years after other major VVA surveys, minimal progress has been made toward increasing women's awareness of

K-band observations of boxy bulges - I. Morphology and surface brightness profiles

NASA Astrophysics Data System (ADS)

Bureau, M.; Aronica, G.; Athanassoula, E.; Dettmar, R.-J.; Bosma, A.; Freeman, K. C.

2006-08-01

In this first paper of a series on the structure of boxy and peanut-shaped (B/PS) bulges, Kn-band observations of a sample of 30 edge-on spiral galaxies are described and discussed. Kn-band observations best trace the dominant luminous galactic mass and are minimally affected by dust. Images, unsharp-masked images, as well as major-axis and vertically summed surface brightness profiles are presented and discussed. Galaxies with a B/PS bulge tend to have a more complex morphology than galaxies with other bulge types, more often showing centred or off-centred X structures, secondary maxima along the major-axis and spiral-like structures. While probably not uniquely related to bars, those features are observed in three-dimensional N-body simulations of barred discs and may trace the main bar orbit families. The surface brightness profiles of galaxies with a B/PS bulge are also more complex, typically containing three or more clearly separated regions, including a shallow or flat intermediate region (Freeman Type II profiles). The breaks in the profiles offer evidence for bar-driven transfer of angular momentum and radial redistribution of material. The profiles further suggest a rapid variation of the scaleheight of the disc material, contrary to conventional wisdom but again as expected from the vertical resonances and instabilities present in barred discs. Interestingly, the steep inner region of the surface brightness profiles is often shorter than the isophotally thick part of the galaxies, itself always shorter than the flat intermediate region of the profiles. The steep inner region is also much more prominent along the major-axis than in the vertically summed profiles. Similarly to other recent work but contrary to the standard `bulge + disc' model (where the bulge is both thick and steep), we thus propose that galaxies with a B/PS bulge are composed of a thin concentrated disc (a disc-like bulge) contained within a partially thick bar (the B/PS bulge), itself

Structure and hydrodynamics of a DNA G-quadruplex with a cytosine bulge.

PubMed

Meier, Markus; Moya-Torres, Aniel; Krahn, Natalie J; McDougall, Matthew D; Orriss, George L; McRae, Ewan K S; Booy, Evan P; McEleney, Kevin; Patel, Trushar R; McKenna, Sean A; Stetefeld, Jörg

2018-06-01

The identification of four-stranded G-quadruplexes (G4s) has highlighted the fact that DNA has additional spatial organisations at its disposal other than double-stranded helices. Recently, it became clear that the formation of G4s is not limited to the traditional G3+NL1G3+NL2G3+NL3G3+ sequence motif. Instead, the G3 triplets can be interrupted by deoxythymidylate (DNA) or uridylate (RNA) where the base forms a bulge that loops out from the G-quadruplex core. Here, we report the first high-resolution X-ray structure of a unique unimolecular DNA G4 with a cytosine bulge. The G4 forms a dimer that is stacked via its 5'-tetrads. Analytical ultracentrifugation, static light scattering and small angle X-ray scattering confirmed that the G4 adapts a predominantly dimeric structure in solution. We provide a comprehensive comparison of previously published G4 structures containing bulges and report a special γ torsion angle range preferentially populated by the G4 core guanylates adjacent to bulges. Since the penalty for introducing bulges appears to be negligible, it should be possible to functionalize G4s by introducing artificial or modified nucleotides at such positions. The presence of the bulge alters the surface of the DNA, providing an opportunity to develop drugs that can specifically target individual G4s.

YOUNG STARS IN AN OLD BULGE: A NATURAL OUTCOME OF INTERNAL EVOLUTION IN THE MILKY WAY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ness, M.; Debattista, Victor P.; Cole, D. R.

2014-06-01

The center of our disk galaxy, the Milky Way, is dominated by a boxy/peanut-shaped bulge. Numerous studies of the bulge based on stellar photometry have concluded that the bulge stars are exclusively old. The perceived lack of young stars in the bulge strongly constrains its likely formation scenarios, providing evidence that the bulge is a unique population that formed early and separately from the disk. However, recent studies of individual bulge stars using the microlensing technique have reported that they span a range of ages, emphasizing that the bulge may not be a monolithic structure. In this Letter we demonstratemore » that the presence of young stars that are located predominantly nearer to the plane is expected for a bulge that has formed from the disk via dynamical instabilities. Using an N-body+ smoothed particle hydrodynamics simulation of a disk galaxy forming out of gas cooling inside a dark matter halo and forming stars, we find a qualitative agreement between our model and the observations of younger metal-rich stars in the bulge. We are also able to partially resolve the apparent contradiction in the literature between results that argue for a purely old bulge population and those that show a population comprised of a range in ages; the key is where to look.« less

ALMA observations of molecular absorption in four directions toward the Galactic bulge

NASA Astrophysics Data System (ADS)

Liszt, H.; Gerin, M.

2018-02-01

Context. Alma Cycle 3 observations serendipitously showed strong absorption from diffuse molecular gas in the Galactic bulge at -200 km s-1 < v < -140 km s-1 toward the compact extragalactic continuum source J1744-3116 at (l, b) = -2.13∘, - 1.00∘. Aims: We aimed to test whether molecular gas in the bulge could also be detected toward the three other, sufficiently strong mm-wave continuum sources seen toward the bulge at |b| < 3∘. Methods: We took absorption profiles of HCO+ (1-0), HCN(1-0), C2H(1-0), CS(2-1) and H13CO+(1-0) in ALMA Cycle 4 toward J1713-3418, J1717-3341, J1733-3722 and J1744-3116. Results: Strong molecular absorption from disk gas at |ν| ≲ 30 km s-1 was detected in all directions, and absorption from the 3 kpc arm was newly detected toward J1717 and J1744. However, only the sightline toward J1744 is dominated by molecular gas overall and no other sightlines showed molecular absorption from gas deep inside the bulge. No molecular absorption was detected toward J1717 where H I emission from the bulge was previously known. As observed in HCO+, HCN, C2H and CS, the bulge gas toward J1744 at v < -135 km s-1 has chemistry and kinematics like that seen near the Sun and in the Milky Way disk generally. We measured isotopologic ratios N(HCO+)/N(H13CO+) > 51(3σ) for the bulge gas toward J1744 and 58 ± 9 and 64 ± 4 for the disk gas toward J1717 and J1744, respectively, all well above the value of 20-25 typical of the central molecular zone. Conclusions: The kinematics and chemistry of the bulge gas observed toward J1744 more nearly resemble that of gas in the Milky Way disk than in the central molecular zone.

Vaginal Atrophy

MedlinePlus

... syndrome of menopause (GSM) increases your risk of: Vaginal infections. Changes in the acid balance of your vagina makes vaginal infections (vaginitis) more likely. Urinary problems. Urinary changes associated ...

A combined photometric and kinematic recipe for evaluating the nature of bulges using the CALIFA sample

NASA Astrophysics Data System (ADS)

Neumann, J.; Wisotzki, L.; Choudhury, O. S.; Gadotti, D. A.; Walcher, C. J.; Bland-Hawthorn, J.; García-Benito, R.; González Delgado, R. M.; Husemann, B.; Marino, R. A.; Márquez, I.; Sánchez, S. F.; Ziegler, B.; Califa Collaboration

2017-07-01

Understanding the nature of bulges in disc galaxies can provide important insights into the formation and evolution of galaxies. For instance, the presence of a classical bulge suggests a relatively violent history. In contrast, the presence of an inner disc instead (also referred to as a "pseudobulge") indicates the occurrence of secular evolution processes in the main disc. However, we still lack criteria to effectively categorise bulges, limiting our ability to study their impact on the evolution of the host galaxies. Here we present a recipe to separate inner discs from classical bulges by combining four different parameters from photometric and kinematic analyses: the bulge Sérsic index nb, the concentration index C20,50, the Kormendy (1977, ApJ, 217, 406) relation and the inner slope of the radial velocity dispersion profile ∇σ. With that recipe we provide a detailed bulge classification for a sample of 45 galaxies from the integral-field spectroscopic survey CALIFA. To aid in categorising bulges within these galaxies, we perform 2D image decomposition to determine bulge Sérsic index, bulge-to-total light ratio, surface brightness and effective radius of the bulge and use growth curve analysis to derive a new concentration index, C20,50. We further extract the stellar kinematics from CALIFA data cubes and analyse the radial velocity dispersion profile. The results of the different approaches are in good agreement and allow a safe classification for approximately 95% of the galaxies. In particular, we show that our new "inner" concentration index performs considerably better than the traditionally used C50,90 when yielding the nature of bulges. We also found that a combined use of this index and the Kormendy relation gives a very robust indication of the physical nature of the bulge.

Establishing the connection between peanut-shaped bulges and galactic bars

NASA Technical Reports Server (NTRS)

Kuijken, Konrad; Merrifield, Michael R.

1995-01-01

It has been suggested that the peanut-shaped bulges seen in some edge-on disk galaxies are due to the presence of a central bar. Although bars cannot be detected photometrically in edge-on galaxies, we show that barred potentials produce a strong kinematic signature in the form of double-peaked line-of-sight velocity distributions with a characteristic 'figure-of-eight' variation with radius. We have obtained spectroscopic observations of two edge-on galaxies with peanut-shaped bulges (NGC 5746 and NGC 5965), and they reveal exactly such line-of-sight velocity distributions in both their gaseous (emission line) and their stellar (absorption line) components. These observations provide strong observational evidence that peanut-shaped bulges are a by-product of bar formation.

MACHO RR Lyrae in the Inner Halo and Bulge

NASA Astrophysics Data System (ADS)

Minniti, Dante; Alcock, Charles; Allsman, Robyn A.; Alves, David; Axelrod, Tim S.; Becker, Andrew C.; Bennett, David; Cook, Kem H.; Drake, Andrew J.; Freeman, Ken C.; Griest, Kim; Lehner, Matt; Marshall, Stuart; Peterson, Bruce; Pratt, Mark; Quinn, Peter; Rodgers, Alex; Stubbs, Chris; Sutherland, Will; Tomaney, Austin; Vandehei, Thor; Welch, Doug L.

The RR Lyrae in the bulge have been proposed to be the oldest populations in the Milky Way, tracers of how the galaxy formed. We study here the distribution of ~1600 bulge RR Lyrae stars found by the MACHO Project. The RR Lyrae with Galactocentric radius 0.4

Selecting anti-microbial treatment of aerobic vaginitis.

PubMed

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

2015-05-01

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

Bulge growth and quenching since z = 2.5 in CANDELS/3D-HST

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lang, Philipp; Wuyts, Stijn; Schreiber, Natascha M. Förster

2014-06-10

Exploiting the deep high-resolution imaging of all five CANDELS fields, and accurate redshift information provided by 3D-HST, we investigate the relation between structure and stellar populations for a mass-selected sample of 6764 galaxies above 10{sup 10} M {sub ☉}, spanning the redshift range 0.5 < z < 2.5. For the first time, we fit two-dimensional models comprising a single Sérsic fit and two-component (i.e., bulge + disk) decompositions not only to the H-band light distributions, but also to the stellar mass maps reconstructed from resolved stellar population modeling. We confirm that the increased bulge prominence among quiescent galaxies, as reportedmore » previously based on rest-optical observations, remains in place when considering the distributions of stellar mass. Moreover, we observe an increase of the typical Sérsic index and bulge-to-total ratio (with median B/T reaching 40%-50%) among star-forming galaxies above 10{sup 11} M {sub ☉}. Given that quenching for these most massive systems is likely to be imminent, our findings suggest that significant bulge growth precedes a departure from the star-forming main sequence. We demonstrate that the bulge mass (and ideally knowledge of the bulge and total mass) is a more reliable predictor of the star-forming versus quiescent state of a galaxy than the total stellar mass. The same trends are predicted by the state-of-the-art, semi-analytic model by Somerville et al. In this model, bulges and black holes grow hand in hand through merging and/or disk instabilities, and feedback from active galactic nuclei shuts off star formation. Further observations will be required to pin down star formation quenching mechanisms, but our results imply that they must be internal to the galaxies and closely associated with bulge growth.« less

Bulge Growth and Quenching since z = 2.5 in CANDELS/3D-HST

NASA Astrophysics Data System (ADS)

Lang, Philipp; Wuyts, Stijn; Somerville, Rachel S.; Förster Schreiber, Natascha M.; Genzel, Reinhard; Bell, Eric F.; Brammer, Gabe; Dekel, Avishai; Faber, Sandra M.; Ferguson, Henry C.; Grogin, Norman A.; Kocevski, Dale D.; Koekemoer, Anton M.; Lutz, Dieter; McGrath, Elizabeth J.; Momcheva, Ivelina; Nelson, Erica J.; Primack, Joel R.; Rosario, David J.; Skelton, Rosalind E.; Tacconi, Linda J.; van Dokkum, Pieter G.; Whitaker, Katherine E.

2014-06-01

Exploiting the deep high-resolution imaging of all five CANDELS fields, and accurate redshift information provided by 3D-HST, we investigate the relation between structure and stellar populations for a mass-selected sample of 6764 galaxies above 1010 M ⊙, spanning the redshift range 0.5 < z < 2.5. For the first time, we fit two-dimensional models comprising a single Sérsic fit and two-component (i.e., bulge + disk) decompositions not only to the H-band light distributions, but also to the stellar mass maps reconstructed from resolved stellar population modeling. We confirm that the increased bulge prominence among quiescent galaxies, as reported previously based on rest-optical observations, remains in place when considering the distributions of stellar mass. Moreover, we observe an increase of the typical Sérsic index and bulge-to-total ratio (with median B/T reaching 40%-50%) among star-forming galaxies above 1011 M ⊙. Given that quenching for these most massive systems is likely to be imminent, our findings suggest that significant bulge growth precedes a departure from the star-forming main sequence. We demonstrate that the bulge mass (and ideally knowledge of the bulge and total mass) is a more reliable predictor of the star-forming versus quiescent state of a galaxy than the total stellar mass. The same trends are predicted by the state-of-the-art, semi-analytic model by Somerville et al. In this model, bulges and black holes grow hand in hand through merging and/or disk instabilities, and feedback from active galactic nuclei shuts off star formation. Further observations will be required to pin down star formation quenching mechanisms, but our results imply that they must be internal to the galaxies and closely associated with bulge growth.

Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women.

PubMed

Carati, D; Zizza, A; Guido, M; De Donno, A; Stefanizzi, R; Serra, R; Romano, I; Ouedraogo, C; Megha, M; Tinelli, A

2016-01-01

Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed. A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered. The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.0 19) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2. The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.

Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause.

PubMed

Labrie, Fernand; Archer, David F; Koltun, William; Vachon, Andrée; Young, Douglas; Frenette, Louise; Portman, David; Montesino, Marlene; Côté, Isabelle; Parent, Julie; Lavoie, Lyne; Beauregard, Adam; Martel, Céline; Vaillancourt, Mario; Balser, John; Moyneur, Érick

2016-03-01

The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause (GSM). In a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial, the effect of daily intravaginal 0.50% DHEA (6.5 mg) (Prasterone, EndoCeutics) was examined on four coprimary objectives, namely percentage of parabasal cells, percentage or superficial cells, vaginal pH, and moderate to severe pain at sexual activity (dyspareunia) identified by the women as their most bothersome vulvovaginal atrophy symptom. The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups, respectively. After daily intravaginal administration of 0.50% DHEA for 12 weeks, when compared to baseline by the analysis of covariance test, the percentage of parabasal cells decreased by 27.7% over placebo (P < 0.0001), whereas the percentage of superficial cells increased by 8.44% over placebo (P < 0.0001), vaginal pH decreased by 0.66 pH unit over placebo (P < 0.0001), and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo (P = 0.0002). On the other hand, moderate to severe vaginal dryness present in 84.0% of women improved at 12 weeks by 1.44 severity score unit compared to baseline, or 0.27 unit over placebo (P = 0.004). At gynecological evaluation, vaginal secretions, epithelial integrity, epithelial surface thickness, and color all improved by 86% to 121% over the placebo effect (P < 0.0001 for all comparisons with placebo). Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology. The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at

THE NUMBER OF TIDAL DWARF SATELLITE GALAXIES IN DEPENDENCE OF BULGE INDEX

DOE Office of Scientific and Technical Information (OSTI.GOV)

López-Corredoira, Martín; Kroupa, Pavel, E-mail: martinlc@iac.es, E-mail: pavel@astro.uni-bonn.de

We show that a significant correlation (up to 5σ) emerges between the bulge index, defined to be larger for a larger bulge/disk ratio, in spiral galaxies with similar luminosities in the Galaxy Zoo 2 of the Sloan Digital Sky Survey and the number of tidal-dwarf galaxies in the catalog by Kaviraj et al. In the standard cold or warm dark matter cosmological models, the number of satellite galaxies correlates with the circular velocity of the dark matter host halo. In generalized gravity models without cold or warm dark matter, such a correlation does not exist, because host galaxies cannot capture infalling dwarfmore » galaxies due to the absence of dark-matter-induced dynamical friction. However, in such models, a correlation is expected to exist between the bulge mass and the number of satellite galaxies because bulges and tidal-dwarf satellite galaxies form in encounters between host galaxies. This is not predicted by dark matter models in which bulge mass and the number of satellites are a priori uncorrelated because higher bulge/disk ratios do not imply higher dark/luminous ratios. Hence, our correlation reproduces the prediction of scenarios without dark matter, whereas an explanation is not found readily from the a priori predictions of the standard scenario with dark matter. Further research is needed to explore whether some application of the standard theory may explain this correlation.« less

DEMOGRAPHICS OF BULGE TYPES WITHIN 11 Mpc AND IMPLICATIONS FOR GALAXY EVOLUTION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, David B.; Drory, Niv, E-mail: dbfisher@astro.umd.edu

2011-06-01

We present an inventory of galaxy bulge types (elliptical galaxy, classical bulge, pseudobulge, and bulgeless galaxy) in a volume-limited sample within the local 11 Mpc sphere using Spitzer 3.6 {mu}m and Hubble Space Telescope data. We find that whether counting by number, star formation rate, or stellar mass, the dominant galaxy type in the local universe has pure disk characteristics (either hosting a pseudobulge or being bulgeless). Galaxies that contain either a pseudobulge or no bulge combine to account for over 80% of the number of galaxies above a stellar mass of 10{sup 9} M{sub sun}. Classical bulges and ellipticalmore » galaxies account for {approx}1/4, and disks for {approx}3/4 of the stellar mass in the local 11 Mpc. About 2/3 of all star formation in the local volume takes place in galaxies with pseudobulges. Looking at the fraction of galaxies with different bulge types as a function of stellar mass, we find that the frequency of classical bulges strongly increases with stellar mass, and comes to dominate above 10{sup 10.5} M{sub sun}. Galaxies with pseudobulges dominate at 10{sup 9.5}-10{sup 10.5} M{sub sun}. Yet lower-mass galaxies are most likely to be bulgeless. If pseudobulges are not a product of mergers, then the frequency of pseudobulges in the local universe poses a challenge for galaxy evolution models.« less

Chemical Characterization of the Inner Galactic bulge: North-South Symmetry

NASA Astrophysics Data System (ADS)

Nandakumar, G.; Ryde, N.; Schultheis, M.; Thorsbro, B.; Jönsson, H.; Barklem, P. S.; Rich, R. M.; Fragkoudi, F.

2018-05-01

While the number of stars in the Galactic bulge with detailed chemical abundance measurements is increasing rapidly, the inner Galactic bulge (|b| < 2°) remains poorly studied, due to heavy interstellar absorption and photometric crowding. We have carried out a high-resolution IR spectroscopic study of 72 M giants in the inner bulge using the CRIRES (ESO/VLT) facility. Our spectra cover the wavelength range of 2.0818 - 2.1444 μm with the resolution of R˜50,000 and have signal-to-noise ratio of 50-100. Our stars are located along the bulge minor axis at l = 0°, b = ±0°, ±1°, ±2°and +3°. Our sample was analysed in a homogeneous way using the most current K-band line list. We clearly detect a bimodal MDF with a metal-rich peak at ˜ +0.3 dex and a metal-poor peak at ˜ -0.5 dex, and no stars with [Fe/H] > +0.6 dex. The Galactic Center field reveals in contrast a mainly metal-rich population with a mean metallicity of +0.3 dex. We derived [Mg/Fe] and [Si/Fe] abundances which are consistent with trends from the outer bulge. We confirm for the supersolar metallicity stars the decreasing trend in [Mg/Fe] and [Si/Fe] as expected from chemical evolution models. With the caveat of a relatively small sample, we do not find significant differences in the chemical abundances between the Northern and the Southern fields, hence the evidence is consistent with symmetry in chemistry between North and South.

Clues to the Formation of Lenticular Galaxies Using Spectroscopic Bulge-Disk Decomposition

NASA Astrophysics Data System (ADS)

Johnston, E. J.; Aragón-Salamanca, A.; Merrifield, M. R.; Bedregal, A. G.

2014-03-01

Lenticular galaxies have long been thought of as evolved spirals, but the processes involved to quench the star formation are still unclear. By studying the individual star formation histories of the bulges and disks of lenticulars, it is possible to look for clues to the processes that triggered their transformation from spirals. To accomplish this feat, we present a new method for spectroscopic bulge-disk decomposition, in which a long-slit spectrum is decomposed into two one-dimensional spectra representing purely the bulge and disk light. We present preliminary results from applying this method to lenticular galaxies in the Virgo and Fornax Clusters, in which we show that the most recent star formation activity in these galaxies occurred within the bulges. We also find that the star formation timescales of the bulges are longer than the disks, and that more massive galaxies take longer to lose their gas during the transformation. These results point towards slow processes, such as ram-pressure stripping or harassment, being the mechanism responsible for the quenching of star formation in spirals, followed by a burst of star formation in the central regions from the gas that has been funnelled inwards through the disk.

Implementation of a protocol to reduce occurrence of retained sponges after vaginal delivery.

PubMed

Lutgendorf, Monica A; Schindler, Lynnett L; Hill, James B; Magann, Everett F; O'Boyle, John D

2011-06-01

Retained sponges (gossypiboma) following vaginal delivery are an uncommon occurrence. Although significant morbidity from such an event is unlikely, there are many reported adverse effects, including symptoms of malodorous discharge, loss of confidence in providers and the medical system, and legal claims. To report a protocol intended to reduce the occurrence of retained sponges following vaginal delivery. After identification of limitations with existing delivery room protocols, we developed a sponge count protocol to reduce occurrence of retained vaginal sponges. We report our experience at Naval Medical Center Portsmouth, a large tertiary care military treatment facility with our efforts to implement a sponge count protocol to reduce retained sponges following vaginal delivery. With appropriate pre-implementation training, protocols which incorporate post-delivery vaginal sweep and sponge counts are well accepted by the health care team and can be incorporated into the delivery room routine.

Semiquantitative culture of Gardnerella vaginalis in laboratory determination of nonspecific vaginitis.

PubMed Central

Ratnam, S; Fitzgerald, B L

1983-01-01

To evaluate the usefulness of quantitative cultures of Gardnerella vaginalis in the laboratory determination of nonspecific vaginitis, the actual and relative numbers of G. vaginalis in genital cultures of a general patient population were assessed semiquantitatively, and the laboratory results were then correlated with the clinical findings. Of the 1,585 women studied, 417 (26.3%) yielded G. vaginalis in culture. Of these, only 113 (27.1%) were found to have symptoms and signs consistent with nonspecific vaginitis. G. vaginalis was obtained in pure or predominant growth from 87 of 100 consecutive cases with nonspecific vaginitis and 32 of 100 consecutive cases without the symptoms or signs of vaginitis (P less than 0.001). Hence, the positive predictive value of isolation of G. vaginalis in pure and predominant growths was determined to be 73% (87 of 119). Conversely, G. vaginalis was isolated in mixed or light growth significantly more often from asymptomatic women than from symptomatic patients, i.e., 68 versus 13 cases. Therefore, the negative predictive value of isolation of G. vaginalis in mixed and light growths was found to be 84% (68 of 81). Quantitation of the relative amount of G. vaginalis growth had higher predictive values as compared with the assessment of G. vaginalis growth alone. We conclude that quantitative culture of G. vaginalis is essential to obtain maximum reliability of culture results in the laboratory determination of nonspecific vaginitis. Although quantitated cultures of G. vaginalis have high predictive values, laboratory results must be interpreted in conjunction with the clinical findings. PMID:6604735

Anterior vaginal wall tenderness (AVWT) as a physical symptom in chronic pelvic pain.

PubMed

Paulson, John D; Paulson, Joseph N

2011-01-01

Chronic pelvic pain is often difficult to diagnose and treat properly. Physicians called on to treat this problem may not be able to give a specific diagnosis. The aim of this study was to see whether the physical presence of anterior vaginal wall tenderness could help narrow down and elucidate diagnoses in a practice focusing on diagnosis and treatment of chronic pelvic pain. The study cohort comprised 284 patients with chronic pelvic pain limited to gynecologic and lower urinary problems. Histories, physical examinations, and endoscopic procedures were performed on each patient. An analysis of this information was conducted. Of the chronic pelvic pain patients, 78% had endometriosis, 81% had interstitial cystitis, and 61% had both concurrently. The sensitivity of anterior vaginal wall tenderness (AVWT) in patients with interstitial cystitis was 95%, and in those with only endometriosis and no interstitial cystitis, the sensitivity was 17%. The positive predictive value for interstitial cystitis was 85%, and for endometriosis it was 67%. Examination of the anterior vaginal wall with an empty bladder at the initial examination can lead one to suspect interstitial cystitis and possibly either concomitant or singular endometriosis and allow the physician to approach the workup accordingly.

Do female patients with nonpathological vaginal discharge need the same evaluation as for Dhat syndrome in males?

PubMed Central

Grover, Sandeep; Avasthi, Ajit; Gupta, Sunil; Hazari, Nandita; Malhotra, Nidhi

2016-01-01

Aim: The aim of this study was to evaluate the concept of female Dhat syndrome characterized by the complaint of nonpathological vaginal discharge in association with somatic, anxiety, and depressive symptoms. Materials and Methods: A total of 26 female subjects with nonpathological vaginal discharge along with depressive and somatic complaints were assessed on a self-rated questionnaire modified from Comprehensive Questionnaire for Assessment of Dhat Syndrome designed for males. They were also assessed for psychiatric comorbidity as per ICD-10. Results: All female subjects received an ICD-10 psychiatric diagnosis, with somatoform/dissociative disorder (57.7%) being the most common. The mean age of onset of vaginal discharge was 24.6 (standard deviation - 7.0) years, noted every day or for 2–3 times per week by more than two-third of the participants. Two-fifth (61.5%) of the women described it as a milky discharge. The most common reason reported for passage of vaginal discharge was that of urinary infection or problems of urinary tract infections (42.3%) followed by vaginal infection/disease (34.6%). More than half (53.8%) of the subjects considered vaginal discharge to be responsible for weakness in the body, weakness in stamina and thinness of physique, while slightly more than two-third (69.2%) of them reported bodily weakness and sleep disturbances. Overall the clinical picture in females was similar to male patients with Dhat syndrome on most of the account. Conclusions: Subgroup of patients with vaginal discharge attribute their somatic and mental symptoms to the passage of whitish vaginal discharge and are distressed due to the same. The clinical picture is similar to Dhat syndrome in males. There is a need to recognize female variant of Dhat syndrome as a culture-bound syndrome. Identification of the same may help in managing this subgroup of patients seeking help from the gynecologists for their nonpathological vaginal discharge or from mental health

Before the Bar: Kinematic Detection of a Spheroidal Metal-poor Bulge Component

NASA Astrophysics Data System (ADS)

Kunder, Andrea; Rich, R. M.; Koch, A.; Storm, J.; Nataf, D. M.; De Propris, R.; Walker, A. R.; Bono, G.; Johnson, C. I.; Shen, Juntai; Li, Z.-Y.

2016-04-01

We present 947 radial velocities of RR Lyrae variable stars in four fields located toward the Galactic bulge, observed within the data from the ongoing Bulge RR Lyrae Radial Velocity Assay (BRAVA-RR). We show that these RR Lyrae stars (RRLs) exhibit hot kinematics and null or negligible rotation and are therefore members of a separate population from the bar/pseudobulge that currently dominates the mass and luminosity of the inner Galaxy. Our RRLs predate these structures and have metallicities, kinematics, and spatial distribution that are consistent with a “classical” bulge, although we cannot yet completely rule out the possibility that they are the metal-poor tail of a more metal-rich ([{Fe}/{{H}}]˜ -1 dex) halo-bulge population. The complete catalog of radial velocities for the BRAVA-RR stars is also published electronically.

The missing bulge globular clusters in M31 - New optical candidates

NASA Technical Reports Server (NTRS)

Wirth, A.; Smarr, L. L.; Bruno, T. L.

1985-01-01

A new method to attack the question of the 'missing' globular clusters in the bulge of M31 is used. Image-processing techniques were used on 13 videocamera fields to obtain an accurate photometric census of stellar objects in M31's bulge down to a limiting B magnitude of 21. This luminosity distribution is compared with the Bahcall-Soneira model of galactic foreground stars. A statistically significant excess of bright images in the luminosity range of globular clusters at M31's distance is found. If the optical candidates considered prove to be globular clusters, they would double the number of known globular clusters in the surveyed region. The colors of a subsample of the candidates are the same as those of the known globular clusters. It is concluded that the previously observed flattening away from a de Vaucouleurs law in the radial distribution of M31 may be an observational selection effect. As an offshoot of this analysis, no evidence is found for very luminous stars in the inner bulge of M31. The lack of such stars indicates that there has not been active star formation (with a normal IMF) in the recent past. Coupled with the existence of many planetary nebulae in the bulge, this may strengthen the case for a galactic wind in M31's bulge.

Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome due to microperforation and pyocolpos in obstructed vaginal canal.

PubMed

Wozniakowska, Ewa; Torres, Anna; Milart, Pawel; Wozniak, Slawomir; Czuczwar, Piotr; Szkodziak, Piotr; Paszkowski, Tomasz

2014-08-01

To present a rare anomaly consisting of uterus didelphys, longitudinal vaginal septum, obstructed hemivagina with pyocolpos, fistula to the open vaginal canal, and ipsilateral renal agenesis, referred as Herlyn-Werner-Wunderlich syndrome (HWWS). A 14-year-old girl with recurring purulent vaginal discharge lasting for a few months. Preoperative examination revealed one vaginal canal with one cervical opening on the right side. There was a fistula leading from the obstructed vaginal canal to the left vagina. Intravaginal ultrasound examination demonstrated a longitudinal vaginal septum and a closed pyocolpos on the right side. The longitudinal vaginal septum was excised by way of electrocauterization under direct vision. HWWS should be considered in the differential diagnosis in patients with uterus didelphys and unusual symptoms such as pyocolpos and vaginal discharge. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Aerobic vaginal pathogens and their sensitivity pattern.

PubMed

Mumtaz, Shamim; Ahmad, Mumtaz; Aftab, Irum; Akhtar, Naeem; ul Hassan, Masood; Hamid, Abdul

2008-01-01

The vaginal flora is a complicated environment, containing dozens of microbiological species in variable quantities and relative proportions. The frequent cause of vaginal discharge is an infection or colonization with different microorganisms. Some pathologic conditions causing vaginitis are well defined yet, 7-72% of women with vaginitis may remain undiagnosed and such forms of abnormal vaginal flora neither considered as normal, nor can be called bacterial vaginosis have been termed as 'intermediate flora' and its management probably differ from that of bacterial vaginosis. It is of crucial importance in pregnant females at risk of preterm delivery. The present study has been conducted especially to elucidate this type of aerobic vaginal isolates and their culture and sensitivity towards currently used antibiotics. This study was conducted at the Microbiology Department of Fauji Foundation Hospital, Rawalpindi over a period of two years (April 2004-March 2006). One thousand, nine hundred and twenty three high vaginal swabs, both from indoor and outdoor patients were collected, cultured and their susceptibility to various antibiotics was determined. Significant growth was obtained in 731 samples. The highest frequency of infection (39.5%) was observed at 31-40 years followed by 41-50 years (35.8%). About 76% were from outdoor and 24% were from indoor patients. Staphylococcus aureus was the most prevalent vaginal pathogen at 11-60 yrs & with highest prevalence at 31-40 years followed by 41-50 years. It was a predominant pathogen in both indoor (35%) as well as outdoor (41.6%) patients, followed by enteric gram-negative bacilli and other gram-positive cocci. There were very few antibiotics among the conventionally available aminoglycosides, third generation cephalosporins, penicillin, quinolones, sulfonamides and tetracyclines possessing good sensitivity (> 80%) against any one the common aerobic vaginal pathogens. The effective chemotherapeutics agents belong to

The stellar population and luminosity function in M31 bulge and Inner Disk Fields

NASA Technical Reports Server (NTRS)

Rich, R. Michael; Mould, J. R.; Graham, James R.

1993-01-01

We report infrared photometry and stellar identifications for stars in five fields in the M31 bulge located from 2 to 11 arcmin from the nucleus. These fields have been chosen such that the bulge/disk star ratio predicted from Kent's (1989) small bulge model varies from 7:1 to 1:5, allowing a study of near pure disk and near pure bulge stellar populations. We reject the hypothesis of Davies et al. (1991) that luminous stars found within 500 pc of the nucleus are due to a contaminating disk population. We find that the bulge contains stars in excess of M(sub bol) = -5 mag and that the bulge luminosity function has a distinct shape different from the disk fields. We find many stars redder than (J-K) = 2 mag, and suggest that these stars may be the counterparts of the IRAS-selected Galactic bulge Miras studied by Whitelock et at. (1991). The number of bright stars (M(sub bol) is less than -5 mag) falls off more rapidly than the r band surface brightness. By building model fields out of a bulge luminosity function and artificial stars, we are able to show that the change in the luminosity function toward the center cannot be explained simply by the mismeasurement of overcrowded star images. However, these tests also raise the possibility that the asymptotic giant branch (AGB) tip may be approximately equal to 1 mag fainter than actually measured in our most crowded field, reaching only M(sub bol) = -5. We compare observed counts of AGB stars with those predicted from theoretical lifetimes using a technique of general interest for this problem, the Fuel Consumption Theorem of Renzini & Buzzoni (1986) Spectral Evolution of Galaxies (Reidel, Dordrecht). Our methodology is generally applicable to the study of other resolved extragalactic stellar populations. The number of observed stars per magnitude up to a luminosity of M(bol) = -5.5 mag is consistent with AGB evolution of the whole population of the innermost bulge field with the standard lifetime on the AGB of 1.3 Myr

Microdose transdermal estrogen therapy for relief of vulvovaginal symptoms in postmenopausal women.

PubMed

Bachmann, Gloria A; Schaefers, Matthias; Uddin, Alkaz; Utian, Wulf H

2009-01-01

The aim of this study was to investigate the effectiveness of microdose transdermal 17beta-estradiol (E2) therapy in postmenopausal women with moderate to severe vulvovaginal symptoms. This report is based on a subset of 121 women who reported most bothersome moderate or severe vulvovaginal symptoms at baseline, from a previous randomized, double-blind, placebo-controlled, multicenter study of 425 healthy, symptomatic, postmenopausal women. Recruits had experienced at least 7 moderate or severe hot flushes daily for at least 1 week or at least 50 moderate or severe hot flushes per week for at least 1 week. Effects on coprimary efficacy variables have been reported previously. Participants received low-dose transdermal E2 plus levonorgestrel (n = 43; nominal delivery 0.023 mg/d E2/0.0075 mg/d levonorgestrel), microdose E2 (n = 42; nominal delivery 0.014 mg/d), or placebo (n = 36) for 12 weeks. Secondary efficacy variables reported herein include mean change from baseline in vaginal pH and vaginal maturation index, the proportion of women with symptoms of vulvar and vaginal atrophy at baseline and week 12, and the proportion of women with moderate-to-severe symptoms of vulvar and vaginal atrophy. Microdose transdermal E2 treatment was associated with a consistent benefit versus placebo in women with vulvovaginal atrophy. There was a statistically significant difference between both E2 versus placebo for changes in vaginal pH and vaginal maturation index. Microdose transdermal E2 offers a useful addition to the therapeutic armamentarium for postmenopausal women in whom vulvovaginal symptoms are particularly troublesome.

The vaginal microbiome: New information about genital tract flora using molecular based techniques

PubMed Central

Lamont, Ronald F.; Sobel, Jack D.; Akins, Robert A.; Hassan, Sonia S.; Chaiworapongsa, Tinnakorn; Kusanovic, Juan Pedro; Romero, Roberto

2011-01-01

Vaginal microbiome studies provide information which may change the way we define vaginal flora. Normal flora appears dominated by one or two species of Lactobacillus. Significant numbers of healthy women lack appreciable numbers of vaginal lactobacilli. Bacterial vaginosis (BV) is not a single entity, but different bacterial communities or profiles of greater microbial diversity than is evident from cultivation-dependent studies. BV should be considered a syndrome of variable composition which results in different symptoms, phenotypical outcomes, and responses to different antibiotic regimens. This information may help to elucidate the link between BV and infection-related adverse outcomes of pregnancy. PMID:21251190

VERY METAL-POOR STARS IN THE OUTER GALACTIC BULGE FOUND BY THE APOGEE SURVEY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garcia Perez, Ana E.; Majewski, Steven R.; Hearty, Fred R.

2013-04-10

Despite its importance for understanding the nature of early stellar generations and for constraining Galactic bulge formation models, at present little is known about the metal-poor stellar content of the central Milky Way. This is a consequence of the great distances involved and intervening dust obscuration, which challenge optical studies. However, the Apache Point Observatory Galactic Evolution Experiment (APOGEE), a wide-area, multifiber, high-resolution spectroscopic survey within Sloan Digital Sky Survey III, is exploring the chemistry of all Galactic stellar populations at infrared wavelengths, with particular emphasis on the disk and the bulge. An automated spectral analysis of data on 2403more » giant stars in 12 fields in the bulge obtained during APOGEE commissioning yielded five stars with low metallicity ([Fe/H] {<=} -1.7), including two that are very metal-poor [Fe/H] {approx} -2.1 by bulge standards. Luminosity-based distance estimates place the 5 stars within the outer bulge, where 1246 of the other analyzed stars may reside. A manual reanalysis of the spectra verifies the low metallicities, and finds these stars to be enhanced in the {alpha}-elements O, Mg, and Si without significant {alpha}-pattern differences with other local halo or metal-weak thick-disk stars of similar metallicity, or even with other more metal-rich bulge stars. While neither the kinematics nor chemistry of these stars can yet definitively determine which, if any, are truly bulge members, rather than denizens of other populations co-located with the bulge, the newly identified stars reveal that the chemistry of metal-poor stars in the central Galaxy resembles that of metal-weak thick-disk stars at similar metallicity.« less

Most pseudo-bulges can be formed at later stages of major mergers

NASA Astrophysics Data System (ADS)

Sauvaget, T.; Hammer, F.; Puech, M.; Yang, Y. B.; Flores, H.; Rodrigues, M.

2018-01-01

Most giant spiral galaxies have pseudo or disc-like bulges that are considered to be the result of purely secular processes. This may challenge the hierarchical scenario predicting about one major merger per massive galaxy (>3 × 1010 M⊙) since the last ∼9 billion years. Here, we verify whether or not the association between pseudo-bulges and secular processes is irrevocable. Using GADGET2 N-body/SPH simulations, we have conducted a systematic study of remnants of major mergers for which progenitors have been selected (1) to follow the gas richness-look back time relationship, and (2) with a representative distribution of orbits and spins in a cosmological frame. Analysing the surface mass density profile of both nearby galaxies and merger remnants with two components, we find that most of them show pseudo-bulges or bar dominated centres. Even if some orbits lead to classical bulges just after the fusion, the contamination by the additional gas that gradually accumulates to the centre and forming stars later on, leads to remnants apparently dominated by pseudo-bulges. We also found that simple smoothed particle hydrodynamics (SPH) simulations should be sufficient to form realistic spiral galaxies as remnants of ancient gas-rich mergers without the need for specifically tuned feedback conditions. We then conclude that pseudo-bulges and bars in spiral galaxies are natural consequences of major mergers when they are realized in a cosmological context, i.e. with gas-rich progenitors as expected when selected in the distant Universe.

Formation of the bulge of Iapetus through long-wavelength folding of the lithosphere

NASA Astrophysics Data System (ADS)

Kay, Jonathan P.; Dombard, Andrew J.

2018-03-01

Previous models that attempted to explain the formation of the pronounced oblate shape of Iapetus suggested that it was a preserved rotational bulge. These models found that heating was provided by short-lived radioactive isotopes that decayed rapidly and allowed the excess flattening of the lithosphere to be locked in by a thickening lithosphere, but placed severe timing constraints on the formation of Iapetus and its bulge. Here, we show that finite element simulations with an elastic-viscous-plastic rheology indicate it is possible to form the bulge through long-wavelength folding of the lithosphere of Iapetus during an epoch of contraction combined with a latitudinal surface temperature gradient. In contrast to models of a frozen rotational bulge, heat generated by long-lived radioactive isotopes warms the interior, which causes porosity loss and forces Iapetus to compact by ∼10%. Our simulations are most successful when there is a 30 K temperature difference between the pole and the equator. Tectonic growth of the bulge is not sensitive to the time scale over which the moon contracts, and lithospheric thickness primarily controls whether a fold can form, not fold wavelength. In addition, long term simulations show that when no stress is applied, the mechanical lithosphere is strong enough to support the bulge, with negligible relaxation over billion year time scales.

Hair Follicle Bulge Stem Cells Appear Dispensable for the Acute Phase of Wound Re‐epithelialization

PubMed Central

Garcin, Clare L.; Ansell, David M.; Headon, Denis J.; Paus, Ralf

2016-01-01

Abstract The cutaneous healing response has evolved to occur rapidly, in order to minimize infection and to re‐establish epithelial homeostasis. Rapid healing is achieved through complex coordination of multiple cell types, which importantly includes specific cell populations within the hair follicle (HF). Under physiological conditions, the epithelial compartments of HF and interfollicular epidermis remain discrete, with K15+ve bulge stem cells contributing progeny for HF reconstruction during the hair cycle and as a basis for hair shaft production during anagen. Only upon wounding do HF cells migrate from the follicle to contribute to the neo‐epidermis. However, the identity of the first‐responding cells, and in particular whether this process involves a direct contribution of K15+ve bulge cells to the early stage of epidermal wound repair remains unclear. Here we demonstrate that epidermal injury in murine skin does not induce bulge activation during early epidermal wound repair. Specifically, bulge cells of uninjured HFs neither proliferate nor appear to migrate out of the bulge niche upon epidermal wounding. In support of these observations, Diphtheria toxin‐mediated partial ablation of K15+ve bulge cells fails to delay wound healing. Our data suggest that bulge cells only respond to epidermal wounding during later stages of repair. We discuss that this response may have evolved as a protective safeguarding mechanism against bulge stem cell exhaust and tumorigenesis. Stem Cells 2016;34:1377–1385 PMID:26756547

Using 3D Spectroscopy to Probe the Orbital Structure of Composite Bulges

NASA Astrophysics Data System (ADS)

Erwin, Peter; Saglia, Roberto; Thomas, Jens; Fabricius, Maximilian; Bender, Ralf; Rusli, Stephanie; Nowak, Nina; Beckman, John E.; Vega Beltrán, Juan Carlos

2015-02-01

Detailed imaging and spectroscopic analysis of the centers of nearby S0 and spiral galaxies shows the existence of ``composite bulges'', where both classical bulges and disky pseudobulges coexist in the same galaxy. As part of a search for supermassive black holes in nearby galaxy nuclei, we obtained VLT-SINFONI observations in adaptive-optics mode of several of these galaxies. Schwarzschild dynamical modeling enables us to disentangle the stellar orbital structure of the different central components, and to distinguish the differing contributions of kinematically hot (classical bulge) and kinematically cool (pseudobulge) components in the same galaxy.

Vaginal Cancer Overview

MedlinePlus

... are here Home > Types of Cancer > Vaginal Cancer Vaginal Cancer This is Cancer.Net’s Guide to Vaginal Cancer. Use the menu below to choose the ... social workers, and patient advocates. Cancer.Net Guide Vaginal Cancer Introduction Statistics Medical Illustrations Risk Factors and ...

Bulge Growth and Quenching Since Z=2.5 in Candels/3D-HST

NASA Technical Reports Server (NTRS)

Lang, Phillip; Wuyts, Stijn; Somerville, Rachel S.; Schreiber, Natascha M. Foerster; Genzel, Reinhard; Bell, Eric F.; Brammer, Gabe; Dekel, Avishai; Faber, Sandra M.; Ferguson, Henry C.;

Difficulty in the management of pregnancy after vaginal radical trachelectomy.

PubMed

Takada, Sakura; Ishioka, Shin-Ichi; Endo, Toshiaki; Baba, Tsuyoshi; Morishita, Miyuki; Akashi, Yushi; Mizuuchi, Masahito; Adachi, Hidefumi; Kim, Miseon; Saito, Tsuyoshi

2013-12-01

We have performed 26 vaginal radical trachelectomies (RTs) for patients with early invasive uterine cervical cancer since 2003 and, to date, have experienced 8 deliveries. The procedure has a high risk for preterm labor and the subsequent occurrence of preterm premature rupture of membranes (pPROM). We report the present situation and the limits of follow-up of pregnancy after vaginal RT. Our operative procedure is based on that of Dargent et al. We usually amputate the cervix approximately 10 mm below the isthmus. To remove the parametrium, we cut at the level of type II hysterectomy. Pregnancy courses after vaginal RT were studied in 8 patients with respect to symptoms, cervical length, and several infectious signs. We recommended that patients enter hospital early in their second trimester, and prophylactic daily vaginal disinfection with povidone-iodine and an ulinastatin vaginal suppository were administered. Careful checking for vaginal infectious signs, as well as cervical length and abdominal tension of patients was also performed. Four patients followed up with this modality were able to continue their pregnancies until late in the third trimester. However, this follow-up modality was not effective for patients who showed cervical incompetence due to slack cervical cerclage. They suffered from pPROM at 26 and 19 weeks of gestation. We need a new approach for the management of pregnant patients after vaginal RT with cervical incompetence due to slack cervical cerclage to prevent cervical infection.

Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis.

PubMed

Kaambo, Evelyn; Africa, Charlene; Chambuso, Ramadhani; Passmore, Jo-Ann Shelley

2018-01-01

A healthy vaginal microbiota is considered to be significant for maintaining vaginal health and preventing infections. However, certain vaginal bacterial commensal species serve an important first line of defense of the body. Any disruption of this microbial barrier might result in a number of urogenital conditions including aerobic vaginitis (AV) and bacterial vaginosis (BV). The health of the vagina is closely associated with inhabitant microbiota. Furthermore, these microbes maintain a low vaginal pH, prevent the acquisition of pathogens, stimulate or moderate the local innate immune system, and further protect against complications during pregnancies. Therefore, this review will focus on vaginal microbial "health" in the lower reproductive tract of women and on the physiological characteristics that determine the well-being of reproductive health. In addition, we explore the distinct versus shared characteristics of BV and AV, which are commonly associated with increased risk for preterm delivery.

Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis

PubMed Central

Kaambo, Evelyn; Africa, Charlene; Chambuso, Ramadhani; Passmore, Jo-Ann Shelley

2018-01-01

A healthy vaginal microbiota is considered to be significant for maintaining vaginal health and preventing infections. However, certain vaginal bacterial commensal species serve an important first line of defense of the body. Any disruption of this microbial barrier might result in a number of urogenital conditions including aerobic vaginitis (AV) and bacterial vaginosis (BV). The health of the vagina is closely associated with inhabitant microbiota. Furthermore, these microbes maintain a low vaginal pH, prevent the acquisition of pathogens, stimulate or moderate the local innate immune system, and further protect against complications during pregnancies. Therefore, this review will focus on vaginal microbial “health” in the lower reproductive tract of women and on the physiological characteristics that determine the well-being of reproductive health. In addition, we explore the distinct versus shared characteristics of BV and AV, which are commonly associated with increased risk for preterm delivery. PMID:29632854

Effect of an upstream bulge configuration on film cooling with and without mist injection.

PubMed

Wang, Jin; Li, Qianqian; Sundén, Bengt; Ma, Ting; Cui, Pei

2017-12-01

To meet the economic requirements of power output, the increased inlet temperature of modern gas turbines is above the melting point of the material. Therefore, high-efficient cooling technology is needed to protect the blades from the hot mainstream. In this study, film cooling was investigated in a simplified channel. A bulge located upstream of the film hole was numerically investigated by analysis of the film cooling effectiveness distribution downstream of the wall. The flow distribution in the plate channel is first presented. Comparing with a case without bulge, different cases with bulge heights of 0.1d, 0.3d and 0.5d were examined with blowing ratios of 0.5 and 1.0. Cases with 1% mist injection were also included in order to obtain better cooling performance. Results show that the bulge configuration located upstream the film hole makes the cooling film more uniform, and enhanceslateral cooling effectiveness. Unlike other cases, the configuration with a 0.3d-height bulge shows a good balance in improving the downstream and lateral cooling effectiveness. Compared with the case without mist at M = 0.5, the 0.3d-height bulge with 1% mist injection increases lateral average effectiveness by 559% at x/d = 55. In addition, a reduction of the thermal stress concentration can be obtained by increasing the height of the bulge configuration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Advanced topical drug delivery system for the management of vaginal candidiasis.

PubMed

Johal, Himmat Singh; Garg, Tarun; Rath, Goutam; Goyal, Amit Kumar

2016-01-01

Vaginal candidiasis or vulvovaginal candidiasis (VC) is a common mucosal infection of vagina, mainly caused by Candida species. The major symptoms of VC are dyspareunia, pruritis, itching, soreness, vagina as well as vulvar erythema and edema. Most common risk factors that lead to the imbalance in the vaginal micro biota are the use of antibiotics, pregnancy, diabetes mellitus, immuno suppression as in AIDS or HIV patients, frequent sexual intercourse, spermicide and intra-uterine devices and vaginal douching. Various anti-fungal drugs are available for effective treatment of VC. Different conventional vaginal formulations (creams, gels, suppositories, powder, ointment, etc.) for VC are available today but have limited efficacy because of lesser residence time on vaginal epithelium due to self-cleansing action of vagina. So to overcome this problem, an extended and intimate contact with vaginal mucosa is desired; which can be accomplished by utilizing mucoadhesive polymers. Mucoadhesive polymers have an excellent binding capacity to mucosal tissues for considerable period of time. This unique property of these polymers significantly enhances retention time of different formulations on mucosal tissues. Currently, various novel formulations such as liposomes, nano- and microparticles, micro-emulsions, bio-adhesive gel and tablets are used to control and treat VC. In this review, we focused on current status of vaginal candidiasis, conventional and nanotechnology inspired formulation approaches.

Chandra Studies of Unidentified X-ray Sources in the Galactic Bulge

NASA Astrophysics Data System (ADS)

Mori, Hideyuki

2013-09-01

We propose to study a complete X-ray sample in the luminosity range of > 10^34 erg s^-1 in the Galactic bulge, including 5 unidentified sources detected in the ROSAT All Sky Survey. Our goal is to obtain a clear picture about X-ray populations in the bulge, by utilizing the excellent Chandra position accuracy leading to unique optical identification together with the X-ray spectral properties. This is a new step toward understanding the formation history of the bulge. Furthermore, because the luminosity range we observe corresponds to a ``missing link'' region ever studied for a neutron star or blackhole X-ray binary, our results are also unique to test accretion disk theories at intermediate mass accretion rates.

Hair Follicle Bulge Stem Cells Appear Dispensable for the Acute Phase of Wound Re-epithelialization.

PubMed

Garcin, Clare L; Ansell, David M; Headon, Denis J; Paus, Ralf; Hardman, Matthew J

2016-05-01

The cutaneous healing response has evolved to occur rapidly, in order to minimize infection and to re-establish epithelial homeostasis. Rapid healing is achieved through complex coordination of multiple cell types, which importantly includes specific cell populations within the hair follicle (HF). Under physiological conditions, the epithelial compartments of HF and interfollicular epidermis remain discrete, with K15(+ve) bulge stem cells contributing progeny for HF reconstruction during the hair cycle and as a basis for hair shaft production during anagen. Only upon wounding do HF cells migrate from the follicle to contribute to the neo-epidermis. However, the identity of the first-responding cells, and in particular whether this process involves a direct contribution of K15(+ve) bulge cells to the early stage of epidermal wound repair remains unclear. Here we demonstrate that epidermal injury in murine skin does not induce bulge activation during early epidermal wound repair. Specifically, bulge cells of uninjured HFs neither proliferate nor appear to migrate out of the bulge niche upon epidermal wounding. In support of these observations, Diphtheria toxin-mediated partial ablation of K15(+ve) bulge cells fails to delay wound healing. Our data suggest that bulge cells only respond to epidermal wounding during later stages of repair. We discuss that this response may have evolved as a protective safeguarding mechanism against bulge stem cell exhaust and tumorigenesis. Stem Cells 2016;34:1377-1385. © 2016 The Authors. Stem Cells published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.

A new reconstructive technique for posterior vaginal wall defects, a case report.

PubMed

Zetlitz, Elisabeth; Manook, Miriam; MacLeod, Alison; Hamilton, Stuart

2013-10-01

Post-partum vaginal laxity is a problem encountered by many women. More uncommon is a resulting vaginal defect. In most cases of laxity, a period of extensive physiotherapy can strengthen the pelvic muscles enough for symptoms to be minimized. However, this is not the case once there is a tissue defect. To present a new reconstructive method for patients with posterior vaginal wall defects. We present a case of a 38-year-old female who, 12 years prior to presentation, had a vaginal delivery. Due to complications during the delivery, she sustained pelvic trauma and developed a posterior vaginal wall defect. She had a sizable soft tissue defect, causing sexual, urinary, and confidence problems. Fat was harvested from the patient's abdomen and injected into the defect after more conservative treatment options were exhausted. The defect was corrected successfully using the minimally invasive Coleman fat grafting technique. This is to our knowledge the first case in the literature where a posterior vaginal defect has been corrected using Coleman fat grafting, and we believe that this treatment method may be of benefit to more patients. © 2013 International Society for Sexual Medicine.

Elucidation of kinematical and dynamical structure of the Galactic bulge

NASA Astrophysics Data System (ADS)

Yano, T.; Gouda, N.; Ueda, H.; Koyama, H.; Kan-ya, Y.; Taruya, A.

2008-07-01

Future space mission of astrometric satellite, GAIA and JASMINE (Japan Astrometry Satellite Mission for Infrared Exploration), will produce astrometric parameter, such as positions, parallaxes, and proper motions of stars in the Galactic bulge. Then kinematical information will be obtained in the future. Accordingly it is expected that our understanding of the dynamical structure will be greatly improved. Therefore it is important to make a method to construct a kinematical and dynamical structure of the Galactic bulge immediately.

Orbits of Selected Globular Clusters in the Galactic Bulge

NASA Astrophysics Data System (ADS)

Pérez-Villegas, A.; Rossi, L.; Ortolani, S.; Casotto, S.; Barbuy, B.; Bica, E.

2018-05-01

We present orbit analysis for a sample of eight inner bulge globular clusters, together with one reference halo object. We used proper motion values derived from long time base CCD data. Orbits are integrated in both an axisymmetric model and a model including the Galactic bar potential. The inclusion of the bar proved to be essential for the description of the dynamical behaviour of the clusters. We use the Monte Carlo scheme to construct the initial conditions for each cluster, taking into account the uncertainties in the kinematical data and distances. The sample clusters show typically maximum height to the Galactic plane below 1.5 kpc, and develop rather eccentric orbits. Seven of the bulge sample clusters share the orbital properties of the bar/bulge, having perigalactic and apogalatic distances, and maximum vertical excursion from the Galactic plane inside the bar region. NGC 6540 instead shows a completely different orbital behaviour, having a dynamical signature of the thick disc. Both prograde and prograde-retrograde orbits with respect to the direction of the Galactic rotation were revealed, which might characterise a chaotic behaviour.

Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study.

PubMed

Larmo, Petra S; Yang, Baoru; Hyssälä, Juha; Kallio, Heikki P; Erkkola, Risto

2014-11-01

Vaginal atrophy, the thinning and drying of vaginal mucosa, is associated with menopause. The standard estrogen treatment is not suitable for all women. To investigate the effects of oral sea buckthorn (SB) oil supplementation on vaginal atrophy. A total of 116 postmenopausal women experiencing symptoms of vaginal dryness, itching or burning were randomized to this placebo-controlled, double-blind study. Ninety-eight participants completed the intervention of three months, during which they consumed 3g of SB or placebo oil daily. At the beginning and end, factors of vaginal health were scored by a gynecologist, vaginal pH and moisture were measured and vaginal health index was calculated. Symptoms of atrophy and menopause were evaluated at study visits and by daily logbooks. Serum samples were collected for the analysis of circulating lipids, liver enzymes and C-reactive protein. Compared to placebo, there was a significantly better rate of improvement in the integrity of vaginal epithelium in the SB group when both compliant and noncompliant participants were included (odds ratio (OR)=3.1, 95% CI 1.11-8.95). A beneficial trend was observed when only the compliant participants were included (OR=2.9; 95% CI 0.99-8.35). There was a tendency (P=0.08) toward better improvement of vaginal health index from baseline to the end in the SB group [(0.8 (SD 2.8)] compared to placebo [-0.1 (SD 2.0)]. SB oil showed beneficial effects on vaginal health, indicating it is a potential alternative for mucosal integrity for those women not able to use estrogen treatment for vaginal atrophy. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Quality of life and sexual function of patients following radical hysterectomy and vaginal extension.

PubMed

Ye, Shuang; Yang, Jiaxin; Cao, Dongyan; Zhu, Lan; Lang, Jinghe; Chuang, Linus T; Shen, Keng

2014-05-01

Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function. The aim of this study was to investigate whether vaginal extension can improve sexual function and quality of life and the problem of sexual dysfunction in early-stage cervical cancer survivors (CCSs) in China. Case-control and questionnaire-based methods were employed. Thirty-one patients who had undergone vaginal extension following RH and 28 patients with matching factors after RH alone were enrolled in the study. Both groups were assessed retrospectively by questionnaires at least 6 months after treatment. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module and the Sexual Function Vaginal Changes Questionnaire are validated measurements for disease- and treatment-specific issues. Vaginal length was 10.03 ± 1.26 cm and 5.92 ± 1.05 cm in study and control group, respectively (P < 0.05). In the study group, 67.7% patients and 64.3% of control group resumed sexual activity at the time of interview, averaging 6 months between treatment and sexual activity. While difficulty emptying bladder, incomplete emptying, and constipation were the most commonly reported symptoms, no significant difference was observed regarding pelvic floor symptoms. Reduced vagina size and shortened vagina was significantly more prominent in the control group, whereas both group presented with hypoactive sexual desire (88.1%), orgasm dysfunction (71.8%), and low enjoyment or relaxation after sex (51.3%). Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and

EMISSION-LINE OBJECTS PROJECTED UPON THE GALACTIC BULGE*

PubMed Central

Herbig, G. H.

1969-01-01

Low-dispersion slit spectrograms have been obtained of 34 faint objects that lie in the direction of the galactic bulge and have the Hα line in emission upon a detectable continuum. Eleven of these are certain or probable symbiotic stars. A rough comparison with R CrB stars in the same area suggests that these brightest symbiotics in the bulge have in the mean Mv ≈ -3 to -4, which suggest Population II red giants rather than conventional Population I M-type objects. The sample also contains a number of hot stars having H and [O II] or [O III] in emission, as well as four conventional Be stars, and six certain or possible planetary nebulae. Images PMID:16578699

Emission-line objects projected upon the galactic bulge.

PubMed

Herbig, G H

1969-08-01

Low-dispersion slit spectrograms have been obtained of 34 faint objects that lie in the direction of the galactic bulge and have the Halpha line in emission upon a detectable continuum. Eleven of these are certain or probable symbiotic stars. A rough comparison with R CrB stars in the same area suggests that these brightest symbiotics in the bulge have in the mean M(v) approximately -3 to -4, which suggest Population II red giants rather than conventional Population I M-type objects. The sample also contains a number of hot stars having H and [O II] or [O III] in emission, as well as four conventional Be stars, and six certain or possible planetary nebulae.

Diffraction and Smith-Purcell radiation on the hemispherical bulges in a metal plate

NASA Astrophysics Data System (ADS)

Syshchenko, V. V.; Larikova, E. A.; Gladkih, Yu. P.

2017-12-01

The radiation resulting from the uniform motion of a charged particle near a hemispheric bulge on a metal plane is considered. The description of the radiation process based on the method of images is developed for the case of non-relativistic particle and a perfectly conducting target. The spectral-angular and spectral densities of the diffraction radiation on the single bulge (as well as the Smith-Purcell radiation on the periodic string of bulges) are computed. The possibility of application of the developed approach to the case of relativistic incident particle is discussed.

[Analysis of mesh related complications after trans-vaginal mesh-augmented pelvic floor reconstruction surgery].

PubMed

Zhang, Kun; Han, Jin-song; Zhu, Fu-li; Yao, Ying

2012-09-01

To evaluate the complications after trans-vaginal mesh-augmented pelvic floor reconstruction in treatment of pelvic organ prolapse (POP). From February 2007 to October 2009, vaginal mesh procedures were performed on 91 women with POP stage III-IV in Peking University Third Hospital. The operative complications were studied. Ninety patients underwent successful surgery among 91 patients. Follow-up rate was 94% (85/90) at a median follow-up of 28.4 (15 - 44) months. One patient underwent intraoperative organ injuries, and 10 patients had postoperation mesh-related complications. The rate of mesh-related complications was 2% (2/85), 2% (2/85), 4% (3/85), 4% (3/85) on 6, 6 - 12, 12 - 24 and more than 24 months following up, respectively. Seven patients underwent conservative treatment and the symptoms were improved. Three patients underwent the second surgery, and the symptoms were cured or relieved. The incidence of mesh-related complications was low, and interventions were effective in vaginal mesh procedure.

Premenarchal, recurrent vaginal discharge associated with an incomplete obstructing longitudinal vaginal septum.

PubMed

Hansen, Keith A; DeWitt, Jason

2005-12-01

To describe an unusual, premenarchal presentation of an obstructive vaginal anomaly. Case Report. University Medical Center. Premenarchal subject Vaginogram, vaginal septum resection. Vaginal septum resection with resolution of vaginal discharge. This case demonstrates some of the typical features of uterus didelphys bicollis with incomplete obstructing hemivagina, but had a unique presentation with premenarchal, recurrent vaginal discharge. Typically, patients with an obstructing mullerian anomaly present after menarche with pelvic pain and a mass. The vaginogram assists in the preoperative definition of abnormal anatomy which allows the surgeon to develop the most appropriate surgical approach. Resection of this incompletely obstructing vaginal septum resulted in resolution of the recurrent vaginal discharge.

Vulvar Pain-Associations Between First-Time Vaginal Intercourse, Tampon Insertion, and Later Experiences of Pain.

PubMed

Elmerstig, Eva; Thomtén, Johanna

2016-11-16

This study examines associations between the first experience of vaginal intercourse/tampon insertion and later experiences of vulvar pain. The study is based on questionnaire data from 1,259 Swedish female senior high-school students, aged 18 to 22 years old. Of these, 592 women reported present vulvar pain. Present vulvar pain was associated with first-time experiences of vaginal intercourse (pain, negative experience, against will) and with pain at tampon insertion. First-time experiences were also related to temporal aspects of present vulvar pain during vaginal intercourse (at the beginning, after a while during, and after). Implications of first-time experiences of vaginal intercourse for future symptoms of vulvar pain are discussed.

Hysterectomy - vaginal - discharge

MedlinePlus

Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you were in the hospital, you had a vaginal hysterectomy. Your surgeon made a cut in your ...

Resolution of subchorionic hematoma and symptoms of threatened miscarriage using vaginal alpha lipoic acid or progesterone: clinical evidences.

PubMed

Costantino, M; Guaraldi, C; Costantino, D

2016-04-01

Alpha Lipoic Acid (ALA) is a safe natural molecule that exerts a selective immunomodulating activity with antioxidant and anti-inflammatory properties. This randomized controlled clinical trial (RCT) tested the effect of the vaginal administration with ALA or Progesterone, in subchorionic hematoma resorption in women with threatened miscarriage. 400 mg of vaginal Progesterone or 10 mg of vaginal ALA were administered to sixty-two pregnant women, in the first trimester of gestation with threatened miscarriage and subchorionic hematoma. Controls were patients who chose not to receive any treatment. In the ALA group the subchorionic hematoma was reabsorbed more quickly in comparison with the progression detected in Progesterone group (p ≤ 0.05). The other parameters checked (pelvic pain and vaginal bleeding) did not show any significant difference and a smaller number of miscarriages was recorded in the ALA group, compared to Progesterone group. Our data provides the first evidence of the efficacy of ALA, administered by vaginal route, in the healing process of patients with threatened miscarriage, thus supporting the normal course of pregnancy. NCT02601898 (ClinicalTrials.gov registry).

Can group B streptococci cause symptomatic vaginitis?

PubMed Central

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

1999-01-01

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

Vulvovaginal symptoms in women with bacterial vaginosis.

PubMed

Klebanoff, Mark A; Schwebke, Jane R; Zhang, Jun; Nansel, Tonja R; Yu, Kai-Fun; Andrews, William W

2004-08-01

A substantial, but highly variable, percentage of women with bacterial vaginosis are said to be asymptomatic. The purpose of this study was to estimate the prevalence of symptoms among women with bacterial vaginosis compared with women without bacterial vaginosis by direct, explicit, and detailed questioning of these women. Women presenting for a routine health care visit at 12 health department clinics in Birmingham, Alabama, were recruited to participate in a longitudinal study of vaginal flora. At the first visit, they underwent a pelvic examination, lower genital tract microbiological evaluation, and an interview that included detailed questions regarding lower genital tract symptoms. The prevalence of symptoms among women with and without bacterial vaginosis (Gram stain score 7 or higher) was compared. Among 2,888 women without gonorrhea, Chlamydia, or trichomonas, 75% of women with and 82% of women without bacterial vaginosis never noted any vaginal odor in the past 6 months (P <.001). The corresponding values were 63% and 65% for never noting vaginal "wetness" (P =.02); 58% and 57% for vaginal discharge (P =.65); 91% and 86% for irritation (P =.004); 88% and 85% for itching (P =.64); and 96% and 94% for dysuria (P =.002), respectively. Cumulatively, 58% of women with bacterial vaginosis noted odor, discharge, and/or wetness in the past 6 months compared with 57% of women without bacterial vaginosis (P =.70). The 2 classic symptoms of bacterial vaginosis discharge and odor are each reported by a minority of women with bacterial vaginosis and are only slightly more prevalent than among women without bacterial vaginosis.

Light, alpha, and Fe-peak element abundances in the galactic bulge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Christian I.; Rich, R. Michael; Kobayashi, Chiaki

2014-10-01

We present radial velocities and chemical abundances of O, Na, Mg, Al, Si, Ca, Cr, Fe, Co, Ni, and Cu for a sample of 156 red giant branch stars in two Galactic bulge fields centered near (l, b) = (+5.25,–3.02) and (0,–12). The (+5.25,–3.02) field also includes observations of the bulge globular cluster NGC 6553. The results are based on high-resolution (R ∼ 20,000), high signal-to-noise ration (S/N ≳ 70) FLAMES-GIRAFFE spectra obtained through the European Southern Observatory archive. However, we only selected a subset of the original observations that included spectra with both high S/N and that did notmore » show strong TiO absorption bands. This work extends previous analyses of this data set beyond Fe and the α-elements Mg, Si, Ca, and Ti. While we find reasonable agreement with past work, the data presented here indicate that the bulge may exhibit a different chemical composition than the local thick disk, especially at [Fe/H] ≳ –0.5. In particular, the bulge [α/Fe] ratios may remain enhanced to a slightly higher [Fe/H] than the thick disk, and the Fe-peak elements Co, Ni, and Cu appear enhanced compared to the disk. There is also some evidence that the [Na/Fe] (but not [Al/Fe]) trends between the bulge and local disk may be different at low and high metallicity. We also find that the velocity dispersion decreases as a function of increasing [Fe/H] for both fields, and do not detect any significant cold, high-velocity populations. A comparison with chemical enrichment models indicates that a significant fraction of hypernovae may be required to explain the bulge abundance trends, and that initial mass functions that are steep, top-heavy (and do not include strong outflow), or truncated to avoid including contributions from stars >40 M {sub ☉} are ruled out, in particular because of disagreement with the Fe-peak abundance data. For most elements, the NGC 6553 stars exhibit abundance trends nearly identical to comparable metallicity bulge

Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis.

PubMed

Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

2013-12-01

Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. anamnesis, clinical, gynecological and microbiological examination of vaginal smear. The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.

Attitudes and perceptions towards vulvar and vaginal atrophy in Italian post-menopausal women: Evidence from the European REVIVE survey.

PubMed

Nappi, Rossella E; Particco, Martire; Biglia, Nicoletta; Cagnacci, Angelo; Di Carlo, Costantino; Luisi, Stefano; Paoletti, Anna Maria

2016-09-01

To achieve a deeper understanding of the attitudes and perceptions of Italian post-menopausal women (PMW) regarding vulvo-vaginal atrophy (VVA). As part of the EU REVIVE study, an online survey was conducted in four European countries; the Italian arm comprised 1000 participants from representative regions of Italy. The perceptions, experiences and needs of Italian PMW in relation to sexual and vaginal health. The most frequent VVA symptom was vaginal dryness (78%). Usually, the severity of symptoms was similar to or worse than when they first appeared. This was particularly true for dyspareunia, the most bothersome symptom (76%). VVA symptoms had a significant impact on Italian participants' ability to achieve pleasurable relations (74%) and spontaneity (70%). Although 75% of participants were still sexually active, their sex drive had been reduced by a third because of VVA. Women expected that doctors would start a discussion of menopausal symptoms and sexual health, but this was rarely the case (11%). Most women had been treated with a vaginal over-the-counter (OTC) product. Women who had discussed their condition with a physician were more likely (68%) to be under treatment for VVA than those who had not (36%). Low compliance was associated with symptom improvement (23%), not having annoying symptoms (22%), and the impossibility if restoring the vagina to normal (14%). Common reasons for treatment dissatisfaction were related to route of administration or discomfort. Lack of efficacy and fear of a hormone effect were perceived as the main limitations for OTC and local estrogen products, respectively. Despite the commonness of VVA and its significant impact on quality of life, the condition remains underdiagnosed in Italy. Discussion of symptoms with doctors influences the diagnosis, and patients' satisfaction with available treatments is not high. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The bulge-disc decomposed evolution of massive galaxies at 1 < z < 3 in CANDELS

NASA Astrophysics Data System (ADS)

Bruce, V. A.; Dunlop, J. S.; McLure, R. J.; Cirasuolo, M.; Buitrago, F.; Bowler, R. A. A.; Targett, T. A.; Bell, E. F.; McIntosh, D. H.; Dekel, A.; Faber, S. M.; Ferguson, H. C.; Grogin, N. A.; Hartley, W.; Kocevski, D. D.; Koekemoer, A. M.; Koo, D. C.; McGrath, E. J.

2014-10-01

We present the results of a new and improved study of the morphological and spectral evolution of massive galaxies over the redshift range 1 < z < 3. Our analysis is based on a bulge-disc decomposition of 396 galaxies with M* > 1011 M⊙ uncovered from the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS) Wide Field Camera 3 (WFC3)/IR imaging within the Cosmological Evolution Survey (COSMOS) and UKIRT Infrared Deep Sky Survey (UKIDSS) UDS survey fields. We find that, by modelling the H160 image of each galaxy with a combination of a de Vaucouleurs bulge (Sérsic index n = 4) and an exponential disc (n = 1), we can then lock all derived morphological parameters for the bulge and disc components, and successfully reproduce the shorter-wavelength J125, i814, v606 HST images simply by floating the magnitudes of the two components. This then yields sub-divided four-band HST photometry for the bulge and disc components which, with no additional priors, is well described by spectrophotometric models of galaxy evolution. Armed with this information, we are able to properly determine the masses and star formation rates for the bulge and disc components, and find that: (i) from z = 3 to 1 the galaxies move from disc dominated to increasingly bulge dominated, but very few galaxies are pure bulges/ellipticals by z = 1; (ii) while most passive galaxies are bulge dominated, and most star-forming galaxies disc dominated, 18 ± 5 per cent of passive galaxies are disc dominated, and 11 ± 3 per cent of star-forming galaxies are bulge dominated, a result which needs to be explained by any model purporting to connect star formation quenching with morphological transformations; (iii) there exists a small but significant population of pure passive discs, which are generally flatter than their star-forming counterparts (whose axial ratio distribution peaks at b/a ≃ 0.7); (iv) flatter/larger discs re-emerge at the highest star formation rates, consistent with

The Split Red Clump of the Galactic Bulge from OGLE-III

NASA Astrophysics Data System (ADS)

Nataf, D. M.; Udalski, A.; Gould, A.; Fouqué, P.; Stanek, K. Z.

2010-09-01

The red clump (RC) is found to be split into two components along several sightlines toward the Galactic bulge. This split is detected with high significance toward the areas (-3.5 < l < 1, b < -5) and (l, b) = (0, + 5.2), i.e., along the bulge minor axis and at least 5 deg off the plane. The fainter (hereafter "main") component is the one that more closely follows the distance-longitude relation of the bulge RC. The main component is ~0.5 mag fainter than the secondary component and with an overall approximately equal population. For sightlines further from the plane, the difference in brightness increases, and more stars are found in the secondary component than in the main component. The two components have very nearly equal (V - I) color.

The Age of the Young Bulge-like Population in the Stellar System Terzan 5: Linking the Galactic Bulge to the High-z Universe

NASA Astrophysics Data System (ADS)

Ferraro, F. R.; Massari, D.; Dalessandro, E.; Lanzoni, B.; Origlia, L.; Rich, R. M.; Mucciarelli, A.

2016-09-01

The Galactic bulge is dominated by an old, metal-rich stellar population. The possible presence and the amount of a young (a few gigayears old) minor component is one of the major issues debated in the literature. Recently, the bulge stellar system Terzan 5 was found to harbor three sub-populations with iron content varying by more than one order of magnitude (from 0.2 up to two times the solar value), with chemical abundance patterns strikingly similar to those observed in bulge field stars. Here we report on the detection of two distinct main-sequence turnoff points in Terzan 5, providing the age of the two main stellar populations: 12 Gyr for the (dominant) sub-solar component and 4.5 Gyr for the component at super-solar metallicity. This discovery classifies Terzan 5 as a site in the Galactic bulge where multiple bursts of star formation occurred, thus suggesting a quite massive progenitor possibly resembling the giant clumps observed in star-forming galaxies at high redshifts. This connection opens a new route of investigation into the formation process and evolution of spheroids and their stellar content. Based on data obtained with (1) the ESA/NASA HST, under programs GO-14061, GO-12933, GO-10845, (2) the Very Large Telescope of the European Southern Observatory during the Science Verification of the camera MAD; (3) the W.M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and NASA.

Differential expression of lactic acid isomers, extracellular matrix metalloproteinase inducer, and matrix metalloproteinase-8 in vaginal fluid from women with vaginal disorders.

PubMed

Beghini, J; Linhares, I M; Giraldo, P C; Ledger, W J; Witkin, S S

2015-11-01

Do metabolites in vaginal samples vary between women with different vaginal disorders. Cross-sectional study. Campinas, Brazil. Seventy-seven women (39.9%) with no vaginal disorder, 52 women (26.9%) with vulvovaginal candidiasis (VVC), 43 women (22.3%) with bacterial vaginosis (BV), and 21 women (10.9%) with cytolytic vaginosis (CTV). Concentrations of D- and L-lactic acid, extracellular matrix metalloproteinase inducer (EMMPRIN), and matrix metalloproteinase-8 (MMP-8), and the influence of Candida albicans on EMMPRIN production by cultured vaginal epithelial cells, were determined by enzyme-linked immunosorbent assay (ELISA). Associations were determined by the Mann-Whitney U-test and by Spearman's rank correlation test. Metabolite levels and their correlation with diagnoses. Vaginal concentrations of D- and L-lactic acid were reduced from control levels in BV (P < 0.0001); L-lactic acid levels were elevated in CTV (P = 0.0116). EMMPRIN and MMP-8 concentrations were elevated in VVC (P < 0.0001). EMMPRIN and L-lactic acid concentrations (P ≤ 0.008), but not EMMPRIN and D-lactic acid, were correlated in all groups. EMMPRIN also increased in proportion with the ratio of L- to D-lactic acid in controls and in women with BV (P ≤ 0.009). Concentrations of EMMPRIN and MMP-8 were correlated in controls and women with VVC (P ≤ 0.0002). Candida albicans induced EMMPRIN release from vaginal epithelial cells. Vaginal secretions from women with BV are deficient in D- and L-lactic acid, women with VVC have elevated EMMPRIN and MMP-8 levels, and women with CTV have elevated L-lactic acid levels. These deviations may contribute to the clinical signs, symptoms, and sequelae that are characteristic of these disorders. © 2014 Royal College of Obstetricians and Gynaecologists.

Value of bacterial culture of vaginal swabs in diagnosis of vaginal infections.

PubMed

Nenadić, Dane; Pavlović, Miloš D

2015-06-01

Vaginal and cervical swab culture is still very common procedure in our country's everyday practice whereas simple and rapid diagnostic methods have been very rarely used. The aim of this study was to show that the employment of simple and rapid diagnostic tools [vaginal fluid wet mount microscopy (VFWMM), vaginal pH and potassium hydroxide (KOH) test] offers better assessment of vaginal environment than standard microbiologic culture commonly used in Serbia. This prospective study included 505 asymptomatic pregnant women undergoing VFWMM, test with 10% KOH, determination of vaginal pH and standard culture of cervicovaginal swabs. Combining findings from the procedures was used to make diagnoses of bacterial vaginosis (BV) and vaginitis. In addition, the number of polymorphonuclear leukocytes (PMN) was determined in each sample and analyzed along with other findings. Infections with Candida albicans and Trichomonas vaginalis were confirmed or excluded by microscopic examination. In 36 (6%) patients cervicovaginal swab cultures retrieved several aerobes and facultative anaerobes, whereas in 52 (11%) women Candida albicans was isolated. Based on VFWMM findings and clinical criteria 96 (19%) women had BV, 19 (4%) vaginitis, and 72 (14%) candidiasis. Of 115 women with BV and vaginitis, pH 4.5 was found in 5, and of 390 with normal findings 83 (21%) had vaginal pH 4.5. Elevated numbers of PMN were found in 154 (30%) women--in 83 (54%) of them VFWMM was normal. Specificity and sensitivity of KOH test and vaginal pH determination in defining pathological vaginal flora were 95% and 81%, and 79% and 91%, respectively. Cervicovaginal swab culture is expensive but almost non-informative test in clinical practice. The use of simpler and rapid methods as vaginal fluid wet mount microscopy, KOH test and vaginal pH offers better results in diagnosis, and probably in the treatment and prevention of sequels of vaginal infections.

The Bulging Behavior of Thick-Walled 6063 Aluminum Alloy Tubes Under Double-Sided Pressures

NASA Astrophysics Data System (ADS)

Cui, Xiao-Lei; Wang, Xiao-Song; Yuan, Shi-Jian

2015-05-01

To make further exploration on the deformation behavior of tube under double-sided pressures, the thick-walled 6063 aluminum alloy tubes with an outer diameter of 65 mm and an average thickness of 7.86 mm have been used to be bulged under the combined action of internal and external pressures. In the experiment, two ends of the thick-walled tubes were fixed using the tooth and groove match. Three levels of external pressure (0 MPa, 40 MPa, and 80 MPa), in conjunction with the internal pressure, were applied on the tube outside and inside simultaneously. The effect of external pressure on the bulging behavior of the thick-walled tubes, such as the limiting expansion ratio, the bulging zone profile, and the thickness distribution, has been investigated. It is shown that the limiting expansion ratio, the bulging zone profile, and the thickness distribution in the homogeneous bulging area are all insensitive to the external pressure. However, the external pressure can make the thick-walled tube achieve a thinner wall at the fracture area. It reveals that the external pressure can only improve the fracture limit of the thick-walled 6063 tubes, but it has very little effect on their homogeneous bulging behavior. It might be because the external pressure can only increase the magnitude of the hydrostatic pressure for the tube but has no effect on the Lode parameter.

The imprints of bars on the vertical stellar population gradients of galactic bulges

NASA Astrophysics Data System (ADS)

Molaeinezhad, A.; Falcón-Barroso, J.; Martínez-Valpuesta, I.; Khosroshahi, H. G.; Vazdekis, A.; La Barbera, F.; Peletier, R. F.; Balcells, M.

2017-05-01

This is the second paper of a series aimed to study the stellar kinematics and population properties of bulges in highly inclined barred galaxies. In this work, we carry out a detailed analysis of the stellar age, metallicity and [Mg/Fe] of 28 highly inclined (I > 65°) disc galaxies, from S0 to S(B)c, observed with the SAURON integral-field spectrograph. The sample is divided into two clean samples of barred and unbarred galaxies, on the basis of the correlation between the stellar velocity and h3 profiles, as well as the level of cylindrical rotation within the bulge region. We find that while the mean stellar age, metallicity and [Mg/Fe] in the bulges of barred and unbarred galaxies are not statistically distinct, the [Mg/Fe] gradients along the minor axis (away from the disc) of barred galaxies are significantly different than those without bars. For barred galaxies, stars that are vertically further away from the mid-plane are in general more [Mg/Fe]-enhanced and thus the vertical gradients in [Mg/Fe] for barred galaxies are mostly positive, while for unbarred bulges the [Mg/Fe] profiles are typically negative or flat. This result, together with the old populations observed in the barred sample, indicates that bars are long-lasting structures, and therefore are not easily destroyed. The marked [Mg/Fe] differences with the bulges of unbarred galaxies indicate that different formation/evolution scenarios are required to explain their build-up, and emphasizes the role of bars in redistributing stellar material in the bulge-dominated regions.

Spectroscopic decomposition of NGC 3521: unveiling the properties of the bulge and disc

NASA Astrophysics Data System (ADS)

Coccato, Lodovico; Fabricius, Maximilian H.; Saglia, Roberto P.; Bender, Ralf; Erwin, Peter; Drory, Niv; Morelli, Lorenzo

2018-06-01

We study the kinematics and the stellar populations of the bulge and disc of the spiral galaxy NGC 3521. At each position in the field of view, we separate the contributions of the bulge and the disc from the total observed spectrum and study their kinematics, age, and metallicities independently. Their properties are clearly distinct: the bulge rotates more slowly, has a higher velocity dispersion, and is less luminous than the disc. We identify three main populations of stars in NGC 3521: old (≥7 Gyr), intermediate (≈3 Gyr), and young (≤1 Gyr). The mass and light of NGC 3521 are dominated by the intermediate stellar population. The youngest population contributes mostly to the disc component and its contribution increases with radius. We also study the luminosity-weighed properties of the stars in NGC 3521. Along the photometric major axis, we find (i) no age gradient for the stars in the bulge, and a negative age gradient for the stars in the disc; (ii) negative metallicity gradients and subsolar α-enhancement for both the bulge and the disc. We propose the following picture for the formation of NGC 3521: initial formation a long time ago (≥7 Gyr), followed by a second burst of star formation or a merger (≈3 Gyr ago), which contributed predominantly to the mass build-up of the bulge. Recently (≤1 Gyr), the disc of NGC 3521 experienced an additional episode of star formation that started in the innermost regions.

BULGES OF NEARBY GALAXIES WITH SPITZER: THE GROWTH OF PSEUDOBULGES IN DISK GALAXIES AND ITS CONNECTION TO OUTER DISKS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, David B.; Drory, Niv; Fabricius, Maximilian H.

2009-05-20

We study star formation rates (SFRs) and stellar masses in bulges of nearby disk galaxies. For this we construct a new SFR indicator that linearly combines data from the Spitzer Space Telescope and the Galaxy Evolution Explorer. All bulges are found to be forming stars irrespective of bulge type (pseudobulge or classical bulge). At present-day SFR the median pseudobulge could have grown the present-day stellar mass in 8 Gyr. Classical bulges have the lowest specific SFR implying a growth times that are longer than a Hubble time, and thus the present-day SFR does not likely play a major role inmore » the evolution of classical bulges. In almost all galaxies in our sample the specific SFR (SFR per unit stellar mass) of the bulge is higher than that of the outer disk. This suggests that almost all galaxies are increasing their B/T through internal star formation. The SFR in pseudobulges correlates with their structure. More massive pseudobulges have higher SFR density, this is consistent with that stellar mass being formed by moderate, extended star formation. Bulges in late-type galaxies have similar SFRs as pseudobulges in intermediate-type galaxies, and are similar in radial size. However, they are deficient in mass; thus, they have much shorter growth times, {approx}2 Gyr. We identify a class of bulges that have nuclear morphology similar to pseudobulges, significantly lower specific SFR than pseudobulges, and are closer to classical bulges in structural parameter correlations. These are possibly composite objects, evolved pseudobulges or classical bulges experiencing transient, enhanced nuclear star formation. Our results are consistent with a scenario in which bulge growth via internal star formation is a natural, and near ubiquitous phenomenon in disk galaxies. Those galaxies with large classical bulges are not affected by the in situ bulge growth, likely because the majority of their stellar mass comes from some other phenomenon. Yet, those galaxies without

Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall

PubMed Central

Shi, Haolin; Balgobin, Sunil; Montoya, T. Ignacio; Yanagisawa, Hiromi; Word, R. Ann

2016-01-01

Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO). Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-). In controls, perineal body length (PBL) and bulge increased significantly after delivery but declined to baseline values within 6–8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge) did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5 during

Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall.

PubMed

Chin, Kathleen; Wieslander, Cecilia; Shi, Haolin; Balgobin, Sunil; Montoya, T Ignacio; Yanagisawa, Hiromi; Word, R Ann

2016-01-01

Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO). Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-). In controls, perineal body length (PBL) and bulge increased significantly after delivery but declined to baseline values within 6-8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge) did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5 during

Vaginal yeast infection

MedlinePlus

Yeast infection - vagina; Vaginal candidiasis; Monilial vaginitis ... Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the ...

Symptoms of Ovarian Cancer

MedlinePlus

... Informed Cancer Home What Are the Symptoms of Ovarian Cancer? Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Be Brave (:60) Ovarian cancer may cause the following signs and symptoms— Vaginal ...

Structure/cleavage-based insights into helical perturbations at bulge sites within T. thermophilus Argonaute silencing complexes

PubMed Central

Sheng, Gang; Gogakos, Tasos; Wang, Jiuyu; Zhao, Hongtu; Serganov, Artem; Juranek, Stefan

2017-01-01

Abstract We have undertaken a systematic structural study of Thermus thermophilus Argonaute (TtAgo) ternary complexes containing single-base bulges positioned either within the seed segment of the guide or target strands and at the cleavage site. Our studies establish that single-base bulges 7T8, 5A6 and 4A5 on the guide strand are stacked-into the duplex, with conformational changes localized to the bulge site, thereby having minimal impact on the cleavage site. By contrast, single-base bulges 6’U7’ and 6’A7’ on the target strand are looped-out of the duplex, with the resulting conformational transitions shifting the cleavable phosphate by one step. We observe a stable alignment for the looped-out 6’N7’ bulge base, which stacks on the unpaired first base of the guide strand, with the looped-out alignment facilitated by weakened Watson–Crick and reversed non-canonical flanking pairs. These structural studies are complemented by cleavage assays that independently monitor the impact of bulges on TtAgo-mediated cleavage reaction. PMID:28911094

Formation of the Lunar Fossil Bulges and Its Implication for the Early Earth and Moon

NASA Astrophysics Data System (ADS)

Qin, Chuan; Zhong, Shijie; Phillips, Roger

2018-02-01

First recognized by Laplace over two centuries ago, the Moon's present tidal-rotational bulges are significantly larger than hydrostatic predictions. They are likely relics of a former hydrostatic state when the Moon was closer to the Earth and had larger bulges, and they were established when stresses in a thickening lunar lithosphere could maintain the bulges against hydrostatic adjustment. We formulate the first dynamically self-consistent model of this process and show that bulge formation is controlled by the relative timing of lithosphere thickening and lunar orbit recession. Viable solutions indicate that lunar bulge formation was a geologically slow process lasting several hundred million years, that the process was complete about 4 Ga when the Moon-Earth distance was less than 32 Earth radii, and that the Earth in Hadean was significantly less dissipative to lunar tides than during the last 4 Gyr, possibly implying a frozen hydrosphere due to the fainter young Sun.

Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis.

PubMed

Ravel, Jacques; Brotman, Rebecca M; Gajer, Pawel; Ma, Bing; Nandy, Melissa; Fadrosh, Douglas W; Sakamoto, Joyce; Koenig, Sara Sk; Fu, Li; Zhou, Xia; Hickey, Roxana J; Schwebke, Jane R; Forney, Larry J

2013-12-02

Bacterial vaginosis (BV) is a common gynecologic diagnosis characterized by dysbiosis of the vaginal microbiota. It is often accompanied by vaginal symptoms such as odor and discharge, but can be asymptomatic. Despite over 50 years of research, the etiology of BV is not well understood, which is a major impediment to treatment and prevention of BV. Here we report on the temporal dynamics of 25 vaginal communities over a 10 week period using samples collected daily from women who were diagnosed with symptomatic BV (15 women), asymptomatic BV (6 women), and women who did not have BV (4 women). This unique resource of samples and data will contribute to a better understanding of the role that the vaginal microbes have in the natural history of BV and lead to improved diagnosis and treatment.

Ongoing Massive Star Formation in the Bulge of M51

NASA Astrophysics Data System (ADS)

Lamers, H. J. G. L. M.; Panagia, N.; Scuderi, S.; Romaniello, M.; Spaans, M.; de Wit, W. J.; Kirshner, R.

2002-02-01

We present a study of Hubble Space Telescope Wide Field Planetary Camera 2 observations of the inner kiloparsec of the interacting galaxy M51 in six bands from 2550 to 8140 Å. The images show an oval-shaped area (which we call the ``bulge'') of about 11''×16'', or 450×650 pc, around the nucleus that is dominated by a smooth ``yellow/reddish'' background population with overimposed dust lanes. These dust lanes are the inner extensions of the spiral arms. The extinction properties, derived in four fields in and outside dust lanes, are similar to the Galactic extinction law. The reddish stellar population has an intrinsic color of (B-V)0~=1.0, suggesting an age in excess of 5 Gyr. We found 30 bright pointlike sources in the bulge of M51, i.e., within 110-350 pc from the nucleus. The point sources have 21.4

Central Stellar Mass Deficits in the Bulges of Local Lenticular Galaxies

NASA Astrophysics Data System (ADS)

Dullo, B. T.

2014-03-01

The centers of giant galaxies display stellar mass deficits (Mdef) which are thought to be a signature left by inspiraling supermassive black hole (SMBH) binaries that are formed in post-merger galaxies. We quantify these deficits for a sample of five luminous lenticular galaxies with bulge magnitude MV ≲ -21 mag and find Mdef ≍ 0.5 - 2MBH (black hole mass). Contrary to the traditionally proposed lenticular galaxy formation mechanisms such as ram-pressure stripping and galaxy harassment, the mass deficits in these galaxies suggest a two stage inside-out process for their assembly. That is, their bulges may have formed through “dry” major-merger events involving SMBHs while their disk was subsequently built up via cold gas accretion scenarios. Interestingly, these bulges have sizes and mass densities comparable to the compact massive galaxies found at z ˜ 2.

Tracing the Chemical Evolution of Metal-rich Galactic Bulge Globular Clusters

NASA Astrophysics Data System (ADS)

Munoz Gonzalez, Cesar; Saviane, Ivo; Geisler, Doug; Villanova, Sandro

2018-01-01

We present in this poster the metallicity characterization of the four metal rich Bulge Galactic Gobular Clusters, which have controversial metallicities. We analyzed our high-resolution spectra (using UVES-580nm and GIRAFFE-HR13 setups) for a large sample of RGB/AGB targets in each cluster in order to measure their metallicity and prove or discard the iron spread hypothesis. We have also characterized chemically stars with potentially different iron content by measuring light (O, Na, Mg, Al), alpha (Si, Ca, Ti), iron–peak (V, Cr, Ni, Mn) and s and r process (Y, Zr, Ba, Eu) elements. We have identified possible channels responsible for the chemical heterogeneity of the cluster populations, like AGB or massive fast-rotating stars contamination, or SN explosion. Also, we have analyzed the origin and evolution of these bulge GCs and their connection with the bulge itself.

Galactic bulge preferred over dark matter for the Galactic centre gamma-ray excess

NASA Astrophysics Data System (ADS)

Macias, Oscar; Gordon, Chris; Crocker, Roland M.; Coleman, Brendan; Paterson, Dylan; Horiuchi, Shunsaku; Pohl, Martin

2018-05-01

An anomalous gamma-ray excess emission has been found in the Fermi Large Area Telescope data1 covering the centre of the Galaxy2,3. Several theories have been proposed for this `Galactic centre excess'. They include self-annihilation of dark-matter particles4, an unresolved population of millisecond pulsars5, an unresolved population of young pulsars6, or a series of burst events7. Here, we report on an analysis that exploits hydrodynamical modelling to register the position of interstellar gas associated with diffuse Galactic gamma-ray emission. We find evidence that the Galactic centre excess gamma rays are statistically better described by the stellar over-density in the Galactic bulge and the nuclear stellar bulge, rather than a spherical excess. Given its non-spherical nature, we argue that the Galactic centre excess is not a dark-matter phenomenon but rather associated with the stellar population of the Galactic bulge and the nuclear bulge.

Clinical Characteristics of Aerobic Vaginitis and Its Association to Vaginal Candidiasis, Trichomonas Vaginitis and Bacterial Vaginosis

PubMed Central

Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

2013-01-01

ABSTRACT Aim of the work: Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Materials and methods: Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. Examination consisted of: anamnesis, clinical, gynecological and microbiological examination of vaginal smear. Results: The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. Conclusion: AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from

Binding of pixantrone to DNA at CpA dinucleotide sequences and bulge structures.

PubMed

Konda, Shyam K; Wang, Haiqiang; Cutts, Suzanne M; Phillips, Don R; Collins, J Grant

2015-06-07

The binding of the anti-cancer drug pixantrone to three oligonucleotide sequences, d(TCATATGA)2, d(CCGAGAATTCCGG)2 {double bulge = DB} and the non-self complementary d(TACGATGAGTA) : d(TACCATCGTA) {single bulge = SB}, has been studied by NMR spectroscopy and molecular modelling. The upfield shifts observed for the aromatic resonances of pixantrone upon addition of the drug to each oligonucleotide confirmed the drug bound by intercalation. For the duplex sequence d(TCATATGA)2, NOEs were observed from the pixantrone aromatic H7/8 and aliphatic Ha/Hb protons to the H6/H8 and H1' protons of the C2, A3, T6 and G7 nucleotides, demonstrating that pixantrone preferentially binds at the symmetric CpA sites. However, weaker NOEs observed to various protons from the T4 and A5 residues indicated alternative minor binding sites. NOEs from the H7/H8 and Ha/Hb protons to both major (H6/H8) and minor groove (H1') protons indicated approximately equal proportions of intercalation was from the major and minor groove at the CpA sites. Intermolecular NOEs were observed between the H7/H8 and H4 protons of pixantrone and the A4H1' and G3H1' protons of the oligonucleotide that contains two symmetrically related bulge sites (DB), indicative of binding at the adenine bulge sites. For the oligonucleotide that only contains a single bulge site (SB), NOEs were observed from pixantrone protons to the SB G7H1', A8H1' and G9H1' protons, confirming that the drug bound selectively at the adenine bulge site. A molecular model of pixantrone-bound SB could be constructed with the drug bound from the minor groove at the A8pG9 site that was consistent with the observed NMR data. The results demonstrate that pixantrone preferentially intercalates at adenine bulge sites, compared to duplex DNA, and predominantly from the minor groove.

Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis

PubMed Central

Noyes, Noelle; Cho, Kyu-Chul; Ravel, Jacques; Forney, Larry J.

2018-01-01

The vaginal microbiome plays an influential role in several disease states in reproductive age women, including bacterial vaginosis (BV). While demographic characteristics are associated with differences in vaginal microbiome community structure, little is known about the influence of sexual and hygiene habits. Furthermore, associations between the vaginal microbiome and risk symptoms of bacterial vaginosis have not been fully elucidated. Using Bayesian network (BN) analysis of 16S rRNA gene sequence results, demographic and extensive questionnaire data, we describe both novel and previously documented associations between habits of women and their vaginal microbiome. The BN analysis approach shows promise in uncovering complex associations between disparate data types. Our findings based on this approach support published associations between specific microbiome members (e.g., Eggerthella, Gardnerella, Dialister, Sneathia and Ruminococcaceae), the Nugent score (a BV diagnostic) and vaginal pH (a risk symptom of BV). Additionally, we found that several microbiome members were directly connected to other risk symptoms of BV (such as vaginal discharge, odor, itch, irritation, and yeast infection) including L. jensenii, Corynebacteria, and Proteobacteria. No direct connections were found between the Nugent Score and risk symptoms of BV other than pH, indicating that the Nugent Score may not be the most useful criteria for assessment of clinical BV. We also found that demographics (i.e., age, ethnicity, previous pregnancy) were associated with the presence/absence of specific vaginal microbes. The resulting BN revealed several as-yet undocumented associations between birth control usage, menstrual hygiene practices and specific microbiome members. Many of these complex relationships were not identified using common analytical methods, i.e., ordination and PERMANOVA. While these associations require confirmatory follow-up study, our findings strongly suggest that future

Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis.

PubMed

Noyes, Noelle; Cho, Kyu-Chul; Ravel, Jacques; Forney, Larry J; Abdo, Zaid

2018-01-01

The vaginal microbiome plays an influential role in several disease states in reproductive age women, including bacterial vaginosis (BV). While demographic characteristics are associated with differences in vaginal microbiome community structure, little is known about the influence of sexual and hygiene habits. Furthermore, associations between the vaginal microbiome and risk symptoms of bacterial vaginosis have not been fully elucidated. Using Bayesian network (BN) analysis of 16S rRNA gene sequence results, demographic and extensive questionnaire data, we describe both novel and previously documented associations between habits of women and their vaginal microbiome. The BN analysis approach shows promise in uncovering complex associations between disparate data types. Our findings based on this approach support published associations between specific microbiome members (e.g., Eggerthella, Gardnerella, Dialister, Sneathia and Ruminococcaceae), the Nugent score (a BV diagnostic) and vaginal pH (a risk symptom of BV). Additionally, we found that several microbiome members were directly connected to other risk symptoms of BV (such as vaginal discharge, odor, itch, irritation, and yeast infection) including L. jensenii, Corynebacteria, and Proteobacteria. No direct connections were found between the Nugent Score and risk symptoms of BV other than pH, indicating that the Nugent Score may not be the most useful criteria for assessment of clinical BV. We also found that demographics (i.e., age, ethnicity, previous pregnancy) were associated with the presence/absence of specific vaginal microbes. The resulting BN revealed several as-yet undocumented associations between birth control usage, menstrual hygiene practices and specific microbiome members. Many of these complex relationships were not identified using common analytical methods, i.e., ordination and PERMANOVA. While these associations require confirmatory follow-up study, our findings strongly suggest that future

A new look at the kinematics of the bulge from an N-body model

NASA Astrophysics Data System (ADS)

Gómez, A.; Di Matteo, P.; Stefanovitch, N.; Haywood, M.; Combes, F.; Katz, D.; Babusiaux, C.

2016-05-01

By using an N-body simulation of a bulge that was formed via a bar instability mechanism, we analyse the imprints of the initial (I.e. before bar formation) location of stars on the bulge kinematics, in particular on the heliocentric radial velocity distribution of bulge stars. Four different latitudes were considered: b = -4°, -6°, -8°, and -10°, along the bulge minor axis as well as outside it, at l = ± 5° and l = ± 10°. The bulge X-shaped structure comprises stars that formed in the disk at different locations. Stars formed in the outer disk, beyond the end of the bar, which are part of the boxy peanut-bulge structure may show peaks in the velocity distributions at positive and negative heliocentric radial velocities with high absolute values that can be larger than 100 km s-1, depending on the observed direction. In some cases the structure of the velocity field is more complex and several peaks are observed. Stars formed in the inner disk, the most numerous, contribute predominantly to the X-shaped structure and present different kinematic characteristics. They display a rather symmetric velocity distribution and a smaller fraction of high-velocity stars. The stellar stream motion, which is induced by the bar changes with the star initial position, can reach more than 40 km s-1 for stars that originated in the external disk, depending on the observed direction. Otherwise it is smaller than approximately 20 km s-1. In all cases, it decreases from b = -4° to -10°. Our results may enable us to interpret the cold high-velocity peak observed in the APOGEE commissioning data, as well as the excess of high-velocity stars in the near and far arms of the X-shaped structure at l = 0° and b = -6°. When compared with real data, the kinematic picture becomes more complex due to the possible presence in the observed samples of classical bulge and/or thick disk stars. Overall, our results point to the existence of complex patterns and structures in the bulge

Protection against rat vaginal candidiasis by adoptive transfer of vaginal B lymphocytes.

PubMed

De Bernardis, Flavia; Santoni, Giorgio; Boccanera, Maria; Lucciarini, Roberta; Arancia, Silvia; Sandini, Silvia; Amantini, Consuelo; Cassone, Antonio

2010-06-01

Vulvovaginal candidiasis is a mucosal infection affecting many women, but the immune mechanisms operating against Candida albicans at the mucosal level remain unknown. A rat model was employed to further characterize the contribution of B and T cells to anti-Candida vaginal protection. Particularly, the protective role of vaginal B cells was studied by means of adoptive transfer of vaginal CD3(-) CD5(+) IgM(+) cells from Candida-immunized rats to naïve animals. This passive transfer of B cells resulted into a number of vaginal C. albicans CFU approximately 50% lower than their controls. Sorted CD3(-) CD5(+) IgM(+) vaginal B lymphocytes from Candida-infected rats proliferated in response to stimulation with an immunodominant mannoprotein (MP) antigen of the fungus. Importantly, anti-MP antibodies and antibody-secreting B cells were detected in the supernatant and cell cultures, respectively, of vaginal B lymphocytes from infected rats incubated in vitro with vaginal T cells and stimulated with MP. No such specific antibodies were found when using vaginal B cells from uninfected rats. Furthermore, inflammatory and anti-inflammatory cytokines, such as interleukin-2 (IL-2), IL-6 and IL-10, were found in the supernatant of vaginal B cells from infected rats. These data are evidence of a partial anti-Candida protective role of CD3(-) CD5(+) IgM(+) vaginal B lymphocytes in our experimental model.

Vaginal Microbiota.

PubMed

Mendling, Werner

2016-01-01

The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. Culturing techniques are not suitable any more for determination of a normal or abnormal vaginal microbiota. Non culture-based modern technologies revealed a complex and dynamic system mainly dominated by lactobacilli.The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Several species of lactobacilli per individuum dominate the healthy vagina. They support a defense system together with antibacterial substances, cytokines, defensins and others against dysbiosis, infections and care for an normal pregnancy without preterm birth.The numbers of Lactobacillus (L.) iners increase in the case of dysbiosis.Bacterial vaginosis (BV) - associated bacteria (BVAB), Atopobium vaginae and Clostridiales and one or two of four Gardnerella vaginalis - strains develop in different mixtures and numbers polymicrobial biofilms on the vaginal epithelium, which are not dissolved by antibiotic therapies according to guidelines and, thus, provoke recurrences.Aerobic vaginitis seems to be an immunological disorder of the vagina with influence on the microbiota, which is here dominated by aerobic bacteria (Streptococcus agalactiae, Escherichia coli). Their role in AV is unknown.Vaginal or oral application of lactobacilli is obviously able to improve therapeutic results of BV and dysbiosis.

A case against an X-shaped structure in the Milky Way young bulge

NASA Astrophysics Data System (ADS)

López-Corredoira, Martín

2016-09-01

Context. A number of recent papers have claimed the discovery of an X-shape structure in the bulge of our Galaxy in the population of the red clumps. Aims: We endeavor to analyze the stellar density of bulge stars in the same regions using a different stellar population that is characteristic of the young bulge (≲ 5 Gyr). Particularly, we use F0-F5 main-sequence stars with distances derived through photometric parallax. Methods: We extract these stars from extinction-corrected color-magnitude diagrams in the near-infrared of VISTA-VVV data in some bulge regions and calculate the densities along the line of sight. We take the uncertaintity in the photometric parallax and the contamination of other sources into account, and we see that these errors do not avoid the detection of a possible double peak along some lines of sight as expected for a X-shape bulge if it existed. Results: Only a single peak in the density distribution along the line of sight is observed, so apparently there is no X-shape structure for this population of stars. Nonetheless, the effects of the dispersion of absolute magnitudes in the selected population might be an alternative explanation, although in principle these effects are insufficient to explain this lack of double peak according to our calculations. Conclusions: The results of the present paper do not demonstrate that previous claims of X-shaped bulge using only red clump stars are incorrect, but there are apparently some puzzling questions if we want to maintain the validity of both the red-clump results and the results of this paper.

A catalog of polychromatic bulge-disc decompositions of ˜17.600 galaxies in CANDELS

NASA Astrophysics Data System (ADS)

Dimauro, Paola; Huertas-Company, Marc; Daddi, Emanuele; Pérez-González, Pablo G.; Bernardi, Mariangela; Barro, Guillermo; Buitrago, Fernando; Caro, Fernando; Cattaneo, Andrea; Dominguez-Sánchez, Helena; Faber, Sandra M.; Häußler, Boris; Kocevski, Dale D.; Koekemoer, Anton M.; Koo, David C.; Lee, Christoph T.; Mei, Simona; Margalef-Bentabol, Berta; Primack, Joel; Rodriguez-Puebla, Aldo; Salvato, Mara; Shankar, Francesco; Tuccillo, Diego

2018-05-01

Understanding how bulges grow in galaxies is critical step towards unveiling the link between galaxy morphology and star-formation. To do so, it is necessary to decompose large sample of galaxies at different epochs into their main components (bulges and discs). This is particularly challenging, especially at high redshifts, where galaxies are poorly resolved. This work presents a catalog of bulge-disc decompositions of the surface brightness profiles of ˜17.600 H-band selected galaxies in the CANDELS fields (F160W < 23, 0 < z < 2) in 4 to 7 filters covering a spectral range of 430 - 1600nm. This is the largest available catalog of this kind up to z = 2. By using a novel approach based on deep-learning to select the best model to fit, we manage to control systematics arising from wrong model selection and obtain less contaminated samples than previous works. We show that the derived structural properties are within ˜10 - 20% of random uncertainties. We then fit stellar population models to the decomposed SEDs (Spectral Energy Distribution) of bulges and discs and derive stellar masses (and stellar mass bulge-to-total ratios) as well as rest-frame colors (U,V,J) for bulges and discs separately. All data products are publicly released with this paper and through the web page https://lerma.obspm.fr/huertas/form_CANDELS and will be used for scientific analysis in forthcoming works.

Mira variables in the Galactic Bulge .

NASA Astrophysics Data System (ADS)

Groenewegen, M. A. T.; Blommaert, J. A. D. L.

The 222 000 I-band light curves of variable stars detected by the OGLE-II survey in the direction of the Galactic Bulge have been fitted and have been correlated with the DENIS and 2MASS databases. Results are presented for 2691 objects with I-band semi-amplitude larger than 0.45 magnitude, corresponding to classical Mira variables. The Mira period distribution of 5 fields at similar longitude but spanning latitudes from -1.2 to -5.8 are statistically indistinguisable indicating similar populations with initial masses of 1.5-2 M⊙ (corresponding to ages of 1-3 Gyr). A field at similar longitude at b = -0.05 from Glass et al. (2001) does show a significantly different period distribution, indicating the presence of a younger population of 2.5-3 M⊙ and ages below 1 Gyr. The K-band period-luminosity relation is presented for the whole sample, and for sub-fields. Simulations are carried out to show that the observations are naturally explained using the model of disk and bulge stars of Binney et al. (1997), for a viewing angle (major-axis Bar - axis perpendicular to the line-of-sight to the Galactic Centre) of 43 ± 17 degrees. A comparison is made with similar objects in the Magellanic Clouds, studied in a previous paper. The slope of the PL-relation in the Bulge and the MCs agree within the errorbars. Assuming the zero point does not depend on metallicity, a distance modulus difference of 3.72 between Bulge and LMC is derived. This implies a LMC DM of 18.21 for an assumed distance to the Galactic Centre (GC) of 7.9 kpc, or, assuming a LMC DM of 18.50, a distance to the GC of 9.0 kpc. From the results in Groenewegen (2004) it is found for carbon-rich Miras that the PL-relation implies a relative SMC-LMC DM of 0.38, assuming no metallicity dependence. This is somewhat smaller than the often quoted value near 0.50. Following theoretical work by Wood (1990) a metallicity term of the form M_K ˜ beta log Z is introduced. If a relative SMC-LMC DM of 0.50 is imposed

[Itraconazole and secnidazole capsules vs. vaginal ovules of fluocinolone acetonide, nystatin and metronidazole in the symptomatic treatment of vaginitis].

PubMed

Alvarado García, A; Gaviño Ambriz, S

1998-04-01

Evaluation of oral treatment in vaginitis and vaginosis using Itraconazol and sechidazol, in comparison to topic treatment using vaginal ovules of acetonido of fluocinolona 0.50 mg, nistatina 100,000 U and metronidazol 500 mg. Longitudinal, prospective and open comparative study. Servicio de Reproducción Humana(Human Reproduction Department), Centro Médico Nacional "20 de Noviembre". Forty female patients, without any relevant differences in their general characteristics, chose diagnosis was vaginitis and vaginosis, who were medically treated through external consultation, divided in two groups of twenty each one. Group 1 oral treatment with itraconazol and secnidazol. Group 2 had topic treatment with fluocinolona, nistatina and metronidazol. All of the patients were controlled in seven and fourteen days time, in order to evaluate the intensity of their clinical symptomatology, as well as the efficacy in both ways of treatment. Leukorrhea was the most important symptom in all the cases, going from minor to serious white discharge. After the treatment, we found a relevant difference statistically significative in patients treated with intraconazol and secnidazol. We did not find any differences in relation to ardor, pruritus, dispareunia and disuria at post-treatment evaluation. However, group 1 betterment was statistically significative between the first and the seventh days of treatment. Treating vaginitis or vaginosis (or both) with itraconazol and secnidazol takes less time for betterment in addition to comfort and easiness of oral administration; therefore, we consider them proper medicines in these specific cases.

VizieR Online Data Catalog: OGLE II. VI photometry of Galactic Bulge (Udalski+, 2002)

NASA Astrophysics Data System (ADS)

Udalski, A.; Szymanski, M.; Kubiak, M.; Pietrzynski, G.; Soszynski, I.; Wozniak, P.; Zebrun, K.; Szewczyk, O.; Wyrzykowski, L.

2003-09-01

We present the VI photometric maps of the Galactic bulge. They contain VI photometry and astrometry of about 30 million stars from 49 fields of 0.225 square degree each in the Galactic center region. The data were collected during the second phase of the OGLE microlensing project. We discuss the accuracy of data and present color-magnitude diagrams of selected fields observed by OGLE in the Galactic bulge. The VI maps of the Galactic bulge are accessible electronically for the astronomical community from the OGLE Internet archive (2 data files).

Vaginal Use of Ibuprofen Isobutanolammonium (Ginenorm): Efficacy, Tolerability, and Pharmacokinetic Data: A Review of Available Data

PubMed Central

Milani, Massimo; Iacobelli, Piero

2012-01-01

Vaginal infection and inflammation with or without vulvar involvement are very common gynecologicaly clinical conditions associated with morbidity and reduced quality of life. Vaginal infections are commonly treated with causal antimicrobial treatments. In addition to specific antimicrobial treatment, anti-inflammatory therapy, both systemic or topical (vaginal douche), could be useful in the integrated treatment approach of these conditions reducing symptoms and speeding up the recovery in vulvovaginitis. Ibuprofen is a well-known effective and well-tolerated anti-COX (anti-COX1 and COX2) compound. In addition, several in vitro studies suggest that Ibuprofen shares antimicrobial and antifungal activities. Ibuprofen isobutanolammonium (Ib-isb) (Ginenorm) is a soluble salt from formulation suitable for external and intravaginal use. This salt completely dissociates in aqueous solution. Ib-isob is available in sachet and vaginal douche pharmaceutical formulations. Clinical efficacy of Ib-isob has been documented in 10 clinical studies (6 controlled and 4 open trials) which have enrolled in total 399 women with vulvovaginitis. The six controlled clinical trials were performed both versus placebo (2 studies) or versus active comparators such as benzydamine. In these studied, Ib-Isb has been used in general for 7 consecutive days with a twice application daily regimen at the dose of 1 g per application. Topical application of Ib-isob induced a marked and rapid reduction in signs (erythema, oedema) and symptoms (itching and burning sensation) of vulvovaginitis. In head-to-head studies carried out in comparison with other topical products, Ib-isob induced a more rapid reduction in both subjective and objective symptoms. In particular a remarkable significant improvement of all the symptoms has been observed in the group of patients treated with Ib-isob in comparison with women receiving benzydamine. The clinical data available for Ib-isob confirm that this salt

Polymicrobial nature of vaginitis in young women: a microbiological and therapeutic study.

PubMed

Kippax, R A; Caradoc-Davies, G; Meech, R J

1982-03-24

Thirty-six young females attending the Student Health Service with vaginitis were investigated by serial semiquantitative aerobic, anaerobic, fungal, mycoplasma and viral cultures over a 10 day period and results were correlated with signs and symptoms. Antifungal therapy (econazole pessaries and cream) resulted in clearance of candida from 13 out of 16 patients where there was no increase in the anaerobic flora. In the four subjects where candida was isolated along with Gardnerella vaginalis plus abnormal anaerobic flora, only one cleared with econazole, the remaining three clearing during therapy with metronidazole. In the nine subjects with Gardnerella vaginalis and abnormal anaerobic flora, metronidazole relieved symptoms despite failure to eradicate G. vaginalis in seven indicating the pathogenic role of the anaerobic flora rather then G. vaginalis. Mycoplasma hominis, Ureaplasma urealyticum and gram negative enteric bacilli were not implicated as primary agents in causing vaginitis.

Conservative Management of Placenta Accreta/Increta after Vaginal Birth

PubMed Central

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

2012-01-01

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

Diagnostic Performance of a Molecular Test versus Clinician Assessment of Vaginitis.

PubMed

Schwebke, Jane R; Gaydos, Charlotte A; Nyirjesy, Paul; Paradis, Sonia; Kodsi, Salma; Cooper, Charles K

2018-06-01

Vaginitis is a common complaint, diagnosed either empirically or using Amsel's criteria and wet mount microscopy. This study sought to determine characteristics of an investigational test (a molecular test for vaginitis), compared to reference, for detection of bacterial vaginosis, Candida spp., and Trichomonas vaginalis Vaginal specimens from a cross-sectional study were obtained from 1,740 women (≥18 years old), with vaginitis symptoms, during routine clinic visits (across 10 sites in the United States). Specimens were analyzed using a commercial PCR/fluorogenic probe-based investigational test that detects bacterial vaginosis, Candida spp., and Trichomonas vaginalis Clinician diagnosis and in-clinic testing (Amsel's test, potassium hydroxide preparation, and wet mount) were also employed to detect the three vaginitis causes. All testing methods were compared to the respective reference methods (Nugent Gram stain for bacterial vaginosis, detection of the Candida gene its2 , and Trichomonas vaginalis culture). The investigational test, clinician diagnosis, and in-clinic testing were compared to reference methods for bacterial vaginosis, Candida spp., and Trichomonas vaginalis The investigational test resulted in significantly higher sensitivity and negative predictive value than clinician diagnosis or in-clinic testing. In addition, the investigational test showed a statistically higher overall percent agreement with each of the three reference methods than did clinician diagnosis or in-clinic testing. The investigational test showed significantly higher sensitivity for detecting vaginitis, involving more than one cause, than did clinician diagnosis. Taken together, these results suggest that a molecular investigational test can facilitate accurate detection of vaginitis. Copyright © 2018 Schwebke et al.

Diagnostic Performance of a Molecular Test versus Clinician Assessment of Vaginitis

PubMed Central

Gaydos, Charlotte A.; Nyirjesy, Paul; Paradis, Sonia; Kodsi, Salma; Cooper, Charles K.

2018-01-01

ABSTRACT Vaginitis is a common complaint, diagnosed either empirically or using Amsel's criteria and wet mount microscopy. This study sought to determine characteristics of an investigational test (a molecular test for vaginitis), compared to reference, for detection of bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Vaginal specimens from a cross-sectional study were obtained from 1,740 women (≥18 years old), with vaginitis symptoms, during routine clinic visits (across 10 sites in the United States). Specimens were analyzed using a commercial PCR/fluorogenic probe-based investigational test that detects bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Clinician diagnosis and in-clinic testing (Amsel's test, potassium hydroxide preparation, and wet mount) were also employed to detect the three vaginitis causes. All testing methods were compared to the respective reference methods (Nugent Gram stain for bacterial vaginosis, detection of the Candida gene its2, and Trichomonas vaginalis culture). The investigational test, clinician diagnosis, and in-clinic testing were compared to reference methods for bacterial vaginosis, Candida spp., and Trichomonas vaginalis. The investigational test resulted in significantly higher sensitivity and negative predictive value than clinician diagnosis or in-clinic testing. In addition, the investigational test showed a statistically higher overall percent agreement with each of the three reference methods than did clinician diagnosis or in-clinic testing. The investigational test showed significantly higher sensitivity for detecting vaginitis, involving more than one cause, than did clinician diagnosis. Taken together, these results suggest that a molecular investigational test can facilitate accurate detection of vaginitis. PMID:29643195

The Gaia-ESO Survey: Exploring the complex nature and origins of the Galactic bulge populations

NASA Astrophysics Data System (ADS)

Rojas-Arriagada, A.; Recio-Blanco, A.; de Laverny, P.; Mikolaitis, Š.; Matteucci, F.; Spitoni, E.; Schultheis, M.; Hayden, M.; Hill, V.; Zoccali, M.; Minniti, D.; Gonzalez, O. A.; Gilmore, G.; Randich, S.; Feltzing, S.; Alfaro, E. J.; Babusiaux, C.; Bensby, T.; Bragaglia, A.; Flaccomio, E.; Koposov, S. E.; Pancino, E.; Bayo, A.; Carraro, G.; Casey, A. R.; Costado, M. T.; Damiani, F.; Donati, P.; Franciosini, E.; Hourihane, A.; Jofré, P.; Lardo, C.; Lewis, J.; Lind, K.; Magrini, L.; Morbidelli, L.; Sacco, G. G.; Worley, C. C.; Zaggia, S.

2017-05-01

Context. As observational evidence steadily accumulates, the nature of the Galactic bulge has proven to be rather complex: the structural, kinematic, and chemical analyses often lead to contradictory conclusions. The nature of the metal-rich bulge - and especially of the metal-poor bulge - and their relation with other Galactic components, still need to be firmly defined on the basis of statistically significant high-quality data samples. Aims: We used the fourth internal data release of the Gaia-ESO survey to characterize the bulge metallicity distribution function (MDF), magnesium abundance, spatial distribution, and correlation of these properties with kinematics. Moreover, the homogeneous sampling of the different Galactic populations provided by the Gaia-ESO survey allowed us to perform a comparison between the bulge, thin disk, and thick disk sequences in the [Mg/Fe] vs. [Fe/H] plane in order to constrain the extent of their eventual chemical similarities. Methods: We obtained spectroscopic data for 2500 red clump stars in 11 bulge fields, sampling the area -10° ≤ l ≤ + 8° and -10° ≤ b ≤ -4° from the fourth internal data release of the Gaia-ESO survey. A sample of 6300 disk stars was also selected for comparison. Spectrophotometric distances computed via isochrone fitting allowed us to define a sample of stars likely located in the bulge region. Results: From a Gaussian mixture models (GMM) analysis, the bulge MDF is confirmed to be bimodal across the whole sampled area. The relative ratio between the two modes of the MDF changes as a function of b, with metal-poor stars dominating at high latitudes. The metal-rich stars exhibit bar-like kinematics and display a bimodality in their magnitude distribution, a feature which is tightly associated with the X-shape bulge. They overlap with the metal-rich end of the thin disk sequence in the [Mg/Fe] vs. [Fe/H] plane. On the other hand, metal-poor bulge stars have a more isotropic hot kinematics and do

Streptococcal toxic shock syndrome secondary to group A Streptococcus vaginitis.

PubMed

Hikone, Mayu; Kobayashi, Ken-Ichiro; Washino, Takuya; Ota, Masayuki; Sakamoto, Naoya; Iwabuchi, Sentaro; Ohnishi, Kenji

2015-12-01

Streptococcal toxic shock syndrome (TSS) is a systemic illness usually caused in the setting of infection by group A Streptococcus (GAS). The primary infections are often invasive infections of the respiratory tract or necrotizing infections of the skin and soft tissue, but some infections occur without relevant focus. GAS vaginitis is a rare condition among adult women and is accordingly thought to be uncommon as a cause of streptococcal TSS. Here we report the cases of two postmenopausal women with streptococcal TSS secondary to GAS vaginitis, one aged 55 and one aged 60. Both came to our emergency department with complaints or symptoms of abdominal pain, fever, hypotension, and multi-organ failure. In both cases, the relevant factor associated with streptococcal infection was a recent episode of GAS vaginitis. Both underwent fluid management and 14 days of antibiotic treatment and fully recovered without complications. Vaginitis was likely to be the primary infectious trigger of TSS in these two cases. Intrauterine device insertion, endometrial biopsy, and post-partum state have all been previously reported in TSS patients, and the female genital tract has been described as a portal of entry. GAS vaginitis warrants appropriate treatment as it may progress to severe systemic infection as described. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Vaginal Douching Among Latinas: Practices and Meaning

PubMed Central

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

2009-01-01

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

Vaginal Cancer—Patient Version

Cancer.gov

Two-thirds of vaginal cancer cases are caused by human papillomavirus (HPV). Vaccines that protect against infection with HPV may reduce the risk of vaginal cancer. When found early, vaginal cancer can often be cured. Start here to find information on vaginal cancer treatment and research.

More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation.

PubMed

Brody, Stuart; Klapilova, Katerina; Krejčová, Lucie

2013-07-01

Research indicated that: (i) vaginal orgasm (induced by penile-vaginal intercourse [PVI] without concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep vaginal/cervical stimulation project via different peripheral nerves to different brain regions. The aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether vaginal stimulation was present during the woman's first masturbation. A sample of 75 Czech women (aged 18-36), provided details of recent VOC, site of genital stimulation during first masturbation, and their recent sexual arousability from the four genital sites. The association of VOC with: (i) sexual arousability perceived from the four genital sites and (ii) involvement of vaginal stimulation in first-ever masturbation. VOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual arousability from other genital sites. VOC was also associated with women's first masturbation incorporating (or being exclusively) vaginal stimulation. The findings suggest (i) stimulating the vagina during early life masturbation might indicate individual readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation. © 2013 International Society for Sexual Medicine.

Management of aerobic vaginitis.

PubMed

Tempera, Gianna; Furneri, Pio Maria

2010-01-01

Aerobic vaginitis is a new nonclassifiable pathology that is neither specific vaginitis nor bacterial vaginosis. The diversity of this microbiological peculiarity could also explain several therapeutic failures when patients were treated for infections identified as bacterial vaginosis. The diagnosis 'aerobic vaginitis' is essentially based on microscopic examinations using a phase-contrast microscope (at ×400 magnification). The therapeutic choice for 'aerobic vaginitis' should take into consideration an antibiotic characterized by an intrinsic activity against the majority of bacteria of fecal origin, bactericidal effect and poor/absent interference with the vaginal microbiota. Regarding the therapy for aerobic vaginitis when antimicrobial agents are prescribed, not only the antimicrobial spectrum but also the presumed ecological disturbance on the anaerobic and aerobic vaginal and rectal microbiota should be taken into a consideration. Because of their very low impact on the vaginal microbiota, kanamycin or quinolones are to be considered a good choice for therapy. Copyright © 2010 S. Karger AG, Basel.

The peculiar Na-O anticorrelation of the bulge globular cluster NGC 6440

NASA Astrophysics Data System (ADS)

Muñoz, C.; Villanova, S.; Geisler, D.; Saviane, I.; Dias, B.; Cohen, R. E.; Mauro, F.

2017-08-01

Context. Galactic globular clusters (GCs) are essential tools for understanding the earliest epoch of the Milky Way, since they are among the oldest objects in the Universe and can be used to trace its formation and evolution. Current studies using high-resolution spectroscopy for many stars in each of a large sample of GCs allow us to develop a detailed observational picture of their formation and their relation with the Galaxy. However, it is necessary to complete this picture by including GCs that belong to all major Galactic components, including the bulge. Aims: Our aim is to perform a detailed chemical analysis of the bulge GC NGC 6440 in order to determine if this object has multiple populations (MPs) and investigate its relation with the bulge of the Milky Way and with the other Galactic GCs, especially those associated with the bulge, which are largely poorly studied. Methods: We determined the stellar parameters and the chemical abundances of light elements (Na, Al), iron-peak elements (Fe, Sc, Mn, Co, Ni), α-elements (O, Mg, Si, Ca, Ti) and heavy elements (Ba, Eu) in seven red giant members of NGC 6440 using high-resolution spectroscopy from FLAMES-UVES. Results: We found a mean iron content of [Fe/H] =-0.50 ± 0.03 dex in agreement with other studies. We found no internal iron spread. On the other hand, Na and Al show a significant intrinsic spread, but the cluster has no significant O-Na anticorrelation nor does it exhibit a Mg-Al anticorrelation. The α-elements show good agreement with the bulge field star trend, although they are at the high alpha end and are also higher than those of other GCs of comparable metallicity. The heavy elements are dominated by the r-process, indicating a strong contribution by SNeII. The chemical analysis suggests an origin similar to that of the bulge field stars.

Improved Model for Predicting the Free Energy Contribution of Dinucleotide Bulges to RNA Duplex Stability.

PubMed

Tomcho, Jeremy C; Tillman, Magdalena R; Znosko, Brent M

2015-09-01

Predicting the secondary structure of RNA is an intermediate in predicting RNA three-dimensional structure. Commonly, determining RNA secondary structure from sequence uses free energy minimization and nearest neighbor parameters. Current algorithms utilize a sequence-independent model to predict free energy contributions of dinucleotide bulges. To determine if a sequence-dependent model would be more accurate, short RNA duplexes containing dinucleotide bulges with different sequences and nearest neighbor combinations were optically melted to derive thermodynamic parameters. These data suggested energy contributions of dinucleotide bulges were sequence-dependent, and a sequence-dependent model was derived. This model assigns free energy penalties based on the identity of nucleotides in the bulge (3.06 kcal/mol for two purines, 2.93 kcal/mol for two pyrimidines, 2.71 kcal/mol for 5'-purine-pyrimidine-3', and 2.41 kcal/mol for 5'-pyrimidine-purine-3'). The predictive model also includes a 0.45 kcal/mol penalty for an A-U pair adjacent to the bulge and a -0.28 kcal/mol bonus for a G-U pair adjacent to the bulge. The new sequence-dependent model results in predicted values within, on average, 0.17 kcal/mol of experimental values, a significant improvement over the sequence-independent model. This model and new experimental values can be incorporated into algorithms that predict RNA stability and secondary structure from sequence.

Role of the CCA bulge of prohead RNA of bacteriophage ø29 in DNA packaging.

PubMed

Zhao, Wei; Morais, Marc C; Anderson, Dwight L; Jardine, Paul J; Grimes, Shelley

2008-11-14

The oligomeric ring of prohead RNA (pRNA) is an essential component of the ATP-driven DNA packaging motor of bacteriophage ø29. The A-helix of pRNA binds the DNA translocating ATPase gp16 (gene product 16) and the CCA bulge in this helix is essential for DNA packaging in vitro. Mutation of the bulge by base substitution or deletion showed that the size of the bulge, rather than its sequence, is primary in DNA packaging activity. Proheads reconstituted with CCA bulge mutant pRNAs bound the packaging ATPase gp16 and the packaging substrate DNA-gp3, although DNA translocation was not detected with several mutants. Prohead/bulge-mutant pRNA complexes with low packaging activity had a higher rate of ATP hydrolysis per base pair of DNA packaged than proheads with wild-type pRNA. Cryoelectron microscopy three-dimensional reconstruction of proheads reconstituted with a CCA deletion pRNA showed that the protruding pRNA spokes of the motor occupy a different position relative to the head when compared to particles with wild-type pRNA. Therefore, the CCA bulge seems to dictate the orientation of the pRNA spokes. The conformational changes observed for this mutant pRNA may affect gp16 conformation and/or subsequent ATPase-DNA interaction and, consequently, explain the decreased packaging activity observed for CCA mutants.

["Mixed" and "miscellaneous" vulvovaginitis: diagnostics and therapy of vaginal administration of nystatin and nifuratel].

PubMed

Cepický, P; Malina, J; Líbalová, Z; Kuzelová, M

2005-05-01

The evaluation of combined and miscellaneous vulvovaginal infections incidence and their treatment with combined vaginal products containing nifuratel and nystatin. Prospective study. Gynecologic outpatient department LEVRET, Prague; Laboratories of Microbiology AescuLab, Prague. 70 consecutive patients were examined with complaint of vaginal fluor and/or pruritus. We established macroscopic features of fluor, pH, amine test and mounts stained with Giemsa and Gram. We qualified the cases with more diagnostic criteria (mycosis, lactobacillosis, anaerobic vaginosis, aerobic vaginitis) as combined infection, those with no diagnostic criteria as miscellaneous. We treated all patients with vaginal tablets nystatin + nifuratel (Macmiror complex). We prescribed clotrimazol cream, if pruritus was present. We evaluated withdrawals of symptoms and relapses during 3 months after treatment. Combined infection was found in 21 patients from 70 (30%). The most frequent combination was that of mycosis and aerobic vaginitis (13/70, 18.6%) or mycosis and anaerobic vaginosis (4/70, 5.7%); 11 patients fulfilled criteria of no diagnosis. We concluded them as "miscelaneous". The treatment was successful in all cases, 10 women relapsed in 3 months. Combined vaginal infection findings are present very often (30%), likewise miscellaneous ones (15%) occur. The treatment of these women in successful with vaginal tablets with nystatin + nifuratel.

Prospective study of vaginal bacterial flora and other risk factors for vulvovaginal candidiasis.

PubMed

McClelland, R Scott; Richardson, Barbra A; Hassan, Wisal M; Graham, Susan M; Kiarie, James; Baeten, Jared M; Mandaliya, Kishorchandra; Jaoko, Walter; Ndinya-Achola, Jeckoniah O; Holmes, King K

2009-06-15

It has been suggested that vaginal colonization with lactobacilli may reduce the risk of vulvovaginal candidiasis (VVC), but supporting data are limited. Our objective was to determine the relationship between vaginal bacterial flora and VVC. We conducted a prospective cohort analysis that involved 151 Kenyan sex workers. At monthly follow-up visits, VVC was defined as the presence of yeast buds, pseudohyphae, or both on a wet preparation (including potassium hydroxide preparation) of vaginal secretions. Generalized estimating equations were used to identify correlates of VVC. Participants returned for a median of 12 visits (interquartile range, 11-12 visits). VVC was identified at 162 visits, including 26 involving symptomatic VVC. Bacterial vaginosis was associated with fewer episodes of VVC (adjusted odds ratio [aOR], 0.29 [95% confidence interval {CI}, 0.16-0.50]). After excluding women with concurrent bacterial vaginosis, another possible cause of vaginal symptoms, the likelihood of symptomatic VVC was higher among those who had had yeast identified on wet preparation of vaginal secretions during the past 60 days (aOR, 4.06 [95% CI, 1.12-14.74]) and those with concurrent vaginal Lactobacillus colonization (aOR, 3.75 [95% CI, 1.30-10.83]). Contrary to the commonly posited hypothesis that vaginal Lactobacillus colonization has a protective effect, we found that such colonization was associated with a nearly 4-fold increase in the likelihood of symptomatic VVC.

Vitamin D Proliferates Vaginal Epithelium through RhoA Expression in Postmenopausal Atrophic Vagina tissue

PubMed Central

Lee, Arum; Lee, Man Ryul; Lee, Hae-Hyeog; Kim, Yeon-Suk; Kim, Jun-Mo; Enkhbold, Temuulee; Kim, Tae-Hee

2017-01-01

Postmenopausal atrophic vagina (PAV) is the thinning of the walls of the vagina and decreased lugae of the vagina. PAV is caused by decreased estrogen levels in postmenopausal women. However, the harmful effects of hormone replacement therapy (HRT) have resulted in considerable caution in its use. Various estrogen agonist treatment options are available. Vitamin D is influences the regulation of differentiation and proliferation of various cells, especially tissues lining stratified squamous epithelium, such as the vaginal epithelium. In this study, we hypothesized that vitamin D could provide an alternative and a safe treatment option for PAV by promoting the proliferation and differentiation of the vaginal epithelium. Thirty six patients were enrolled in this case-control study. Vitamin D associated proteins in a vitamin D and sex hormone treated vaginal epithelial cell line as well as normal and PAV tissues were measured. To confirm of cell-to-cell junction protein expression, cell line and tissue studies included RT-PCR, immunohistochemistry staining, and immunoblot analyses. The expression of cell-to-cell junction proteins was higher in women with symptoms of atrophic vagina tissue compared to women without the symptoms. Vitamin D stimulated the proliferation of the vaginal epithelium by activating p-RhoA and Erzin through the vitamin D receptor (VDR). The results suggest that vitamin D positively regulates cell-to-cell junction by increasing the VDR/p-RhoA/p-Ezrin pathway. This is the first study to verify the relationship of the expression of RhoA and Ezrin proteins in vaginal tissue of PAV. PMID:28843271

Vitamin D Proliferates Vaginal Epithelium through RhoA Expression in Postmenopausal Atrophic Vagina tissue.

PubMed

Lee, Arum; Lee, Man Ryul; Lee, Hae-Hyeog; Kim, Yeon-Suk; Kim, Jun-Mo; Enkhbold, Temuulee; Kim, Tae-Hee

2017-09-30

Postmenopausal atrophic vagina (PAV) is the thinning of the walls of the vagina and decreased lugae of the vagina. PAV is caused by decreased estrogen levels in postmenopausal women. However, the harmful effects of hormone replacement therapy (HRT) have resulted in considerable caution in its use. Various estrogen agonist treatment options are available. Vitamin D is influences the regulation of differentiation and proliferation of various cells, especially tissues lining stratified squamous epithelium, such as the vaginal epithelium. In this study, we hypothesized that vitamin D could provide an alternative and a safe treatment option for PAV by promoting the proliferation and differentiation of the vaginal epithelium. Thirty six patients were enrolled in this case-control study. Vitamin D associated proteins in a vitamin D and sex hormone treated vaginal epithelial cell line as well as normal and PAV tissues were measured. To confirm of cell-to-cell junction protein expression, cell line and tissue studies included RT-PCR, immunohistochemistry staining, and immunoblot analyses. The expression of cell-to-cell junction proteins was higher in women with symptoms of atrophic vagina tissue compared to women without the symptoms. Vitamin D stimulated the proliferation of the vaginal epithelium by activating p-RhoA and Erzin through the vitamin D receptor (VDR). The results suggest that vitamin D positively regulates cell-to-cell junction by increasing the VDR/p-RhoA/p-Ezrin pathway. This is the first study to verify the relationship of the expression of RhoA and Ezrin proteins in vaginal tissue of PAV.

Clinicoetiological Characterization of Infectious Vaginitis amongst Women of Reproductive Age Group from Navi Mumbai, India

PubMed Central

Narayankhedkar, Anuradha; Hodiwala, Anahita; Mane, Arati

2015-01-01

Vaginitis is one of the commonest reproductive tract infections in sexually active women. In the present study clinicoetiological characterization of infectious vaginitis amongst 380 women of reproductive age group (18–45 years) was done. Bacterial vaginosis (BV) was detected by Nugent's scoring, Candida infection by culture, and trichomoniasis (TV) by wet mount. One hundred and ten (28.9%) women presented with symptoms of vaginitis. The presenting symptoms were vaginal discharge 106 (96.4%), vulval itching/irritation 19 (17.3%), malodor 5 (4.5%), pain in abdomen 3 (2.7%), and dysuria 1 (0.9%). The commonest etiology detected was Candida in 33 (30%) cases, of which 18 (54.5%) were C. albicans and 15 (45.5%) non-albicans Candida (NAC) infections. The NAC isolates were C. glabrata (n = 10), C. tropicalis (n = 3), and C. krusei (n = 2). BV and TV were observed in 19 (17.3%) and 2 (1.8%) cases, respectively. A statistically significant association between Candida infection and presence of curdy-white discharge (p = 0.001) and vulval itching/irritation (p = 0.007) was noted. To conclude, we observed the etiological predominance of Candida infection, with considerable prevalence of NAC, indicating the need for microbiological investigation up to species level in cases of Candida infections, to ensure appropriate management. PMID:26351613

Clinicoetiological Characterization of Infectious Vaginitis amongst Women of Reproductive Age Group from Navi Mumbai, India.

PubMed

Narayankhedkar, Anuradha; Hodiwala, Anahita; Mane, Arati

2015-01-01

Vaginitis is one of the commonest reproductive tract infections in sexually active women. In the present study clinicoetiological characterization of infectious vaginitis amongst 380 women of reproductive age group (18-45 years) was done. Bacterial vaginosis (BV) was detected by Nugent's scoring, Candida infection by culture, and trichomoniasis (TV) by wet mount. One hundred and ten (28.9%) women presented with symptoms of vaginitis. The presenting symptoms were vaginal discharge 106 (96.4%), vulval itching/irritation 19 (17.3%), malodor 5 (4.5%), pain in abdomen 3 (2.7%), and dysuria 1 (0.9%). The commonest etiology detected was Candida in 33 (30%) cases, of which 18 (54.5%) were C. albicans and 15 (45.5%) non-albicans Candida (NAC) infections. The NAC isolates were C. glabrata (n = 10), C. tropicalis (n = 3), and C. krusei (n = 2). BV and TV were observed in 19 (17.3%) and 2 (1.8%) cases, respectively. A statistically significant association between Candida infection and presence of curdy-white discharge (p = 0.001) and vulval itching/irritation (p = 0.007) was noted. To conclude, we observed the etiological predominance of Candida infection, with considerable prevalence of NAC, indicating the need for microbiological investigation up to species level in cases of Candida infections, to ensure appropriate management.

Vaginal Bleeding

MedlinePlus

... bleeding is any vaginal bleeding unrelated to normal menstruation. This type of bleeding may include spotting of ... two or more hours. Normal vaginal bleeding, or menstruation, occurs every 21 to 35 days when the ...

Vaginal Odor

MedlinePlus

... usually don't cause vaginal odors. Neither do yeast infections. Generally, if you have vaginal odor without ... Avoid douching. All healthy vaginas contain bacteria and yeast. The normal acidity of your vagina keeps bacteria ...

Clindamycin Vaginal

MedlinePlus

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

Vaginal Diseases

MedlinePlus

Vaginal problems are some of the most common reasons women go to the doctor. They may have ... common problem is vaginitis, an inflammation of the vagina. Other problems that affect the vagina include sexually ...

Successful vaginal delivery at term after vaginal reconstruction with labium minus flaps in a patient with vaginal atresia: A rare case report.

PubMed

Liu, Yu; Wang, Yi-Feng

2017-07-01

We report a case of successful vaginal delivery after vaginal reconstruction with labium minus flaps in a 23-year-old patient with congenital vaginal atresia. The patient primarily presented with amenorrhea and cyclic abdominal pain; transabdominal ultrasonography revealed an enlarged uterus due to hematometra and absence of the lower segment of the vagina. Eight years ago, she had undergone an unsuccessful attempt at canalization at a local hospital. Upon referral to our hospital, she underwent vaginal reconstruction with labium minus flaps. Four months after this procedure, she became pregnant and, subsequently, successfully and safely vaginally delivered a healthy female baby weighing 3250 g at 38 +1 weeks' gestation. The delivery did not involve perineal laceration by lateral episiotomy. To the best of our knowledge, this is the first reported case of successful vaginal delivery at term after vaginal reconstruction with labium minus flaps in a patient with vaginal atresia. © 2017 Japan Society of Obstetrics and Gynecology.

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis.

PubMed

Donders, Gilbert G G; Vereecken, Annie; Bosmans, Eugene; Dekeersmaecker, Alfons; Salembier, Geert; Spitz, Bernard

2002-01-01

To define an entity of abnormal vaginal flora: aerobic vaginitis. Observational study. University Hospital Gasthuisberg, Leuven, Belgium. 631 women attending for routine prenatal care or attending vaginitis clinic. Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured. Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-beta and leukaemia inhibitory factor in the vaginal fluid. Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

The vaginal mycobiome: A contemporary perspective on fungi in women's health and diseases.

PubMed

Bradford, L Latéy; Ravel, Jacques

2017-04-03

Most of what is known about fungi in the human vagina has come from culture-based studies and phenotypic characterization of single organisms. Though valuable, these approaches have masked the complexity of fungal communities within the vagina. The vaginal mycobiome has become an emerging field of study as genomics tools are increasingly employed and we begin to appreciate the role these fungal communities play in human health and disease. Though vastly outnumbered by its bacterial counterparts, fungi are important constituents of the vaginal ecosystem in many healthy women. Candida albicans, an opportunistic fungal pathogen, colonizes 20% of women without causing any overt symptoms, yet it is one of the leading causes of infectious vaginitis. Understanding its mechanisms of commensalism and patho-genesis are both essential to developing more effective therapies. Describing the interactions between Candida, bacteria (such as Lactobacillus spp.) and other fungi in the vagina is funda-mental to our characterization of the vaginal mycobiome.

The vaginal mycobiome: A contemporary perspective on fungi in women's health and diseases

PubMed Central

2017-01-01

ABSTRACT Most of what is known about fungi in the human vagina has come from culture-based studies and phenotypic characterization of single organisms. Though valuable, these approaches have masked the complexity of fungal communities within the vagina. The vaginal mycobiome has become an emerging field of study as genomics tools are increasingly employed and we begin to appreciate the role these fungal communities play in human health and disease. Though vastly outnumbered by its bacterial counterparts, fungi are important constituents of the vaginal ecosystem in many healthy women. Candida albicans, an opportunistic fungal pathogen, colonizes 20% of women without causing any overt symptoms, yet it is one of the leading causes of infectious vaginitis. Understanding its mechanisms of commensalism and patho-genesis are both essential to developing more effective therapies. Describing the interactions between Candida, bacteria (such as Lactobacillus spp.) and other fungi in the vagina is funda-mental to our characterization of the vaginal mycobiome. PMID:27657355

Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey.

PubMed

Crann, Sara E; Cunningham, Shannon; Albert, Arianne; Money, Deborah M; O'Doherty, Kieran C

2018-03-23

The vaginal microbiome influences quality of life and health. The composition of vaginal microbiota can be affected by various health behaviors, such as vaginal douching. The purpose of this study was to examine the types and prevalence of diverse vaginal/genital health and hygiene behaviors among participants living in Canada and to examine associations between behavioral practices and adverse gynecological health conditions. An anonymous online survey, available in English and French, was distributed across Canada. The sample consisted of 1435 respondents, 18 years or older, living in Canada. Respondents reported engaging in diverse vaginal/genital health and hygiene behavioral practices, including the use of commercially manufactured products and homemade and naturopathic products and practices. Over 95% of respondents reported using at least one product in or around the vaginal area. Common products and practices included vaginal/genital moisturizers, anti-itch creams, feminine wipes, washes, suppositories, sprays, powders, and waxing and shaving pubic hair. The majority of the sample (80%) reported experiencing one or more adverse vaginal/genital symptom in their lifetime. Participants who had used any vaginal/genital product(s) had approximately three times higher odds of reporting an adverse health condition. Several notable associations between specific vaginal/genital health and hygiene products and adverse health conditions were identified. This study is the first of its kind to identify the range and prevalence of vaginal/genital health and hygiene behaviors in Canada. Despite a lack of credible information about the impact of these behaviors on women's health, the use of commercially manufactured and homemade products for vaginal/genital health and hygiene is common. Future research can extend the current exploratory study by identifying causal relationships between vaginal/genital health and hygiene behaviors and changes to the vaginal microbiome.

New insights on the origin of the High Velocity Peaks in the Galactic Bulge

NASA Astrophysics Data System (ADS)

Fernández-Trincado, J. G.; Robin, A. C.; Moreno, E.; Pérez-Villegas, A.; Pichardo, B.

2017-12-01

We provide new insight on the origin of the cold high-V_{los} peaks (˜200 kms^{-1}) in the Milky Way bulge discovered in the APOGEE commissioning data (Nidever et al. 2012). Here we show that such kinematic behaviour present in the field regions towards the Galactic bulge is not likely associated with orbits that build the boxy/peanut (B/P) bulge. To this purpose, a new set of test particle simulations of a kinematically cold stellar disk evolved in a 3D steady-state barred Milky Way galactic potential, has been analysed in detail. Especially bar particles trapped into the bar are identified through the orbital Jacobi energy E_{J}, which allows us to identify the building blocks of the B/P feature and investigate their kinematic properties. Finally, we present preliminary results showing that the high-V_{los} features observed towards the Milky Way bulge are a natural consequence of a large-scale midplane particle structure, which is unlikely associated with the Galactic bar.

Pelvic floor muscles training to reduce symptoms and signs of vulvovaginal atrophy: a case study.

PubMed

Mercier, Joanie; Morin, Mélanie; Lemieux, Marie-Claude; Reichetzer, Barbara; Khalifé, Samir; Dumoulin, Chantale

2016-07-01

Vulvovaginal atrophy (VVA), caused by decreased levels of estrogen, is a common problem in aging women. Main symptoms of VVA are vaginal dryness and dyspareunia. First-line treatment consists of the application of local estrogen therapy (ET) or vaginal moisturizer. In some cases however, symptoms and signs persist despite those interventions. This case study describes a 77-year-old woman with severe VVA symptoms despite use of local ET and the addition of pelvic floor muscle (PFM) training to her treatment. A patient with stress urinary incontinence and VVA was referred to a randomized clinical trial on PFM training. On pretreatment evaluation while on local ET, she showed VVA symptoms on the ICIQ Vaginal Symptoms questionnaire and the ICIQ-Female Sexual Matters associated with lower urinary tract Symptoms questionnaire, and also showed VVA signs during the physical and dynamometric evaluation of the PFM. She was treated with a 12-week PFM training program. The patient reported a reduction in vaginal dryness and dyspareunia symptoms, as well as a better quality of sexual life after 12 weeks of PFM training. On posttreatment physical evaluation, the PFMs' tone and elasticity were improved, although some other VVA signs remained unchanged. Pelvic floor muscle training may improve some VVA symptoms and signs in women taking local ET. Further study is needed to investigate and confirm the present case findings and to explore mechanisms of action of this intervention for VVA.

First detection of the white dwarf cooling sequence of the galactic bulge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calamida, A.; Sahu, K. C.; Anderson, J.

2014-08-01

We present Hubble Space Telescope data of the low-reddening Sagittarius window in the Galactic bulge. The Sagittarius Window Eclipsing Extrasolar Planet Search field (∼3'× 3'), together with three more Advanced Camera for Surveys and eight Wide-Field Camera 3 fields, were observed in the F606W and F814W filters, approximately every two weeks for 2 yr, with the principal aim of detecting a hidden population of isolated black holes and neutron stars through astrometric microlensing. Proper motions were measured with an accuracy of ≈0.1 mas yr{sup –1} (≈4 km s{sup –1}) at F606W ≈ 25.5 mag, and better than ≈0.5 mas yr{supmore » –1} (≈20 km s{sup –1}) at F606W ≈ 28 mag, in both axes. Proper-motion measurements allowed us to separate disk and bulge stars and obtain a clean bulge color-magnitude diagram. We then identified for the first time a white dwarf (WD) cooling sequence in the Galactic bulge, together with a dozen candidate extreme horizontal branch stars. The comparison between theory and observations shows that a substantial fraction of the WDs (≈30%) are systematically redder than the cooling tracks for CO-core H-rich and He-rich envelope WDs. This evidence would suggest the presence of a significant number of low-mass WDs and WD-main-sequence binaries in the bulge. This hypothesis is further supported by the finding of two dwarf novae in outburst, two short-period (P ≲ 1 day) ellipsoidal variables, and a few candidate cataclysmic variables in the same field.« less

Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis.

PubMed

Brody, Stuart; Weiss, Petr

2010-08-01

Evidence was recently provided for vaginal orgasm, orgasm triggered purely by penile-vaginal intercourse (PVI), being associated with better psychological functioning. Common sex education and sexual medicine approaches might undermine vaginal orgasm benefits. To examine the extent to which women's vaginal orgasm consistency is associated with (i) being told in childhood or adolescence that the vagina was the important zone for inducing female orgasm; (ii) how well they focus mentally on vaginal sensations during PVI; (iii) greater PVI duration; and (iv) preference for above-average penis length.   In a representative sample of the Czech population, 1,000 women reported their vaginal orgasm consistency (from never to almost every time; only 21.9% never had a vaginal orgasm), estimates of their typical foreplay and PVI durations, what they were told in childhood and adolescence was the important zone for inducing female orgasm, their degree of focus on vaginal sensations during PVI, and whether they were more likely to orgasm with a longer than average penis. The association of vaginal orgasm consistency with the predictors noted above. Vaginal orgasm consistency was associated with all hypothesized correlates. Multivariate analysis indicated the most important predictors were being educated that the vagina is important for female orgasm, being mentally focused on vaginal sensations during PVI, and in some analyses duration of PVI (but not foreplay) and preferring a longer than average penis. Focusing attention on penile-vaginal sensation supports vaginal orgasm and the myriad benefits thereof. Brody S, and Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. © 2009 International Society for Sexual Medicine.

Supermassive black holes and their host galaxies. I. Bulge luminosities from dedicated near-infrared data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Läsker, Ronald; Van de Ven, Glenn; Ferrarese, Laura, E-mail: laesker@mpia.de

2014-01-01

In an effort to secure, refine, and supplement the relation between central supermassive black hole masses, M {sub •}, and the bulge luminosities of their host galaxies, L {sub bul}, we obtained deep, high spatial resolution K-band images of 35 nearby galaxies with securely measured M {sub •}, using the wide-field WIRCam imager at the Canada-France-Hawaii-Telescope. A dedicated data reduction and sky subtraction strategy was adopted to estimate the brightness and structure of the sky, a critical step when tracing the light distribution of extended objects in the near-infrared. From the final image product, bulge and total magnitudes were extractedmore » via two-dimensional profile fitting. As a first order approximation, all galaxies were modeled using a simple Sérsic-bulge+exponential-disk decomposition. However, we found that such models did not adequately describe the structure that we observed in a large fraction of our sample galaxies which often include cores, bars, nuclei, inner disks, spiral arms, rings, and envelopes. In such cases, we adopted profile modifications and/or more complex models with additional components. The derived bulge magnitudes are very sensitive to the details and number of components used in the models, although total magnitudes remain almost unaffected. Usually, but not always, the luminosities and sizes of the bulges are overestimated when a simple bulge+disk decomposition is adopted in lieu of a more complex model. Furthermore, we found that some spheroids are not well fit when the ellipticity of the Sérsic model is held fixed. This paper presents the details of the image processing and analysis, while we discuss how model-induced biases and systematics in bulge magnitudes impact the M {sub •}-L {sub bul} relation in a companion paper.« less

Supermassive Black Holes and Their Host Galaxies. I. Bulge Luminosities from Dedicated Near-infrared Data

NASA Astrophysics Data System (ADS)

Läsker, Ronald; Ferrarese, Laura; van de Ven, Glenn

2014-01-01

In an effort to secure, refine, and supplement the relation between central supermassive black hole masses, M •, and the bulge luminosities of their host galaxies, L bul, we obtained deep, high spatial resolution K-band images of 35 nearby galaxies with securely measured M •, using the wide-field WIRCam imager at the Canada-France-Hawaii-Telescope. A dedicated data reduction and sky subtraction strategy was adopted to estimate the brightness and structure of the sky, a critical step when tracing the light distribution of extended objects in the near-infrared. From the final image product, bulge and total magnitudes were extracted via two-dimensional profile fitting. As a first order approximation, all galaxies were modeled using a simple Sérsic-bulge+exponential-disk decomposition. However, we found that such models did not adequately describe the structure that we observed in a large fraction of our sample galaxies which often include cores, bars, nuclei, inner disks, spiral arms, rings, and envelopes. In such cases, we adopted profile modifications and/or more complex models with additional components. The derived bulge magnitudes are very sensitive to the details and number of components used in the models, although total magnitudes remain almost unaffected. Usually, but not always, the luminosities and sizes of the bulges are overestimated when a simple bulge+disk decomposition is adopted in lieu of a more complex model. Furthermore, we found that some spheroids are not well fit when the ellipticity of the Sérsic model is held fixed. This paper presents the details of the image processing and analysis, while we discuss how model-induced biases and systematics in bulge magnitudes impact the M •-L bul relation in a companion paper.

Bulge-Formed Cooling Channels In A Wall

NASA Technical Reports Server (NTRS)

Mcaninch, Michael D.; Holbrook, Richard L.; Lacount, Dale F.; Kawashige, Chester M.; Crapuchettes, John M.; Scala, James

1996-01-01

Vessels bounded by walls shaped as surfaces of revolution and contain integral cooling channels fabricated by improved method involving combination of welding and bulge forming. Devised to make rocket nozzles; also useful in fabrication of heat exchangers, stationary combustion chambers, and chemical-reactor vessels. Advantages include easier fabrication and greater flexibility of design.

Prevalence of vaginal candidiasis among pregnant women with abnormal vaginal discharge in Maiduguri.

PubMed

Ibrahim, S M; Bukar, M; Mohammed, Y; Mohammed, B; Yahaya, M; Audu, B M; Ibrahim, H M; Ibrahim, H A

2013-01-01

Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. High vaginal swab samples and data on epidemiological characteristics were collected from 400 pregnant women with complaints of abnormal vaginal discharge at booking clinic of University of Maiduguri Teaching Hospital. The data was analysed using SPSS 16.0 statistical software. The prevalence of abnormal vaginal discharge in pregnancy was 31.5%. The frequency of abnormal vaginal discharge was 183 (45.8%) among those aged 20-24 years, 291 (72.8%) in multipara, 223 (55.8%) in those with Primary education and 293 (73.2%) in unemployed. Vulval pruritus 300 (75.0%) was significantly related to abnormal vaginal discharge (P < 0.001). The prevalence of C. albicans was 41%. The frequencies of Vulval itching, Dyspareunia and vulval excoriation among those with candidiasis were 151 (50.3%), 14 (56.0%) and 75 (75.0%) respectively (P < 0.001). The prevalence of abnormal vaginal discharge in pregnancy was high in this study and C. albicans was the commonest cause. It is recommended that a pregnant woman complaining of abnormal vaginal discharge be assessed and Laboratory diagnosis done in order to give appropriate treatment.

A novel 3D deformation measurement method under optical microscope for micro-scale bulge-test

NASA Astrophysics Data System (ADS)

Wu, Dan; Xie, Huimin

2017-11-01

A micro-scale 3D deformation measurement method combined with optical microscope is proposed in this paper. The method is based on gratings and phase shifting algorithm. By recording the grating images before and after deformation from two symmetrical angles and calculating the phases of the grating patterns, the 3D deformation field of the specimen can be extracted from the phases of the grating patterns. The proposed method was applied to the micro-scale bulge test. A micro-scale thermal/mechanical coupling bulge-test apparatus matched with the super-depth microscope was exploited. With the gratings fabricated onto the film, the deformed morphology of the bulged film was measured reliably. The experimental results show that the proposed method and the exploited bulge-test apparatus can be used to characterize the thermal/mechanical properties of the films at micro-scale successfully.

X-ray Selected Symbiotic Candidates in the Galactic Bulge Survey

NASA Astrophysics Data System (ADS)

Hynes, Robert I.; Wetuski, Joshua` D.; Jonker, Peter; Torres, Manuel; Heinke, Craig O.; Maccarone, Tom; Steeghs, Danny; Britt, Christopher; Johnson, Christopher; Nelemans, Gijs

2017-06-01

The Galactic Bulge Survey (GBS) is a broad, shallow survey of Bulge X-ray sources with extensive multiwavelength support. The limiting sensitivity, about 2×1032 erg/s at the Bulge distance, is well suited to finding symbiotic X-ray binaries (SyXBs) containing neutron stars accreting from a cool giant wind, as well as X-ray bright white dwarf systems. Giant counterparts can be securely detected in IR photometry, allowing us to estimate the total number of symbiotics detected by the GBS, and identify a good number of promising candidates. Such an X-ray selected symbiotic sample may be quite different to the traditional symbiotic star population which is usually selected by optical spectroscopy, and consequently biased towards systems with rich line emission. Of the 1640 unique X-ray sources identified by the GBS we find 91 significant matches with candidate Bulge giants. We expect 68 coincidences, so estimate a total sample of about 23 X-ray emitting cool giants detected by the GBS. Most of these are likely to be SyXBs or symbiotics of some type. Narrowing our search to sources coincident to 1", we find 23 matches, with only 8 coincidences expected, so this subsample has a relatively high purity, and likely includes most of the GBS symbiotics. The properties of this subsample are mostly consistent with cool giants, with typical SEDs, long-term lightcurves, and spectra. The sources are inconsistent in color with nearby M dwarfs and show small proper motions, so the foreground contamination is likely small. We present a selection of the best studied objects, focusing on one extremely variable X-ray source coincident with a carbon giant. This is quite an unusual object as carbon stars are rare in the Bulge. The scientific results reported in this article are based on observations made by the Chandra X-ray Observatory and data obtained from the Chandra Data Archive. Support for this work was provided by the National Aeronautics and Space Administration through Chandra

Two Red Clumps and the X-shaped Milky Way Bulge

NASA Astrophysics Data System (ADS)

McWilliam, Andrew; Zoccali, Manuela

2010-12-01

From Two Micron All Sky Survey infrared photometry, we find two red clump (RC) populations coexisting in fields toward the Galactic bulge at latitudes |b|>5fdg5, ranging over ~13° in longitude and 20° in latitude. These RC peaks indicate two stellar populations separated by ~2.3 kpc at (l, b) = (+1, - 8) the two RCs are located at 6.5 and 8.8 ± 0.2 kpc. The double-peaked RC is inconsistent with a tilted bar morphology. Most of our fields show the two RCs at roughly constant distance with longitude, also inconsistent with a tilted bar; however, an underlying bar may be present. Stellar densities in the two RCs change dramatically with longitude: on the positive longitude side the foreground RC is dominant, while the background RC dominates negative longitudes. A line connecting the maxima of the foreground and background populations is tilted to the line of sight by ~20°±4°, similar to claims for the tilt of a Galactic bar. The distance between the two RCs decreases toward the Galactic plane; seen edge-on the bulge is X-shaped, resembling some extragalactic bulges and the results of N-body simulations. The center of this X is consistent with the distance to the Galactic center, although better agreement would occur if the bulge is 2-3 Gyr younger than 47 Tuc. Our observations may be understood if the two RC populations emanate, nearly tangentially, from the Galactic bar ends, in a funnel shape. Alternatively, the X, or double funnel, may continue to the Galactic center. From the Sun, this would appear peanut/box shaped, but X-shaped when viewed tangentially.

Kinematics and abundances of K giants in the nuclear bulge of the Galaxy

NASA Astrophysics Data System (ADS)

Rich, R. Michael

1990-10-01

Radial velocities have been determined for 53 K giants in Baade's window, which belong to the nuclear bulge population and have abundances derived from low resolution spectra. Additional radial velocities for an overlapping sample of 71 bulge K giants show the same dependence of velocity dispersion on abundance; in both samples, the lower velocity dispersion of the metal-rich giants is found to be significant at a level above 90 percent. Extant data support the hypothesis that both M giants and IRAS bulge sources follow steep density laws similar to that which has been predicted for the metal-rick K giants. The abundance distribution of 88 K giants in Baade's window is noted to be notably well fitted by the simple, 'closed box' model of chemical evolution.

The Optical Gravitational Lensing Experiment. BVI Maps of Dense Stellar Regions. III. The Galactic Bulge

NASA Astrophysics Data System (ADS)

Udalski, A.; Szymanski, M.; Kubiak, M.; Pietrzynski, G.; Soszynski, I.; Wozniak, P.; Zebrun, K.; Szewczyk, O.; Wyrzykowski, L.

2002-09-01

We present the VI photometric maps of the Galactic bulge. They contain VI photometry and astrometry of about 30 million stars from 49 fields of 0.225 square degree each in the Galactic center region. The data were collected during the second phase of the OGLE microlensing project. We discuss the accuracy of data and present color-magnitude diagrams of selected fields observed by OGLE in the Galactic bulge. The VI maps of the Galactic bulge are accessible electronically for the astronomical community from the OGLE Internet archive.

The Extinction Toward the Galactic Bulge from RR Lyrae Stars

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kunder, A; Popowski, P; Cook, K

2007-11-07

The authors present mean reddenings toward 3525 RR0 Lyrae stars from the Galactic bulge fields of the MACHO Survey. These reddenings are determined using the color at minimum V-band light of the RR0 Lyrae stars themselves and are found to be in general agreement with extinction estimates at the same location obtained from other methods. Using 3256 stars located in the Galactic Bulge, they derive the selective extinction coefficient R{sub V,VR} = A{sub V}/E(V-R) = 4.2 {+-} 0.2. this value is what is expected for a standard extinction law with R{sub V,BV} = 3.1 {+-} 0.3

Vaginal Fistula

MedlinePlus

Vaginal fistula Overview A vaginal fistula is an abnormal opening that connects your vagina to another organ, such as your bladder, colon or rectum. Your ... describe the condition as a hole in your vagina that allows stool or urine to pass through ...

Characterizing Pelvic Organ Prolapse in Adult Spina Bifida Patients.

PubMed

Liu, Joceline S; Vo, Amanda X; Doolittle, Johnathan; Hamoui, Nabeel; Lewicky-Gaupp, Christina; Kielb, Stephanie J

2016-11-01

To report the distribution of pelvic organ prolapse (POP) stages in adult spina bifida (SB) patients. The severity of POP in the SB population has not been previously reported. Retrospective review of SB patients ≥18 years with a documented POP quantification examination between 2006 and 2014 were included. Patient demographics, gestation, parity, POP quantification examinations and prolapse symptoms were obtained. Thirty-three SB patients were identified with a mean age of 33.2 years. Five patients (15.2%) had stage 0 prolapse, 12 (36.4%) had stage 1, 12 (36.4%) had stage 2, 3 (9.1%) had stage 3, and 1 (3.0%) had stage 4. Of the 16 patients with advanced POP (stage 2 prolapse or greater), only 6 patients (37.5%) reported symptoms related to POP. All 6 symptomatic patients endorsed sensation of a vaginal bulge. Two of the 6 patients also reported dyspareunia. Additionally, 1 patient with advanced POP presented with vaginal bulge, noted by a caregiver, and cervical bleeding, but was otherwise asymptomatic. Twenty-four patients (72.7%) were nulliparous, and 12 of the 24 nulliparous patients (50%) demonstrated prolapse. Despite young age and frequent nulliparity, patients with SB are more likely to have POP than the general population. Additionally, the majority of SB patients with prolapse are asymptomatic. Assessment of pelvic organ prolapse should be included in the evaluation of adult SB females due to the low rate of symptoms even in the setting of advanced stage prolapse and potential impact on both urinary and bowel function. Copyright © 2016 Elsevier Inc. All rights reserved.

JASMINE-Astrometric Map of the Galactic Bulge-

NASA Astrophysics Data System (ADS)

Gouda, N.; Kobayashi, Y.; Yamada, Y.; Yano, T.; Tsujimoto, T.; Suganuma, M.; Niwa, Y.; Yamauchi, M.; Kawakatsu, Y.; Matsuhara, H.; Moda, A.; Tsuiki, A.; Utashima, M.; Ogawa, A.; Sako, N.

2006-08-01

We introduce a Japanese plan of infrared(z-band:0.9μm) space astrometry (JASMINE-project). JASMINE is the satellite (Japan Astrometry Satellite Mission for INfrared Exploration) which will measure the distances and apparent motions of stars around the center of the Milky Way with yet unprecedented precision. It will measure parallaxes, positions with the accuracy of 10 micro-arcsec and proper motions with the accuracy of 4 micro-arcsec/year for stars brighter than z=14mag. JASMINE can observe about ten million stars belonging to the bulge components of our Galaxy, which are hidden by the interstellar dust extinction in optical bands. Number of stars with sigma/pi <0.1 in the direction of the Galactic central bulge is about 1000 times larger than those observed in optical bands, where pi is a parallax and sigma is an error of the parallax. With the completely new "map of the bulge in the Milky Way", it is expected that many new exciting scientific results will be obtained in various fields of astronomy. We will introduce some scientific topics which will be obtained by JASMINE. Presently, JASMINE is in a development phase, with a target launch date around 2015. We adopt the following instrument design of JASMINE in order to get the accurate positions of many stars. We adopt a 3-mirrors optical system (modified Korsch system) with a primary mirror of 0.75m. On the astro-focal plane, we put dozens of new type of CCDs for z-band to get a wide field of view. The consideration of overall system(bus) design is now going on in cooperation with Japan Aerospace Exploration Agency (JAXA). The introduction of JASMINE and the present status of the project will be shown in the presentation.

Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study.

PubMed

Tempera, G; Bonfiglio, G; Cammarata, E; Corsello, S; Cianci, A

2004-07-01

The term 'aerobic vaginitis' defines a 'new' vaginal pathology that is neither classifiable as specific vaginitis nor as bacterial vaginosis. We studied a sample of 30 women with a clinical and microbiological diagnosis of aerobic vaginitis and compared the efficacy and tolerability of kanamycin and meclocycline, two products commercially available in Italy in the form of vaginal pessaries. In chronological order of enrollment, the patients were alternately treated with kanamycin or meclocycline; the dose of administration in both groups was of one pessary per day for 6 days. The evaluation of the therapeutic efficacy was carried out both at the first check-up (7th-8th day) and at a second check-up (13th-16th day). At the first follow-up carried out immediately at the end of therapy, the percentage of normalisation of clinical signs and symptoms was increased independently of the type of treatment in the case of moderate grade aerobic vaginitis, while kanamycin was produced a better effect in the group with severe aerobic vaginitis. Furthermore, at the second follow-up, a direct correlation with recovery of vaginal homeostasis was demonstrated by the normalisation of the vaginal pH and by the presence of lactobacilli, only in kanamycin treated group. In conclusion, our results showed the validity of the treatment with kanamycin intravaginally in this recently recognised disease.

Postmenopausal vaginal atrophy: evaluation of treatment with local estrogen therapy

PubMed Central

Minkin, Mary Jane; Maamari, Ricardo; Reiter, Suzanne

2014-01-01

Postmenopausal vaginal atrophy, resulting from decreased estrogen production, frequently requires treatment. Estrogen preparations provide the most effective treatment; local application is preferred to systemic drugs when treating only vaginal symptoms. As local estrogen therapies have comparable efficacy, this study aimed to understand treatment practices, assess experiences with different forms of local estrogen-delivering applicators, and evaluate satisfaction. Women who were US residents aged ≥18 years, menopausal (no spontaneous menstrual period for ≥1 year or with a double oophorectomy), and receiving local estrogen therapy for 1–6 months (vaginal cream [supplied with a reusable applicator] or vaginal tablets [supplied with a single-use/disposable applicator]), completed an online questionnaire. Data from 200 women (100 cream users and 100 tablet users; mean therapy duration 3.48 months) showed that most stored medication in the room in which it was applied (88%) and applied it at bedtime (71%), a procedure for which cream users required, on average, more than twice the time of tablet users (5.08 minutes versus 2.48 minutes). Many cream users applied larger-than-prescribed amounts of cream, attempting to achieve greater efficacy (42%), or lower-than-recommended doses (45%), most frequently to avoid messiness (33%) or leakage (30%). More tablet users (69%) than cream users (14%) were “extremely satisfied” with their applicator. Postmenopausal women using local estrogen therapy were generally more satisfied with the application of vaginal tablets than cream. Patient satisfaction may help to facilitate accurate dosing. Positive perceptions of medication will help to optimize treatment, which, although not assessed in this study, is likely, in turn, to improve vaginal health. PMID:24648772

Vaginal lactobacilli profile in pregnant women with normal & abnormal vaginal flora.

PubMed

Yeruva, Thirupathaiah; Rajkumar, Hemalatha; Donugama, Vasundhara

2017-10-01

Lactobacilli species that are better adapted to vaginal environment of women may colonize better and offer protection against vaginal pathogenic bacteria. In this study, the distribution of common Lactobacillus species was investigated in pregnant women. Sixty seven pregnant women were included in the study and vaginal samples were collected for Gram staining. Women were classified as normal vaginal flora, intermediate flora and bacterial vaginosis (BV) based on Nugent's score. Vaginal samples were also collected for the identification of Lactobacillus spp. by multiplex polymerase chain reaction (PCR) profiling of 16S rDNA amplification method. Lactobacillus crispatus (100%) was the most predominant Lactobacillus spp. present in pregnant women with normal flora, followed by L. iners (77%), L. jensenii (74%) and L. helveticus (60%). While, L. iners was commonly present across groups in women with normal, intermediate or BV flora, L. crispatus, L. jensenii and L. helveticus decreased significantly as the vaginal flora changed to intermediate and BV. In women with BV, except L. iners other species of lactobacilli was less frequently prevalent. Species such as L. rhamnosus, L. fermentum, L. paracasei and L. casei were not detected in any vaginal sample. L. crispatus, L. jensinii and L. helveticus were predominant species in women with normal flora. L. crispatus alone or in combination with L. jensinii and L. helveticus may be evaluated for probiotic properties for the prevention and treatment of BV.

A Prospective Study of Vaginal Bacterial Flora and Other Risk Factors for Vulvovaginal Candidiasis

PubMed Central

McClelland, R. Scott; Richardson, Barbra A.; Hassan, Wisal M.; Graham, Susan M.; Kiarie, James; Baeten, Jared M.; Mandaliya, Kishorchandra; Jaoko, Walter; Ndinya-Achola, Jeckoniah O.; Holmes, King K.

2009-01-01

Background: It has been suggested that vaginal lactobacilli may reduce the risk of vulvovaginal candidiasis (VVC), but supporting data are limited. Our objective was to determine the relationship between vaginal bacterial flora and VVC. Methods: We conducted a prospective cohort analysis among 151 Kenyan sex workers. At monthly follow-up, VVC was defined as the presence of yeast buds, pseudohyphae, or both on vaginal wet preparation or KOH preparation. Generalized estimating equations were used to identify correlates of VVC. Results: Participants returned for a median of 12 (interquartile range 11-12) visits. Vulvovaginal candidiasis was present at 162 visits, including 26 with symptomatic VVC. Bacterial vaginosis (BV) was associated with fewer episodes of VVC (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] 0.16-0.50). After excluding women with concurrent BV, another possible cause of vaginal symptoms, the likelihood of symptomatic VVC was higher in those with yeast on vaginal wet preparation in the past 60 days (aOR 4.06, 95% CI 1.12-14.74) and those with concurrent vaginal Lactobacillus colonization (aOR 3.75, 95% CI 1.30-10.83). Conclusions: Contrary to a commonly posed hypothesis of a protective effect, we found that vaginal Lactobacillus colonization was associated with a >4-fold increase in the likelihood of symptomatic VVC. PMID:19456235

Vaginal biogenic amines: biomarkers of bacterial vaginosis or precursors to vaginal dysbiosis?

PubMed Central

Nelson, Tiffanie M.; Borgogna, Joanna-Lynn C.; Brotman, Rebecca M.; Ravel, Jacques; Walk, Seth T.; Yeoman, Carl J.

2015-01-01

Bacterial vaginosis (BV) is the most common vaginal disorder among reproductive age women. One clinical indicator of BV is a “fishy” odor. This odor has been associated with increases in several biogenic amines (BAs) that may serve as important biomarkers. Within the vagina, BA production has been linked to various vaginal taxa, yet their genetic capability to synthesize BAs is unknown. Using a bioinformatics approach, we show that relatively few vaginal taxa are predicted to be capable of producing BAs. Many of these taxa (Dialister, Prevotella, Parvimonas, Megasphaera, Peptostreptococcus, and Veillonella spp.) are more abundant in the vaginal microbial community state type (CST) IV, which is depleted in lactobacilli. Several of the major Lactobacillus species (L. crispatus, L. jensenii, and L. gasseri) were identified as possessing gene sequences for proteins predicted to be capable of putrescine production. Finally, we show in a small cross sectional study of 37 women that the BAs putrescine, cadaverine and tyramine are significantly higher in CST IV over CSTs I and III. These data support the hypothesis that BA production is conducted by few vaginal taxa and may be important to the outgrowth of BV-associated (vaginal dysbiosis) vaginal bacteria. PMID:26483694

Vaginal biogenic amines: biomarkers of bacterial vaginosis or precursors to vaginal dysbiosis?

PubMed

Nelson, Tiffanie M; Borgogna, Joanna-Lynn C; Brotman, Rebecca M; Ravel, Jacques; Walk, Seth T; Yeoman, Carl J

2015-01-01

Bacterial vaginosis (BV) is the most common vaginal disorder among reproductive age women. One clinical indicator of BV is a "fishy" odor. This odor has been associated with increases in several biogenic amines (BAs) that may serve as important biomarkers. Within the vagina, BA production has been linked to various vaginal taxa, yet their genetic capability to synthesize BAs is unknown. Using a bioinformatics approach, we show that relatively few vaginal taxa are predicted to be capable of producing BAs. Many of these taxa (Dialister, Prevotella, Parvimonas, Megasphaera, Peptostreptococcus, and Veillonella spp.) are more abundant in the vaginal microbial community state type (CST) IV, which is depleted in lactobacilli. Several of the major Lactobacillus species (L. crispatus, L. jensenii, and L. gasseri) were identified as possessing gene sequences for proteins predicted to be capable of putrescine production. Finally, we show in a small cross sectional study of 37 women that the BAs putrescine, cadaverine and tyramine are significantly higher in CST IV over CSTs I and III. These data support the hypothesis that BA production is conducted by few vaginal taxa and may be important to the outgrowth of BV-associated (vaginal dysbiosis) vaginal bacteria.

The REJOICE trial: a phase 3 randomized, controlled trial evaluating the safety and efficacy of a novel vaginal estradiol soft-gel capsule for symptomatic vulvar and vaginal atrophy

PubMed Central

Constantine, Ginger D.; Simon, James A.; Pickar, James H.; Archer, David F.; Kushner, Harvey; Bernick, Brian; Gasper, Gina; Graham, Shelli; Mirkin, Sebastian

2017-01-01

Abstract Objective: To evaluate the safety and efficacy of TX-004HR vaginal estradiol soft-gel capsules for moderate-to-severe dyspareunia associated with postmenopausal vulvar and vaginal atrophy. Methods: In this randomized, double-blind, placebo-controlled, phase 3 study, postmenopausal women with a self-identified most bothersome symptom of dyspareunia received 4, 10, or 25 μg TX-004HR or placebo for 12 weeks. Four co-primary efficacy endpoints were change from baseline to week 12 in percentages of superficial and parabasal cells, vaginal pH, and severity of dyspareunia. Secondary endpoints included severity of vaginal dryness and vulvar and/or vaginal itching or irritation. Endometrial histology and adverse events (AEs) were included in the safety endpoints. Results: In all, 764 women were randomized (modified intent-to-treat population, n = 747; mean age 59 y). Compared with placebo, all three doses of TX-004HR significantly improved the four co-primary endpoints (P < 0.0001 for all, except dyspareunia with 4 μg, P = 0.0149). Changes in cytology, pH, and dyspareunia were also significant at weeks 2, 6, and 8. Vaginal dryness and vaginal itching/irritation improved. Sex hormone binding globulin concentrations did not change with treatment. TX-004HR was well-tolerated, with no clinically meaningful differences in treatment-emergent AEs versus placebo, and no treatment-related serious AEs or deaths. Conclusions: TX-004HR (4, 10, and 25 μg) was safe, well-tolerated, and effective for treating moderate-to-severe dyspareunia within 2 weeks with minimal systemic estrogen exposure. This novel product may be a potential new treatment option for women experiencing postmenopausal vulvar and vaginal atrophy. PMID:27922936

Spiral Galaxy Central Bulge Tangential Speed of Revolution Curves

NASA Astrophysics Data System (ADS)

Taff, Laurence

2013-03-01

The objective was to, for the first time in a century, scientifically analyze the ``rotation curves'' (sic) of the central bulges of scores of spiral galaxies. I commenced with a methodological, rational, geometrical, arithmetic, and statistical examination--none of them carried through before--of the radial velocity data. The requirement for such a thorough treatment is the paucity of data typically available for the central bulge: fewer than 10 observations and frequently only five. The most must be made of these. A consequence of this logical handling is the discovery of a unique model for the central bulge volume mass density resting on the positive slope, linear, rise of its tangential speed of revolution curve and hence--for the first time--a reliable mass estimate. The deduction comes from a known physics-based, mathematically valid, derivation (not assertion). It rests on the full (not partial) equations of motion plus Poisson's equation. Following that is a prediction for the gravitational potential energy and thence the gravitational force. From this comes a forecast for the tangential speed of revolution curve. It was analyzed in a fashion identical to that of the data thereby closing the circle and demonstrating internal self-consistency. This is a hallmark of a scientific method-informed approach to an experimental problem. Multiple plots of the relevant quantities and measures of goodness of fit will be shown. Astronomy related

THE VERTICAL X-SHAPED STRUCTURE IN THE MILKY WAY: EVIDENCE FROM A SIMPLE BOXY BULGE MODEL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li Zhaoyu; Shen Juntai, E-mail: jshen@shao.ac.cn

2012-09-20

A vertical X-shaped structure in the Galactic bulge was recently reported. Here, we present evidence of a similar X-shaped structure in the Shen et al. 2010 bar/boxy bulge model that simultaneously matches the stellar kinematics successfully. The X-shaped structure is found in the central region of our bar/boxy bulge model and is qualitatively consistent with the observed one in many aspects. End-to-end separations of the X-shaped structure in the radial and vertical directions are roughly 3 kpc and 1.8 kpc, respectively. The X-shaped structure contains about 7% of light in the boxy bulge region, but it is significant enough tomore » be identified in observations. An X-shaped structure naturally arises in the formation of bar/boxy bulges and is mainly associated with orbits trapped around the vertically extended x{sub 1} family. Like the bar in our model, the X-shaped structure tilts away from the Sun-Galactic center line by 20 Degree-Sign . The X-shaped structure becomes increasingly symmetric about the disk plane, so the observed symmetry may indicate that it formed at least a few billion years ago. The existence of the vertical X-shaped structure suggests that the formation of the Milky Way bulge is shaped mainly by internal disk dynamical instabilities.« less

Vaginal bleeding in pregnancy

MedlinePlus

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal ... Up to 1 in 4 women have vaginal bleeding at some time during their pregnancy. Bleeding is more common in the first 3 months (first trimester), especially with twins.

FLUCONAZOLE AND BORIC ACID FOR TREATMENT OF VAGINAL CANDIDIASIS--NEW WORDS ABOUT OLD ISSUE.

PubMed

Khameneie, K M; Arianpour, N; Roozegar, R; Aklamli, M; Amiri, M M

2013-04-01

To compare boric acid as an effective treatment for VVC compared to fluconazole. We also studied the efficiency of these drugs in preventing recurrence of VVC. A cross sectional, randomized, double-blind study. Gynaecology clinic of Imam Reza hospital, Tehran - Iran Women with signs and symptoms related to Vulvo Vaginal Candidiasis. Seventy five patients out of total 150 patients with signs and symptoms related to Vulvo Vaginal Candidiasis were treatedwith boric acidpowder everynight for a week and the remaining 75 patients received Fluconazole. The cure rate in first group was 46.7% but the cure rate in second group was 37.3%. The difference was not statistically significant (P>0.3). Difference between the efficacy of the two drugs was not significant either (P=0.47). The recurrence rate among patients in first group was 35% while it was 32% in second group. Their difference was not statistically significant (P=0.54). According to our findings, treatment of vaginal candidiasis with boric acid is as effective as fluconazole. The availability of boric acid and its relatively low cost suggests it as a safe and effective drug for treatment of candidiasis.

Vaginal Cancer—Health Professional Version

Cancer.gov

Vaginal cancer is often squamous cell carcinoma. Other types of vaginal cancer are adenocarcinoma, melanoma, and sarcoma. Infection with certain types of human papillomavirus (HPV) causes most vaginal cancer. Find evidence-based information on vaginal cancer treatment and research.

Vaginal drug distribution modeling.

PubMed

Katz, David F; Yuan, Andrew; Gao, Yajing

2015-09-15

This review presents and applies fundamental mass transport theory describing the diffusion and convection driven mass transport of drugs to the vaginal environment. It considers sources of variability in the predictions of the models. It illustrates use of model predictions of microbicide drug concentration distribution (pharmacokinetics) to gain insights about drug effectiveness in preventing HIV infection (pharmacodynamics). The modeling compares vaginal drug distributions after different gel dosage regimens, and it evaluates consequences of changes in gel viscosity due to aging. It compares vaginal mucosal concentration distributions of drugs delivered by gels vs. intravaginal rings. Finally, the modeling approach is used to compare vaginal drug distributions across species with differing vaginal dimensions. Deterministic models of drug mass transport into and throughout the vaginal environment can provide critical insights about the mechanisms and determinants of such transport. This knowledge, and the methodology that obtains it, can be applied and translated to multiple applications, involving the scientific underpinnings of vaginal drug distribution and the performance evaluation and design of products, and their dosage regimens, that achieve it. Copyright © 2015 Elsevier B.V. All rights reserved.

What the Milky Way bulge reveals about the initial metallicity gradients in the disc

NASA Astrophysics Data System (ADS)

Fragkoudi, F.; Di Matteo, P.; Haywood, M.; Khoperskov, S.; Gomez, A.; Schultheis, M.; Combes, F.; Semelin, B.

2017-11-01

We use APOGEE DR13 data to examine the metallicity trends in the Milky Way (MW) bulge and we explore their origin by comparing two N-body models of isolated galaxies that develop a bar and a boxy/peanut (b/p) bulge. Both models have been proposed as scenarios for reconciling a disc origin of the MW bulge with a negative vertical metallicity gradient. The first model is a superposition of co-spatial, I.e. overlapping, disc populations with different scale heights, kinematics, and metallicities. In this model the thick, metal-poor, and centrally concentrated disc populations contribute significantly to the stellar mass budget in the inner galaxy. The second model is a single disc with an initial steep radial metallicity gradient; this disc is mapped by the bar into the b/p bulge in such a way that the vertical metallicity gradient of the MW bulge is reproduced, as has been shown already in previous works in the literature. However, as we show here, the latter model does not reproduce the positive longitudinal metallicity gradient of the inner disc, nor the metal-poor innermost regions seen in the data. On the other hand, the model with co-spatial thin and thick disc populations reproduces all the aforementioned trends. We therefore see that it is possible to reconcile a (primarily) disc origin for the MW bulge with the observed trends in metallicity by mapping the inner thin and thick discs of the MW into a b/p. For this scenario to reproduce the observations, the α-enhanced, metal-poor, thick disc populations must have a significant mass contribution in the inner regions, as has been suggested for the Milky Way.

Extremely metal-poor stars from the cosmic dawn in the bulge of the Milky Way.

PubMed

Howes, L M; Casey, A R; Asplund, M; Keller, S C; Yong, D; Nataf, D M; Poleski, R; Lind, K; Kobayashi, C; Owen, C I; Ness, M; Bessell, M S; Da Costa, G S; Schmidt, B P; Tisserand, P; Udalski, A; Szymański, M K; Soszyński, I; Pietrzyński, G; Ulaczyk, K; Wyrzykowski, Ł; Pietrukowicz, P; Skowron, J; Kozłowski, S; Mróz, P

2015-11-26

The first stars are predicted to have formed within 200 million years after the Big Bang, initiating the cosmic dawn. A true first star has not yet been discovered, although stars with tiny amounts of elements heavier than helium ('metals') have been found in the outer regions ('halo') of the Milky Way. The first stars and their immediate successors should, however, preferentially be found today in the central regions ('bulges') of galaxies, because they formed in the largest over-densities that grew gravitationally with time. The Milky Way bulge underwent a rapid chemical enrichment during the first 1-2 billion years, leading to a dearth of early, metal-poor stars. Here we report observations of extremely metal-poor stars in the Milky Way bulge, including one star with an iron abundance about 10,000 times lower than the solar value without noticeable carbon enhancement. We confirm that most of the metal-poor bulge stars are on tight orbits around the Galactic Centre, rather than being halo stars passing through the bulge, as expected for stars formed at redshifts greater than 15. Their chemical compositions are in general similar to typical halo stars of the same metallicity although intriguing differences exist, including lower abundances of carbon.

Vaginal pH and Microbicidal Lactic Acid When Lactobacilli Dominate the Microbiota

PubMed Central

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

2013-01-01

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

Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota.

PubMed

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

2013-01-01

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.

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 ...

New VVV Survey Globular Cluster Candidates in the Milky Way Bulge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minniti, Dante; Gómez, Matías; Geisler, Douglas

It is likely that a number of Galactic globular clusters remain to be discovered, especially toward the Galactic bulge. High stellar density combined with high and differential interstellar reddening are the two major problems for finding globular clusters located toward the bulge. We use the deep near-IR photometry of the VISTA Variables in the Vía Láctea (VVV) Survey to search for globular clusters projected toward the Galactic bulge, and hereby report the discovery of 22 new candidate globular clusters. These objects, detected as high density regions in our maps of bulge red giants, are confirmed as globular cluster candidates bymore » their color–magnitude diagrams. We provide their coordinates as well as their near-IR color–magnitude diagrams, from which some basic parameters are derived, such as reddenings and heliocentric distances. The color–magnitude diagrams reveal well defined red giant branches in all cases, often including a prominent red clump. The new globular cluster candidates exhibit a variety of extinctions (0.06 < A {sub Ks} < 2.77) and distances (5.3 < D < 9.5 kpc). We also classify the globular cluster candidates into 10 metal-poor and 12 metal-rich clusters, based on the comparison of their color–magnitude diagrams with those of known globular clusters also observed by the VVV Survey. Finally, we argue that the census for Galactic globular clusters still remains incomplete, and that many more candidate globular clusters (particularly the low luminosity ones) await to be found and studied in detail in the central regions of the Milky Way.« less

Comparison of clinical diagnosis and microbiological test results in vaginal infections.

PubMed

Karaca, M; Bayram, A; Kocoglu, M E; Gocmen, A; Eksi, F

2005-01-01

Lower genital tract infections continue to be a problem due to the fact that the clinical diagnosis is usually inadequate, and subsequent care is suboptimal. This study aimed at evaluating the accuracy of clinical diagnosis by comparing it with microbiologic test results, and to determine the causative agents of vaginal infections. Sixty-seven nonpregnant women (18-45 years of age) with the clinical diagnosis of lower genital tract infection were enrolled in the study. Patients were not included if they had a history of vaginal infection during the previous three-month period or intrauterine device. The clinical diagnosis was based on the combinations of symptoms, direct observation of wet mount, homogeneous discharge, vaginal pH > 4.5, and detection of the amine odor after exposure of vaginal secretions to 10% KOH. Vaginal samples were taken with two cotton swabs, one was used for pH determination, and the second was utilized for microbiological tests. Gram staining and cultures with Sabouraud agar and chocolate agar were performed for microbiological diagnosis, and the results were compared. The clinical diagnoses included 26 (38.8%) candidiasis, 18 (26.8%) bacterial vaginosis, three (4.5%) trichomoniasis, and 20 (29.9%) mixed vaginal infections. Of the 26 patients with clinical diagnoses of candidiasis, 12 (46.1%) revealed Candiada albicans, nine (34.6) patients revealed microorganisms other than candida species, and five (19.2%) patients had no growth. Five (27.8%) bacterial vaginosis patients revealed Gardnarella vaginalis and 12 patients (66.6%) did not grow any microorganism. The overall rate of accurate clinical diagnoses confirmed by microbiological test results was 43.2%. Seventeen (43.6) of the 39 microbiological test results correlated with clinical diagnosis, and no growth was observed in 28 (41.8%) cultures. We conclude that the clinical diagnosis of vaginal infection is inadequate and should be confirmed with microbiological testing if the resources

Vaginal mucosal flap as a sling preservation for the treatment of vaginal exposure of mesh.

PubMed

Kim, Sea Young; Park, Jong Yeon; Kim, Han Kwon; Park, Chang Hoo; Kim, Sung Jin; Sung, Gi Teck; Park, Chang Myon

2010-06-01

Tension-free vaginal tape (TVT) procedures are used for the treatment of stress urinary incontinence in women. The procedures with synthetic materials can have a risk of vaginal erosion. We experienced transobturator suburethral sling (TOT) tape-induced vaginal erosion and report the efficacy of a vaginal mucosal covering technique. A total of 560 female patients diagnosed with stress urinary incontinence underwent TOT procedures at our hospital between January 2005 and August 2009. All patients succeeded in follow-ups, among which 8 patients (mean age: 50.5 years) presented with vaginal exposure of the mesh. A vaginal mucosal covering technique was performed under local anesthesia after administration of antibiotics and vaginal wound dressings for 3-4 days. Seven of the 8 patients complained of persistent vaginal discharge postoperatively. Two of the 8 patients complained of dyspareunia of their male partners. The one remaining patient was otherwise asymptomatic, but mesh erosion was discovered at the routine follow-up visit. Six of the 8 patients showed complete mucosal covering of the mesh after the operation (mean follow-up period: 16 moths). Vaginal mucosal erosion recurred in 2 patients, and the mesh was then partially removed. One patient had recurrent stress urinary incontinence. Vaginal mucosal covering as a sling preservation with continued patient continence may be a feasible and effective option for the treatment of vaginal exposure of mesh after TOT tape procedures.

Non-albicans Candida Vulvovaginitis: Treatment Experience at a Tertiary Care Vaginitis Center.

PubMed

Powell, Anna M; Gracely, Edward; Nyirjesy, Paul

2016-01-01

The aims of this study are to analyze a cohort of women with vulvovaginal symptoms and positive cultures for non-albicans Candida (NAC) to determine whether yeast was responsible for their symptoms and to evaluate the mycological effectiveness of various regimens. This observational study was performed from retrospective chart review of patients with positive NAC cultures between April 1, 2008, and January 31, 2011, at a tertiary care vaginitis center. Patient intake demographics were entered into a database. Follow-up visits were analyzed for data about patient treatments and outcomes. Patients were considered a clinical cure if their symptoms were significantly improved and mycologic cure (MC) if later yeast cultures were negative. If clinical symptoms improved at the same time as MC, the isolate was considered the proximate cause for the symptoms. One hundred eight patients meeting entry criteria were analyzed. Boric acid was effective at obtaining MC in 32 (78%) of 41 patients with C. glabrata, 3 of 3 patients with C. tropicalis, and 3 of 3 patients with C. lusitaniae. Fluconazole was effective as initial treatment for 3 (60%) of 5 patients with C. glabrata and 13 (81%) of 16 patients with C. parapsilosis. In 52.7% of C. glabrata, 66.7% of C. parapsilosis, and 57.1% of C. tropicalis cases, effective antifungal therapy led to symptom improvement. In a tertiary care vaginitis center, NAC, when isolated on culture, caused clinically significant infections in approximately half of symptomatic patients. A majority of infections can be effectively treated with boric acid or fluconazole regardless of the non-albicans Candida species.

Mechanics of membrane bulging during cell-wall disruption in Gram-negative bacteria

NASA Astrophysics Data System (ADS)

Daly, Kristopher E.; Huang, Kerwyn Casey; Wingreen, Ned S.; Mukhopadhyay, Ranjan

2011-04-01

The bacterial cell wall is a network of sugar strands crosslinked by peptides that serve as the primary structure for bearing osmotic stress. Despite its importance in cellular survival, the robustness of the cell wall to network defects has been relatively unexplored. Treatment of the Gram-negative bacterium Escherichia coli with the antibiotic vancomycin, which disrupts the crosslinking of new material during growth, leads to the development of pronounced bulges and eventually of cell lysis. Here, we model the mechanics of the bulging of the cytoplasmic membrane through pores in the cell wall. We find that the membrane undergoes a transition between a nearly flat state and a spherical bulge at a critical pore radius of ~20 nm. This critical pore size is large compared to the typical distance between neighboring peptides and glycan strands, and hence pore size acts as a constraint on network integrity. We also discuss the general implications of our model to membrane deformations in eukaryotic blebbing and vesiculation in red blood cells.

Formation of the Lunar Fossil Bulges and its Implication for the Early Earth and Moon

NASA Astrophysics Data System (ADS)

Qin, C.; Zhong, S.; Phillips, R. J.

2017-12-01

First recognized by Laplace more than two centuries ago, the lunar gravitational and shape anomalies associated with rotational and tidal bulges are significantly larger than predicted from the hydrostatic theory. The harmonic degree-2 gravitational coefficients of the Moon, C20 and C22 (measuring the size of the rotational and tidal bulges), are 17 and 14 times of their hydrostatic counterparts, respectively, after removal of the effect from large impact basins. The bulges are commonly considered as remnant hydrostatic features, "frozen-in" when the Moon was closer to the Earth, experiencing larger tidal-rotational forces. The extant hypothesis is that as the Moon cooled and migrated outwards, a strong outer layer (lithosphere) thickened and reached a stress state that supported the bulges, which no longer tracked the hydrostatic ellipticity. However, this process is poorly understood and an appropriate dynamical model has not been engaged. Here we present the first dynamically self-consistent model of lunar bulge formation that couples a lunar interior thermal evolution model to the tidal-rotational forcing of the Moon. The forcing magnitude decreases with time as the Moon despins on the receding orbit, while the recession rate is controlled by the Earth's tidal dissipation factor Q. Assuming a viscoelastic rheology, the cooling of the Moon is described by a model with high viscosity lithosphere thickening with time. While conventional methods are not suitable for models with time-dependent viscoelastic structure, a semi-analytical method has been developed to address this problem. We show that the bulge formation is controlled by the relative timing of lithosphere thickening and lunar orbit recession. Based on our calculations, we conclude that the development of the fossil bulges may have taken as long as 400 million years after the formation of lunar lithosphere and was complete when the lunar orbit semi-major axis, a, was 32 Earth's radius, RE. We find a

Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

PubMed

Miller, Elizabeth A; Beasley, DeAnna E; Dunn, Robert R; Archie, Elizabeth A

2016-01-01

The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus , which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies ( N = 21 mammals for pH and 14 mammals for lactobacilli relative abundance). We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4-7.8). Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli relative abundance and multiple metrics of STD or birth injury risk ( P -values ranged from 0.13 to 0.99). Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

Clinical trial shows lasting function of a new moisturizing cream against vaginal dryness.

PubMed

Henneicke-von Zepelin, Hans-Heinrich; Williams, Ragna; Havemeister, Wiebke; Wigger-Alberti, Walter; Nolte, Klaus-Ulrich

2017-05-01

Vaginal dryness and associated symptoms may occur in women of any age and are a frequent burden after menopause. The North American Menopause Society recommends long-acting non-hormonal vaginal creams as first-line therapy. A new type of such creams was developed (Remifemin® FeuchtCreme in Austria and Germany). This hormone-free cream contains hamamelis virginiana distillate and well-established vaginal cream ingredients. We explored its physical function and tolerability in an open interventional clinical trial. 20 postmenopausal women (54 to 76 years, median 60) treated their vaginal dryness using this cream once daily for 7 days and reported about their symptoms before, 4 to 8 h after first and 14 to 22 h after last application. A physician assessed tolerability and local physical function. All patients completed the study. Local physical function significantly improved from dryness at baseline (mean 4.0 ± SD 1.8) to a normal moisture level, on average (6.3 ± 2.1 after first, 6.7 ± 2.1 after last application, p = 0.0001). Subjective assessment of a feeling vaginal dryness showed a significant improvement at both times (p = 0.0001). Onset and duration of feeling moisturized were reported to be 0 to 2 min and 11.3 ± 6.9 h after application. All women reported vaginal dryness at baseline. 55 and 80% of patients reported no dryness after first application and at the end of the investigation. The cream was seen at the application site for up to 21 h. Tolerability assessments did not reveal any relevant change over time. There were four adverse events in 4 patients, all not serious and of mild intensity: urinary urgency (2), diarrhoea (1) and mild spotting after first application (1). The latter was caused by the dry surface of the applicator and was avoided by moisturizing the surface of the applicator at subsequent applications. In conclusion, these study results indicate a well-tolerated and long-acting function of this new

Effect of Explosion Bulge Test Parameters on the Measurement of Deformation Resistance for Steel

DTIC Science & Technology

2014-02-01

UNCLASSIFIED UNCLASSIFIED Effect of Explosion Bulge Test Parameters on the Measurement of Deformation Resistance for Steel C...Measurement of Deformation Resistance for Steel Executive Summary The Explosion Bulge Test has been used for over 60 years as a standard test for...the assessment of steel toughness and deformation resistance under blast loading conditions [1-3]. However, details of the test conditions vary

Was the Milky Way Bulge Formed from the Buckling Disk Instability, Hierarchical Collapse, Accretion of Clumps, or All of the Above?

NASA Astrophysics Data System (ADS)

Nataf, David M.

2017-09-01

The assembly of the Milky Way bulge is an old topic in astronomy, one now in a period of renewed and rapid development. That is due to tremendous advances in observations of bulge stars, motivating observations of both local and high-redshift galaxies, and increasingly sophisticated simulations. The dominant scenario for bulge formation is that of the Milky Way as a nearly pure disk galaxy, with the inner disk having formed a bar and buckled. This can potentially explain virtually all bulge stars with [Fe/H] ≳ -1.0, which comprise 95% of the stellar population. The evidence is the incredible success in N-body models of this type in making non-trivial, non-generic predictions, such as the rotation curve and velocity dispersion measured from radial velocities, and the spatial morphologies of the peanut/X-shape and the long bar. The classical bulge scenario, whereby the bulge formed from early dissipative collapse and mergers, remains viable for stars with [Fe/H] ≲ -1.0 and potentially a minority of the other stars. A classical bulge is expected from Λ-CDM cosmological simulations, can accentuate the properties of an existing bar in a hybrid system, and is most consistent with the bulge abundance trends such as [Mg/Fe], which are elevated relative to both the thin and thick disks. Finally, the clumpy-galaxy scenario is considered, as it is the correct description of most Milky Way precursors given observations of high-redshift galaxies. Simulations predict that these star-forming clumps will sometimes migrate to the centres of galaxies where they may form a bulge, and galaxies often include a bulge clump as well. They will possibly form a bar with properties consistent with those of the Milky Way, such as the exponential profile and metallicity gradient. Given the relative successes of these scenarios, the Milky Way bulge is plausibly of composite origin, with a classical bulge and/or inner halo numerically dominant for stars with [Fe/H] ≲ -1.0, a buckling

The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk.

PubMed

Kindinger, Lindsay M; Bennett, Phillip R; Lee, Yun S; Marchesi, Julian R; Smith, Ann; Cacciatore, Stefano; Holmes, Elaine; Nicholson, Jeremy K; Teoh, T G; MacIntyre, David A

2017-01-19

Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix. Lactobacillus iners dominance at 16 weeks of gestation was significantly associated with both a short cervix <25 mm (n = 15, P < 0.05) and preterm birth <34 +0  weeks (n = 18; P < 0.01; 69% PPV). In contrast, Lactobacillus crispatus dominance was highly predictive of term birth (n = 127, 98% PPV). Cervical shortening and preterm birth were not associated with vaginal dysbiosis. A longitudinal characterization of vaginal microbiota (<18, 22, 28, and 34 weeks) was then undertaken in women receiving vaginal progesterone (400 mg/OD, n = 25) versus controls (n = 42). Progesterone did not alter vaginal bacterial community structure nor reduce L. iners-associated preterm birth (<34 weeks). L. iners dominance of the vaginal microbiota at 16 weeks of gestation is a risk factor for preterm birth, whereas L. crispatus dominance is protective against preterm birth. Vaginal progesterone does not appear to impact the pregnancy vaginal microbiota. Patients and clinicians who may be concerned about "infection risk" associated with the use of a vaginal pessary during high-risk pregnancy can be reassured.

Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography.

PubMed

Altman, Daniel; López, Annika; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; Pollack, Johan; Mellgren, Anders

2005-01-01

The aim of the present study was to compare clinical and radiological findings when assessing posterior vaginal wall prolapse. Defecography can be used to complement the clinical evaluation in patients with posterior vaginal wall prolapse. Further development of the defecography technique, using contrast medium in the urinary bladder and intraperitoneally, have resulted in cystodefecoperitoneography (CDP). Thirty-eight women underwent clinical examination using the pelvic organ prolapse quantification system (POP-Q) followed by CDP. All patients answered a standardized bowel function questionnaire. Statistical analysis measuring correlation between POP-Q and CDP using Pearson's correlation coefficient (r) and Spearman's rank order correlation coefficient (rs) demonstrated a poor to moderate correlation, r=0.49 and rs=0.55. Although there was a strong association between large rectoceles (>3 cm) at CDP and symptoms of rectal emptying difficulties (p<0.001), severity and prevalence of bowel dysfunction showed poor coherence with clinical prolapse staging and findings at radiological imaging. Vaginal topography and POP-Q staging predict neither radiological size nor visceral involvement in posterior vaginal wall prolapse. Radiological evaluation may therefore be a useful complement in selected patients.

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

PubMed

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

2015-02-01

The objective of this study was to compare the effects of systemic and local estrogen treatment on collagen assembly and biomechanical properties of the vaginal wall. Ovariectomized nulliparous rats were treated with estradiol or conjugated equine estrogens (CEEs) either systemically, vaginal CEE, or vaginal placebo cream for 4 wk. Low-dose local CEE treatment resulted in increased vaginal epithelial thickness and significant vaginal growth without uterine hyperplasia. Furthermore, vaginal wall distensibility increased without compromise of maximal force at failure. Systemic estradiol resulted in modest increases in collagen type I with no change in collagen type III mRNA. Low-dose vaginal treatment, however, resulted in dramatic increases in both collagen subtypes whereas moderate and high dose local therapies were less effective. Consistent with the mRNA results, low-dose vaginal estrogen resulted in increased total and cross-linked collagen content. The inverse relationship between vaginal dose and collagen expression may be explained in part by progressive downregulation of estrogen receptor-alpha mRNA with increasing estrogen dose. We conclude that, in this menopausal rat model, local estrogen treatment increased total and cross-linked collagen content and markedly stimulated collagen mRNA expression in an inverse dose-effect relationship. High-dose vaginal estrogen resulted in downregulation of estrogen receptor-alpha and loss of estrogen-induced increases in vaginal collagen. These results may have important clinical implications regarding the use of local vaginal estrogen therapy and its role as an adjunctive treatment in women with loss of vaginal support. © 2015 by the Society for the Study of Reproduction, Inc.

VizieR Online Data Catalog: SDSS bulge, disk and total stellar mass estimates (Mendel+, 2014)

NASA Astrophysics Data System (ADS)

Mendel, J. T.; Simard, L.; Palmer, M.; Ellison, S. L.; Patton, D. R.

2014-01-01

We present a catalog of bulge, disk, and total stellar mass estimates for ~660000 galaxies in the Legacy area of the Sloan Digital Sky Survey Data (SDSS) Release 7. These masses are based on a homogeneous catalog of g- and r-band photometry described by Simard et al. (2011, Cat. J/ApJS/196/11), which we extend here with bulge+disk and Sersic profile photometric decompositions in the SDSS u, i, and z bands. We discuss the methodology used to derive stellar masses from these data via fitting to broadband spectral energy distributions (SEDs), and show that the typical statistical uncertainty on total, bulge, and disk stellar mass is ~0.15 dex. Despite relatively small formal uncertainties, we argue that SED modeling assumptions, including the choice of synthesis model, extinction law, initial mass function, and details of stellar evolution likely contribute an additional 60% systematic uncertainty in any mass estimate based on broadband SED fitting. We discuss several approaches for identifying genuine bulge+disk systems based on both their statistical likelihood and an analysis of their one-dimensional surface-brightness profiles, and include these metrics in the catalogs. Estimates of the total, bulge and disk stellar masses for both normal and dust-free models and their uncertainties are made publicly available here. (4 data files).

Literature Review of Benign Müllerian Papilloma Contrasted With Vaginal Rhabdomyosarcoma.

PubMed

McQuillan, Sarah K; Grover, Sonia R; Pyman, Jan; Jayasinghe, Yasmin L

2016-08-01

Benign müllerian papillomas of the genital tract are rare and, hence, can be mistaken for vaginal rhabdomyosarcoma on initial clinical review. This review of the literature will consolidate the previous cases of müllerian papilloma reported and looks for clues to differentiate the 2 entities. We provide a case report and literature review, with patients from a pediatric adolescent gynecology clinic in a tertiary center. We conducted a search of English-language publications from 1951 (the first case report) until January 2014 by using the search words "Müllerian papilloma" and "prepubertal bleeding." References from previous published reports were also obtained for completeness. Literature review of benign müllerian papilloma. Since 1951, 56 cases of müllerian papilloma were reported, including 4 cases at our institution. Comorbid conditions were found in 31.5% of cases (with 3 cases associated with mesenchymal tumors). The average length of time from onset of symptoms (primarily vaginal bleeding) to diagnosis was 6.7 months (range, 1 day to 3 years), with only 1 case diagnosed incidentally. Median age of presentation was 5 years (range, 1 day to 52 years). Most cases were localized and resected with ease. Histology reveals complex papillary lesions without cytologic atypia. Benign müllerian papilloma is distinguished from the more significant diagnosis of vaginal rhabdomyosarcoma by initial length of vaginal bleeding at presentation, lack of vaginal wall extension, ease of resection, and histopathology. This is compared with vaginal rhabdomyosarcoma which commonly exhibits both localized and distant spread. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

A parametric description of the 3D structure of the Galactic bar/bulge using the VVV survey

NASA Astrophysics Data System (ADS)

Simion, I. T.; Belokurov, V.; Irwin, M.; Koposov, S. E.; Gonzalez-Fernandez, C.; Robin, A. C.; Shen, J.; Li, Z.-Y.

2017-11-01

We study the structure of the inner Milky Way using the latest data release of the VISTA Variables in the Via Lactea (VVV) survey. The VVV is a deep near-infrared, multi-colour photometric survey with a coverage of 300 square degrees towards the bulge/bar. We use red clump (RC) stars to produce a high-resolution dust map of the VVV's field of view. From de-reddened colour-magnitude diagrams, we select red giant branch stars to investigate their 3D density distribution within the central 4 kpc. We demonstrate that our best-fitting parametric model of the bulge density provides a good description of the VVV data, with a median percentage residual of 5 per cent over the fitted region. The strongest of the otherwise low-level residuals are overdensities associated with a low-latitude structure as well as the so-called X-shape previously identified using the split RC. These additional components contribute only ˜5 per cent and ˜7 per cent respectively to the bulge mass budget. The best-fitting bulge is `boxy' with an axial ratio of [1:0.44:0.31] and is rotated with respect to the Sun-Galactic Centre line by at least 20°. We provide an estimate of the total, full sky, mass of the bulge of M_bulge^{Chabrier} = 2.36 × 10^{10} M_{⊙} for a Chabrier initial mass function. We show that there exists a strong degeneracy between the viewing angle and the dispersion of the RC absolute magnitude distribution. The value of the latter is strongly dependent on the assumptions made about the intrinsic luminosity function of the bulge.

New VVV Survey Globular Cluster Candidates in the Milky Way Bulge

NASA Astrophysics Data System (ADS)

Minniti, Dante; Geisler, Douglas; Alonso-García, Javier; Palma, Tali; Beamín, Juan Carlos; Borissova, Jura; Catelan, Marcio; Clariá, Juan J.; Cohen, Roger E.; Contreras Ramos, Rodrigo; Dias, Bruno; Fernández-Trincado, Jose G.; Gómez, Matías; Hempel, Maren; Ivanov, Valentin D.; Kurtev, Radostin; Lucas, Phillip W.; Moni-Bidin, Christian; Pullen, Joyce; Ramírez Alegría, Sebastian; Saito, Roberto K.; Valenti, Elena

2017-11-01

It is likely that a number of Galactic globular clusters remain to be discovered, especially toward the Galactic bulge. High stellar density combined with high and differential interstellar reddening are the two major problems for finding globular clusters located toward the bulge. We use the deep near-IR photometry of the VISTA Variables in the Vía Láctea (VVV) Survey to search for globular clusters projected toward the Galactic bulge, and hereby report the discovery of 22 new candidate globular clusters. These objects, detected as high density regions in our maps of bulge red giants, are confirmed as globular cluster candidates by their color-magnitude diagrams. We provide their coordinates as well as their near-IR color-magnitude diagrams, from which some basic parameters are derived, such as reddenings and heliocentric distances. The color-magnitude diagrams reveal well defined red giant branches in all cases, often including a prominent red clump. The new globular cluster candidates exhibit a variety of extinctions (0.06 < A Ks < 2.77) and distances (5.3 < D < 9.5 kpc). We also classify the globular cluster candidates into 10 metal-poor and 12 metal-rich clusters, based on the comparison of their color-magnitude diagrams with those of known globular clusters also observed by the VVV Survey. Finally, we argue that the census for Galactic globular clusters still remains incomplete, and that many more candidate globular clusters (particularly the low luminosity ones) await to be found and studied in detail in the central regions of the Milky Way. Based on observations taken within the ESO programs 179.B-2002 and 298.D-5048.

[POLYGYNAX IN THE TREATMENT OF VAGINAL INFECTIONS IN PREGNANT AND NON-PREGNANT WOMEN--CLINICAL EXPERIENCE].

PubMed

Popovski, N; Popovski, K; Nedelkovski, V

2016-01-01

Vaginal infections /VI/ represent some of the most common diseases by infection of FGS. The aim of this study is to analyze clinical and bacteriological efficacy of Polygynax in the treatment of vaginal infections and to take into account the correlation between the results of microbiological controls and reduction of clinical symptoms. The study included 100 patients, including 50 pregnant and non-pregnant 50 for a period of 3 months. All of them was diagnosed with vaginitis clinical examination, taken material from vagina for microbiological testing. The studied women was conducted targeted therapy Polygynax 12 capsules, in the form of vaginal capsules for 12 days, after which the sample control microbiology. Behind the subjective complaints of the patient and to reduce them as a result of treatment. The effective implementation of Polygynax 12 capsules is equally good as in non-pregnant and pregnant women. In a summary of the survey data to make relevant analyzes and conclusions from the results.

Milky Way demographics with the VVV survey. I. The 84-million star colour-magnitude diagram of the Galactic bulge

NASA Astrophysics Data System (ADS)

Saito, R. K.; Minniti, D.; Dias, B.; Hempel, M.; Rejkuba, M.; Alonso-García, J.; Barbuy, B.; Catelan, M.; Emerson, J. P.; Gonzalez, O. A.; Lucas, P. W.; Zoccali, M.

2012-08-01

Context. The Milky Way (MW) bulge is a fundamental Galactic component for understanding the formation and evolution of galaxies, in particular our own. The ESO Public Survey VISTA Variables in the Vía Láctea is a deep near-IR survey mapping the Galactic bulge and southern plane. Particularly for the bulge area, VVV is covering ~315 deg2. Data taken during 2010 and 2011 covered the entire bulge area in the JHKs bands. Aims: We used VVV data for the whole bulge area as a single and homogeneous data set to build for the first time a single colour - magnitude diagram (CMD) for the entire Galactic bulge. Methods: Photometric data in the JHKs bands were combined to produce a single and huge data set containing 173 150 467 sources in the three bands, for the ~315 deg2 covered by VVV in the bulge. Selecting only the data points flagged as stellar, the total number of sources is 84 095 284. Results: We built the largest colour-magnitude diagrams published up to date, containing 173.1+ million sources for all data points, and more than 84.0 million sources accounting for the stellar sources only. The CMD has a complex shape, mostly owing to the complexity of the stellar population and the effects of extinction and reddening towards the Galactic centre. The red clump (RC) giants are seen double in magnitude at b ~ -8° -10°, while in the inner part (b ~ -3°) they appear to be spreading in colour, or even splitting into a secondary peak. Stellar population models show the predominance of main-sequence and giant stars. The analysis of the outermost bulge area reveals a well-defined sequence of late K and M dwarfs, seen at (J - Ks) ~ 0.7-0.9 mag and Ks ≳ 14 mag. Conclusions: The interpretation of the CMD yields important information about the MW bulge, showing the fingerprint of its structure and content. We report a well-defined red dwarf sequence in the outermost bulge, which is important for the planetary transit searches of VVV. The double RC in magnitude seen in the

Assisted Vaginal Delivery

MedlinePlus

... Patient Education FAQs Assisted Vaginal Delivery Patient Education Pamphlets - Spanish Assisted Vaginal Delivery FAQ192, February 2016 PDF ... on Patient Safety For Patients Patient FAQs Spanish Pamphlets Teen Health About ACOG About Us Leadership & Governance ...

Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall.

PubMed

Ripperda, Christopher M; Maldonado, Pedro Antonio; Acevedo, Jesus F; Keller, Patrick W; Akgul, Yucel; Shelton, John M; Word, Ruth Ann

2017-07-01

Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model. Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43). MSCs did not survive after injection and had no appreciable effects on healing of the vaginal wall. Acute postoperative administration of vaginal estrogen altered the response of the vaginal wall to injury with decreased stiffness, decreased collagen content, and decreased expression of transcripts for matrix components in the stromal compartment. Conversely, vaginal estrogen resulted in marked proliferation of the epithelial layer and increased expression of genes related to epithelial barrier function and protease inhibition. Transcripts for genes involved in chronic inflammation and adaptive immunity were also down-regulated in the estrogenized epithelium. Collectively, these data indicate that, in contrast to the reported positive effects of preoperative estrogen on the uninjured vagina, acute administration of postoperative vaginal estrogen has adverse effects on the early phase of healing of the stromal layer. In contrast, postoperative estrogen plays a positive role in healing of the vaginal epithelium after injury.

Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall

PubMed Central

Ripperda, Christopher M.; Maldonado, Pedro Antonio; Acevedo, Jesus F.; Keller, Patrick W.; Akgul, Yucel; Shelton, John M.; Word, Ruth Ann

2017-01-01

Abstract Objective: Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model. Methods: Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43). Results: MSCs did not survive after injection and had no appreciable effects on healing of the vaginal wall. Acute postoperative administration of vaginal estrogen altered the response of the vaginal wall to injury with decreased stiffness, decreased collagen content, and decreased expression of transcripts for matrix components in the stromal compartment. Conversely, vaginal estrogen resulted in marked proliferation of the epithelial layer and increased expression of genes related to epithelial barrier function and protease inhibition. Transcripts for genes involved in chronic inflammation and adaptive immunity were also down-regulated in the estrogenized epithelium. Conclusions: Collectively, these data indicate that, in contrast to the reported positive effects of preoperative estrogen on the uninjured vagina, acute administration of postoperative vaginal estrogen has adverse effects on the early phase of healing of the stromal layer. In contrast, postoperative estrogen plays a positive role in healing of the vaginal epithelium after injury. PMID:28169915

Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

PubMed Central

Miller, Elizabeth A.; Beasley, DeAnna E.; Dunn, Robert R.; Archie, Elizabeth A.

2016-01-01

The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N = 21 mammals for pH and 14 mammals for lactobacilli relative abundance). We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4–7.8). Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli relative abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99). Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

Vaginal and Sexual Health Treatment Strategies within a Female Sexual Medicine Program for Cancer Patients and Survivors

PubMed Central

Carter, Jeanne; Stabile, Cara; Seidel, Barbara; Baser, Raymond E.; Goldfarb, Shari; Goldfrank, Deborah J.

2016-01-01

Purpose We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program, and identify improvements of physical symptoms, per patient and clinical evaluation. Methods Evalubility criteria included gynecologic exam at initial visit; at least one follow-up with gynecologic exam within 8 months of initial visit; and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least 1 follow-up from 09/12–10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n=90, 53%), gynecologic (n=54, 32%), or colorectal/anal (n=15, 9%) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Results Mean number of visits was 3.43. Mean age was 55.4 years; 92% (n=155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy and function) associated with cancer treatment and support. At last assessment, 89% had complied with the clinical recommendation (moisturize 2–5+ times/week). Vaginal pH scores >6.5 declined over time (p=0.03). VAS scores improved by last assessment (p<0.001), as did VuAS scores (p=0.001). Sexual function scores significantly improved (p<0.001), confidence about future sexual activity increased (p=0.004), and sexual/vaginal health concerns decreased (p=0.00003). Conclusion Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in

Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors.

PubMed

Carter, Jeanne; Stabile, Cara; Seidel, Barbara; Baser, Raymond E; Goldfarb, Shari; Goldfrank, Deborah J

2017-04-01

We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program and identify improvements of physical symptoms, per patient and clinical evaluation. Evaluability criteria included gynecologic exam at initial visit, at least one follow-up with gynecologic exam within 8 months of initial visit, and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least one follow-up from 09/12 to 10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n = 90, 53 %), gynecologic (n = 54, 32 %), or colorectal/anal (n = 15, 9 %) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Mean number of visits was 3.43. Mean age was 55.4 years; 92 % (n = 155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises, and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy, and function) associated with cancer treatment and support. At last assessment, 89 % had complied with the clinical recommendation (moisturize 2-5+ times/week). Vaginal pH scores >6.5 declined over time (p = 0.03). VAS scores improved by last assessment (p < 0.001), as did VuAS scores (p = 0.001). Sexual function scores significantly improved (p < 0.001), confidence about future sexual activity increased (p = 0.004), and sexual/vaginal health concerns decreased (p = 0.00003). Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal

River bulge evolution and dynamics in a non-tidal sea - Daugava River plume in the Gulf of Riga, Baltic Sea

NASA Astrophysics Data System (ADS)

Soosaar, Edith; Maljutenko, Ilja; Uiboupin, Rivo; Skudra, Maris; Raudsepp, Urmas

2016-03-01

Satellite remote sensing imagery and numerical modelling were used for the study of river bulge evolution and dynamics in a non-tidal sea, the Gulf of Riga (GoR) in the Baltic Sea. Total suspended matter (TSM) images showed a clearly formed anti-cyclonically rotating river bulge from Daugava River discharge during the studied low wind period. In about 7-8 days the bulge grew up to 20 km in diameter, before being diluted. A high-resolution (horizontal grid step of 125 m) General Estuarine Transport Model (GETM) was used for detailed description of the development of the river plume in the southern GoR over the period when satellite images were acquired. In the model simulation, the bulge growth rate was estimated as rb ˜ t0.5 ± 0.04 (R2 = 0.90). Both the model simulation and the satellite images showed that river water was mainly contained in the bulge and there were numerous intrusions at the outer perimeter of the bulge. We performed numerical sensitivity tests with actual bathymetry and measured river runoff without wind forcing (1) having an initial three-dimensional density distribution, and (2) using initially a homogeneous ambient density field. In the first case, the anti-cyclonic bulge did not develop within the course of the model simulation and the coastal current was kept offshore due to ambient density-driven circulation. In the second case, the river plume developed steadily into an anti-cyclonically recirculating bulge, with rb ˜ t0.28 ± 0.01 (R2 = 0.98), and a coastal current. Additional simulations with constant cross-shore and alongshore winds showed a significant effect of the wind in the evolution of the river bulge, even if the wind speed was moderate (3-4 m s-1). While previous studies conclude that the mid-field bulge region is governed by a balance between centrifugal, Coriolis and pressure gradient terms, our study showed that geostrophic balance is valid for the entire mid-field of the bulge, except during the 1-1.5 rotation period at

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

PubMed

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

2014-01-01

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. 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. 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. Fecal incontinence symptoms did not correlate with anal pressures and anal sphincter anatomy changes, but women with sphincter defects have shorter anterior EAS and IAS and a longer gap.

Time-dependent dose-response relation for absence of vaginal elasticity after gynecological radiation therapy.

PubMed

Alevronta, Eleftheria; Åvall-Lundqvist, Elisabeth; Al-Abany, Massoud; Nyberg, Tommy; Lind, Helena; Waldenström, Ann-Charlotte; Olsson, Caroline; Dunberger, Gail; Bergmark, Karin; Steineck, Gunnar; Lind, Bengt K

2016-09-01

To investigate the dose-response relation between the dose to the vagina and the patient-reported symptom 'absence of vaginal elasticity' and how time to follow-up influences this relation. The study included 78 long-term gynecological cancer survivors treated between 1991 and 2003 with external beam radiation therapy. Of those, 24 experienced absence of vaginal elasticity. A normal tissue complication model is introduced that takes into account the influence of time to follow-up on the dose-response relation and the patient's age. The best estimates of the dose-response parameters were calculated using Probit, Probit-Relative Seriality (RS) and Probit-time models. Log likelihood (LL) values and the Akaike Information Criterion (AIC) were used to evaluate the model fit. The dose-response parameters for 'absence of vaginal elasticity' according to the Probit and Probit-time models with the 68% Confidence Intervals (CI) were: LL=-39.8, D 50 =49.7 (47.2-52.4) Gy, γ 50 =1.40 (1.12-1.70) and LL=-37.4, D 50 =46.9 (43.5-50.9) Gy, γ 50 =1.81 (1.17-2.51) respectively. The proposed model, which describes the influence of time to follow-up on the dose-response relation, fits our data best. Our data indicate that the steepness of the dose-response curve of the dose to the vagina and the symptom 'absence of vaginal elasticity' increases with time to follow-up, while D 50 decreases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

River bulge evolution and dynamics in a non-tidal sea - Daugava River plume in the Gulf of Riga, Baltic Sea

NASA Astrophysics Data System (ADS)

Soosaar, E.; Maljutenko, I.; Uiboupin, R.; Skudra, M.; Raudsepp, U.

2015-10-01

Satellite remote sensing imagery and numerical modelling were used for the study of river bulge evolution and dynamics in a non-tidal sea, the Gulf of Riga (GoR) in the Baltic Sea. Total suspended matter (TSM) images showed a clearly formed anti-cyclonically rotating river bulge from Daugava River discharge during the studied low wind period. In about 7-8 days the bulge grew up to 20 km in diameter, before being diluted. Bulge growth rate was estimated as rb ~ t 0.31± 0.23 (R2 = 0.87). A high resolution (horizontal grid step of 125 m) General Estuarine Transport Model (GETM) was used for detailed description of the development of the river plume in the southern GoR over the period when satellite images were acquired. In the model simulation, the rb ~ t 0.5± 0.04 (R2 = 0.90). Both the model simulation and the satellite images showed that river water was mainly contained in the bulge and there were numerous intrusions at the outer perimeter of the bulge. We made numerical sensitivity tests with actual bathymetry and measured river runoff without wind forcing: (1) having initial 3-dimensional density distribution, (2) using initially a homogeneous ambient density field. In the first case, the anti-cyclonic bulge did not develop within the course of the model simulation and coastal current was kept offshore due to ambient density-driven circulation. In the second case, the river plume developed steadily into an anti-cyclonically recirculating bulge and a coastal current. This showed a significant effect of the wind in the evolution of the river bulge, even if the wind speed was moderate (3-4 m s-1). In the second case, rb ~ t 0.28± 0.01 (R2 = 0.98). While previous studies conclude that mid-field bulge region is governed by balance between centrifugal, Coriolis and pressure gradient terms, our study showed that geostrophic balance is valid for the entire mid-field of the bulge. In addition, while there is discharge into the homogenous GoR in case of high inflow

Near-infrared counterparts to the Galactic Bulge Survey X-ray source population

NASA Astrophysics Data System (ADS)

Greiss, S.; Steeghs, D.; Jonker, P. G.; Torres, M. A. P.; Maccarone, T. J.; Hynes, R. I.; Britt, C. T.; Nelemans, G.; Gänsicke, B. T.

2014-03-01

We report on the near-infrared matches, drawn from three surveys, to the 1640 unique X-ray sources detected by Chandra in the Galactic Bulge Survey (GBS). This survey targets faint X-ray sources in the bulge, with a particular focus on accreting compact objects. We present all viable counterpart candidates and associate a false alarm probability (FAP) to each near-infrared match in order to identify the most likely counterparts. The FAP takes into account a statistical study involving a chance alignment test, as well as considering the positional accuracy of the individual X-ray sources. We find that although the star density in the bulge is very high, ˜90 per cent of our sources have an FAP <10 per cent, indicating that for most X-ray sources, viable near-infrared counterparts candidates can be identified. In addition to the FAP, we provide positional and photometric information for candidate counterparts to ˜95 per cent of the GBS X-ray sources. This information in combination with optical photometry, spectroscopy and variability constraints will be crucial to characterize and classify secure counterparts.

True vaginal prolapse in a bitch.

PubMed

Alan, M; Cetin, Y; Sendag, S; Eski, F

2007-08-01

Frequently, vaginal fold prolapse is the protrusion of edematous vaginal tissue into and through the opening of the vulva occurring during proestrus and estrus stages of the sexual cycle. True vaginal prolapse may occur near parturition, as the concentration of serum progesterone declines and the concentration of serum oestrogen increases. In the bitch, this type of true vaginal prolapse is a very rare condition. This short communication describes a 5-year-old female, cross-breed dog in moderate condition, weighing 33 kg, with distocia and true vaginal prolapse. Abdominal palpation and transabdominal ultrasonography revealed live and dead foetuses in the uterine horns. One dead and four live fetuses were removed from uterus by cesarean section. The ovariohysterectomy was performed after repositioning the vaginal wall with a combination of traction from within the abdomen and external manipulation through the vulva. Re-occurrence of a vaginal prolapse was not observed and the bitch recovered completely after the surgical therapy. Compared to other vaginal disorders, vaginal prolapse is an uncommon condition in the bitch. In the present case, extreme tenesmus arising from distocia may have predisposed to the vaginal prolapse. The cause of dystocia was probably the disposition of the first foetus. We concluded that the vaginal prolapse was the result of dystocia in the present case.

Phase I trial of a Lactobacillus crispatus vaginal suppository for prevention of recurrent urinary tract infection in women.

PubMed

Czaja, Christopher A; Stapleton, Ann E; Yarova-Yarovaya, Yuliya; Stamm, Walter E

2007-01-01

We performed a phase I trial to assess the safety and tolerance of a Lactobacillus vaginal suppository for prevention of recurrent UTI. Premenopausal women with a history of recurrent UTI were randomized to use L. crispatus CTV-05 or placebo vaginal suppositories daily for five days. 30 women were randomized (15 to L. crispatus CTV-05). No severe adverse events occurred. Mild to moderate vaginal discharge and genital irritation were reported by women in both study arms. Seven women randomized to L. crispatus CTV-05 developed pyuria without associated symptoms. Most women had high concentrations of vaginal H202-producing lactobacilli before randomization. L. crispatus, L. jensenii, and L. gasseri were the most common Lactobacillus species identified, with stable prevalence over time. L. crispatus CTV-05 can be given as a vaginal suppository with minimal sideeffects to healthy women with a history of recurrent UTI. Mild inflammation of the urinary tract was noted in some women.

Phase I Trial of a Lactobacillus crispatus Vaginal Suppository for Prevention of Recurrent Urinary Tract Infection in Women

PubMed Central

Czaja, Christopher A.; Stapleton, Ann E.; Yarova-Yarovaya, Yuliya; Stamm, Walter E.

2007-01-01

Objectives: We performed a phase I trial to assess the safety and tolerance of a Lactobacillus vaginal suppository for prevention of recurrent UTI. Methods: Premenopausal women with a history of recurrent UTI were randomized to use L. crispatus CTV-05 or placebo vaginal suppositories daily for five days. Results: 30 women were randomized (15 to L. crispatus CTV-05). No severe adverse events occurred. Mild to moderate vaginal discharge and genital irritation were reported by women in both study arms. Seven women randomized to L. crispatus CTV-05 developed pyuria without associated symptoms. Most women had high concentrations of vaginal H202-producing lactobacilli before randomization. L. crispatus, L. jensenii, and L. gasseri were the most common Lactobacillus species identified, with stable prevalence over time. Conclusions: L. crispatus CTV-05 can be given as a vaginal suppository with minimal sideeffects to healthy women with a history of recurrent UTI. Mild inflammation of the urinary tract was noted in some women. PMID:18288237

Dinoprostone vaginal insert versus intravenous oxytocin to reduce postpartum blood loss following vaginal or cesarean delivery.

PubMed

Ozalp, E; Tanir, H M; Sener, T

2010-01-01

To compare the impact of a dinoprostone vaginal insert and intravenous oxytocin in reducing blood loss of women undergoing vaginal or cesarean delivery. This study was conducted among term singleton pregnancies delivered vaginally or by elective cesarean section. In the vaginally delivered cases, active management of the third stage of labor was conducted. During cesarean delivery, 20 IU of intravenous oxytocin was administered. Women, who either delivered via the vaginal or abdominal route, were then randomly allocated to receive 10 mg vaginal dinoprostone insert for 12 hours (group I, n: 100) or intravenous oxytocin (group II, n: 100), respectively. Mean blood loss and need for additional uterotonics and postpartum hemoglobin and hematocrit levels at 24 and 36 hours after delivery did not differ between the two groups. Women allocated to the dinoprostone vaginal insert arm experienced more nausea and vomiting. Dinoprostone vaginal insert was as effective as intravenous oxytocin in the prevention of postpartum blood loss.

The Optical Gravitational Lensing Experiment: Analysis of the Bulge RR Lyrae Population from the OGLE-III Data

NASA Astrophysics Data System (ADS)

Pietrukowicz, P.; Udalski, A.; Soszyński, I.; Nataf, D. M.; Wyrzykowski, Ł.; Poleski, R.; Kozłowski, S.; Szymański, M. K.; Kubiak, M.; Pietrzyński, G.; Ulaczyk, K.

2012-05-01

We have analyzed the data on 16,836 RR Lyrae (RR Lyr) variables observed toward the Galactic bulge during the third phase of the Optical Gravitational Lensing Experiment (OGLE-III), which took place in 2001-2009. Using these standard candles, we show that the ratio of total-to-selective extinction toward the bulge is given by RI = AI /E(V - I) = 1.080 ± 0.007 and is independent of color. We demonstrate that the bulge RR Lyr stars form a metal-uniform population, slightly elongated in its inner part. The photometrically derived metallicity distribution is sharply peaked at [Fe/H] = -1.02 ± 0.18, with a dispersion of 0.25 dex. In the inner regions (|l| < 3°, |b| < 4°) the RR Lyr tend to follow the barred distribution of the bulge red clump giants. The distance to the Milky Way center inferred from the bulge RR Lyr is R 0 = 8.54 ± 0.42 kpc. We report a break in the mean density distribution at a distance of ~0.5 kpc from the center indicating its likely flattening. Using the OGLE-III data, we assess that (4-7) × 104 type ab RR Lyr variables should be detected toward the bulge area of the ongoing near-IR VISTA Variables in the Via Lactea (VVV) survey, where the uncertainty partially results from the unknown RR Lyr spatial density distribution within 0.2 kpc from the Galactic center.

A new operation technique for uterine prolapse: Vaginally-assisted laparoscopic sacrohysteropexy

PubMed Central

Sanverdi, İlhan; Kılıççı, Çetin; Polat, Mesut; Özkaya, Enis; Kılıç, Sami Gökhan; Dizdar, Merve; Karateke, Ateş

2017-01-01

Objective: To describe the new surgical technique and report the safety and feasibility of vaginally-assisted laparoscopic sacrohysteropexy (VALSH). Materials and Methods: Thirty-three women with stage 3 or more uterine prolapse underwent VALSH operation. Patients were followed up for 12 months for mesh-related complications and improvements of symptoms. The operation had three sections; 1st laparoscopic, 2nd vaginal, 3rd laparoscopic. Results: The mean age, gravidity, and parity of the study population were 46.5 years (range, 25-68 years), 4.3 (1-9), and 2.9 (1-6), respectively. The mean duration of operation was 59.5 min (range, 20-120 min). There were significant differences between the pre- and post-operative values of pelvic organ prolapse quantification parameters, which were favorable in the latter evaluation (p<0.001); total vaginal length was preserved after surgery (p>0.05). Conclusion: VALSH is a safe and minimally-invasive procedure in uterovaginal prolapse, with favorable anatomic and functional outcomes at 12 months post-operatively. PMID:29085709

An Optimal Strategy for Accurate Bulge-to-disk Decomposition of Disk Galaxies

NASA Astrophysics Data System (ADS)

Gao, Hua; Ho, Luis C.

2017-08-01

The development of two-dimensional (2D) bulge-to-disk decomposition techniques has shown their advantages over traditional one-dimensional (1D) techniques, especially for galaxies with non-axisymmetric features. However, the full potential of 2D techniques has yet to be fully exploited. Secondary morphological features in nearby disk galaxies, such as bars, lenses, rings, disk breaks, and spiral arms, are seldom accounted for in 2D image decompositions, even though some image-fitting codes, such as GALFIT, are capable of handling them. We present detailed, 2D multi-model and multi-component decomposition of high-quality R-band images of a representative sample of nearby disk galaxies selected from the Carnegie-Irvine Galaxy Survey, using the latest version of GALFIT. The sample consists of five barred and five unbarred galaxies, spanning Hubble types from S0 to Sc. Traditional 1D decomposition is also presented for comparison. In detailed case studies of the 10 galaxies, we successfully model the secondary morphological features. Through a comparison of best-fit parameters obtained from different input surface brightness models, we identify morphological features that significantly impact bulge measurements. We show that nuclear and inner lenses/rings and disk breaks must be properly taken into account to obtain accurate bulge parameters, whereas outer lenses/rings and spiral arms have a negligible effect. We provide an optimal strategy to measure bulge parameters of typical disk galaxies, as well as prescriptions to estimate realistic uncertainties of them, which will benefit subsequent decomposition of a larger galaxy sample.

An Optimal Strategy for Accurate Bulge-to-disk Decomposition of Disk Galaxies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gao Hua; Ho, Luis C.

The development of two-dimensional (2D) bulge-to-disk decomposition techniques has shown their advantages over traditional one-dimensional (1D) techniques, especially for galaxies with non-axisymmetric features. However, the full potential of 2D techniques has yet to be fully exploited. Secondary morphological features in nearby disk galaxies, such as bars, lenses, rings, disk breaks, and spiral arms, are seldom accounted for in 2D image decompositions, even though some image-fitting codes, such as GALFIT, are capable of handling them. We present detailed, 2D multi-model and multi-component decomposition of high-quality R -band images of a representative sample of nearby disk galaxies selected from the Carnegie-Irvine Galaxymore » Survey, using the latest version of GALFIT. The sample consists of five barred and five unbarred galaxies, spanning Hubble types from S0 to Sc. Traditional 1D decomposition is also presented for comparison. In detailed case studies of the 10 galaxies, we successfully model the secondary morphological features. Through a comparison of best-fit parameters obtained from different input surface brightness models, we identify morphological features that significantly impact bulge measurements. We show that nuclear and inner lenses/rings and disk breaks must be properly taken into account to obtain accurate bulge parameters, whereas outer lenses/rings and spiral arms have a negligible effect. We provide an optimal strategy to measure bulge parameters of typical disk galaxies, as well as prescriptions to estimate realistic uncertainties of them, which will benefit subsequent decomposition of a larger galaxy sample.« less

Vaginitis: current microbiologic and clinical concepts.

PubMed Central

Hill, L V; Embil, J A

1986-01-01

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

Vaginitis: current microbiologic and clinical concepts.

PubMed

Hill, L V; Embil, J A

1986-02-15

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

Relations among Menopausal Symptoms, Sleep Disturbance and Depressive Symptoms in Midlife

PubMed Central

Brown, Jessica P.; Gallicchio, Lisa; Flaws, Jodi F.; Tracy, J. Kathleen

2009-01-01

Objectives To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women Methods A large population-based cross-sectional study of 639 women (ages 45 to 54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression Scale (CES-D), demographics, health behaviors, menstrual history, and menopausal symptoms Results After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence. Conclusions The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance. PMID:19128903

Effect of Vaginal or Systemic Estrogen on Dynamics of Collagen Assembly in the Rat Vaginal Wall1

PubMed Central

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

2014-01-01

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

The Globular Clusters of the Galactic Bulge: Results from Multiwavelength Follow-up Imaging

NASA Astrophysics Data System (ADS)

Cohen, Roger; Geisler, Doug; Mauro, Francesco; Alonso Garcia, Javier; Hempel, Maren; Sarajedini, Ata

2018-01-01

The Galactic globular clusters (GGCs) located towards the bulge of the Milky Way suffer from severe total and differential extinction and high field star densities. They have therefore been systematically excluded from deep, large-scale homogenous GGC surveys, and will present a challenge for Gaia. Meanwhile, existing observations of bulge GGCs have revealed tantalizing hints that they hold clues to Galactic formation and evolution not found elsewhere. Therefore, in order to better characterize these poorly studied stellar systems and place them in the context of their optically well-studied counterparts, we have undertaken imaging programs at optical and near-infrared wavelengths. We describe these programs and present a variety of results, including self-consistent measurement of bulge GGC ages and structural parameters. The limitations imposed by spatially variable extinction and extinction law are highlighted, along with the complimentary nature of forthcoming facilities, allowing us to finally complete our picture of the Milky Way GGC system.

Pilot randomized trial for treatment of bacterial vaginosis using in situ forming metronidazole vaginal gel.

PubMed

Shaaban, Omar M; Fetih, Gihan N; Abdellah, Noura H; Ismail, Saeyd; Ibrahim, Maggie A; Ibrahim, El-sayed A

2011-07-01

To compare the efficacy of a novel vaginal delivery system for metronidazole (0.8% MTZ in situ gel) versus a conventional MTZ vaginal gel product in the treatment of bacterial vaginosis (BV). All consecutive patients who presented to a tertiary care hospital with symptoms suggestive of BV were approached to participate in the study. Forty-two eligible participants were randomly assigned to either MTZ in situ gel or a conventional vaginal gel product twice daily for 5 days. All participants were re-examined after one and 4 weeks of the beginning of treatment to ensure cure of infection and any side-effects. Demographic criteria of the participants were comparable in the two treatment groups. The cure rate after one week from the treatment was 85% in the in situ gel group and 71.4% in the conventional vaginal gel group (P = 0.294), while after 4 weeks, the cure rate showed significant difference in the in situ gel group as compared to the conventional vaginal gel group (16/20 [80%]) and (9/19 [47.4%]), respectively (P = 0.034). Pilot testing showed that in situ MTZ vaginal gel is more effective than the conventional vaginal gel for long-term cure of BV. These findings suggest a novel and efficient long-term treatment of BV. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

Directed shift of vaginal microbiota induced by vaginal application of sucrose gel in rhesus macaques.

PubMed

Hu, Kai-tao; Zheng, Jin-xin; Yu, Zhi-jian; Chen, Zhong; Cheng, Hang; Pan, Wei-guang; Yang, Wei-zhi; Wang, Hong-yan; Deng, Qi-wen; Zeng, Zhong-ming

2015-04-01

Sucrose gel was used to treat bacterial vaginosis in a phase III clinical trial. However, the changes of vaginal flora after treatment were only examined by Nugent score in that clinical trial, While the vaginal microbiota of rhesus macaques is characterized by anaerobic, Gram-negative bacteria, few lactobacilli, and pH levels above 4.6, similar to the microbiota of patients with bacterial vaginosis. This study is aimed to investigate the change of the vaginal microbiota of rehsus macaques after topical use of sucrose gel to reveal more precisely the bacterial population shift after the topical application of sucrose gel. Sixteen rhesus macaques were treated with 0.5 g sucrose gel vaginally and three with 0.5 g of placebo gel. Vaginal swabs were collected daily following treatment. Vaginal pH levels and Nugent scores were recorded. The composition of the vaginal micotbiota was tested by V3∼V4 16S rDNA metagenomic sequencing. Dynamic changes in the Lactobacillus genus were analyzed by qPCR. The vaginal microbiota of rhesus macaques are dominated by anaerobic Gram-negative bacteria, with few lactobacilli and high pH levels above 4.6. After five days' treatment with topical sucrose gel, the component percentage of Lactobacillus in vaginal microbiota increased from 1.31% to 81.59%, while the component percentage of Porphyromonas decreased from 18.60% to 0.43%, Sneathia decreased from 15.09% to 0.89%, Mobiluncus decreased from 8.23% to 0.12%, etc.. The average vaginal pH values of 16 rhesus macaques of the sucrose gel group decreased from 5.4 to 3.89. There were no significant changes in microbiota and vaginal pH observed in the placebo group. Rhesus macaques can be used as animal models of bacterial vaginosis to develop drugs and test treatment efficacy. Furthermore, the topical application of sucrose gel induced the shifting of vaginal flora of rhesus macaques from a BV kind of flora to a lactobacilli-dominating flora. Copyright © 2015 The Authors. Published by

Fast track vaginal surgery.

PubMed

Ottesen, Marianne; Sørensen, Mette; Rasmussen, Yvonne; Smidt-Jensen, Steen; Kehlet, Henrik; Ottesen, Bent

2002-02-01

Our aim was to describe the need for postoperative hospitalization after vaginal surgery for utero-vaginal prolapse with well-defined charts for postoperative care. A prospective, descriptive study. Consecutive women admitted for first-time vaginal surgery for utero-vaginal prolapse at a public university hospital in Copenhagen, Denmark, underwent surgery and postoperative care in a fast track setting from September 15, 1999 to June 15 2000. A multimodal rehabilitation model with emphasis on information, standardized general anesthesia, reduced surgical distress, optimized pain-relief, early oral nutrition and ambulation, minimal use of indwelling catheter and vaginal packing. Postoperative hospital stay, complications, re-admission, success rate, patients' satisfaction and acceptability. Forty-one women with a median age of 69 years (range, 44-88 years) were included. All underwent anterior and/or posterior vaginal repair. Nineteen (46.3%) underwent vaginal hysterectomy, and eight (19.5%) underwent the Manchester procedure. Postoperative hospital stay was median 24 hr. Only three (7.3%) were discharged later than 48 hr. No re-admissions occurred. The most frequent complications were urinary retention exceeding 450 ml, and urinary tract infection (12.2%, and 9.8%, respectively). Short-term success rate was 97.6%. Patients' satisfaction rates were 85.4-95.1%. The median score of acceptability was 10 on a 0-10 points scale. The need for postoperative hospitalization was median 24 hr after vaginal surgery in a fast track setting, independently of the complexity of the procedure performed. Short-term success rate, satisfaction rates, and acceptability were all excellent. Follow up has been established to evaluate long-term success rates and recurrence.

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

PubMed

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

2015-02-01

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

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

PubMed Central

ITO, TAKUJI; BAI, TAO; TANAKA, TETSUJI; YOSHIDA, KENJI; UEYAMA, TAKASHI; MIYAJIMA, MASAYASU; NEGISHI, TAKAYUKI; KAWASAKI, TAKAHIKO; TAKAMATSU, HYOTA; KIKUTANI, HITOSHI; KUMANOGOH, ATSUSHI; YUKAWA, KAZUNORI

2015-01-01

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

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

PubMed Central

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

2005-01-01

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

Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture.

PubMed

Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens; Jangö, Hanna

2017-06-01

To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women randomly identified, 763 were eligible and received a questionnaire. Maternal and obstetric data were retrieved from the national registry. The response rate was 58.3%. In total, 394 women were included for analysis after reviewing responses according to previously defined exclusion criteria. Median follow-up time was 9.8 years after the first delivery and 6.4 years after the second. The prevalence of flatal incontinence, fecal incontinence and fecal urgency were 11.7, 4.1, and 12.3%, respectively. Overall, 20.1% had any degree of anal incontinence and/or fecal urgency. In 6.3% these symptoms affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal deliveries without OASIS at long-term follow-up. Episiotomy or vacuum extraction did not alter the risk of long-term anal incontinence.

Heterogeneity of Vaginal Microbial Communities within Individuals▿ #

PubMed Central

Kim, Tae Kyung; Thomas, Susan M.; Ho, Mengfei; Sharma, Shobha; Reich, Claudia I.; Frank, Jeremy A.; Yeater, Kathleen M.; Biggs, Diana R.; Nakamura, Noriko; Stumpf, Rebecca; Leigh, Steven R.; Tapping, Richard I.; Blanke, Steven R.; Slauch, James M.; Gaskins, H. Rex; Weisbaum, Jon S.; Olsen, Gary J.; Hoyer, Lois L.; Wilson, Brenda A.

2009-01-01

Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal microbial populations have not been investigated using molecular methods. Here, we evaluated site-specific microbial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S rRNA gene clone libraries were prepared from samples obtained from different locations (cervix, fornix, outer vaginal canal) and by different methods (swabbing, scraping, lavaging) from the vaginal tracts of eight clinically healthy, asymptomatic women. The data reveal that the vaginal microbiota is not homogenous throughout the vaginal tract but differs significantly within an individual with regard to anatomical site and sampling method used. Thus, this study illuminates the complex structure of the vaginal ecosystem and calls for the consideration of microenvironments when sampling vaginal microbiota as a clinical predictor of vaginal health. PMID:19158255