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Treatment of recurrent vulvovaginal candidiasis in women planning a pregnancy
No full textTreatment of recurrent vulvovaginal candidiasis in women planning a pregnancy
Borovikov I.O., Kutsenko I.I., Gerasimenko E.E.
Kuban State Medical University, Krasnodar
Aim: evaluation of treatment methods for recurrent vulvovaginal candidiasis (VVC) in patients planning pregnancy.
Patients and Methods: a comparative, open, randomized study of the results of treatment of 150 women with recurrent vulvovaginal candidiasis (RVVK) in which, after completing the course of the proposed therapy, fertilization took place within
6 months, followed by successful fetal bearing and childbirth: group I (n = 50) - intravaginal clotrimazole cream 2% application once a day for 6 days; II group (n = 50) - polyenic macrolide natamycin intravaginally at a dose of 100 mg once a day for
10 days; III group (n = 50) - orally fluconazole to reduce the recurrence rate of VVC 150 mg every 3 days (1st, 4th and 7th day). The direct microscopy method, measurement of the pH level of the vaginal environment and culture technique was used.
Results: it has been established that the intravaginal application of clotrimazole and fluconazole according to the clinical and microbiological efficacy of RVVK therapy is comparable and is 1.6 ± 0.2 times higher in clinical and 1.2 ± 0.15 times in microbiological efficacy than the intravaginal application of natamycin. The advantage of clotrimazole is a faster relief of candidiasis symptoms, a higher safety profile and microbiological sanation from the concomitant opportunistic pathogenic microflora.
Key words: recurrent vulvovaginal candidiasis, antimycotics, clotrimazole, natamycin, fluconazole, planning pregnancy.
For citation: Borovikov I.O., Kutsenko I.I., Gerasimenko E.E. Treatment of recurrent vulvovaginal candidiasis in women planning a pregnancy // RMJ. 2018. № 2(I). P. 13–18.<br
Experience of clinical management of mixed urogenital tract infections in women
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Experience of clinical management of mixed urogenital tract infections in women
I.O. Borovikov, I.I. Kutsenko, E.R. Rubinina
Kuban state medical university, Krasnodar, Russian Federation
The article considers experience of managing the patients with various infections of the urogenital tract (bacterial vaginosis in combination with urogenital candidiasis and chlamydia infection, bacterial vaginosis during pregnancy). The clinical features of combined forms of urogenital infection in women are presented and variants of treatment of this pathology are offered with an assessment of their clinical and microbiological efficacy.
Aim: assessment of clinical experience of various options for the management of women with urogenital infections.
Patients and Methods: the article presents the analysis of the therapy of 63 patients with a mixed form of urogenital infection (a combination of bacterial vaginosis and vulvovaginal candidosis — n=32 and bacterial vaginosis with chlamydial infection — n=31), and 28 pregnant women in gestation period 28-36 weeks with diagnosed bacterial vaginosis. An assessment of the state of microbiota in the urogenital tract was carried out using a polymerase chain reaction (PCR) in real time. Diagnosis of Chlamydia infection was carried out by PCR. Diagnosis of infection with various species of Candida spp.: direct microscopy, seeding with pure culture separation and the final identification of the pathogen. Quantitative assessment of urogenital biota was carried out in absolute and relative values. Treatment of bacterial vaginosis in combination with vulvovaginal vandidiasis was conducted locally clindamycin phosphate and systemic fluconazole, with the combination of bacterial vaginosis and chlamydia infection used clindamycin with azithromycin, in pregnant women in the II-III trimester treatment of bacterial vaginosis was clindamycin in combination with natamycin.
Results: clinical cure of patients with bacterial vaginosis in combination with candidiasis with complex therapy with clindamycin combined with fluconazole was 87.5±4.6%, microbiological — 82.3±6.1%. For patients with bacterial vaginosis in combination with chlamydial infection and clindamycin phosphate therapy in combination with azithromycin, the clinical efficacy was 82.8±8.2%, the microbiological efficacy was 79.6±5.9%. The microbiological efficacy of treatment of bacterial vaginosis with clindamycin phosphate in the II–III trimesters of pregnancy was 86.3%.
Conclusions: high efficacy of local therapy of bacterial vaginosis with antibacterial drug clindamycin phosphate (which can also be used in the II and III trimester of pregnancy) is revealed, the systemic antifungal drug fluconazole does not lose its relevance and efficacy as antimycotic therapy.
Key words: bacterial vaginosis, vulvovaginal candidiasis, chlamydia infection, antimycotics, fluconazole, clindamycin phosphate.
For citation: Borovikov I.O., Kutsenko I.I., Rubinina E.R. Experience of clinical management of mixed urogenital tract infections in women. Russian journal of Woman and Child Health. 2018;1(1):26–32.
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Prepregnancy preparation of women with mixed vaginal dysbiosis
No full textPrepregnancy preparation of women with mixed vaginal dysbiosis
I.O. Borovikov, I.I. Kutsenko, E.R. Rubinina, S.K. Batman, A.S. Magay
Kuban State Medical University, Krasnodar, Russian Federation
The paper discusses prepregnancy preparation of women with mixed vaginal dysbiosis. Clinical features of this disorder, therapeutic options and their clinical and microbiological efficacy are addressed.
Aim: To analyze clinical experience and efficacy of different variants of topical treatment in women with mixed vaginal dysbiosis planning to become pregnant.
Patients and Methods: Comparative open randomized study was performed in 123 women with mixed vaginal dysbiosis who became pregnant (and went into labor) within 6 months after treatment completion. Group I (n=31) received complex medication containing metronidazole and miconazole/Metromicon-Neo® (1 intravaginal suppository twice a day for 7 days). Group II (n=32) received intravaginal applications of clotrimazole (2% cream) once a day for 6 days. Group III (n=30) received intravaginal applications of clindamycin phosphate 2% cream once a day for 6 days. Group IV (n=30) received complex medication containing neomycin sulfate and nystatin, prednisone (1 vaginal tablet at night for 10 days). After decontamination therapy all women underwent topical intravaginal contamination with medications containing lyophilizate of acidophilic lactobacilli. Urogenital microbiota were assessed (by PCR), vaginal pH was measured, and Hay/Ison criteria were analyzed.
Results: Similarly high clinical and microbiological efficacy of prepregnancy topical therapy with Metromicon-Neo® and clindamycin for mixed vaginal dysbiosis was demonstrated. However, intravaginal administration of clindamycin phosphate required further additional antifungal treatment. Metromicon-Neo® (metronidazole and miconazole) was characterized by greater medication adherence.
Keywords: vaginal dysbiosis, bacteria, Lactobacillus, metronidazole, miconazole, clotrimazole, clindamycin phosphate, neomycin sulfate, nystatin.
For citation: Borovikov I.O., Kutsenko I.I., Rubinina E.R. et al. Prepregnancy preparation of women with mixed vaginal dysbiosis. Russian Journal of Woman and Child Health. 2019;2(2):–119.<br
Acute gestational cystitis (treatment characteristics)
No full textAcute gestational cystitis (treatment characteristics)
I.O. Borovikov, I.I. Kutsenko, E.R. Rubinina, E.E. Gerasimenko, S.K. Betmen
Kuban State Medical University, Krasnodar, Russian Federation
Aim: to evaluate the clinical experience of different options for the management of women with acute gestational cystitis.
Patients and Methods: 96 female patients with acute gestational cystitis in the gestation period of 28–36 weeks, in whom uropathogenic microflora growth ≥105 CFU/ml was detected during urine culture, underwent a course of treatment, an analysis of which was conducted. Diagnosis of acute gestational cystitis was carried out on the basis of the clinical picture (acute onset, dysuria, pollakiuria, urinary urgency, incontinence and tenderness in the lower pelvic area, possible hematuria) and laboratory diagnostics (cito tests to detect bacteriuria and leukocyturia, clinical urine tests, Nechiporenko test, urine culture with flora and sensitivity to antibiotics). Assessment of a microbiota state of the urogenital tract was carried out using urine culture. Depending on the type of therapy, all pregnant women were divided into 3 groups: I (n=32) — treated with the drug fosfomycin trometamol; II (n=32) — cefuroxime axetil; III (n=32) — amoxicillin in combination with clavulanic acid. Prevention and treatment of concomitant vulvovaginal candidiasis was carried out by intravaginal applications of clotrimazole (2% cream).
Results: the highest clinical and microbiological efficacy of treatment of acute gestational cystitis was found in the preparation containing fosfomycin trometamol (94.5%), with better compliance (among the adverse effects of drugs administration, respondents first of all noted the need of administration of cefuroxime axetil bis in day and amoxicillin in combination with clavulanic acid three times for five days, as well as a higher incidence of adverse effects when during the intake of these drugs). In group II and III, the efficacy of therapy was, respectively, 88.1 and 80.9%. As a concomitant antimycotic therapy, topical application of clotrimazole in the form of a vaginal cream (2%) has proven its effectiveness.
Conclusion: fosfomycin trometamol (Fosfomycin Esparma) showed high clinical and microbiological efficacy in the treatment of acute gestational cystitis in the II and III trimester of pregnancy.
Key words: acute gestational cystitis, vulvovaginal candidiasis, antibacterial therapy, uroseptics, antimycotics, fosfomycin trometamol.
For citation: Borovikov I.O., Kutsenko I.I., Rubinina E.R. et al. Acute gestational cystitis (treatment characteristics). Russian Journal of Woman and Child Health. 2018;1(2):124–130.<br
Low-grade squamous intraepithelial lesion: therapeutic and pathogenic properties of activated glycyrrhizinic acid
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I.O. Borovikov1, I.I. Kutsenko1, H.I. Gorring1, E.R. Rubinina1, V.P. Bulgakova1,2
1Kuban State Medical University, Krasnodar, Russian Federation
2LLC “Clinic Ekaterininskaya”, Krasnodar, Russian Federation
Background: the importance of human papilloma virus (HPV) prevalence is accounted for by HPV malignancy including cervical cancer. Cervical cancer is the fourth most commonly occurring cancer in women and the seventh most commonly occurring cancer overall. The lack of effective preventive, screening, and treatment strategies for precancerous cervical lesions (i.e., squamous intraepithelial lesions) is the major cause of high cervical cancer prevalence.
Aim: to assess the efficacy of local treatment with activated glycyrrhizinic acid (0.1% spray) in women with low-grade squamous intraepithelial lesion (LSIL).
Patients and Methods: 76 women who received were enrolled. Clinical examination as well as colposcopy, cytohistology, and cytobiochemistry were performed. LSIL diagnosis was verified by clinical microbiological and cytological studies (fluid cytology). Infection with high-risk HPV was verified by PCR for the detection of 12 high-risk HPV types. Oxidative processes in cervical mucosa were assessed by measuring NO, reactive oxygen species, and lipids. Macrophage enzyme activity was evaluated by myeloperoxidase, acidic phosphatase, and non-specific esterase. 30 healthy women were cytobiochemical controls.
Results: 85.5% and 90.8% of women with LSIL had a normal colposcopy in 30 days and a year, respectively, after the treatment with activated glycyrrhizinic acid. No koilocytotic atypia was revealed in 81.6% and 89.5% of women in 30 days and a year, respectively, after the treatment. The treatment has also resulted in the changes in cervical oxidation processes, i.e., electron paramagnetic resonance (EPR) signal intensity of lipid peroxyl radicals has reduced by 3.8 times and NO by 2.4 times while EPR signals of O2 were almost undetectable. As to cervical macrophage enzymes, the activity of myeloperoxidase and acidic phosphatase has increased by 54.4±5.9% and 63.9±6.4%, respectively, while the activity of non-specific esterase has increased more than twice.
Conclusion: high clinical efficacy of the local treatment with activated glycyrrhizinic acid for LSIL (which have resulted in the normalization of immune and oxidation processes in the cervix) was demonstrated.
Keywords: human papilloma virus, squamous intraepithelial lesion, glycyrrhizinic acid.
For citation: Borovikov I.O., Kutsenko I.I., Gorring H.I. et al. Low-grade squamous intraepithelial lesion: therapeutic and pathogenic properties of activated glycyrrhizinic acid. Russian Journal of Woman and Child Health. 2019;2(4):301–305.
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Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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