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[PMID]: 28450252 [Au] Autor: Exacoustos C; Pizzo A; Lazzeri L; Pietropolli A; Piccione E; Zupi E [Ad] Endereço: Department of Biomedicine and Prevention, Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata", Rome, Italy. [Ti] Título: Three-Dimensional Hysterosalpingo Contrast Sonography with Gel Foam: Methodology and Feasibility to Obtain 3-Dimensional Volumes of Tubal Shape. [So] Source: J Minim Invasive Gynecol;24(5):827-832, 2017 Jul - Aug. [Is] ISSN: 1553-4669 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVES: To investigate the feasibility of hysterosalpingo foam sonography (HyFoSy) with automated 3-dimensional (3D) software in the evaluation of tubal patency and visualization of the tubal course by obtaining a 3D volume acquisition of tubes. DESIGN: Prospective observational study (Canadian Task Force classification III). SETTING: University hospital. PATIENTS: A total of 132 infertile females evaluated between October 2013 and February 2015. INTERVENTIONS: All patients underwent HyFoSy with the new automated 3D coded contrast imaging (CCI) followed by 2-dimensional (2D) real-time HyFoSy. To evaluate the feasibility of 3D visualization of the tubal course, consecutive volume acquisitions were performed during gel foam contrast agent injection. Conventional 2D real-time hysterosalpingo contrast sonography (HyCoSy) by detection of gel foam moving through the tubes and around the ovaries was finally performed and considered to indicate the final results of tubal status. MEASUREMENTS AND MAIN RESULTS: All the patients underwent 3D CCI HyFoSy, followed by 2D real-time HyFoSy. After both procedures, we observed 108 patients (81.8%) with bilateral tubal patency, 22 patients (16.6%) with unilateral tubal patency, and 2 patients (1.5%) with bilateral tubal occlusion. The concordance rate for tubal status between the first and second 3D volume acquisitions and the final 2D real-time evaluation was 84.8% and 97.0%, respectively. CONCLUSIONS: Transvaginal ultrasound HyFoSy with 3D volume reconstruction of the uterus and tubes is an accurate and safe technique that allows complete visualization of tubal shape and patency with high patient compliance. [Mh] Termos MeSH primário: Endossonografia/métodos Testes de Obstrução das Tubas Uterinas/métodos Tubas Uterinas/diagnóstico por imagem Histerossalpingografia/métodos Imagem Tridimensional/métodos [Mh] Termos MeSH secundário: Adulto Meios de Contraste Tubas Uterinas/patologia Estudos de Viabilidade Feminino Seres Humanos Infertilidade Feminina/diagnóstico Infertilidade Feminina/diagnóstico por imagem Tamanho do Órgão Ovário/diagnóstico por imagem Estudos Prospectivos Software Útero/diagnóstico por imagem Cremes, Espumas e Géis Vaginais [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Contrast Media); 0 (Vaginal Creams, Foams, and Jellies) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE

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[PMID]: 28797020 [Au] Autor: Ngandu NK; Carlson JM; Chopera DR; Ndabambi N; Abdool Karim Q; Abdool Karim S; Williamson C [Ad] Endereço: *Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town and National Health Laboratory Services, Cape Town, South Africa;†Currently, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa;‡Microsoft Research, Redmond, WA; and§Centre for the AIDS Programme of Research in South Africa, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. [Ti] Título: Brief Report: Selection of HIV-1 Variants With Higher Transmission Potential by 1% Tenofovir Gel Microbicide. [So] Source: J Acquir Immune Defic Syndr;76(1):43-47, 2017 Sep 01. [Is] ISSN: 1944-7884 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Women in the CAPRISA 004 trial assigned to use 1% tenofovir (TFV) microbicide gel, who became HIV-1 infected, had higher viral load set-point and slower antibody avidity maturation compared with placebo participants. We investigated whether TFV gel was selected for viruses with altered genetic characteristics. SETTING: The participants of the CAPRISA 004 trial (n = 28 TFV and 43 placebo) were from KwaZulu-Natal Province, South Africa and were infected with HIV-1 subtype C. After HIV-1 diagnosis, they were recruited into the CAPRISA 002 cohort. METHODS: We analyzed gag sequences from the earliest time point post infection (within 3 months of estimated time of infection). Transmission index was measured using a model which predicts the likelihood of an amino acid to be transmitted. Phylogenetic distance from a regional consensus sequence was calculated from a maximum likelihood phylogenetic tree. RESULTS: Transmission index and distance from the most common (consensus) sequence have been shown to be markers of transmission fitness. We found that viruses infecting TFV gel recipients were closer to the consensus sequence of regional strains (P = 0.003) and had higher transmission index (P = 0.01). The transmission index was weakly correlated with concomitant viral load (Spearman r = 0.22, P = 0.06). CONCLUSION: Decreased acquisition risk may have increased the barrier to infection therefore selecting for fitter, more consensus-like viruses. Such virus fitness effects will need to be considered for future pre-exposure prophylaxis and vaccine trials. [Mh] Termos MeSH primário: Fármacos Anti-HIV/farmacologia Anti-Infecciosos/farmacologia Infecções por HIV/transmissão Infecções por HIV/virologia HIV-1/efeitos dos fármacos HIV-1/genética Tenofovir/uso terapêutico Cremes, Espumas e Géis Vaginais/uso terapêutico [Mh] Termos MeSH secundário: Fármacos Anti-HIV/administração & dosagem Fármacos Anti-HIV/uso terapêutico Anti-Infecciosos/administração & dosagem Anti-Infecciosos/uso terapêutico Ensaios Clínicos como Assunto Feminino Infecções por HIV/prevenção & controle Seres Humanos Filogenia Profilaxia Pré-Exposição Análise de Sequência de DNA África do Sul/epidemiologia Resultado do Tratamento Carga Viral Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-HIV Agents); 0 (Anti-Infective Agents); 0 (Vaginal Creams, Foams, and Jellies); 0 (gag Gene Products, Human Immunodeficiency Virus); 99YXE507IL (Tenofovir) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM; X [Da] Data de entrada para processamento: 170811 [St] Status: MEDLINE [do] DOI: 10.1097/QAI.0000000000001458

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[PMID]: 28594757 [Au] Autor: Taege SK; Adams W; Mueller ER; Brubaker L; Fitzgerald CM; Brincat C [Ad] Endereço: Departments of Obstetrics & Gynecology and Urology, Loyola University Medical Center, and the Departments of Obstetrics & Gynecology, Urology, and Physical Medicine and Rehabilitation, and the Health Sciences Division, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois. [Ti] Título: Anesthetic Cream Use During Office Pessary Removal and Replacement: A Randomized Controlled Trial. [So] Source: Obstet Gynecol;130(1):190-197, 2017 Jul. [Is] ISSN: 1873-233X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To estimate the effect of lidocaine-prilocaine cream on patient pain at the time of office pessary removal and reinsertion. METHODS: In this double-blind, randomized placebo-controlled trial, participants undergoing routine pessary care in a urogynecology office at a tertiary referral center were randomized to application of 4 g of either lidocaine-prilocaine or placebo cream 5 minutes before pessary change. Visual analog scale pain scores were collected from the patient at baseline, after pessary removal, and after pessary reinsertion. Physicians also recorded their estimate of patient pain at pessary removal and reinsertion. The primary outcome was the participant-reported visual analog scale pain score at the time of pessary removal and reinsertion. A sample size of 26 per group (n=52) was planned to estimate an absolute mean difference in visual analog scale pain of 2.1 cm at the time of pessary removal. An analysis of covariance was used to evaluate pain at removal and reinsertion as a function of treatment assignment controlling for baseline pain. RESULTS: From July 2015 through February 2016, 116 women were screened and 54 were recruited: 28 in the lidocaine-prilocaine cream group and 26 in the placebo group. One patient in the lidocaine-prilocaine cream group was later withdrawn owing to vaginal erosion. The participants were all postmenopausal women, with an average age of 77.8 years. Most characteristics were similar between groups. After adjusting for baseline pain, participants randomized to the lidocaine-prilocaine group had lower pain at pessary removal when compared with those assigned to placebo (mean difference=-2.05, 95% confidence interval -3.69 to -0.41; P=.015). CONCLUSION: Lidocaine-prilocaine cream use at the time of office pessary removal reduces patient-reported pain. Clinicians may wish to include this simple intervention to optimize patient comfort and compliance. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02380742. [Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico Lidocaína/uso terapêutico Pessários/utilização Prilocaína/uso terapêutico [Mh] Termos MeSH secundário: Administração Intravaginal Idoso Anestésicos Locais/administração & dosagem Método Duplo-Cego Combinação de Medicamentos Feminino Seres Humanos Lidocaína/administração & dosagem Medição da Dor Satisfação do Paciente Prilocaína/administração & dosagem Resultado do Tratamento Cremes, Espumas e Géis Vaginais [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Anesthetics, Local); 0 (Drug Combinations); 0 (Vaginal Creams, Foams, and Jellies); 046O35D44R (Prilocaine); 98PI200987 (Lidocaine) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170731 [Lr] Data última revisão: 170731 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170609 [St] Status: MEDLINE [do] DOI: 10.1097/AOG.0000000000002098

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[PMID]: 28420227 [Au] Autor: Marrai R; Lissi G; Togni S; Maramaldi G; Barbara M; Giacomelli L [Ad] Endereço: Obstetrics and Gynecology Unit, G. Pasquinucci Hospital, Massa, Italy. [Ti] Título: Efficacy and tolerability of a plant-based, multi-component cream (Ginetrox®) in vulvovaginal disorders of the genitourinary syndrome during menopause. [So] Source: Minerva Ginecol;69(3):245-249, 2017 Jun. [Is] ISSN: 1827-1650 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: BACKGROUND: Genitourinary syndrome of menopause (GSM) is a symptomatic condition including vaginal dryness, irritation, dyspareunia and recurrent urinary tract infections which affects 40-54% of post-menopausal women. Although several estrogen-based therapies are available, it is generally preferable to avoid hormonal therapy, particularly in women with mild symptoms or at risk for estrogen-responsive neoplasia. Therefore, the most common treatment options are over-the-counter vaginal creams for symptomatic relief. METHODS: Thirty-three postmenopausal women suffering from GSM were enrolled in this observational study. A multi-component cream (Ginetrox®, Indena, Milan, Italy) was applied on the vestibular area of the vagina for three months. The primary endpoints were: vaginal burning and/or pain, assessed by Visual Analog Scale and dyspareunia, assessed using the Marinoff Score. As a secondary endpoint, vestibular health was evaluated through a four-point scale. Side effects and adherence to treatment were also recorded. RESULTS: Statistically significant improvement was observed in pain scores and dyspareunia at the end of the treatment compared to baseline values. The vestibular health index significantly decreased after 3 months. Tolerability was acceptable. CONCLUSIONS: This preliminary study suggests that the plant-based, multi-component cream Ginetrox® could be effective and safe in counteracting menopause-related vaginal discomfort symptoms. [Mh] Termos MeSH primário: Menopausa Preparações de Plantas/administração & dosagem Doenças Vaginais/tratamento farmacológico Doenças da Vulva/tratamento farmacológico [Mh] Termos MeSH secundário: Administração Intravaginal Idoso Dispareunia/tratamento farmacológico Dispareunia/etiologia Feminino Seres Humanos Itália Adesão à Medicação Meia-Idade Dor/epidemiologia Dor/etiologia Preparações de Plantas/efeitos adversos Síndrome Resultado do Tratamento Cremes, Espumas e Géis Vaginais Doenças Vaginais/etiologia Doenças da Vulva/etiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Plant Preparations); 0 (Vaginal Creams, Foams, and Jellies) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171023 [Lr] Data última revisão: 171023 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170420 [St] Status: MEDLINE [do] DOI: 10.23736/S0026-4784.17.04015-1

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[PMID]: 28383379 [Au] Autor: Kim YH; Park S; Lee M; Hahn S; Jeon MJ [Ad] Endereço: Departments of Obstetrics and Gynecology and Pathology, Ewha Womans University School of Medicine, and the Department of Obstetrics and Gynecology, College of Medicine, and the Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea. [Ti] Título: Effect of a pH-Balanced Vaginal Gel on Dyspareunia and Sexual Function in Breast Cancer Survivors Who Were Premenopausal at Diagnosis: A Randomized Controlled Trial. [So] Source: Obstet Gynecol;129(5):870-876, 2017 May. [Is] ISSN: 1873-233X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To assess whether a pH-balanced vaginal gel containing lactic acid is more effective than a placebo (lactate-free gel) in improving dyspareunia and sexual function among breast cancer survivors who were premenopausal at diagnosis and had dyspareunia after adjuvant chemotherapy. METHODS: In a single-center, double-blind, randomized trial, a pH-balanced gel or placebo was administered three times per week at bedtime as well as during sexual intercourse for 8 weeks. The primary outcome was the improvement of dyspareunia measured by pain score of the Female Sexual Function Index after the treatment. Secondary outcomes included the total and individual domains of Female Sexual Function Index score, sexual dysfunction (a total Female Sexual Function Index score less than 25.0), vaginal pH, vaginal maturation index, and adverse events related to the intervention. A sample size of 47 per group was planned to achieve 80% power to detect a 19% difference in the primary outcome. RESULTS: From October 2009 and March 2013, 167 women were screened and 136 were randomized: 69 to a pH-balanced gel and 67 to placebo. Baseline characteristics were similar in both groups. Although there was no difference between the two groups, both experienced a significant improvement of dyspareunia. The increase in median pain score from baseline was 1.2 in both groups (median [interquartile range] from 2.8 [2.0-4.0] to 4.0 [2.8-4.8] in the pH-balanced group and from 3.2 [2.0-4.0] to 4.4 [3.2-4.8] in the placebo group; all P<.01). Overall Female Sexual Function Index score and the frequency of sexual dysfunction also did not differ between the two groups although there was a significant improvement. On the other hand, vaginal pH and vaginal maturation index were slightly but significantly improved only in the pH-balanced group. There were no severe adverse events in either group. CONCLUSION: The pH-balanced vaginal gel is not superior to the placebo in improving dyspareunia and overall sexual function. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://www.clinicaltrials.gov, NCT00981305. [Mh] Termos MeSH primário: Neoplasias da Mama Dispareunia/tratamento farmacológico Pré-Menopausa Cremes, Espumas e Géis Vaginais/uso terapêutico [Mh] Termos MeSH secundário: Administração Intravaginal Método Duplo-Cego Feminino Seres Humanos Concentração de Íons de Hidrogênio Meia-Idade Estudos Prospectivos Sobreviventes Resultado do Tratamento Cremes, Espumas e Géis Vaginais/administração & dosagem [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Vaginal Creams, Foams, and Jellies) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170713 [Lr] Data última revisão: 170713 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170407 [St] Status: MEDLINE [do] DOI: 10.1097/AOG.0000000000001988

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[PMID]: 28323291 [Au] Autor: Michnova L; Dostal J; Kudela M; Hamal P; Langova K [Ad] Endereço: IVF Clinic Olomouc, Horni Lan 6, Olomouc, Czech Republic. [Ti] Título: Vaginal use of micronized progesterone for luteal support.A randomized study comparing Utrogestan® and Crinone® 8. [So] Source: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub;161(1):86-91, 2017 Mar. [Is] ISSN: 1213-8118 [Cp] País de publicação: Czech Republic [La] Idioma: eng [Ab] Resumo: BACKGROUND AND OBJECTIVE: Luteal phase physiology is distorted by in vitro fertilization (IVF) cycles using gonadotropin-releasing hormone (GnRH) agonists and antagonists, Controlled ovarian hyperstimulation leads to luteal phase defect and for this reason, luteal phase support is now an integral part of IVF/ICSI-ET programs. The support is provided by hCG, progesterone or GnRH-a. This study compared the efficiency, safety and tolerance of two vaginal micronized progesterones, Utrogestan and Crinone 8%. METHODS: 111 women, 18-40 years old, FSH < 10 IU/L and normal uterus findings were included. The efficiency of the two preparations to provide luteal support was evaluated by the fertilization, implantation, pregnancy and take-home baby rates. The safety was compared through the results of vaginal findings and vaginal inflammation markers before and after treatment. Comparison of tolerance was made by evaluating 21 subjective patient questionnaire parameters. RESULTS: There were no significant differences between the preparations in terms of efficiency or safety though Crinone 8% was better tolerated. CONCLUSION: The outcomes of this study suggest that a vaginal gel with micronized progesterone (Crinone 8%) is the optimal choice at this time for luteal support. [Mh] Termos MeSH primário: Fase Luteal/efeitos dos fármacos Progesterona/administração & dosagem [Mh] Termos MeSH secundário: Administração Intravaginal Adolescente Adulto Criopreservação Esquema de Medicação Transferência Embrionária Feminino Fertilização In Vitro/métodos Hormônio Foliculoestimulante/metabolismo Seres Humanos Infertilidade Feminina/terapia Indução da Ovulação/métodos Gravidez Resultado da Gravidez Taxa de Gravidez Progesterona/efeitos adversos Progesterona/análogos & derivados Estudos Prospectivos Cremes, Espumas e Géis Vaginais Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Crinone); 0 (Utrogestan); 0 (Vaginal Creams, Foams, and Jellies); 4G7DS2Q64Y (Progesterone); 9002-68-0 (Follicle Stimulating Hormone) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171023 [Lr] Data última revisão: 171023 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170322 [St] Status: MEDLINE [do] DOI: 10.5507/bp.2017.007

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[PMID]: 28302110 [Au] Autor: Palacios S; Losa F; Dexeus D; Cortés J [Ad] Endereço: Gynecology and Obstetrics Department, Instituto Palacios de Medicina y Salud de la Mujer, C/Antonio Acuña 9, E-28009, Madrid, Spain. spalacios@institutopalacios.com. [Ti] Título: Beneficial effects of a Coriolus versicolor-based vaginal gel on cervical epithelization, vaginal microbiota and vaginal health: a pilot study in asymptomatic women. [So] Source: BMC Womens Health;17(1):21, 2017 Mar 16. [Is] ISSN: 1472-6874 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: To assess the effect of a 12-day treatment using a vaginal gel based on niosomes containing hyaluronic acid, ß-glucan, alpha-glucan oligosaccharide, Coriolus versicolor, Asian centella, Azadirachta indica and Aloe vera on vaginal microbiota, cervical epithelization and vaginal health. METHODS: Open-label, prospective pilot study conducted in asymptomatic women in daily practice. Cervical epithelization was evaluated by colposcopy using an ectopy epithelization score (from 5: no ectopy to 1: severe ectopy and bleeding), vaginal microbiota using the VaginaStatus-Diagnostic test (Instiüt für Mikroökologie, Herborn, Germany) and further rated by the investigator using a 5-point Liker scale (from 5: normal to 1: very severe deterioration in which all evaluated species were altered), and vaginal health using the Vaginal Health Index. RESULTS: In 21 women, a positive effect to improve epithelization of the cervical mucosa, with a mean score of 4.42 at the final visit as compared to 3.09 at baseline (P < 0.0001) (43% improvement). In 10 women, there was a trend of improving of vaginal microbiota status, with a mean score of 4.0 at the final visit vs. 3.3 at baseline (P = NS) (21.2% improvement). In 11 women, the Vaginal Health Index increased from 19.0 at baseline to 22.3 at the final visit (P = 0.007). The concentration of Lactobacillus spp. increased 54.5% of women and pH decreased from 4.32 to 4.09. CONCLUSIONS: These encouraging preliminary results provide the basis for designing a randomized controlled study, and for potential use in human papilloma virus infection. TRIAL REGISTRATION: ISRCTN77955077 . Registration date: February 15, 2017. Retrospectively registered. [Mh] Termos MeSH primário: Vagina/microbiologia Cremes, Espumas e Géis Vaginais/farmacologia [Mh] Termos MeSH secundário: Adulto Muco do Colo Uterino/microbiologia Colposcopia/métodos Interpretação Estatística de Dados Feminino Seres Humanos Lactobacillus/crescimento & desenvolvimento Microbiota/efeitos dos fármacos Projetos Piloto Estudos Prospectivos Espanha Cremes, Espumas e Géis Vaginais/administração & dosagem Cremes, Espumas e Géis Vaginais/uso terapêutico [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Vaginal Creams, Foams, and Jellies) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170815 [Lr] Data última revisão: 170815 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170318 [St] Status: MEDLINE [do] DOI: 10.1186/s12905-017-0374-2

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[PMID]: 28295174 [Au] Autor: Beckmann M; Gibbons K; Flenady V; Kumar S [Ad] Endereço: Mothers Babies and Women's Health Services, Mater Health, Brisbane, Queensland, Australia. [Ti] Título: Predictors of mode of birth and duration of labour following induction using prostaglandin vaginal gel. [So] Source: Aust N Z J Obstet Gynaecol;57(2):168-175, 2017 Apr. [Is] ISSN: 1479-828X [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: BACKGROUND AND AIMS: Using data from a randomised controlled trial (RCT) comparing two policies of prostaglandin (PGE2) vaginal gel induction of labour (IOL) at term, this study aimed to determine: (i) demographic/clinical factors that predict IOL outcomes; and (ii) clinical characteristic(s) of women who would benefit from a policy of amniotomy once technically possible as opposed to giving more PGE2. MATERIAL AND METHODS: Following an initial PGE2 dose, women were randomised to amniotomy or repeat-PGE2. Using RCT data, two multivariate models were developed, assessing the relationship between demographic/clinical characteristics and the outcomes of caesarean section (CS), and vaginal delivery within 24 h (VD < 24 h). Regression-equations were used to predict the likelihood of CS and VD < 24 h, varying independent predictors from the multivariate analyses. RESULTS: Of 245 term women undergoing IOL, 90 had a CS, 155 delivered vaginally and 79 had a VD < 24 h. Controlling for confounders, nulliparity [adjusted odds ratio (aOR) = 3.71 (1.55, 8.88)] and modified Bishop's score (MBS) at first review [aOR = 0.78 (0.66, 0.92)] were independently associated with CS. Nulliparity [aOR = 0.06 (0.02, 0.15)], MBS at first review [aOR = 1.66 (1.35, 2.05)], and a policy of early amniotomy [aOR = 2.28 (1.04, 5.00)] were associated with VD < 24 h. Modelling using regression equations, and varying both MBS at first review and parity, there was no scenario where repeat PGE2 was predicted to be superior to an earlier amniotomy. CONCLUSIONS: Following IOL using PGE2 vaginal gel at term, both parity and cervical favourability at first review are associated with CS and VD < 24 h. All combinations of parity and MBS at first review predicted fewer CS and greater likelihood of VD < 24 h with a policy of amniotomy once technically possible. [Mh] Termos MeSH primário: Cesárea/estatística & dados numéricos Dinoprostona/administração & dosagem Trabalho de Parto Induzido Ocitócicos/administração & dosagem Parto [Mh] Termos MeSH secundário: Adulto Âmnio/cirurgia Maturidade Cervical Protocolos Clínicos Feminino Seres Humanos Paridade Gravidez Fatores de Tempo Cremes, Espumas e Géis Vaginais Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Oxytocics); 0 (Vaginal Creams, Foams, and Jellies); K7Q1JQR04M (Dinoprostone) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171025 [Lr] Data última revisão: 171025 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170316 [St] Status: MEDLINE [do] DOI: 10.1111/ajo.12588

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[PMID]: 28259230 [Au] Autor: Marnach ML; Torgerson RR [Ad] Endereço: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN. Electronic address: marnach.mary@mayo.edu. [Ti] Título: Vulvovaginal Issues in Mature Women. [So] Source: Mayo Clin Proc;92(3):449-454, 2017 Mar. [Is] ISSN: 1942-5546 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Mature women often present with symptomatic vulvovaginal atrophy and vulvar dermatoses, causing noncoital pain, dyspareunia, and sexual changes. Diagnosis of these conditions can be challenging, and long-term management is required to decrease morbidity and enhance quality of life. Vaginal estrogen therapies remain safe and effective for treating symptomatic vulvovaginal atrophy. A vulvar biopsy is easy to perform and generally well tolerated when indicated for the diagnosis of lichen simplex chronicus, lichen sclerosus, and lichen planus. Therapy with moderate- to high-potency corticosteroids is effective for these frequently debilitating conditions. [Mh] Termos MeSH primário: Dispareunia/etiologia Estrogênios/administração & dosagem Pós-Menopausa/fisiologia Disfunções Sexuais Fisiológicas/diagnóstico Dermatopatias/diagnóstico Vulva/patologia Doenças da Vulva/diagnóstico Saúde da Mulher [Mh] Termos MeSH secundário: Administração Intravaginal Atrofia/tratamento farmacológico Fármacos Dermatológicos/administração & dosagem Fármacos Dermatológicos/uso terapêutico Diagnóstico Diferencial Dispareunia/prevenção & controle Terapia de Reposição de Estrogênios/métodos Estrogênios/uso terapêutico Feminino Seres Humanos Líquen Plano/diagnóstico Líquen Plano/tratamento farmacológico Neurodermatite/diagnóstico Neurodermatite/tratamento farmacológico Qualidade de Vida Disfunções Sexuais Fisiológicas/tratamento farmacológico Disfunções Sexuais Fisiológicas/etiologia Dermatopatias/tratamento farmacológico Cremes, Espumas e Géis Vaginais/administração & dosagem Cremes, Espumas e Géis Vaginais/uso terapêutico Doenças da Vulva/tratamento farmacológico Líquen Escleroso Vulvar/diagnóstico Líquen Escleroso Vulvar/tratamento farmacológico [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Dermatologic Agents); 0 (Estrogens); 0 (Vaginal Creams, Foams, and Jellies) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170609 [Lr] Data última revisão: 170609 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170306 [St] Status: MEDLINE

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MEDLINE

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[PMID]: 27876429 [Au] Autor: Juliato PT; Rodrigues AT; Stahlschmidt R; Juliato CR; Mazzola PG [Ad] Endereço: a Postgraduate Program in Biosciences and Technology of Bioactive Products , Institute of Biology, State University of Campinas , Brazil. [Ti] Título: Can polyacrylic acid treat sexual dysfunction in women with breast cancer receiving tamoxifen? [So] Source: Climacteric;20(1):62-66, 2017 Feb. [Is] ISSN: 1473-0804 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVE: There is a lack of safety data supporting the use of hormone therapy in women who have had breast cancer and who have complained of genitourinary syndrome of menopause (GSM). The objective was to test the efficacy of two non-hormonal therapies for vaginal dryness. METHODS: This was a randomized trial with 52 women with breast cancer who were being treated with tamoxifen and who complained of vaginal dryness. The volunteers answered two questionnaires to evaluate sexual function (Female Sexual Function Index, FSFI) and a customized GSM questionnaire. The women were randomized into two groups: 25 (48.1%) in the polyacrylic acid group and 27 (51.9%) in the lubricant group, using either one of the treatments for 30 days, and after they were invited to answer the questionnaires again. RESULTS: There was improvement in the FSFI after both treatments. The polyacrylic acid group showed a decrease in sexual dysfunction from 96% to 24% (p < 0.0001) and the lubricant group showed a decrease from 88.9% to 55.6% (p = 0.0027). CONCLUSIONS: The results of this study showed that both treatments improved sexual function; however, polyacrylic acid was superior to the lubricant in treating sexual dysfunction. [Mh] Termos MeSH primário: Resinas Acrílicas/administração & dosagem Antineoplásicos Hormonais/efeitos adversos Disfunções Sexuais Fisiológicas/tratamento farmacológico Tamoxifeno/efeitos adversos Cremes, Espumas e Géis Vaginais/administração & dosagem [Mh] Termos MeSH secundário: Neoplasias da Mama/tratamento farmacológico Feminino Seres Humanos Meia-Idade Comportamento Sexual/efeitos dos fármacos Disfunções Sexuais Fisiológicas/induzido quimicamente Doenças Vaginais/induzido quimicamente Doenças Vaginais/tratamento farmacológico [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Acrylic Resins); 0 (Antineoplastic Agents, Hormonal); 0 (Vaginal Creams, Foams, and Jellies); 094ZI81Y45 (Tamoxifen); 4Q93RCW27E (carbopol 940) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161124 [St] Status: MEDLINE [do] DOI: 10.1080/13697137.2016.1258396

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