Frequency of cervical intraepithelial neoplasia and infectious agents for vaginitis in menstrual cycle phase.
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The study objective was to verify differences in the diagnosis of infectious agents and CIN in cytological smears in the proliferative and secretory phases of the menstrual cycle.A retrospective study was carried out at the Federal University of "Triângulo Mineiro". Presence of Candida albicans, Trichomonas vaginalis, clue cells, Doderlein bacilli, cytolytic flora, coccoid bacillus, CIN and HPV were collected from the vaginal cytology tests, cervical and endocervical in healthy women of reproductive age from 1994 to 2004 (about 14,000 in total). The cytologies were divided into two groups: proliferative and secretory phase. Chi-square and Fisher's exact tests were used for statistical analysis with the significance level set at less than 0.05.The frequency of cytolysis and candidiasis was higher in the secretory phase of the menstrual cycle (p < 0.0001). When the presence of CIN associated with vulvovaginitis was evaluated, there was no significant difference in cytologies with CIN between the first and the second phases of the menstrual cycle.Frequency of the cytolytic flora and Candida albicans is influenced by the phase of the menstrual cycle, but CIN is not.Keywords:
Vaginal flora
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Aim: To evaluate the presence of infectious agents for vaginitis in patients with ASCUS. Methods: 33,388 patients who underwent cervical-vaginal cytology from 08/1993 to 05/2002 were included in the study, and 1,104 (3.4%) presented positive ASCUS. The appraised infectious agents were Coccobacilli, Candida sp, Trichomonas vaginalis, and clue cells (Gardnerella vaginalis). Results: In the group with ASCUS a larger frequency of Coccobacilli (22.37%) and Trichomonas vaginalis (5.25%) was found when compared with the group with negative ASCUS (17.79% and 3.98%, respectively; p < 0.05). Cytolysis occurred more frequently in patients with ASCUS (3.8 vs 6.3%, first phase and 4.5 vs 10%, second phase). Conclusions: We believe that some diagnoses of ASCUS can be induced by the presence of infectious agents for vaginitis, mainly cocci and coccoides. ASCUS occurs more frequently in the first phase of the menstrual cycle, therefore in less acid vaginal pH.
Ascus (bryozoa)
Trichomonas Vaginitis
Vaginal flora
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The aim of this study is to detect the rate of cytolytic vaginosis (CV) cases in patients with symptoms resembling those ones of candida vaginitis and to distinguish them from candidiasis cases by examining of 2947 Papanicolaou-stained vaginal smears. Fifty four of 2947 patients (1.83%) were diagnosed as having CV based on cytologic criteria such as naked nuclei of intermediate cells (IC), the overgrowth of lactobacilli, cytoplasmic fragmentations due to lysis of the cells. None of these smears contained candidal blastospores and hyphae and polymorphonuclear leucocytes. The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. The study indicated that special attention has to be paid during evaluation the vaginal smears of the patients with presumed vaginal candidiasis in order to prevent an erroneous diagnosis of CV.
Vaginal smear
Vaginal discharge
Vaginal disease
Vaginal flora
Cytopathology
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Introduction: The infections of female genital tract, especially the cervix are asymptomatic in presentation and pose a diagnostic challenge. Vaginal infections can lead to cytoplasmic and nuclear abnormalities in the epithelial cells. Additionally, these infections could augur an inflammatory response of varying nature. The most common flora include Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, Human Papilloma Virus (HPV), Human Herpes Virus (HHV) and Actinomyces sp.Aim: This study seeks to measure the role of Papanicolaou smear in detection of pathologic flora: Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, HPV, HHV and Actinomyces; in a rural health care set up amongst women in the reproductive and menopausal age group.Materials and Methods: A retrospective study of cervical smears by Papanicolaou method, over a 14 month period was carried out in a tertiary care centre including a total number of 150 patients.Results: Of the total of 150 samples examined, Candida species was the most frequently detected (8.7%) followed by Trichomonas vaginalis (5.3%) and Gardnerella vaginalis species (4.7%). HPV-induced changes were noted in a mere 2% of cases. Actinomyces species was noted in less than 1% of cases.Conclusion: The Papanicolaou test for examining cervical smear has definite uses in detecting vaginal microorganisms. Apart from detection of the usual pathogenic flora, the test has utility in defining the degree of inflammation and additional reparative changes
Pap smears
Flora
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Abstract In a prospective cohort study, 10 symptomatic women with recurrent vulvovaginal candidiasis were taught how to prepare vaginal smears of their own vaginal fluids on days 7, 14, 21, and 28. The 40 smears were stained with the PAS‐method and examined by three different cytopathologists for presence of Candida . Thereafter, the smears were restained with Giemsa‐stain to determine presence of lactobacilli, Gardnerella vaginalis (“clue cells”) and neutrophils. All three cytopathologists unequivocally established Candida blastospores and (pseudo)hyphae in 27 out of the 40 PAS‐stained vaginal smears, whereas in the remaining 13 smears Candida was not found. All 10 patients had Candida in their smears during the second half of their menstrual cycle. Self sampled smears prove to be reliable for establishing the presence of Candida in symptomatic patients with candidiasis. Candida is associated with a lactobacillus ‐predominated vaginal flora, but with the absence of Gardnerella vaginalis . Further studies may be directed towards the interaction between the various members of the vaginal flora. This study should open molecular methodology for determining the possible interactions of lactobacilli and Candida . Diagn. Cytopathol. 2007;35:635–639. © 2007 Wiley‐Liss, Inc.
Gardnerella vaginalis
Vaginal flora
Vaginal smear
Gram staining
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Objective:To investigate the gynecological clinic detection rate,proportion and age distribution of vaginal microflora imbalance.Methods:Gram staining gynecological clinic patients with clinical symptoms of vaginal secretions,detection of vaginal pH.Results:Vaginal microbial disorder detection rate was 51.33%,vulvovaginal candidiasis accounted for 28.99%,bacterial vaginosis accounting for 8.57%,trichomoniasis vaginosis was 2.03%,mixed vaginitis was 0.48%,undefined vaginal microbial imbalance was 59.92%.Vaginal microbial disorders in patients composition of each age group:20 years old was 2.4%,21-30 age group was 32.7%,31-40 age group was 38.2%,41-50 age group was 21.7%,50 years old group was 5.0%,all kinds of vaginal micro-ecological imbalance,the median age in addition to mixed vaginitis was in 21-30 years old,the other are in the 31-40 years of age.Conclusions:Vulvovaginal candidiasis were higher than bacterial vaginosis,trichomonas vaginitis and mixed vaginitis.Vulvovaginal candidiasis,bacterial vaginosis,trichomonas vaginitis and mixed vaginitis were predilection in reproductive age females.In addition to inflammation of the vagina,there are most of the vaginal microbial disorders need to define.
Trichomoniasis
Trichomonas Vaginitis
Trichomonas
Vaginal smear
Vaginal disease
Vaginal flora
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Bacterial vaginosis is one of the most frequent disorders of vaginal ecosystem in women during their reproductive life. The first concept in the pathogenesis of bacterial vaginosis points out that the unfamiliar initial influence on vaginal ecosystem decreases lactobacillus concentration, which results in the increase of vaginal secretion pH and multiplication of Gardnerela vaginalis and other anaerobes. The aim of this study was to compare the frequency of cervical neoplasia in women with and without bacterial vaginosis. The research included 158 patients, between 18 and 51 years of age, at the Clinic of Gynecology and Obstetrics in Nis. Clinical processing of patients consisted of cytological, colposcopic and pathohistological examinations. Bacterial vaginosis was, beside clue cell detection with native preparation, diagnosed by the application of other Amsel’s criteria: presence of characteristic vaginal secretion, positive amino test, values of vaginal secretion pH over 4.5. The results showed that 23.42% of the patients had bacterial vaginosis. The greatest percent of the patients with bacterial vaginosis (24.32%) was between 20 and 34 years of age. In the examined population, 7.59% of the patients had positive pathohistological finding. The number of normal pathohistological findings was statistically significantly lower in the patients with bacterial vaginosis (75.68%) than in those without bacterial vaginosis (97.52%), (χ 2 =16.28, p<0.001). Acta Medica Medianae 2011;50(1):5-10.
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Bacterial vaginosis is a disorder in the composition of the vaginal flora that leads to a decrease in the number of hydrogen peroxide-producing lactobacilli and a predominance of various anaerobic bacteria. A retrospective cohort study, performed on a series of 192 patients aged 20 to 59 years, divided into two groups: study and control. The study group included 128 sexually active women with a Pap smear that showed the presence of a squamous intraepithelial lesion or squamous invasive cervical cancer. The control group included 64 sexually active women with a normal PAP test. In all women we done: Nugent's score system, and as indicated, all women in the study group and colposcopic cervical biopsy with endocervical curettage for histopathological analysis. Bacterial vaginosis was detected in 43.75% of patients with squamous cell abnormalities of the cervix and in 12.50% of patients with normal cervical cytology. Data analysis showed: correlation between the presence of bacterial vaginosis and the occurrence of squamous cell abnormalities of the cervix (chi-square test = 4.1906, p <0.05); increase in the presence of bacterial vaginosis with increasing cytopathological (chi-square test = 12,198, p˂0.05) and histopathological (chi-square test = 6.3434, p˂0.05) degree of cervical lesion and that bacterial vaginosis was most common in patients under 30 years of age (57.14%; 16/28). There is a statistically significant correlation between the modalities, the presence of bacterial vaginosis and the absence of bacterial vaginosis between the study and the control group (chi-square test = 18.75, p˂0.05). The percentage difference between the modalities presence of bacterial vaginosis and absence of bacterial vaginosis between the study and the control group was statistically insignificant for p˃0.05 (p = 0.1863, t = 1.9799, 95% CI = -138.8260-54,260). Our study showed an association between bacterial vaginosis and squamous cell abnormalities of the cervix
Squamous intraepithelial lesion
Pap test
Vaginal flora
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OBJECTIVE To learn the infection status of bacterical vaginosis,Candida vaginitis and trichomonal vaginitis among women of childbearing age in Wuxi.METHODS The bacterial vaginosis was detected by bacterial vaginosis combination determination kit to vagina fornices secretion,the Candida and trichomonad were detected by microscopic examination to vagina secretion among three kinds of patients in the gynecology clinic(2142 cases),medical examination center(1885 cases),and hospitalized patients(218 cases) in Wuxi area.RESULTS The positive rates of the bacterial vaginosis,Candida vaginitis and trichomonal were respectively 19.44%,16.43%,and 7.19% in gynecology clinic patients.The positive rates were respectively 8.17%,6.47%,and 1.91% in medical examination center patients,and the the positive rates were 2.75%,1.83%,and 1.38% in hospitalized patients.The difference in the incidence rate of the bacterial vaginosis,Candida vaginitis and trichomonal vaginitis among the patients in the gynecology clinic and medical examination center and the hospitalized patients was statistically significant(P0.01).The positive detection rate of bacterial vaginosis was higher than that of the Candida vaginitis and trichomonal vaginitis.The difference between the incidence of bacterial vaginosis with mixed infections in gynecology clinic and the incidence of single bacterial vaginosis,Candida vaginitis and trichomonal vaginitis in the patients of mechanical examination center and the hospitalized patients was not statistically significant.CONCLUSION It is necessary for the gynecology clinic to screen out the bacterial vaginosis,Candida and trichomonad from the vaginal secretions.
Trichomonas Vaginitis
Vaginal disease
Vaginal secretion
Trichomonas
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Objective: The objective of this study is to determine the incidence of cytolytic vaginosis among patients undergoing cervicovaginal cytology for vaginal discharge, pruritus, dyspareunia, and other symptoms. Cytolytic vaginosis is also known as Lactobacillus overgrowth syndrome or Doderlein's cytolysis. It is characterized by an abundant growth of Lactobacilli resulting in lysis of vaginal epithelial cells. Methods: A total of 308 women presented to gynecological outpatient department. All of the patients were subjected to Pap test with the help of cytobrush. The cervicovaginal smears were fixed in methanol, stained with papanicolaou stain, and studied under a microscope independently by two pathologists. Results: Of 308 patients, 190 (61.7%) had an inflammatory lesion and were negative for intraepithelial malignancy. Of 190 cases, 31 (16.3%) were diagnosed with cytolytic vaginosis based on the clinical and morphological features. Conclusion: Cytolytic vaginosis is a fairly common entity often misdiagnosed as candidiasis. Morphological features play an important role in identifying cytolytic vaginosis. The results of this study may contribute to reports in the literature indicating the importance of cytolytic vaginosis which is not included in the current Bethesda system for reporting of cervical cytology.
Gram staining
Vaginal flora
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