Download Vulvovaginal Infections, Second Edition by William J. Ledger, Steven S. Witkin PDF

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By William J. Ledger, Steven S. Witkin

Vulvovaginal Infections provides new wisdom to assist clinicians appropriately diagnose and deal with their sufferers and highlights for researchers closing unsolved difficulties and the main promising parts for persevered research. scientific gynecologists will locate functional suggestion and broad perception into fixing real-life medical scenarios.

The booklet opens by way of featuring details at the microbiology of the vagina and vaginal immunology. It then discusses the prognosis of vulvovaginal disorder, together with actual exam, screening procedures, and laboratory testing.

Diagnosis is by means of masking numerous vulvovaginal infections together with bacterial vaginosis, Candida vulvovaginitis, Trichomonas vaginalis vaginitis, genital herpes, human papillomavirus genital infections, allergic vulvovaginitis, menopausal vulvovaginitis, cytolytic vaginosis, cardio vaginitis, and more.

For every one of those stipulations, the publication offers info on its heritage, microbiology, immunology, prevention, analysis, and therapy. remedy info are supplied with an emphasis on nuances that may be utilized to girls who fail to reply to drugs prescribed or who reply after which develop into symptomatic as soon as remedy has ended.

This new version discusses significant advances within the characterization of endogenous microbiota that populate the genital tract in ladies of every age. It additionally presents a extra subtle appreciation of immune mechanisms present in the fit woman genital tract and adjustments that elevate either susceptibility and effects of varied infectious and noninfectious issues. an enormous impetus for scripting this new version is to assist the busy clinician, resident, or fellow by way of explaining advances in person problems in a way that's appropriate to their practice.

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Additional info for Vulvovaginal Infections, Second Edition

Example text

Albicans colonization in reproductive age women, and its infrequent occurrence in children or menopausal women who are not using estrogen supplements, strongly suggests that colonization is hormone dependent. Estrogen promotes elevated glycogen production by vaginal epithelial cells, which is the primary nutrient source for Candida. Conditions that elevate hormone production—pregnancy, diabetes, high-estrogen-­ containing oral contraceptives—are all associated Vulvovaginal Infections 30 with increased Candida growth and a higher frequency of infection.

It should be noted that boric acid taken orally is poisonous and has been removed from commercial products because of its potential toxicity, especially for children. 41 Boric acid is not well absorbed through the vagina, but instances of neurotoxicity (nausea, headaches, disorientation) have been noted in women with prolonged intravaginal use. Treatment failures with boric acid require access to a pharmacy with compounding capabilities, for there are no tested commercial products available. In the Weill Cornell clinic, a vaginal cream with 6% amphotericin has been successfully employed in combination with the cessation of HRT in a postmenopausal woman after a prior treatment failure with vaginal boric acid and then with the 6% amphotericin cream alone.

The cross-talk between opportunistic fungi and the mammalian host via microbiota’s metabolism. Semin Immunopathol 2015;37:163–171. Sobel JD, Chaim W. Vaginal microbiology of women with acute recurrent vulvovaginal candidiasis. J Clin Microbiol 1996;34:2497–2499. Zhou X, Westman R, Hickey R et al. Vaginal microbiota of women with frequent vulvovaginal candidiasis. Infect Immun 2009;77:4130–4135. Liu M-B, Xu S-R, He Y et al. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis.

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