The purpose of this study was to determine the effectiveness of Lactobacillus-containing vaginal tablets in the treatment of bacterial vaginosis (BV) and in the restoration of a healthy vaginal flora. Thirty-nine women with BV were enrolled in a double-blind, placebo-controlled clinical trial. Patients received either one Lactobacillus-containing tablet or placebo daily for 7 days. Clinical criteria, vaginal Gram stain scores and symptoms were compared with those at the initial visit and those at completion of therapy and 2 weeks later. After completion of therapy, all of the patients in the Lactobacillus-treated group (n = 18) were free of BV, showing a normal (83%) or intermediate (17%) vaginal flora, as compared with only two patients free of BV with intermediate flora (12%) from among the 16 placebo-treated women (p <0.001). Two weeks after completion of therapy, treatment was successful (score <7) in 61% of Lactobacillus-treated patients as compared with 19% of those in the placebo group (p <0.05). In the treatment group, the total number of symptomatic patients and the intensity of their symptoms, in particular vaginal malodour, were significantly reduced at both follow-up visits. The data indicate that intravaginal administration of exogenous selected strains of lactobacilli can restore a normal vaginal microbiota and be used in treating bacterial vaginosis.
Early detection of breast cancer is of paramount importance for its management. Therefore, new diagnostic tools are continously searched, including 3D‐US and 3D Power Doppler, and for later management, the study of the sentinel node. 3D ultrasonography (3‐D US) may be of value in the differential diagnosis of the following conditions. Cysts Not all cysts display a typical US appearance. Small cysts may lack the distal sound enhancement. Inflammatory cysts may exhibit a thickened wall. However, the major problem it the not so rare presence of intracystic echoes, which may be either real or artifactual. Fibroadenomas A refraction artifact (edge shadowing) is often noted at each lateral margin of smooth‐marginated fibroadenomas. Contours are irregular in about 25% of cases, and in about 5% shadowing makes it impossible to rule out malignancy. Carcinomas Shadowing is associated only with those carcinomas that have a significant amount of fibrosis (< 50% of cases in our experience). Some partial shadowing seen with some carcinomas may also be caused by beam scattering by jagged margins, with 3D scan potentially useful for diagnosis. The sentinel node. Axillary lymph node status is the most important pathological determinant of prognosis in early breast cancer, whereas local axillary lynphadenectomy is the most reliable staging procedure. However, routine axillary dissection does not benefit the majority of patients with early breast cancer who are node‐negative, thereby sustaining the potential morbidity of the procedure. Sentinel node is the first regional node to receive lymph from the breast and accurately represents the metastatic status of the primary cancer. Sentinel node biopsy appears to offer an alternative to routine axillary lymph node dissection for staging patients with breast cancer. (Supported in part my MURST and CNR, Italy)
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