Vulvovaginal candidiasis (VVC), particularly the recurrent form, remains an intractable problem for clinicians, microbiologists, and patients. It is essential to confirm the clinical diagnosis by mycological methods and avoid empirical therapy. The recovery of yeast in fungal culture, such as on Sabouraud dextrose agar, remains the gold standard for diagnosis. In this investigation, we examined 474 participants, including 122 (25.7%) with acute VVC cases, 249 (52.5%) who had recurrent VVC (RVVC) cases, and 103 (21.7%) healthy controls. We also administered a questionnaire to obtain information on patient lifestyle and medical, gynecological, and sexual history. In addition, we compared the performance of chromID Candida agar (CAN2) to CHROMagar Candida (CAC) and Sabouraud dextrose agar with gentamicin and chloramphenicol (SGC2). The yeasts were identified by conventional methods including the germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX system. We detected yeasts in 60 of 122 (49.2%) patients with acute VVC cases, 110 of 249 (44.2%) with RVVC cases, and in 35 of 103 (34%) healthy controls (P = 0.07). A total of 205 samples were found to be positive for fungi (43.2%), of which 176 (85.9%) were monofungal, and 29 (14.1%) were polyfungal. In addition, 198 of these samples (96.6%) were positive on CAN2, 195 (95.1%) on CAC, 189 (92.2%) on SGC2, and 183 (89.3%) samples on all three (P = 0.17). The 234 yeast isolates recovered were C. albicans (n = 118), C. glabrata (n = 82), C. kefyr (n = 11), C. krusei (n = 9), C. lipolytica (n = 3), C. colliculosa (n = 2), C. parapsilosis (n = 2), C. pelliculosa (n = 2), C. tropicalis (n = 2), and other species of Candida (n = 3). Of the 29 polyfungal populations, 28 (96.6%) were detected in CAN2, 25 in (86.2%) CAC, and 25 (86.2%) on both (P = 0.35). Notably, we detected the high predominance of C. albicans+C. glabrata (86.2%) in polyfungal populations. Briefly, the detection of C. albicans after 24 h of incubation was easier on CAN2 (64.4%) than on CAC (25.4%). This study showed that CAN2 is a rapid and reliable medium for immediate identification of C. albicans and for detecting polyfungal populations in vaginal specimens. We observed that the use of antibiotics, intrauterine devices, as well as, perineal laceration, short anovaginal distance (< 3 cm), and genital epilation in common areas are predisposing factors for RVVC (P < 0.001). In addition, we detected that the use of menstrual pad, using an (IUD), and having a history of childbirth increased the risk of both acute and recurrent VVC (P < 0.01), whereas the use of a daily pad and walking daily significantly decreased the risk of both acute and recurrent VVC (P < 0.01).

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The results confirmed the opinion that EOP is a distinct and more severe clinical entity than LOP. In particular, higher proteinuria is associated with EOP.

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ÖZETAmaç: Doğuştan kalp hastalıkları için yüksek ve düşük risk taşıyan gebelerde intrauterin kalp hastalığı sıklığını belirlemek ve karşılaştırmak. Yöntemler: Üniversitemiz Tıp Fakültesi Pediatrik Kardiyoloji Ünitesinde fetal ekokardiyografi yapılan 3782 gebenin kayıtları ve ekokardiyografi sonuçları retrospektif olarak değerlendirildi. Gruplar arasındaki değişkenler Ki-kare testi kullanılarak analiz edildi. Bulgular: Yüksek ve düşük riskli gruplardaki tüm fetüslerin 213'ünde (%5.6) yapısal kalp hastalığı bulundu. En sık patolojiler ventriküler septal defekt (%36.2) ve atriyoventriküler septal defekt (%14.1) idi. Yüksek riskli grupta doğuştan kalp hastalığı sıklığı %7.8 (169 fetüs) bulundu; %4.1'i kompleks, %2.3'ü önemli, %1.4'ü minör patolojiydi. Düşük riskli grupta bu oran %2.7 (44 fetüs) idi; %0.6'sı kompleks, %0.8'i önemli ve %1.3'ü minör patolojiydi. Bu grupta bazı nedenlerle başvuranlarda yapısal kalp hastalığı sıklığı yüksek bulundu; önceki gebelikte intrauterin fetal ölüm (%6.3), anormal birinci ve ikinci üç aylık dönem tarama testleri (%4.3) ve çoğul gebelik (%3.4). Fetal ekokardiyografik incelemenin duyarlılığı %86, özgül-lüğü %98 bulundu. Sonuç: Doğuştan kalp hastalığı sıklığı beklenildiği gibi yüksek riskli grupta daha yüksek bulundu. Düşük riskli grupta yer almalarına rağmen önceki gebelikte intrauterin fetal ölüm, anormal birinci ve ikinci üç aylık dönem tarama testleri ve çoğul gebelik nedeniyle başvuranlardaki kalp hastalığı sıklığı ile yüksek riskli gruptaki kalp hastalığı sıklığı arasında istatistiksel olarak anlamlı bir fark bulunmadı. Bu nedenle kardiyoloji kliniğinin bu konuda uzman kardiyoloğu ve ekipmanı yeterli ise yukarıdaki nedenlerle başvuran gebelere rutin fetal ekokardiyografik çalışma yapılmasını öneriyoruz. (Anadolu Kardiyol Derg 2011; 2: 125-30) Anahtar kelimeler: Doğuştan kalp hastalığı, fetal ekokardiyografi, yüksek riskli gebelik, düşük riskli gebelik ABSTRACT Objective: To establish and compare the frequency of intrauterine congenital heart defects in high-risk and low-risk pregnancies for congenital heart diseases. Methods: Records of 3782 patients who underwent fetal echocardiography at the Pediatric Cardiology Unit were reviewed for reasons of referral and results of echocardiography retrospectively. The categorical variables between the groups were analyzed using a Chi-square test. Results: Structural heart defects were found in 213 (5.6%) fetuses in both high and low risk groups. Most common defects were ventricular septal defect (36.2%) and atrioventricular septal defect (14.1%). Frequency of congenital heart diseases was 7.8% (169 fetuses) in high-risk group: 4.1% were complex, 2.3% significant and 1.4% were minor. In low-risk group, the frequency was 2.7% (44 fetuses): 0.6% were complex, 0.8% significant and 1.3% were minor. In this group, rates of congenital defects were high regarding particular reasons: intrauterine fetal death in previous pregnancy (6.3%), abnormal first or second trimester screening tests (4.3%), and multiple gestations (3.4%). The sensitivity and...