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Biomedical subjects

J D Milne

Publications and source records attributed to J D Milne.

12 recordsLinked to original sources

Vaginal candidosis: relation between yeast counts and symptoms and clinical signs in non-pregnant women.

Of 277 non-pregnant women, 67 (24%) harboured Candida albicans in the genital tract. Of 56 women yielding C albicans who had no other infection diagnosed, 14 were symptomless and 10 had no clinical signs of vulval redness, vaginitis, or discharge. Symptoms and signs tended to be more severe in women with higher yeast counts. Of 22 women with moderate or severe symptoms (pruritus with or without discharge) and signs, 15 had yeast counts of more than 10(3) colony forming units (cfu)/ml, whereas six of nine women with no symptoms or signs had counts of fewer than 10(3) cfu/ml.

Candida albicans

Intermittent local prophylaxis against recurrent vaginal candidosis.

Women with recurrent vaginal candidosis were treated until the infection cleared and were then given one clotrimazole 500 mg vaginal tablet a month or an identical placebo as prophylaxis. Of 21 women who received placebo, 16 developed symptoms or signs within three months, compared with nine of 17 women given active treatment. Women who relapsed were treated and then given active prophylaxis once a month. Of 30 women given such treatment, 13 relapsed within three months. Women who relapsed were treated and then given two clotrimazole 500 mg vaginal tablets a month. Of 17 women given prophylaxis twice a month, four developed symptoms or signs within three months, but 10 remained clear for 12 months. No appreciable difference was seen in the incidence of mycological recurrence between the different regimens; within three months over half the women in all treatment groups had become recolonised.

Adolescent

Evaluation of a new slide latex agglutination test for diagnosis of vaginal candidosis.

A new commercial slide latex particle agglutination test for rapid (2 min) diagnosis of vaginal candidosis was evaluated and compared with conventional methods. Of the 263 women studied, 63 (23.9%) had yeasts in the vagina. Clinical signs of vulvitis or vaginitis were seen in 23 women (8.8%) and 40 (15.2%) were harbouring yeasts without clinical signs. Yeast counts were generally higher in women with clinical signs of vaginal candidosis than in those without. The test was positive in 15 of the 23 women (65.2%) with clinical signs, the incidence of a positive test increasing in direct proportion to the amount of yeasts isolated. The test's sensitivity, specificity and predictive values were comparable to those of microscopy and culture. Being both rapid and simple to perform, this new test offers a useful alternative to conventional methods for the diagnosis of vaginal candidosis.

Antigens, Fungal

Epidemiological investigation of patients with vulvovaginal candidosis. Application of a resistogram method for strain differentiation of Candida albicans.

The resistogram method was applied to 420 isolates of Candida albicans obtained from 30 selected patients undergoing treatment for vulvovaginitis. Of these, 16 patients each harboured a particular strain of C. albicans which persisted in the mouth or intestinal tract or both. In three of these patients, this strain persisted in the genital tract, and, in eight patients, it later recolonised the genital tract. Fourteen patients harboured more than one strain of C. albicans: one failed to respond to treatment and continued to harbour the same strain in the genital tract; in five the original strain later recolonised the genital tract and a second strain remained confined to the mouth or intestinal tract or both; and in three a second strain, present in the intestinal tract, later colonised the genital tract. Each of the male partners of seven patients harboured a strain of C. albicans that was identical to the strain, or to one of the strains, that had been isolated from his female partner.

Adolescent

Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis.

One hundred patients with vulvovaginal candidosis were entered in a double-blind trial to compare the effect of six days' local treatment with clotrimazole with that of the same treatment plus 10 days' oral treatment with nystatin. No significant differences were detected in the rate of cure or relapse between the treatment groups. The cure rate was lowest and the relapse rate highest in patients in whom vaginal candidosis had last been diagnosed during the preceding 12 months.

Administration, Oral

Immunoglobulin classes of human serum antibodies in vaginal candidiasis.

The titre and immunoglobulin class of antibodies against Candida albicans in serum from 60 non-pregnant women was determined. IgG titres up to 1 : 32, IgA titres up to 1 : 8, and IgM titres up to 1 : 4 were detected in 30 women with vaginal candidiasis. Similar titres were found in 20 women harbouring yeasts in the mouth or rectum, and in 10 women who were not harbouring yeasts in the vagina, mouth or rectum. Serum fractionation confirmed that antibodies to C. albicans are found in the three immunoglobulin classes and that those antibodies reside in highest titre in the IgG class. No secretory IgA antibodies against C. albicans were detected in the serum of these women.

Antibodies, Fungal

Antibodies to Candida albicans in human cervicovaginal secretions.

The incidence of IgA and IgG antibodies against Candida albicans was determined in cervicovaginal secretions from 95 non-pregnant women. IgG antibodies were detected in 21.2% of women with vaginal candidosis, in 23.5% of women harbouring yeasts in the vagina without clinical signs of infection, and in 26.6% of women not harbouring yeasts in the vagina. IgA antibodies were found in 6.1% of women with vaginal candidosis, in 5.9% of women harbouring yeasts in the vagina without clinical signs of infection, and in 8.9% of women not harbouring yeasts in the vagina. IgG antibodies against C. albicans were detected in the serum of all 95 women. It is suggested that a proportion of the antibodies found in the secretions was derived from the circulation.

Adolescent

Treatment of vaginal candidiasis with miconazole.

An open trial was carried out in 50 women with clinical signs and mycological evidence of vaginal candidiasis to compare the effectiveness of treatment with 2% miconazole cream with that of nystatin pessaries. Both groups were given intravaginal treatment for 14 days and were followed up at monthly intervals for 3 months. Relief of symptoms and clinical signs was comparable in the two groups but the mycological cure rate at 1 month was higher with miconazole. At 2 and 3 months, however, there was no significant difference between the cure rate obtained with the two treatments in the patients still included in the study.

Candidiasis, Vulvovaginal