There was no significant Prexasertib supplier difference in the postoperative complication rate (33.3% compared with 27.3%; P>.99) between one-stage and two-stage operations. All operations were performed without severe surgical-related complications or death. Approximately 78% of patients had complete resection of tumor and 22.2% of the patients experienced incomplete resection. Eleven (55%) patients received hormone therapy postoperatively.
During mean follow-up time of 20.5 months, recurrence occurred in five patients (27.8%) but all the patients survived.
CONCLUSIONS: Precise and full-scale preoperative evaluation, complete tumor resection, and multidisciplinary cooperation are crucial for successful treatment. (Obstet Gynecol 2012;120:1400-06) DOI: http://10.1097/AOG.0b013e31826ebb90″
“OBJECTIVE: As a result of high recurrence rates of Candida albicans vaginitis, successful suppressive fluconazole is widely used, and drug resistance is considered rare. We report increased occurrence of secondary fluconazole resistance, analysis of risk factors thereof, and describe management of fluconazole-refractory vaginitis.
METHODS: Patients referred to the Vaginitis Clinic at Wayne State University with clinically refractory fluconazole-resistant (minimum inhibitory concentration [MIC] 2 micrograms/mL or greater) C albicans vaginitis from 2000
to 2010 were enrolled. Patients MI-503 molecular weight Galunisertib TGF-beta/Smad inhibitor completed a questionnaire pertaining to demographics, comorbidities, behavioral characteristics, exposure to antimicrobials and antifungals, fluconazole consumption in defined daily doses in the previous 6 months, management received, and outcomes. With patients not located, data were extracted from charts. Susceptibilities to antifungals were determined by broth microdilution.
RESULTS: Twenty-five women with fluconazole-resistant recurrent C albicans vaginitis were identified, and 16 returned filled questionnaires. Study cohort consisted mainly of married, insured white women with more than 12 years of formal education and average or above average
socioeconomic status. Median fluconazole MIC was 8 micrograms/mL (range 2-128 micrograms/mL). Risk factors for mycologic failure included increased fluconazole consumption (P=.03) with 16 of 25 women exposed to low-dose weekly fluconazole maintenance therapy. All patients were clinically controlled successfully, although treatment was difficult and often prolonged.
CONCLUSION: Fluconazole-resistant C albicans vaginitis was previously considered rare. We report 25 cases over an 11-year period, indicating an emerging problem. All patients had fluconazole consumption in the previous 6 months. Management of fluconazole refractory disease is extremely difficult with limited options, and new therapeutic modalities are needed.