Trichomoniasis: trends in diagnosis and management

Article Abstract:

Vaginitis (inflammation of the vagina) is often caused by Trichomoniasis vaginalis. Currently, this form of vaginitis affects approximately 3 million women in the US each year. It is considered a venereal disease, although some cases of non-sexual transmission have been reported. A review and description are presented of the procedures for diagnosing trichomonal vaginitis. The vaginal saline wet mount is the most commonly used method, but much less sensitive (able to correctly identify that a patient has the disease) than culture methods, particularly when used by the average microscopist. Trichomoniasis often was present in women throughout reproductive life before the advent of metronidazole in the 1960s. This drug, a member of the nitroimidazole class, is usually given orally three times a day for seven consecutive days. Resistance to metronidazole has been reported and strains of T. vaginalis can be classified according to their level of resistance (marginal, low, moderate, or high). Most strains have resistance that is marginal or very low. Marginally resistant trichomoniasis can usually be cured by retreatment with the standard dose of metronidazole. In cases that are particularly hard to treat, a combination of oral and vaginal medication may be effective. Metronidazole is known to cross the placenta and has caused mutations in bacteria and cancer in animals. Therefore, it should be avoided in the first trimester of pregnancy and taken as a single dose only if absolutely necessary later in pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Metronidazole

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Diagnosis and assessment of sigmoidoceles

Article Abstract:

Herniations of the sigmoid colon through the pelvic floor may sometimes be found in women with defects of the pelvic floor. Defecating proctograms can be used to help diagnose them. A group of 234 women with symptomatic pelvic floor defects underwent defecating proctograms in which images of the bowel were taken during the strain of defecation. Nine of the women had herniations of the sigmoid colon. None of them were suspected through physical diagnosis alone, although all herniations of the rectum were diagnosed by physical examination.

Abnormalities, Constipation, Colon (Anatomy), Colon, Hernia

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Trichomoniasis: under control or undercontrolled?

Article Abstract:

Aside from human papillomavirus, trichomoniasis is the most common sexually transmitted infection in the United States, yet it is considered as of minor importance. However, recently accumulated evidence implicated Trichomonas vaginalis as a contributor to a variety of adverse outcomes among both sexes.

United States, Sexually transmitted diseases, Risk factors

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