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001-es BibID:	BIBFORM104386
Első szerző:	Kozma Bence (szülész-nőgyógyász)
Cím:	Zinc-containing Vaginal Gel for the Prevention of Recurrent Vaginal Infections : a Pilot Trial / Kozma Bence, Sipos Attila Gergely, Pákozdy Krisztina, Takács Péter
Dátum:	2022
ISSN:	0937-3462
Megjegyzések:	Introduction: Zinc deficiency is closely linked to impaired mucosal integrity which is critical for the prevention of infections. The presence of zinc in the epidermis promotes epidermal homeostasis. Oral supplementation with zinc had no significant impact on cervicovaginal lavage zinc level despite a significant rise in serum zinc level. However, vaginal application of zinc in the form of a zinc-containing vaginal gel is undoubtedly a viable option to deliver zinc to the vagina. Zinc transporters are present in the vagina and ZIP4 is present in the vagina wall for absorption of vaginal zinc replenishment. Objective: To test the hypothesis that prophylactic use of zinc containing vaginal gel decreases the reoccurrence rate of vaginal infection in women with a diagnosis of recurrent vaginal infections. Methods: Women with a history of recurrent vaginal infections (bacterial vaginosis or recurrent vulvovaginal candidiasis) were offered prophylactic treatment with a commercially available zinc-containing vaginal moisturizer gel. Women were asked to use the vaginal gel daily for two weeks and after that twice per week. Women were asked to return to the clinic if any symptoms of vaginal infection were present for evaluation. Results: Eight women were enrolled. The mean age was 32 ? 6 years, mean BMI 24 ? 5, Gravida 1.5 (0-3), Para 1.5 (0-3). All women were premenopausal. None of the patients were using any oral or vaginal hormonal treatment. The number of sexual partners was 1 (1-3). On average, there was at least one infection every three months before treatment. After treatment with the zinc-containing vaginal gel, 5 out 8 women did not have an infection in the first three months (P=0.04). Three women developed one vaginal infection resulting in a 62% reduction in infections. Conclusions: Zinc-containing vaginal gel may help to prevent recurrent vaginal infections. Further studies are required to delineate the possible mechanism of action: zinc - immunoprotective -immunomodulation through vaginal dendritic cells / Langerhans cells; lactic acid ? acidic pH favors lactobacilli and prevents overgrowth of other organisms; hydroxyethyl cellulose - gentle exfoliation - increased availability of glycogen, favors lactobacilli growth.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt folyóiratcikk
Megjelenés:	International Urogynecology Journal. - 33 : Suppl. 2 (2022), p. S402. -
További szerzők:	Sipos Attila Gergely (1990-) (szülész-nőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Takács Péter (1968-) (szülész-nőgyógyász)
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001-es BibID:	BIBFORM094906
Első szerző:	Kozma Bence (szülész-nőgyógyász)
Cím:	Vaginal elasticity is significantly decreased in vaginal atrophy : a strain elastography study / Kozma Bence, Damjanovich Péter, Pákozdy Krisztina, Sipos Attila Gergely, Bombicz Mariann, Takács Péter
Dátum:	2021
ISSN:	0937-3462
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt folyóiratcikk
Megjelenés:	International Urogynecology Journal. - 31 : Suppl1 (2021), p. S33-S34. -
További szerzők:	Damjanovich Péter Gábor (1985-) (szülész-nőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Sipos Attila Gergely (1990-) (szülész-nőgyógyász) Bombicz Mariann (1987-) (gyógyszerész) Takács Péter (1968-) (szülész-nőgyógyász)
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001-es BibID:	BIBFORM116413
Első szerző:	Takács Péter (szülész-nőgyógyász)
Cím:	A Randomized Controlled Trial to Assess the Effectiveness of a Specially Formulated Food Supplement and Pelvic Floor Muscle Training in Women with Stress-Predominant Urinary Incontinence / Takács Péter, Krasznai Zoárd, Pákozdy Krisztina, Koroknai Erzsébet, Kozma Bence
Dátum:	2023
Megjegyzések:	Introduction: Pelvic floor muscle training (PFMT) is the first-line treatment approach for stress urinary incontinence (SUI). Creatine and leucine have been shown to improve muscle function. Since PFMT has been shown to improve the symptoms of SUI, and creatine- leucine supplementation may augment muscle training, we considered that women with stress urinary incontinence might benefit from supplementation with creatine-leucine while practicing FMT. Objective: To assess the effectiveness of a specially formulated creatine-leucine-zinc-calcium-magnesium based food supplement and PFMT in women with stress-predominant urinary incontinence. Methods: Women with stress or stress-predominant urinary incontinence were randomized in 1:1 ratio to receive daily oral supplementation for six weeks with either a specially formulated food supplement (treatment group) or placebo (control group). Both groups were instructed to perform standardized daily PFMT. Patients and evaluators were blinded to the allocation. Primary outcome was Urogenital Distress Inventory Short Form (UDI-6) score. Secondary outcomes were Incontinence Impact Questionnaire (IIQ?7) score, Patient's Global Impression of Severity (PGI?S), Biomechanical Integrity score (BI-score) measured by Vaginal Tactile Imager and vaginal squeeze pressure measured by perineometer. To have a power of 80% and a significance level of 5% to detect a decrease of 16 points in UDI-6 score a sample size of 32 was needed with 16 patients in each arm of our trial. The trial was registered at ClinicalTrials.gov and IRB approved. Results: Sixteen women in the control group and sixteen in the treatment group completed the trial. Between group analysis revealed no significant differences between the control and treatment group except for mean change (delta) in vaginal squeeze pressure [(cmH2O, mean +/- SD), 5+/-12 vs. 15+/-15, P=0.04] and mean change (delta) n PGI-S score [(mean +/- SD), -0.2+/-0.9 vs. -0.8+/-0.8, P=0.04]. Out of the 52 examined VTI parameters significantly more parameters improved in the treatment group compared to the control group (11/52 vs. 3/52, P=0.04). Within group analysis showed that UDI-6, IIQ-7 scores improved significantly from baseline to six weeks in the treatment group but not in the control group [UDI-6 score (mean+/-SD) 45+/-21 vs. 29+/-21, P=0.02; 43+/-18 vs. 33+/-26, P=0.22] [IIQ-7 score (mean+/-SD) 50+/-30 vs. 30+/-21, P=0.01; 48+/-23 vs. 40+/-28, P=0.36]. Similarly maximum vaginal squeeze pressure was significantly stronger in the treatment group compared to baseline after ix weeks but not in the control group [Maximum vaginal squeeze pressure (cmH2O, mean+/-SD), 30+/-15 vs. 45+/-28, P=0.001 and 36+/-18 vs. 41+/-21, P=0.13]. PGI-S scores only improved in the treatment group from baseline to six weeks after treatment [PGI-S score (mean+/-SD) 3.1+/-0.8 vs. 2.3+/-0.8, P=0.0001]. BI-score on average improved significantly, twice as much, in the treatment group compared to control group (SD unit, mean, from -1.06 to -0.58, P=0.001 and from -0.66 to -0.42, P=0.04). Conclusions: Women with stress-predominant urinary incontinence receiving a specially formulated supplement in addition to daily PFMT for six weeks had significantly improved urinary symptoms (decrease in UDI-6 score and IIQ-7) and BI-score compared to their baseline. Women in the treatment group on average improved twice as much in their BI-score as women in the control group.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt folyóiratcikk
Megjelenés:	International Urogynecology Journal. - 34 : Suppl. 1 (2023), p. S26. -
További szerzők:	Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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