human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To determine if oral metronidazole ( MTZ-400 mg bid ) with 2 % vaginal clindamycin-cream ( Clind ) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol ( Prob ) reduces 6-month bacterial vaginosis ( BV ) recurrence . Methods Double-blind placebo-controlled parallel-group single-site study with balanced r and omization ( 1∶1∶1 ) conducted at Melbourne Sexual Health Centre , Australia . Participants with symptomatic BV [ Nugent Score ( NS ) = 7–10 or ≥3 Amsel 's criteria and NS = 4–10 ] , were r and omly allocated to MTZ-Clind , MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months . MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days . Primary outcome was BV recurrence ( NS of 7–10 ) on self-collected vaginal-swabs over 6-months . Cumulative BV recurrence rates were compared between groups by Chi-squared statistics . Kaplan-Meier , log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups . Results 450 18–50 year old females were r and omized and 408 ( 91 % ) , equally distributed between groups , provided ≥1 NS post-r and omization and were included in analyses ; 42 ( 9 % ) participants with no post-r and omization data were excluded . Six-month retention rates were 78 % ( n = 351 ) . One-month BV recurrence ( NS 7–10 ) rates were 3.6 % ( 5/140 ) , 6.8 % ( 9/133 ) and 9.6 % ( 13/135 ) in the MTZ-Clind , MTZ-Prob and MTZ-Placebo groups respectively , p = 0.13 . Hazard ratios ( HR ) for BV recurrence at one-month , adjusted for adherence to vaginal therapy , were 0.43 ( 95%CI 0.15–1.22 ) and 0.75 ( 95 % CI 0.32–1.76 ) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively . Cumulative 6-month BV recurrence was 28.2 % ; ( 95%CI 24.0–32.7 % ) with no difference between groups , p = 0.82 ; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac , adjusted for adherence to vaginal therapy were 1.09(95 % CI = 0.70–1.70 ) and 1.03(95 % CI = 0.65–1.63 ) , respectively . No serious adverse events occurred . Conclusion Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin , or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic , does not reduce BV recurrence . Trial Registration ANZCTR.org.au Background : Bacterial vaginosis ( BV ) is a common vaginal infection caused by a lack of endogenous lactobacilli and overgrowth of pathogens that frequently recurs following antibiotic treatment . Methods : A phase 2a study assessed colonization efficiency , safety , tolerability , and acceptability of Lactobacillus crispatus CTV-05 ( LACTIN-V ) administered by a vaginal applicator . Twenty-four women with BV were r and omized in a 3:1 ratio of active product to placebo . Participants used LACTIN-V at 2 × 109 colony-forming units (cfu)/dose or placebo for 5 initial consecutive days , followed by a weekly application over 2 weeks . They returned for follow-up on Days 10 and 28 . Results : Sixty-one percent of the 18 women r and omized to the LACTIN-V group were colonized with L. crispatus CTV-05 at Day 10 or Day 28 . Among LACTIN-V users with complete adherence to the study regimen , 78 % were colonized at Day 10 or Day 28 . Of the 120 adverse events ( AEs ) that occurred , 108 ( 90 % ) and 12 ( 10 % ) were of mild and moderate severity , respectively . AEs were evenly distributed between the LACTIN-V and placebo group . Of the total AEs , 93 ( 78 % ) were genitourinary in origin . The most common genitourinary AEs included vaginal discharge ( 46 % ) , abdominal pain ( 46 % ) , dysuria ( 21 % ) , pollakiuria ( 21 % ) , vaginal odor ( 21 % ) , and genital pruritus ( 17 % ) . No grade 3 or 4 AEs or serious AEs occurred and no deep epithelial disruption was seen during colposcopic evaluation . The product was well tolerated and accepted . Conclusions : LACTIN-V colonized well , and was safe and acceptable in women treated for BV BACKGROUND Urinary tract infections ( UTIs ) are common among women and frequently recur . Depletion of vaginal lactobacilli is associated with UTI risk , which suggests that repletion may be beneficial . We conducted a double-blind placebo-controlled trial of a Lactobacillus crispatus intravaginal suppository probiotic ( Lactin-V ; Osel ) for prevention of recurrent UTI in premenopausal women . METHODS One hundred young women with a history of recurrent UTI received antimicrobials for acute UTI and then were r and omized to receive either Lactin-V or placebo daily for 5 d , then once weekly for 10 weeks . Participants were followed up at 1 week and 10 weeks after intervention and for UTIs ; urine sample s for culture and vaginal swabs for real-time quantitative 16S ribosomal RNA gene polymerase chain reaction for L. crispatus were collected . RESULTS Recurrent UTI occurred in 7/48 15 % of women receiving Lactin-V compared with 13/48 27 % of women receiving placebo ( relative risk [ RR ] , .5 ; 95 % confidence interval , .2 - 1.2 ) . High-level vaginal colonization with L. crispatus ( ≥10(6 ) 16S RNA gene copies per swab ) throughout follow-up was associated with a significant reduction in recurrent UTI only for Lactin-V ( RR for Lactin-V , .07 ; RR for placebo , 1.1 ; P < .01 ) . CONCLUSIONS Lactin-V after treatment for cystitis is associated with a reduction in recurrent UTI . Larger efficacy trials of this novel preventive method for recurrent UTI are warranted . CLINICAL TRIALS REGISTRATION . NCT00305227 Bacterial vaginosis ( BV ) is the most prevalent vaginal infection worldwide and is characterized by depletion of the indigenous lactobacilli . Antimicrobial therapy is often ineffective . We hypothesized that probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 might provide an adjunct to antimicrobial treatment and improve cure rates .  Sixty-four Brazilian women diagnosed with BV were r and omly assigned to receive a single dose of tinidazole ( 2 g ) supplemented with either 2 placebo capsules or 2 capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 every morning for the following 4 weeks . At the end of treatment ( day 28 ) , the probiotic group had a significantly higher cure rate of BV ( 87.5 % ) than the placebo group ( 50.0 % ) ( p = 0.001 ) . In addition , according to the Gram-stain Nugent score , more women were assessed with " normal " vaginal microbiota in the probiotic group ( 75.0 % vs. 34.4 % in the placebo group ; p = 0.011 ) . This study shows that probiotic lactobacilli can provide benefits to women being treated with antibiotics for an infectious condition Background Bacterial vaginosis ( BV ) is the most prevalent vaginal disorder in adult women worldwide . A number of clinical studies indicate that re-establishment of the physiological ecosystem by re-colonization of vaginal mucosa by lactobacilli may be an effective therapy for BV both after initial antimicrobial therapy or when given alone . A vaginal pH < 4.5 is considered physiological and its measurement has been reported as an objective parameter , very sensitive to alterations of vaginal microflora and correlated with clinical ly relevant BV . Objective The aims of this work were to assess the effectiveness of a long-term ( 24 months ) intravaginal treatment with Lactobacillus rhamnosus ( NORMOGIN ® ) on the vaginal pH and on the clinical symptoms in a group of 40 women affected by BV diagnosed by the Amsel criteria . Method A prospect i ve open clinical trial was performed in 40 consecutive cases evaluated for B.V. by the Amsel criteria . Results Vaginal pH was above the physiological value of 4.5 in 36 out of 40 patients at the first visit . It returned under 4.5 value in 24/40 and 32/40 women after 12 and 24 months of treatment , respectively . pH values were significantly decreased at 12 month treatment ( P < 0.001 ) and further reduction in pH values was found at 24 months of treatment ( P < 0.02 vs. 12 months ) . The gradual return to a vaginal physiological pH was associated with a reduction of the intensity of symptoms as shown by the decrease in the symptoms score . Conclusions The present study supports the use of pH measurement for sensitive , objective , and simple therapy follow-up in women with BV and shows that long-term administration of vaginal tablets containing Lactobacillus rhamnosus represents an effective and safe treatment for restoring the physiological vaginal pH and controlling BV symptoms Abstract The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines . Sixty-seven patients with bacterial vaginosis ( BV ) , 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study . The subjects were r and omized to receive probiotic lactobacilli vaginal tablets ( L. brevis CD2 , L. salivarius subsp . salicinius , L. plantarum ) or the vaginal pH tablet ( active comparator ) . Cervico-vaginal lavage was collected to measure the concentrations of IL-1β , TNFα and IL-6 by ELISA . Neutral sphingomyelinase activity was also quantified in both arms before and after treatment . The probiotic vaginal tablet was well tolerated and no side effects were reported . The study demonstrated a cure rate of nearly 80 % ; i.e. , 32 % of the women could restore normal vaginal flora and 47 % had improved Nugent score , whereas 20 % of the subjects did not clear BV in the first follow-up ( after 8 days treatment ) . The pH tablet containing pH lowering compounds induced resolution of BV and restoration of normal vaginal flora in 74 % and 26 % , respectively . The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects . A significant reduction in IL-1β and IL-6 vaginal cytokines was observed after treatment with lactobacilli , while the active comparator did not have any effect on local proinflammatory cytokines . Vaginal neutral sphingomyelinase activity was not modified in either group . Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response Eighty-four patients with bacterial vaginosis diagnosed according to Amsel 's criteria were r and omized to receive either oral metronidazole 500 mg twice a day for seven days , or one vaginal tablet containing freeze-dried Lactobacillus rhamnosus once a week at bedtime for two months starting one week after the last antibiotic administration . Followup was performed at days 30 , 90 and 180 . Chi-squared analysis showed a significant difference between the two treatment groups at day 90 ( P = 0.05 ) . Safe and effective long-term vaginal administration of Lactobacillus rhamnosus appears to be a useful complementary approach in the management of bacterial vaginosis Objective : To assess the effectiveness of the association of 2 specific strains , Lactobacillus fermentum LF10 ( DSM 19187 ) and Lactobacillus acidophilus LA02 ( DSM 21717 ) , specifically formulated in slow-release effervescent tablets , in patients with recurrent vulvovaginal c and idiasis . Study Design : The study was a clinical trial of 58 women diagnosed with recurrent VVC ( ≥4 culture-confirmed episodes in a 12-mo period ) . All patients were given 200 mg of fluconazole orally as an 
    Output:
    
agent
Probiotic interventions were effective for treatment and prevention of BV , prevention of recurrences of c and idiasis and UTIs , and clearing HPV lesions .
Although clinical practice recommendations were limited by the strength of evidence , probiotic interventions were effective in treatment and prevention of urogenital infections as alternatives or co-treatments .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To determine if oral metronidazole ( MTZ-400 mg bid ) with 2 % vaginal clindamycin-cream ( Clind ) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol ( Prob ) reduces 6-month bacterial vaginosis ( BV ) recurrence . Methods Double-blind placebo-controlled parallel-group single-site study with balanced r and omization ( 1∶1∶1 ) conducted at Melbourne Sexual Health Centre , Australia . Participants with symptomatic BV [ Nugent Score ( NS ) = 7–10 or ≥3 Amsel 's criteria and NS = 4–10 ] , were r and omly allocated to MTZ-Clind , MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months . MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days . Primary outcome was BV recurrence ( NS of 7–10 ) on self-collected vaginal-swabs over 6-months . Cumulative BV recurrence rates were compared between groups by Chi-squared statistics . Kaplan-Meier , log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups . Results 450 18–50 year old females were r and omized and 408 ( 91 % ) , equally distributed between groups , provided ≥1 NS post-r and omization and were included in analyses ; 42 ( 9 % ) participants with no post-r and omization data were excluded . Six-month retention rates were 78 % ( n = 351 ) . One-month BV recurrence ( NS 7–10 ) rates were 3.6 % ( 5/140 ) , 6.8 % ( 9/133 ) and 9.6 % ( 13/135 ) in the MTZ-Clind , MTZ-Prob and MTZ-Placebo groups respectively , p = 0.13 . Hazard ratios ( HR ) for BV recurrence at one-month , adjusted for adherence to vaginal therapy , were 0.43 ( 95%CI 0.15–1.22 ) and 0.75 ( 95 % CI 0.32–1.76 ) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively . Cumulative 6-month BV recurrence was 28.2 % ; ( 95%CI 24.0–32.7 % ) with no difference between groups , p = 0.82 ; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac , adjusted for adherence to vaginal therapy were 1.09(95 % CI = 0.70–1.70 ) and 1.03(95 % CI = 0.65–1.63 ) , respectively . No serious adverse events occurred . Conclusion Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin , or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic , does not reduce BV recurrence . Trial Registration ANZCTR.org.au Background : Bacterial vaginosis ( BV ) is a common vaginal infection caused by a lack of endogenous lactobacilli and overgrowth of pathogens that frequently recurs following antibiotic treatment . Methods : A phase 2a study assessed colonization efficiency , safety , tolerability , and acceptability of Lactobacillus crispatus CTV-05 ( LACTIN-V ) administered by a vaginal applicator . Twenty-four women with BV were r and omized in a 3:1 ratio of active product to placebo . Participants used LACTIN-V at 2 × 109 colony-forming units (cfu)/dose or placebo for 5 initial consecutive days , followed by a weekly application over 2 weeks . They returned for follow-up on Days 10 and 28 . Results : Sixty-one percent of the 18 women r and omized to the LACTIN-V group were colonized with L. crispatus CTV-05 at Day 10 or Day 28 . Among LACTIN-V users with complete adherence to the study regimen , 78 % were colonized at Day 10 or Day 28 . Of the 120 adverse events ( AEs ) that occurred , 108 ( 90 % ) and 12 ( 10 % ) were of mild and moderate severity , respectively . AEs were evenly distributed between the LACTIN-V and placebo group . Of the total AEs , 93 ( 78 % ) were genitourinary in origin . The most common genitourinary AEs included vaginal discharge ( 46 % ) , abdominal pain ( 46 % ) , dysuria ( 21 % ) , pollakiuria ( 21 % ) , vaginal odor ( 21 % ) , and genital pruritus ( 17 % ) . No grade 3 or 4 AEs or serious AEs occurred and no deep epithelial disruption was seen during colposcopic evaluation . The product was well tolerated and accepted . Conclusions : LACTIN-V colonized well , and was safe and acceptable in women treated for BV BACKGROUND Urinary tract infections ( UTIs ) are common among women and frequently recur . Depletion of vaginal lactobacilli is associated with UTI risk , which suggests that repletion may be beneficial . We conducted a double-blind placebo-controlled trial of a Lactobacillus crispatus intravaginal suppository probiotic ( Lactin-V ; Osel ) for prevention of recurrent UTI in premenopausal women . METHODS One hundred young women with a history of recurrent UTI received antimicrobials for acute UTI and then were r and omized to receive either Lactin-V or placebo daily for 5 d , then once weekly for 10 weeks . Participants were followed up at 1 week and 10 weeks after intervention and for UTIs ; urine sample s for culture and vaginal swabs for real-time quantitative 16S ribosomal RNA gene polymerase chain reaction for L. crispatus were collected . RESULTS Recurrent UTI occurred in 7/48 15 % of women receiving Lactin-V compared with 13/48 27 % of women receiving placebo ( relative risk [ RR ] , .5 ; 95 % confidence interval , .2 - 1.2 ) . High-level vaginal colonization with L. crispatus ( ≥10(6 ) 16S RNA gene copies per swab ) throughout follow-up was associated with a significant reduction in recurrent UTI only for Lactin-V ( RR for Lactin-V , .07 ; RR for placebo , 1.1 ; P < .01 ) . CONCLUSIONS Lactin-V after treatment for cystitis is associated with a reduction in recurrent UTI . Larger efficacy trials of this novel preventive method for recurrent UTI are warranted . CLINICAL TRIALS REGISTRATION . NCT00305227 Bacterial vaginosis ( BV ) is the most prevalent vaginal infection worldwide and is characterized by depletion of the indigenous lactobacilli . Antimicrobial therapy is often ineffective . We hypothesized that probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 might provide an adjunct to antimicrobial treatment and improve cure rates .  Sixty-four Brazilian women diagnosed with BV were r and omly assigned to receive a single dose of tinidazole ( 2 g ) supplemented with either 2 placebo capsules or 2 capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 every morning for the following 4 weeks . At the end of treatment ( day 28 ) , the probiotic group had a significantly higher cure rate of BV ( 87.5 % ) than the placebo group ( 50.0 % ) ( p = 0.001 ) . In addition , according to the Gram-stain Nugent score , more women were assessed with " normal " vaginal microbiota in the probiotic group ( 75.0 % vs. 34.4 % in the placebo group ; p = 0.011 ) . This study shows that probiotic lactobacilli can provide benefits to women being treated with antibiotics for an infectious condition Background Bacterial vaginosis ( BV ) is the most prevalent vaginal disorder in adult women worldwide . A number of clinical studies indicate that re-establishment of the physiological ecosystem by re-colonization of vaginal mucosa by lactobacilli may be an effective therapy for BV both after initial antimicrobial therapy or when given alone . A vaginal pH < 4.5 is considered physiological and its measurement has been reported as an objective parameter , very sensitive to alterations of vaginal microflora and correlated with clinical ly relevant BV . Objective The aims of this work were to assess the effectiveness of a long-term ( 24 months ) intravaginal treatment with Lactobacillus rhamnosus ( NORMOGIN ® ) on the vaginal pH and on the clinical symptoms in a group of 40 women affected by BV diagnosed by the Amsel criteria . Method A prospect i ve open clinical trial was performed in 40 consecutive cases evaluated for B.V. by the Amsel criteria . Results Vaginal pH was above the physiological value of 4.5 in 36 out of 40 patients at the first visit . It returned under 4.5 value in 24/40 and 32/40 women after 12 and 24 months of treatment , respectively . pH values were significantly decreased at 12 month treatment ( P < 0.001 ) and further reduction in pH values was found at 24 months of treatment ( P < 0.02 vs. 12 months ) . The gradual return to a vaginal physiological pH was associated with a reduction of the intensity of symptoms as shown by the decrease in the symptoms score . Conclusions The present study supports the use of pH measurement for sensitive , objective , and simple therapy follow-up in women with BV and shows that long-term administration of vaginal tablets containing Lactobacillus rhamnosus represents an effective and safe treatment for restoring the physiological vaginal pH and controlling BV symptoms Abstract The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines . Sixty-seven patients with bacterial vaginosis ( BV ) , 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study . The subjects were r and omized to receive probiotic lactobacilli vaginal tablets ( L. brevis CD2 , L. salivarius subsp . salicinius , L. plantarum ) or the vaginal pH tablet ( active comparator ) . Cervico-vaginal lavage was collected to measure the concentrations of IL-1β , TNFα and IL-6 by ELISA . Neutral sphingomyelinase activity was also quantified in both arms before and after treatment . The probiotic vaginal tablet was well tolerated and no side effects were reported . The study demonstrated a cure rate of nearly 80 % ; i.e. , 32 % of the women could restore normal vaginal flora and 47 % had improved Nugent score , whereas 20 % of the subjects did not clear BV in the first follow-up ( after 8 days treatment ) . The pH tablet containing pH lowering compounds induced resolution of BV and restoration of normal vaginal flora in 74 % and 26 % , respectively . The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects . A significant reduction in IL-1β and IL-6 vaginal cytokines was observed after treatment with lactobacilli , while the active comparator did not have any effect on local proinflammatory cytokines . Vaginal neutral sphingomyelinase activity was not modified in either group . Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response Eighty-four patients with bacterial vaginosis diagnosed according to Amsel 's criteria were r and omized to receive either oral metronidazole 500 mg twice a day for seven days , or one vaginal tablet containing freeze-dried Lactobacillus rhamnosus once a week at bedtime for two months starting one week after the last antibiotic administration . Followup was performed at days 30 , 90 and 180 . Chi-squared analysis showed a significant difference between the two treatment groups at day 90 ( P = 0.05 ) . Safe and effective long-term vaginal administration of Lactobacillus rhamnosus appears to be a useful complementary approach in the management of bacterial vaginosis Objective : To assess the effectiveness of the association of 2 specific strains , Lactobacillus fermentum LF10 ( DSM 19187 ) and Lactobacillus acidophilus LA02 ( DSM 21717 ) , specifically formulated in slow-release effervescent tablets , in patients with recurrent vulvovaginal c and idiasis . Study Design : The study was a clinical trial of 58 women diagnosed with recurrent VVC ( ≥4 culture-confirmed episodes in a 12-mo period ) . All patients were given 200 mg of fluconazole orally as an 
    Output:
    