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VAGINAL COMBINED THERAPY. A NEW APPROACH TO VAGINAL INFECTIONS. DR. DAN CALMAN Dr. DAYAN – HOLISTIC MEDICAL CENTER. Vaginal Infections. The frequency of Vaginitis is difficult to ascertain. General Gynecologic clinics: 5-15% STD clinics: 32-64%. In the U.S.A. Infectious Candidiasis

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vaginal combined therapy

VAGINAL COMBINED THERAPY

A NEW APPROACH TO VAGINAL INFECTIONS

DR. DAN CALMAN

Dr. DAYAN – HOLISTIC MEDICAL CENTER

vaginal infections
Vaginal Infections

The frequency of Vaginitis is difficult to ascertain.

  • General Gynecologic clinics: 5-15%
  • STD clinics: 32-64%

In theU.S.A.

causes of vaginitis
Infectious

Candidiasis

Trichomoniasis

Viral Infs.

Desquamative Inflammatory Vaginitis (Clindamycin responsive)

Foreign Bodies

Parasitic

Noninfectious

Atrophic Vaginitis

Allergic Vaginitis

Collagen Vascular Dis. (Behçet’s syn., Pemphigus)

Causes of Vaginitis
most common causes of vaginitis
Most Common Causes Of Vaginitis
  • Bacterial Vaginosis (22-50%)

increased numbers of organisms such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis .

  • Trichomoniasis (4-35%)

single-celled protozoan parasiteTrichomonas vaginalis.

Trichomonas is associated with many perinatal complications and an increased incidence of transmission of HIV.

  • Vaginal Yeast Infection& Candidiasis (17-39%)

Vaginal candidiasis, Fungal infection of the vagina,sometimes called thrush.

Approx. 75% of women will experience an episode of vulvovaginal Candidiasis

recurrence rate
Recurrence Rate
  • Vulvovaginal candidiasis – Chronic or reccurent infections (4 or more infections per year) may occur in 5% of the population.

RECCURENT DISEASE IS MORE DIFFICULT TO TREAT !!!!!

  • Bacterial Vaginitis- About 30% of patients have recurrence within 3 months.
this calls for

THIS CALLS FOR

A NEW APPROACH TO VAGINAL INFECTIONS !!!!!!!

hyperthermia
Hyperthermia

Some pathogens fail to survive at high temperature levels.

hyperthermia cont
Hyperthermia (Cont.)

Candida

Extremely vulnerable to heat.

At high temperature Candida transforms into its protective form (hyphae).

If not treated in 3 weeks it will return to its original form.

Thus, the second session should be performed exactly 3 weeks later.

hyperthermia cont10
Hyperthermia (Cont.)

T. Vaginalis

Succumbs to temperature above 40ºC, and dies in not more than 35-40 minutes.

hyperthermia cont11
Hyperthermia (Cont.)
  • Hyperthermia eradicates bacterial and yeast infections
  • High temperature causes Vasodilatation and enhanced blood supply to the vagina.
  • High Temperature causes regeneration of epithelium of the vaginal walls.
medispec ltd s gynatherm tm
Medispec Ltd.’s GynathermTM

Treatment is performed by inserting a probe into the patient’s vagina, the probe being heated gradually by circulating water.

gynatherm all over the globe partial list
Gynatherm All Over The Globe – Partial List
  • Denmark
  • Brazil
  • Switzerland
  • Sweden
  • Portugal
  • Italy
  • Guatamala
  • Hong-Kong
  • China
  • Russia
  • Ukraine
safety
Safety

An animal study in a canine model demonstrated no thermal damage to the vaginal epithelium. (Factor, J; 1993, Beilinson)

effectiveness
Effectiveness
  • An animal study in a canine model demonstrated negative post treatment cultures in initially infected ( Chlamydia & Trichomonas) dogs (Factor, J; 1993, Beilinson)
vaginal heating success rate
Vaginal Heating Success Rate
  • Di Fraia, A.:43-47ºC for 20 min. sessions (3-6 sessions) – 91.3%
  • Kaplan, B.: 43-49C for 20 min. sessions (x2) - a significant improvement was found in 77 % of patients., both objectively and subjectively.
ozone
Ozone
  • A molecule that manifests bactericidal, virucidal and fungicidal actions.
  • First World War- ozone’s bactericidal properties were used to treat infected wounds, mustard gas burns and fistulas.
  • Ozone’s applications: wounds, fistulas, decubitus ulcers, osteomyelitis, burns, staph. Infections, fungal and radiation lesions, Herpes simplex and Zoster, gangrene
ozone cont
Ozone (Cont.)
  • High ozone concentrations – for disinfection and debridment.
  • Low ozone concentrations – promote epithelialization and healing.
  • Ozone’s T1/2 is 45 min. at 20ºC, losing its concentration to 16% of its initial value in 2 hours.
  • Ozone has a very high diffusion coefficient into tissues.
  • As a result – OZONE SERVES AS OXYGEN’S SECONDARY MESSENGER TO TISSUES.
ozone s curing potential
Ozone’s Curing Potential
  • Antibacterial effect
  • Enhancement of Oxygen saturation in tissues
both treatment methods

Both Treatment Methods

Stand on their own as effective modes of treatment for recurrent /chronic Vaginitis

combination therapy
Combination Therapy

(Vaginal douching with low concentration Ozone)

+

(VaginalHyperthermia with the Gynatherm)

=

EFFECTIVITY ENHANCEMENT !!!!!

estimated mechanism
Estimated Mechanism

Heat Vasodilatation Vaginal blood supply (and O2) Enhancement+ Bacterial Eradication

Ozone Enhanced O2 supply to the tissue+ Bacterial Eradication

estimated mechanism cont
Estimated Mechanism (Cont.)

Both treatment methods enhance bacterial eradication + vaginal tissue regeneration

treatment protocol
Treatment Protocol

Research Protocol (anamnesis, physical exam., PAP smear, microbiological culture)

  • 3-6 treatment sessions with 3 weeks interval.
  • First treatment after the first menstruation.
  • Prior to treatment the vagina is washed with 30ml of dissolved Ozone.
  • Probe is applied at body temperature for 1-2 min. for adaptation
  • Temperature is raised up to 49ºC for 18-19 additional min. (total of 20 min)
treatment protocol cont
Treatment Protocol (Cont.)
  • Next treatments should be administered in the same application of temperature and time.
  • Between thermotherapy sessions, once every 10 days vaginal enemas with low concentration ozone gas are performed.
our medical center success rate
Our Medical Center Success Rate

75-80% improvement

No AE reported

conclusion
Conclusion
  • We find combined Thermal + Ozone therapy safe and highly effective for the treatment of Recurrent / Chronic Vaginitis.
  • Long-term follow-up is needed to elucidate effectivity of treatment.
  • Further cooperation between medical centers should be encouragedfor additional data collection.