Admission blood lactate concentration has been shown to be a useful indicator of disease severity in human medicine and numerous studies have associated hyperlactatemia with patients at high risk of death who should be treated aggressively regardless of the cause of the lactate generation. The degree and duration of hyperlactacidaemia also have been correlated with the subsequent development of organ failure. Similarly, in a small number of studies about equine colic, blood lactate concentration has been investigated as a useful prognostic variable . In neonatal foals blood lactate was studied first by Magdesian (2003) who described venous blood lactate concentration in 14 normal foals during the initial 48 hours post-partum. A preliminary study about lactate concentration in foals presenting to a neonatal intensive care unit reported that surviving foals had earlier lactate clearance. The measurement of blood lactate concentration is traditionally available with a wet chemistry laboratory method or with blood-gas analyzers, for clinicians working at university or large private hospital. But this methods may not be easily accessible to many practitioners in field conditions. Several relatively inexpensive, easy to use and rapid pocket size monitors to measure lactate concentration have been validated in human patients and athletes. None of these portable lactate analyzer have been evaluated in clinically normal neonatal foals or in foals referred to a neonatal intensive care unit. The aims of this study were to validate the Lactate Scout analyzer in neonatal foals, investigating the correlation between lactate concentration in whole blood measured with the portable monitor and measured in plasma with the reference laboratory analyzer. The effect of hematocrit (Hct) on the accuracy of Lactate Scout was also evaluated. Further, we determined the utility of venous lactate measurement in critically-ill foals, describing lactate values in the most frequent neonatal pathologies, evaluating serial blood lactate measurements during hospitalization and investigating its prognostic value. The study also describes normal range for lactate in healthy neonatal foals during the first 72 hours of life.

No description available.

Over the past few years, in veterinary medicine there has been an increased interest in understanding the biology of mesenchymal stem cells (MSCs). This interest comes from their potential clinical use especially in wound repair, tissue engineering and application in therapeutics fields, including regenerative surgery. MSCs can be isolated directly from bone marrow aspirates, adipose tissue, umbilical cord and various foetal tissues. In this study, mesenchymal stem cells were isolated from equine bone marrow, adipose tissue, cord blood, Wharton’s Jelly and, for the first time, amniotic fluid. All these cell lines underwent in vitro differentiation in chondrocytes, osteocytes and adipocytes. After molecular characterization, cells resulted positive for mesenchymal markers such as CD90, CD105, CD44 and negative for CD45, CD14, CD34 and CD73. Adipose tissue and bone marrow mesenchymal stem cells were successfully applied in the treatment of tendinitis in race horses. Furthermore, for the first time in the horse, skin wounds of septicemic foal, were treated applying amniotic stem cells. Finally, results never reported have been obtained in the present study, isolating mesenchymal stem cells from domestic cat foetal fluid and membranes. All cell lines underwent in vitro differentiation and expressed mesenchymal molecular markers.

Lo sviluppo e la funzionalità della placenta influenzano direttamente la crescita ed il benessere del feto all'interno dell'utero, quindi qualsiasi problema strutturale o funzionale della placenta influenzerà lo sviluppo del feto. Lo scopo di questa tesi è stato quello di approfondire diversi aspetti clinici e clinico-patologici dell’insufficienza placentare nella specie equina, con l’intento di individuare dei parametri che possano essere di ausilio per l’identificazione precoce del puledro a rischio e della necessità di interventi terapeutici. La valutazione della concentrazione di lattato nel sangue e nel liquido amniotico potrebbe essere un utile strumento diagnostico per la diagnosi di acidosi metabolica associata ad ipossia/ischemia nel puledro e per identificare la necessità di un intervento precoce alla nascita. La risposta all’ipossia sembra essere mediata dall’HIF-1 e dall’HSF-1 anche nel puledro neonato, e se questi dati venissero confermati su un numero maggiore di animali, i due marcatori proteici e la MDA potrebbero essere utilizzati per la diagnosi di PAS nel puledro. L’esame di tutta l’unità placentare riveste un ruolo di fondamentale importanza per l’acquisizione di informazioni riguardo all’ambiente di vita intrauterino del puledro, ed è quindi auspicabile nella pratica ostetrica routinaria una maggiore attenzione all’esame della placenta, soprattutto in caso di patologie materno-fetali. Tra i parametri biochimici valutati al momento della nascita, la creatininemia e la glicemia possono fornire informazioni sull’efficienza dello scambio placentare ed essere quindi utilizzati per individuare puledri a rischio. Infine, lo sviluppo di una macro per il software ImageJ porta alla luce uno strumento nuovo, semplice da usare ed economico, per la valutazione morfometrica dell’arborizzazione dei villi placentari; tuttavia la ricerca necessità ulteriori indagini su un numero maggiore di animali per valutare le differenze morfometriche tra placente normali e patologiche. / Fetal health and growth are directly influenced by the development and function of the placenta. For this reason, structural or functional problems of the placenta may affect fetal development. The aim of this thesis s to investigate clinicopathological features of placental insufficiency in horses, in order to detect the most useful parameters in identifying foals at risk and the need for therapeutic interventions. The evaluation of blood and amniotic fluid lactate concentrations could be a useful tool to diagnose metabolic acidosis associated with hypoxia/ischemia in foal, and to identify the need for early intervention at birth. The body’s reactions to hypoxia are mediated by HIF-1α and HSF-1 also in the newborn foal, and if these data were confirmed on a greater number of animals, HIF-1α and HSF-1 expression and MDA concentration could be used for clinical diagnosis of PAS. Examination of fetal membranes plays a key role to acquire information concerning the intrauterine environment, and a careful examination of the placenta is recommended in routine obstetrical practice, especially in case of maternal and/or fetal diseases. Among biochemical parameters evaluated at birth, blood creatinine and glucose levels can provide information about the efficiency of placental exchange and thus it could be used for identifying foals at risk. At the end, the development of a macro for the software ImageJ provides a new, simple to use and inexpensive tool for the morphometric evaluation of the chorionic villi, but additional studies on a larger number of animals are required to evaluate the morphometric differences between normal and pathological placentas.

AntecedentesLa ropivacaína es un anestésico local, con menos toxicidad cardíaca yneurológica que la bupivacaína, tiene un amplio margen de seguridad,además la ropivacaína tiene un aclaramiento y una vida media máscorta.HipótesisEl nuevo anestésico local ropivacaína (amida) debido a sus propiedadesfísico-químicas, tiene un efecto mínimo sobre la dinámica uterina y lasaturación de oxígeno fetal, con bloqueo motor limitado y alto gradode confort analgésico.ObjetivosEstudiar el efecto de la ropivacaína sobre el trabajo del parto ycompararlo con el anestésico local la bupivacaína.Estudiar el efecto de la anestesia epidural sobre el trabajo delparto.Estudiar el efecto de la anestesia epidural sobre la saturación deoxígeno fetal.Materiales y MétodosUn centenar de parturientas nuliparas en estado activo fueronincluidas en este estudio a doble ciego, aleatorizado. Se recogierondatos demográficos del paciente, datos obstétricos, los efectossecundarios materno- fetal y neonatal.La vigilancia fetal se realizómediante un cardiotocográfo y la monitorización de la saturación deoxígeno fetal mediante un oxímetro de pulso fetal, el control de laactividad uterina mediante cateter de presión intrauterina así comola hemodinámica materna.Divididas en dos grupos de 50 aleateoriamente: Grupo B (Bupi) laanalgesia epidural con bupivacaína 484 determinaciones fueronestudiados; 210 preepidural y 274 postepidural. Grupo R (Ropi) laanalgesia epidural con ropivacaína 556 determinaciones fueronestudiados, 245 preepidural y 311 postepidural.Se comparó intragrupo de manera independiente del efecto de laanestesia epidural sobre las variables de estudio.Así mismo se comparó intergrupos del efecto de cada anestésico sobrelas variables de estudio una vez aplicada la anestesia epidural.ResultadosNo hay diferencias demográficas entre ropivacaína y bupivacaína entrelas pacientes estudiadas. El trabajo de parto en nuestro estudio fuediferente entre los dos anestésicos locales , observamos que lospacientes anestesiados con ropivacaína presentan: un aumento del tono18 (8) en comparación con la bupivacaína, 16,5 (10) p <0,002),respectivamente; aumento de la intensidad 48 (20) en comparación a labupivacaína, 42 (22) (p <0,002), respectivamente, un aumento de laactividad uterina 195 (90,9) 167,2 (102,56) (p <0.00) y el aumento dela presión máxima 67 + 19 en comparación con la bupivacaína 60 +26,25. Los valores se expresan como media + desviación estándar, con p<0,00.No se observaron diferencias relacionadas con la frecuencia cardíacafetal o neonatal,resultado podría ser identificados entre lospacientes tratados con ropivacaína o bupivacaína.ConclusionesLa anestesia epidural con bupivacaína 0,2% interfiere con la mecánicadel trabajo del parto.La anestesia epidural con ropivacaína 0,2%, no interfiere con lamecánica del trabajo del parto, observando un aumento en laintensidad, tono, la presión máxima y la actividad uterina.La cantidad de oxitocina durante la primera hora de la anestesiaepidural con ropivacaína 0,2%, puede disminuirse significativamente.La anestesia epidural con bupivacaína 0,2%, o con ropivacaína 0,2% noafecta a la monitorización de la saturación de oxígeno fetal. / Background: The ropivacaine is local anesthetic, with less cardiac and neurological toxicity than bupivacaine, introduces a wide safety margin, the ropivacaine has shorter clearance and average life. Hypotesis The new local anesthetic amide ropivacaine due to its physicochemical properties, has a minimal effect on the dynamics and uterine fetal oxygen saturation, with limited motor block and high degree of analgesic comfort. Objective Study the effect of epidural anesthesia during childbirth. Study the effect of ropivacaine during labor and delivery, and compare it with the local anesthetic bupivacaine. Study the effect of epidural anesthesia on fetal oxygen saturation. Materials and Methods One hundred term parturients nuliparas in active labor were included in this double-blind, randomized trial. Patient demographics, obstetric data, maternal side effects, and fetal and neonatal well-being were noted. Fetal monitoring using a cardiotocograph and a measure of fetal oxygen saturation oximetry, monitoring the uterin activity and maternal hemodinamic. Split randomly into two groups of 50: Group B(Bupi) epidural analgesia with bupivacaine. 484 determinations were studied; 210 preepidural and 274 postepidural. Group R (Ropi) epidural analgesia with ropivacaine. 556 determinations were studied, 245 preepidural and 311 postepidural. Intra-group comparison of the effect of epidural anesthesia on the study variables. Inter-group comparison of anaesthetic effect of each variable on the study once applied epidural anaesthesia. Results No demographic differences among bupivacaine and ropivacaine treated patients were observed. Labor characteristics and outcome of postepidural labor were differenced in our study, we observed that the patients anesthetized with ropivacaine present: increased tone 18(8) compared to bupivacaine, 16.5(10) p<0.002) respectively; increased intensity 48(20) compared to bupivacaine, 42(22)(p<0.002) respectively; increased uterine activity 195 (90.9) 167.2(102.56) (p<0.00) and increase in maximum pressure 67 + 19 compared to bupivacaine 60 + 26.25. Values are expressed as average + standard deviation, with p < 0.00. No differences related to fetal heart rate or neonatal outcomecould be identified among patients treated with bupivacaine or ropivacaine. Conclusions. Epidural anesthesia with bupivacaine 0.2% interferes with the work of childbirth mechanics. Epidural anesthesia with ropivacaine 0.2% does not interfere with the working of childbirth mechanics, noting an increase in intensity, tone, the maximum pressure and uterine activity. The amount of oxytocin given during the first hour of epidural anesthesia with ropivacaine 0.2% can be lowered significantly. The epidural anesthesia with bupivacaine 0.2%, or 0.2% ropivacaine does not affect the monitoring of the fetal oxygen saturation.

La Sindrome da Asfissia Perinatale (PAS) è una delle più comuni patologie che colpiscono il puledro neonato nelle prime 72 h di vita. È una patologia difficile da diagnosticare in quanto non esistono parametri o segni clinici specifici, la sintomatologia è molto variabile in base alla durata e all’intensità dell’insulto ipossico ischemico e al tipo di organo maggiormente colpito. Lo scopo di questo studio è la ricerca e la valutazione di alcuni parametri biochimico-clinici e di alcuni biomarkers per la diagnosi precoce e il corretto trattamento dei puledri affetti da PAS. Nei puledri neonati che presentano questa patologia è stata riscontrata un’ipermagnesiemia al momento del ricovero associata a prognosi infausta, probabilmente causata da un grave danno cellulare con rilascio in circolo del magnesio intracellulare. La PAS potrebbe essere un’ulteriore causa di Euthyroid Sick Syndrome, in quanto abbiamo riscontrato una diminuzione delle concentrazioni di T3 e T4 nei puledri malati rispetto ai sani della stessa età, come avviene in altre malattie sistemiche. Lo studio del profilo proteomico ha permesso di separare le più importanti frazioni proteiche del liquido amniotico di cavalla, mettendo in evidenza similitudini e differenze qualitative e quantitative nei ferogrammi dei puledri sani e di quelli affetti da PAS ed una maggiore variabilità è stata riscontrata nei profili dei liquidi amniotici dei puledri malati. Il glutatione è risultato poco espresso nel puledro neonato, i puledri sani presentano concentrazioni più basse sia rispetto ai malati della stessa età sia agli adulti ma con una tendenza all’aumento nelle prime 24 ore di vita per i sani ed un calo nei malati. La somministrazione della terapia antiradicalica non influisce sulle concentrazioni di glutatione totale ed i puledri deceduti presentano concentrazioni più alte. / Perinatal Asphyxia Syndrome (PAS) that occurs during the perinatal period is one of the most common diseases affecting foals within the first 72 h of life. The diagnosis of PAS is very difficult and relies on an accurate history, identification of neurological signs, and exclusion of other cause of neurological deficits. No specific clinical-pathological and laboratory findings have been highly suggestive of neonatal asphyxia, many of the noted clinical signs can occur with other clinical conditions and depending on the duration and the intensity of hypoxic insult and the tissue injury. The aim of this study was to discover Perinatal Asphyxia Syndrome biomarkers in neonatal foals having an early identification and interventions of the foals at highest risk developing this syndrome. Foals affected by PAS present hypermagnesaemia at admission compared to healthy foals, may be the results of serious tissue damage with cell death and release of intracellular Mg. Higher concentrations is associated to poor outcome. Data obtained in this trial suggest that PAS may cause lower T3 and T4 concentrations in affected foals than in age-matched healthy foals, as reported for other systemic illnesses. PAS could be a cause of Euthyroid Sick Syndrome. The differences revealed between electrophoretic patterns of healthy and sick foals amniotic fluids have showed a qualitative and quantitative variability in the proteomic profile. We found a high proteomic profiling variability also among sick foals. The acute period of hypoxia-ischemia is followed by a period of reperfusion, the second tissue injury occurs in this phase. The cell damage is caused by post-ischemic release of oxygen radicals. Glutathione (endogenous antiradical) concentration (tGSH) is lower in healthy foals compared to sick foals and adults. The antiradical therapy didn’t change the tGSH concentration and no-surviving foals had higher concentration.

Tesis por compendio de publicaciones / Esta Tesis analiza las diferencias individuales en la toma de decisiones relacionadas con la lactancia materna. Para ello, combina enfoques y métodos teóricos de diversos campos de la investigación en psicología y utiliza diferentes muestras y procedimientos para medir las variables de interés. La contribución de esta Tesis se demuestra por cuatro trabajos de investigación que han sido publicados o aceptados para su publicación en revistas indexadas en bases de datos internacionales. Los objetivos específicos de investigación fueron: primero, analizar el papel de los factores genéticos y ambientales en la iniciación y mantenimiento de la lactancia materna, para determinar qué parte de la variabilidad observada en estos comportamientos proviene de factores genéticos y de los factores ambientales. Segundo, estudiar la relación entre dos fenotipos relacionados con las decisiones reproductivas de las mujeres, el número de niños y de la duración media de la lactancia materna, así como las contribuciones genéticas y ambientales a la varianza y covarianza en estos rasgos. Tercero, examinar la evolución de las tasas de lactancia materna desde 1960 hasta el final del siglo XX y analizar la relación entre estas tendencias y las diferencias en los niveles de educación de las madres. Y cuarto, describir los estilos diferenciales de personalidad en función de la elección del método de alimentación y examinar el grado de adaptabilidad de los estilos de personalidad identificados, así como su asociación con la toma de decisiones en la lactancia materna. Los estudios han utilizado dos muestras principales, utilizando cada uno de ellos diferentes submuestras. La primera de ellas está extraída de las participantes del Registro de Gemelos de Murcia y ha sido utilizada para los tres primeros estudios. La segunda, formada por mujeres atendidas en servicios de salud, fue usada en el último. En los cuatro estudios que componen la Tesis Doctoral se utilizaron tres cuestionarios sociodemográficos y de salud y en el último, se utilizó además el Inventario de Estilos de Personalidad de Millon. Los dos primeros estudios que componen se basan en la metodología de los estudios de gemelos clásicos, el tercero utilizó datos de las gemelas para hacer un análisis epidemiológico, incluyendo modelos de regresión “joinpoint”, y en el cuarto estudio se realizaron análisis de tipo descriptivo-correlacional. Los principales resultados son que aproximadamente la mitad de la variación interindividual en el inicio de la lactancia y el mantenimiento se debe a la variación genética, mientras que el resto se explica por experiencias personales únicas, factores ambientales aleatorios y errores de medición. También, que existe una correlación baja pero significativa entre el número de hijos y la duración media de la lactancia maternal y que sin embargo, no hay una idea clara de la estructura y las relaciones genéticas y ambientales entre estos dos fenotipos, al menos en las sociedades modernas. Las tasas de lactancia materna en la Región de Murcia muestran una curva en forma de U en la segunda parte del siglo pasado, con las duraciones más bajas registradas durante la década de los 70. La asociación entre la educación y la lactancia materna no es constante en el tiempo. Y por último, las mujeres primíparas que establecen la lactancia materna exclusiva y las que utilizan la lactancia artificial presentan perfiles de personalidad diferenciales en relación con la población de referencia y, además, se diferencian entre ellas en ciertos estilos de personalidad, indicando ambos perfiles de personalidad una adaptación saludable para el medio ambiente. En general, los resultados contribuyen a un mejor conocimiento de los factores asociados a las diferencias en el inicio, el establecimiento y la duración de la lactancia materna y proporcionan información y orientaciones para el diseño de intervenciones de salud. / This Thesis examines the individual differences in decision-making related to breastfeeding. For that purpose, it combines theoretical approaches and methods from several fields of research in Psychology and uses different samples and procedures to measure the variables of interest. The contribution of this Thesis is demonstrated by four research papers which have been published or accepted for publication in journals indexed in international databases. The specific research objectives were: first, to analyze the role of genetic and environmental factors in the initiation and maintenance of breastfeeding, to determine how much of the observed variability in these behaviors comes from genetic factors and from environmental factors. Second, to study the relationship between two relevant phenotypes related to women’s reproductive decisions, the number of children and the average duration of breastfeeding, as well as genetic and environmental contributions to the variance and covariance in these traits. Third, to examine the evolution of breastfeeding rates from the 1960s to the end of the the 20th century and to analyze the relationship between these trends and differences in mothers’ levels of education. And the last one, to describe differential personality styles as a function of the choice of feeding method and to examine the degree of adaptiveness of the identified personality styles, as well as their association with decision-making in breastfeeding. The studies have used two main samples, and each of them used different subsamples. The first one was taken from the participants in the Murcia Twin Registry and was used for the first three studies. The second one was compounded by women who were attended in health services and was used in the last one. The four studies used socio-demographic and health questionnaires and the Millon Inventory of Personality Styles was also used in the last one. The first two studies were based in the classic twin design, the third one used twin data to do an epidemiological analysis with joinpoint regression techniques and the last study used descriptive-correlational analyses. The main findings of each of the studies are the following: approximately half of the inter-individual variation in breastfeeding initiation and maintenance is due to genetic variation, while the rest is explained by unique personal experiences, random environmental factors and measurement error. Also, that there is a low but significant correlation between number of children and the mean duration of breastfeeding. However, there is not a clear picture of the genetic and environmental structure and relationship between these two phenotypes, at least in modern societies. Breastfeeding rates in the Murcia Region show a U-shaped curve during the second part of last century, with the lowest durations registered during the 1970s. The association between maternal education and breastfeeding is not consistent over time. And last, primiparous women who establish exclusive breastfeeding and those who use formula feeding present differential personality profiles in relation to the reference population and, additionally, they differ between them in certain personality styles. Both personality profiles indicate a healthy adaptation to the environment. Overall, the results contribute to a deeper knowledge of the factors associated with the differences in initiation, establishment and duration of breastfeeding and they provide relevant information and direction for the design of health interventions.

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Objetivo: Analisar a expressão dos fatores angiogênicos (VEGF, MMP-2 e MMP-9), e dos inibidores teciduais específicos de metaloproteinases da matriz (TIMP-1 e TIMP-2) em amostras de tumores, obtidas de um grupo de pacientes com câncer primário de mama, e avaliar a correlação destes com o linfonodo sentinela (LNS) e outros fatores clinicopatológicos selecionados, como idade, diâmetro do tumor, tipo histológico, grau histológico e invasão vascular. Métodos: Amostras de tumores primários, de 88 mulheres com câncer de mama, fixados em formalina e emblocados em parafina foram analisados. A técnica de imunohistoquímica (IHQ), usando o complexo Avidina-Biotina-Peroxidase, foi usada para medir a imunorreação dos antígenos nos tumores. A análise estatística para comparar a associação entre fatores estudados com os grupos LNS positivo e negativo e as demais variáveis selecionadas, foi realizada através de programa estatístico, segundo o teste t de Student, Qui-quadrado de Pearson, teste U de Mann-Whitney, teste H de Kruskal-Wallis e correlação de Spearman. Resultados: Nenhuma correlação estatisticamente significativa foi encontrada entre a expressão do VEGF, MMP-2, MMP-9, TIMP-1 e TIMP-2 e a presença de células tumorais no LNS. Entretanto, tumores com maior diâmetro (p< 0,01) e a presença de invasão vascular (p< 0,01) estavam positivamente correlacionados com a positividade do LNS. Uma correlação significativa entre alta expressão de VEGF (p= 0,04) e baixos níveis de TIMP-1 (p= 0,02) com o tipo histológico ductal também foi observada. Alem disso, baixos níveis de TIMP-2 mostraram uma correlação significativa com a idade jovem (< 50 anos; p= 0,01) e tumores de maior diâmetro (2,0 a 5,0 cm; p= 0,04). Conclusão: O LNS positivo foi correlacionado com tumores de maior diâmetro (p< 0,01) e com a presença de invasão vascular (p< 0,01). Altos níveis de VEGF e baixos níveis de TIMP-1 foram observados em pacientes com tumores do tipo ductal, enquanto altos níveis de TIMP-1 foram observados em tumores lobulares. A confirmação destes resultados necessita mais estudos.

DIAS, Oswaldo José Queiroz. Avaliação da eficácia do fitoterápico a base de Cymbopogon citratus Stapf em candidiase vaginal : estudo controlado, cego e randomizado. 2014. 69 f. Dissertação (Mestrado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2014. / Submitted by denise santos (denise.santos@ufc.br) on 2015-05-22T13:44:24Z No. of bitstreams: 1 2014_dis_ojqdias.pdf: 1330498 bytes, checksum: 3d0449abb01565001bdc832d78f733af (MD5) / Approved for entry into archive by denise santos(denise.santos@ufc.br) on 2015-05-22T13:57:54Z (GMT) No. of bitstreams: 1 2014_dis_ojqdias.pdf: 1330498 bytes, checksum: 3d0449abb01565001bdc832d78f733af (MD5) / Made available in DSpace on 2015-05-22T13:57:54Z (GMT). No. of bitstreams: 1 2014_dis_ojqdias.pdf: 1330498 bytes, checksum: 3d0449abb01565001bdc832d78f733af (MD5) Previous issue date: 2014 / Candidiasis is one of the most common causes of infection of the female genital tract . Its clinical diagnosis is suggested by the presence of the classic symptoms : vulvovaginal pain, itching and burning , i nflammation , thick, lumpy and malodoro us leucorrhea, vulvar and vaginal hyperemia, swollen and cracked v aginal mucosa with white plates . Those finding s should be confirmed by laboratory diagnosis . M ycological examination should confirm the presence of bla stoconi dia structures , associated or not with pseudohyphae in the vaginal exudate . Cymbopogon citratus ( DC. ) Stapf , known as lemon grass is a tall, thick grass with a strong citrus scent . It is used in folk medicine to treat various diseases and studie s have proven its antidepressant, antioxidant, antiseptic, astringent, bactericidal , fungicidal , sedative and calming effects . Its action against microorganisms of the genus Candida spp has been proven in vitro . The objective of this study was to evaluat e the therapeutic efficacy of the intravaginal herbal medicine made with the essential oil of Cymbopogon citratus Stapf ( OEC c ) in the t reatment of vaginal candidiasis . At the Maternity Hospital in Assis Chateubriant , 32 female patients aged 18 - 49 years wit h positive clinical and laboratory diagnosis for vaginal candidiasis were randomly assigned for two treatment groups to receive study drug or control drug blind treatment daily for 7 days as clinical protocol approved by the Research Ethics and conducted a ccording to the Guidelines for Good Clinical Practice . 25 patients completed treatment and participation in the study, 12 in the grou p using the Miconazole (control ) and 13 in the group that used the cream base OEC c ( test) . The results of the clinical ex amination before and after treatment were analyzed by Fisher's exact test , which showed no statistically significant difference between the groups OEC c and Miconazole in the proportion of patients who progressed to the absence of characteristic findings o f candidiasis ( P = 0 , 59) . This result was also obtained when comparing mycological examination ( P = 0.32 ) . With regard to adverse events , the data were analyzed by Fisher's exact test , which showed no statistically significant difference between M iconazole and OEC c groups regarding the proportion of patients reporting any adverse event during the study ( P = 1.00 ) . The treatment outcome of patients who used OEC c in the test group was not statistically different from the results obtained from the use of miconazole in the control group , either in its clinical efficacy , or in the presence of adverse events , showing that the use of the vaginal cream with OEC c can be an effective and safe tr eatment for vaginal candidiasis . / A candidíase é uma das causas mais comuns de infecção do trato genital feminino. Seu diagnóstico clínico é sugerido pela presença dos sintomas clássicos, como dor vulvovaginal, prurido e ardor, inflamação, leucorréia espessa, grumosa e com mau odor, vulva e vagina hiperemiadas, edemaciadas e com fissuras, mucosa vaginal com placas brancas. Esta constatação deve ser confirmada pelo diagnóstico laboratorial, o exame micológico deve confirmar a presença de estruturas blastoconidiadas, associadas ou não a pseudohifas no exudato vaginal. O Cymbopogon citratus (DC.) Stapf, conhecido como capim-limão é uma grama alta e grossa com um forte aroma cítrico. É utilizado na medicina popular no tratamento de várias enfermidades e estudos já comprovaram seus efeitos antidepressivo, antioxidante, antiséptico, adstringente, bactericida, fungicida, calmante e sedativo. Sua ação contra microorganismos do gênero Candida spp já foi comprovada in vitro. O objetivo deste trabalho foi avaliar a eficácia terapêutica do medicamento fitoterápico de uso intravaginal a base do óleo essencial das folhas de Cymbopogon citratus Stapf (OECc) no tratamento da candidíase vaginal. Na Maternidade Escola Assis Chateubriant, 32 pacientes do sexo feminino com idade entre 18-49 anos com diagnóstico clínico e laboratorial positivo para candidíase vaginal foram randomicamente designadas para os grupos de tratamento, para receber o medicamento em estudo ou o medicamento controle, em tratamento cego, diariamente, durante 7 dias, conforme protocolo clínico aprovado pelo Comitê de Ética e Pesquisa e realizado de acordo com as Normas de Boas Práticas Clínicas. Destas, 25 concluíram o tratamento e a participação no estudo, sendo 12 no grupo que utilizou o Miconazol (controle) e 13 no grupo que utilizou o creme a base de OECc (teste). Os resultados do exame clínico pré e pós-tratamento foram analisados pelo teste exato de Fisher, que não evidenciou diferença estatisticamente significante entre os grupos OECc e Miconazol em relação à proporção de pacientes que evoluíram com ausência de achados característicos de candidíase (P = 0,59). Tal resultado também foi obtido na comparação dos exames micológicos ( P = 0,32). Com relação aos eventos adversos, os dados foram analisados pelo teste exato de Fisher, que não evidenciou diferença estatisticamente significante entre os grupos OECc e Miconazol em relação à proporção de pacientes que relataram algum evento adverso ao longo do estudo (P = 1,00). O resultado do tratamento das pacientes que utilizaram o OECc no grupo teste não foi estatisticamente diferente do resultado obtido com a utilização do miconazol no grupo controle, seja na questão da sua eficácia clínica, seja na presença de eventos adversos, mostrando que o uso do creme a base de OECc pode ser uma forma eficaz e segura de tratamento para a candidíase vaginal.