Vaginal yeasts in the era of "over the counter" antifungals

OBJECTIVE: To establish whether there has been any rise in the prevalence of non-albicans Candida species isolated from vaginal swabs since the introduction of “over the counter” antifungal treatments. METHOD: A retrospective review looking at all positive vaginal yeast isolates collected from women attending one genitourinary medicine clinic during the 6 year period from 1993 to 1998 inclusive. All positive vaginal yeast isolates were included, regardless of whether or not the patients were symptomatic. Isolates from HIV positive women were excluded from the analysis. RESULT: No increase in non-albicans vaginal yeast isolates was shown during the period studied. The proportion of non-albicans yeasts remained constant at approximately 5% of the total yeasts isolated. The most common non-albicans yeast isolated was C glabrata. CONCLUSION: There is no evidence from this study to suggest that the increasing use of “over the counter” antifungal treatment has selected for atypical, possibly inherently azole resistant, strains of vaginal yeasts in HIV seronegative women

Universal statistics of point vortex turbulence

A new methodology, based on the central limit theorem, is applied to describe the statistical mechanics of two-dimensional point vortex motion in a bounded container D, as the number of vortices N tends to infinity. The key to the approach is the identification of the normal modes of the system with the eigenfunction solutions of the so-called hydrodynamic eigenvalue problem of the Laplacian in D. The statistics of the projection of the vorticity distribution onto these eigenfunctions (‘vorticity projections’) are then investigated. The statistics are used first to obtain the density-of-states function and caloric curve for the system, generalising previous results to arbitrary (neutral) distributions of vortex circulations. Explicit expressions are then obtained for the microcanonical (i.e. fixed energy) probability density functions of the vorticity projections in a form that can be compared directly with direct numerical simulations of the dynamics. The energy spectra of the resulting flows are predicted analytically. Ensembles of simulations with N=100, in several conformal domains, are used to make a comprehensive validation of the theory, with good agreement found across a broad range of energies. The probability density function of the leading vorticity projection is of particular interest because it has a unimodal distribution at low energy and a bimodal distribution at high energy. This behaviour is indicative of a phase transition, known as Onsager–Kraichnan condensation in the literature, between low-energy states with no mean flow in the domain and high-energy states with a coherent mean flow. The critical temperature for the phase transition, which depends on the shape but not the size of D, and the associated critical energy are found. Finally the accuracy and the extent of the validity of the theory, at finite N, are explored using a Markov chain phase-space sampling method

An investigation into the pathogenesis of vulvo-vaginal candidosis

OBJECTIVE: To monitor yeasts isolated from women during and between episodes of recurrent vulvo-vaginal candidosis (VVC) to determine whether vaginal relapse or re-infection occurred. METHODS:Women presenting at the genitourinary medicine clinic with signs and symptoms of VVC were recruited to the study (n = 121). A vaginal washing, high vaginal swab (HVS) and rectal swab were taken and the women treated with a single 500 mg clotrimazole pessary.Women were asked to re-attend after 1, 4, and 12 weeks, or when the VVC recurred, when vaginal washings and HVS were repeated. Candida isolates recovered were strain typed using the Ca3 probe and their similarity assessed. Antifungal susceptibility to fluconazole and clotrimazole were determined. RESULTS: Of the women recruited, 47 completed the study, either returning for four visits or suffering a recurrence during the study period. Of the 22 women who experienced recurrence, the same strain was responsible for the initial and recurrent episode in 17 women. For the remaining five women, four had strain replacement and one had a change of species. None of the isolates recovered from the women demonstrated resistance to either clotrimazole or fluconazole. CONCLUSIONS: Our findings support the theory of vaginal relapse and thus may support the use of more prolonged courses of antifungal therapy initially to increase the chances of eradication of the yeast

Dates, Diet, and Dismemberment: Evidence from the Coldrum Megalithic Monument, Kent

We present radiocarbon dates, stable isotope data, and osteological analysis of the remains of a minimum of 17 individuals deposited in the western part of the burial chamber at Coldrum, Kent. This is one of the Medway group of megalithic monuments – sites with shared architectural motifs and no very close parallels elsewhere in Britain – whose location has been seen as important in terms of the origins of Neolithic material culture and practices in Britain. The osteological analysis identified the largest assemblage of cut-marked human bone yet reported from a British early Neolithic chambered tomb; these modifications were probably undertaken as part of burial practices. The stable isotope dataset shows very enriched & 15N values, the causes of which are not entirely clear, but could include consumption of freshwater fish resources. Bayesian statistical modelling of the radiocarbon dates demonstrates that Coldrum is an early example of a British Neolithic burial monument, though the tomb was perhaps not part of the earliest Neolithic evidence in the Greater Thames Estuary. The site was probably initiated after the first appearance of other early Neolithic regional phenomena including an inhumation burial, early Neolithic pottery and a characteristic early Neolithic post-and-slot structure, and perhaps of Neolithic flint extraction in the Sussex mines. Coldrum is the only site in the Medway monument group to have samples which have been radiocarbon dated, and is important both for regional studies of the early Neolithic and wider narratives of the processes, timing, and tempo of Neolithisation across Britai

Dynamics and statistical mechanics of point vortices in bounded domains

A general treatment of the dynamics and statistical mechanics of point vortices in bounded domains is introduced in Chapter 1. Chapter 2 then considers high positive energy statistical mechanics of 2D Euler vortices. In this case, the most-probable equilibrium dynamics are given by solutions of the sinh-Poisson equation and a particular heart-shaped domain is found in which below a critical energy the solution has a dipolar structure and above it a monopolar structure. Sinh-Poisson predictions are compared to long-time averages of dynamical simulations of the $N$ vortex system in the same domain. Chapter 3 introduces a new algorithm (VOR-MFS) for the solution of generalised point vortex dynamics in an arbitrary domain. The algorithm only requires knowledge of the free-space Green's function and utilises the exponentially convergent method of fundamental solutions to obtain an approximation to the vortex Hamiltonian by solution of an appropriate boundary value problem. A number of test cases are presented, including quasi-geostrophic shallow water (QGSW) point vortex motion (governed by a Bessel function). Chapter 4 concerns low energy (positive and negative) statistical mechanics of QGSW vortices in `Neumann oval' domains. In this case, the `vorticity fluctuation equation' -- analogous to the sinh-Poisson equation -- is derived and solved to give expressions for key thermodynamic quantities. These theoretical expressions are compared with results from direct sampling of the microcanonical ensemble, using VOR-MFS to calculate the energy of the QGSW system. Chapter 5 considers the distribution of 2D Euler vortices in a Neumann oval. At high energies, vortices of one sign cluster in one lobe of the domain and vortices of the other sign cluster in the other lobe. For long-time simulations, these clusters are found to switch lobes. This behaviour is verified using results from the microcanonical ensemble