17,340 research outputs found

    Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006

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    Deaths caused by systemic mycoses such as paracoccidioidomycosis, cryptococcosis, histoplasmosis, candidiasis, aspergillosis, coccidioidomycosis and zygomycosis amounted to 3,583 between 1996-2006 in Brazil. When analysed as the underlying cause of death, paracoccidioidomycosis represented the most important cause of deaths among systemic mycoses (~ 51.2%). When considering AIDS as the underlying cause of death and the systemic mycoses as associated conditions, cryptococcosis (50.9%) appeared at the top of the list, followed by candidiasis (30.2%), histoplasmosis (10.1%) and others. This mortality analysis is useful in understanding the real situation of systemic mycoses in Brazil, since there is no mandatory notification of patients diagnosed with systemic mycoses in the official health system.FAPESPCNP

    Treatment of Aspergillosis.

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    Infections caused by Aspergillus spp. remain associated with high morbidity and mortality. While mold-active antifungal prophylaxis has led to a decrease of occurrence of invasive aspergillosis (IA) in those patients most at risk for infection, breakthrough IA does occur and remains difficult to diagnose due to low sensitivities of mycological tests for IA. IA is also increasingly observed in other non-neutropenic patient groups, where clinical presentation is atypical and diagnosis remains challenging. Early and targeted systemic antifungal treatment remains the most important predictive factor for a successful outcome in immunocompromised individuals. Recent guidelines recommend voriconazole and/or isavuconazole for the primary treatment of IA, with liposomal amphotericin B being the first alternative, and posaconazole, as well as echinocandins, primarily recommended for salvage treatment. Few studies have evaluated treatment options for chronic pulmonary aspergillosis (CPA), where long-term oral itraconazole or voriconazole remain the treatment of choice

    Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium.

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    BACKGROUND: Invasive fungal diseases (IFDs) remain important causes of morbidity and mortality. The consensus definitions of the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group have been of immense value to researchers who conduct clinical trials of antifungals, assess diagnostic tests, and undertake epidemiologic studies. However, their utility has not extended beyond patients with cancer or recipients of stem cell or solid organ transplants. With newer diagnostic techniques available, it was clear that an update of these definitions was essential. METHODS: To achieve this, 10 working groups looked closely at imaging, laboratory diagnosis, and special populations at risk of IFD. A final version of the manuscript was agreed upon after the groups' findings were presented at a scientific symposium and after a 3-month period for public comment. There were several rounds of discussion before a final version of the manuscript was approved. RESULTS: There is no change in the classifications of "proven," "probable," and "possible" IFD, although the definition of "probable" has been expanded and the scope of the category "possible" has been diminished. The category of proven IFD can apply to any patient, regardless of whether the patient is immunocompromised. The probable and possible categories are proposed for immunocompromised patients only, except for endemic mycoses. CONCLUSIONS: These updated definitions of IFDs should prove applicable in clinical, diagnostic, and epidemiologic research of a broader range of patients at high-risk

    Fungicidal activity plus reservoir effect allow short treatment courses with terbinafine in tinea pedis

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    Terbinafine, a synthetic allylamine, exerts fungicidal activity against dermatophytes, the causative pathogens of tinea pedis. As proven in numerous clinical trials, tinea pedis can be effectively and safely treated by topical terbinafine. In fact, a 1-week application of terbinafine 1% cream eradicated fungal pathogens at least as effectively as 4-week treatment courses with topical azole derivative antifungals and showed lower relapse rates. A new innovative single-application formulation of terbinafine 1% in a film-forming solution produces a high concentration gradient on the skin surface and enables a prolonged (up to 13 days) exposure of the skin to terbinafine. High drug penetration into the skin results in an otherwise not obtained drug reservoir in the horny layer, the location of dermatophytes in tinea pedis. Although azole antimycotics can also effectively penetrate into the horny layer of the skin, short-term therapy might not be feasible due to its primarily fungistatic activity against dermatophytes. Thus, we conclude that the high efficacy of short-term treatment with terbinafine in patients with tinea pedis is possible due to its fungicidal activity coupled with a distinct reservoir formation in the upper layers of the epidermis. Copyright (C) 2008 S. Karger AG, Basel

    Recognition and Clinical Presentation of Invasive Fungal Disease in Neonates and Children

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    AW and JK are supported by the Wellcome Trust Strategic Award (grant 097377) and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of AberdeenPeer reviewedPublisher PD

    Isolation of keratinophilic fungi and aerobic actinomycetes from park soils in Gorgan, North of Iran

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    Background: Keratinophilic fungi are a group of fungi that colonize in various keratinous substrates and degrade them to the components with low molecular weight. This study was conducted to determine the prevalence of keratinophilic fungi and aerobic Actinomycetes in soil of city parks in Gorgan. Objectives: In this study, we surveyed the city park soils of Gorgan (a northern province of Iran) to determine the identities and diversity of soil aerobic Actinomycetes, keratinophilic and non-keratinophilic fungi. Materials and Methods: A total of 244 soil samples were collected from 22 diferent parks of Gorgan, North of Iran. The samples were collected from the superfcial layer with depth not exceeding than 0-10 cm in sterile polyethylene bags. We used hair bait technique for isolation keratinophilic fungi. The colonies identifed by macroscopic and microscopic characterization after slide culturing. Actinomycetes were isolated by antibiotic dilution methods and detected by using physiological tests such as Lysozyme, Casein, Xanthine, Hypoxanthine, Gelatin, Urea Broth, and modifed acid-fast stain. Results: Totally, 75 isolates of aerobic Actinomycetes were detected that Actinomadura madurae and Nocardia asteroides were the most prevalent strains, with 14.66 and 28% prevalence respectively. Microsporum gypseum was more frequent than other keratinophilic fungi (22.96%) and Aspergillus spp. was the most species of saprophyte fungi (15.92%). Conclusions: This study showed that the collected soil from studied areas was rich of keratinophilic fungi and Actinomycetes, therefore hygiene protocol should be taken to prevent the spread of pathogenic and saprophytes fungi in the environment of susceptible person. © 2013, Ahvaz Jundishapur University of Medical Sciences
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