ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pseudomonas aeruginosa , Pseudomonas aeruginosa/isolation & purification , Pseudomonas aeruginosa/pathogenicity , Onychomycosis/complications , Onychomycosis/diagnosis , Onychomycosis/microbiology , Antifungal Agents/therapeutic use , Arthrodermataceae/isolation & purification , Onychomycosis/drug therapy , Onychomycosis/physiopathology , Gram-Negative Bacteria , Gram-Negative Bacteria/isolation & purificationSubject(s)
Arthrodermataceae , Pseudomonas aeruginosa , Tinea Pedis/diagnosis , Tinea Pedis/microbiology , Humans , Male , Middle AgedABSTRACT
La onicomicosis, o infección fúngica de las uñas, constituye una de las enfermedades micóticas más prevalentes en la población. Su tratamiento tiene una efectividad limitada, además de ser largo y tedioso y, en el caso de los antifúngicos sistémicos, no está exento de efectos adversos. La terapia fotodinámica (TFD) podría ser una buena alternativa para las infecciones cutáneas superficiales, entre ellas la onicomicosis. El presente artículo revisa la experiencia publicada, tanto in vitro como in vivo, acerca de la utilidad de la TFD en las onicomicosis, mostrando el potencial de diversos fotosensibilizantes, así como sus limitaciones. Desde el punto de vista clínico el azul de metileno y el ácido 5-aminolevulínico muestran tasas de curación del 80% y el 43% respectivamente al año de seguimiento. Finalmente, basado en la bibliografía y en la propia experiencia, se propone un protocolo de 3 sesiones de TFD, usando metil-aminolevulinato 16% como fotosensibilizante y luz roja (lambda = 630 nm, 37J.cm−2), separadas por 1 o 2 semanas. Estas irán precedidas de la aplicación de urea 40% durante unos días. Nuevos ensayos clínicos deben optimizar los protocolos y establecer qué pacientes se benefician especialmente de recibir este tratamiento
Onychomycosis, or fungal infection of the nails, is one of the most prevalent fungal diseases in the general population. Treatment is of limited effectiveness, tedious, and must be administered for long periods. Furthermore, systemic antifungal agents are associated with adverse effects. Photodynamic therapy (PDT) may prove to be a viable alternative in the treatment of superficial skin infections, including onychomycosis. We review articles relating to the usefulness of PDT in onychomycosis in both in vitro and in vivo settings and discuss the potential and limitations of various photosensitizing agents. In vivo, methylene blue and 5-aminolevulinic acid have led to cure rates in 80% and 43% of cases, respectively, at 12 months. Finally, based on data in the literature and our own experience, we propose a protocol of 3 PDT sessions, separated by an interval of 1 or 2 weeks, using methyl aminolevulinate 16% as a photosensitizing agent and red light (Lambda = 630 nm, 37J.cm -2). Each session is preceded by the topical application of urea 40% over several days. Clinical trials are needed to optimize PDT protocols and to identify those patients who will benefit most from this treatment
Subject(s)
Female , Humans , Male , Onychomycosis/therapy , Phototherapy/instrumentation , Phototherapy , Aminolevulinic Acid/therapeutic use , 5-Aminolevulinate Synthetase/therapeutic use , Methylene Blue/therapeutic use , Photosensitizing Agents/therapeutic use , Onychomycosis/drug therapy , Onychomycosis/physiopathology , Fungi/radiation effectsABSTRACT
Onychomycosis, or fungal infection of the nails, is one of the most prevalent fungal diseases in the general population. Treatment is of limited effectiveness, tedious, and must be administered for long periods. Furthermore, systemic antifungal agents are associated with adverse effects. Photodynamic therapy (PDT) may prove to be a viable alternative in the treatment of superficial skin infections, including onychomycosis. We review articles relating to the usefulness of PDT in onychomycosis in both in vitro and in vivo settings and discuss the potential and limitations of various photosensitizing agents. In vivo, methylene blue and 5-aminolevulinic acid have led to cure rates in 80% and 43% of cases, respectively, at 12 months. Finally, based on data in the literature and our own experience, we propose a protocol of 3 PDT sessions, separated by an interval of 1 or 2 weeks, using methyl aminolevulinate 16% as a photosensitizing agent and red light (λ=630 nm, 37 J.cm(-2)). Each session is preceded by the topical application of urea 40% over several days. Clinical trials are needed to optimize PDT protocols and to identify those patients who will benefit most from this treatment.
Subject(s)
Onychomycosis/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Aminolevulinic Acid/administration & dosage , Aminolevulinic Acid/analogs & derivatives , Aminolevulinic Acid/therapeutic use , Antifungal Agents/therapeutic use , Clinical Protocols , Clinical Trials as Topic , Drug Administration Schedule , Evidence-Based Medicine , Fungi/drug effects , Fungi/radiation effects , Humans , Methylene Blue/administration & dosage , Methylene Blue/therapeutic use , Photosensitizing Agents/administration & dosage , Treatment Outcome , Urea/administration & dosage , Urea/therapeutic useSubject(s)
Cholera/diagnosis , Antigens, Bacterial/analysis , Bacteriological Techniques , Child , Cholera/blood , HumansABSTRACT
No disponible
Subject(s)
Child , Infant, Newborn , Humans , Bacteremia , Cross Infection , Intensive Care Units, Neonatal , Spain , Cohort Studies , Bacteriological Techniques , Bacteria , Antigens, Bacterial , CholeraSubject(s)
Feces/parasitology , Hymenolepiasis/parasitology , Hymenolepis/isolation & purification , Intestinal Diseases, Parasitic/parasitology , Africa, Northern/ethnology , Animals , Anticestodal Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Child , Female , Giardiasis/complications , Giardiasis/diagnosis , Giardiasis/drug therapy , Growth Disorders/etiology , Humans , Hymenolepiasis/complications , Hymenolepiasis/diagnosis , Hymenolepiasis/drug therapy , Hymenolepiasis/epidemiology , Intestinal Diseases, Parasitic/diagnosis , Intestinal Diseases, Parasitic/drug therapy , Intestinal Diseases, Parasitic/epidemiology , Metronidazole/therapeutic use , Niclosamide/therapeutic use , Spain/epidemiologySubject(s)
Meningitis, Bacterial , Salmonella Infections , Salmonella enteritidis/isolation & purification , Aged , Humans , Male , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/epidemiology , Salmonella Infections/diagnosis , Salmonella Infections/drug therapy , Salmonella Infections/epidemiologyABSTRACT
BACKGROUND: The aim of this study was to know the frequency and the clinical characteristics of urinary infection by non typhi Salmonella in our area in Spain. PATIENTS AND METHODS: The clinical histories of patients with urinary infection by non typhi Salmonella diagnosed in the Hospital General del Guadalajara from January 1990 to July 1999 were reviewed. RESULTS: During the period studied nine patients with urinary infection by non typhi Salmonella were diagnosed, representing 0.056% of the urinary infection diagnosed in our hospital over the same period. All the patients presented underlying disease and five were undergoing immunosuppressor treatment. Four patients presented urological disease. The most frequent serogroup was Salmonella enteritidis (7 cases). All the episodes were symptomatic. The same microorganism was isolated in stools in four patients. The evolution was favorable in five of the nine cases. Recurrence was observed in two patients and secondary bacteremia in one. Six patients required antibiotic treatment over two or more weeks. The mean length of treatment was of 2.5 weeks. CONCLUSIONS: Urinary infection by non typhi Salmonella is predominantly observed in patients undergoing immunosuppression or with urological disease. Prolonged antibiotic treatment is recommended due to its bad evolution.
