The Experts below are selected from a list of 144840 Experts worldwide ranked by ideXlab platform
Gerald Pierard - One of the best experts on this subject based on the ideXlab platform.
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oral Antifungal exacerbated inflammatory flare up reactions of dermatomycosis case reports and review of the literature
American Journal of Clinical Dermatology, 2006Co-Authors: Arjen Nikkels, Nazli Nikkelstassoudji, Gerald PierardAbstract:Inflammatory flare-up reactions of some dermatomycoses, particularly those caused by zoophilic fungi, are typical and potentially severe adverse effects following the intake of some oral Antifungals. However, this condition has not previously been reported with the most frequently used Antifungals in dermatology, namely fluconazole, itraconazole, and terbinafine. In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral Antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral Antifungal agents. Details of the patients' age, sex, occupation, and atopic background; the site of the lesion, its clinical and histologic features, and any systemic signs; the identity of the fungal pathogen; the Antifungal agent taken by the patient; the time between drug intake and occurrence of the flare-up; the approach to management; and the outcome were documented for each patient. A PubMed literature search was also conducted, focusing on inflammatory exacerbations induced by griseofulvin, ketoconazole, itraconazole, fluconazole, and terbinafine. The patients were four farmers and one veterinarian (all male). All primary lesions were inflammatory dermatophytoses, including one kerion. Inflammatory exacerbation of the skin lesions started 12-24 hours after the intake of oral Antifungals. Mild systemic changes, including slight fever and malaise, occurred in two cases. Itraconazole 400 mg/day was implicated as the causative agent in four cases and terbinafine 250 mg/day in one case. Mycologic cultures grew Trichophytonverrucosum in four cases. Antifungal treatment was discontinued in all patients. Oral and topical corticosteroids were administered to the two patients with systemic changes; the other three patients were treated with topical corticosteroids only. Two days after the onset of corticosteroids, lower doses of itraconazole (100 mg/day) and terbinafine (125 mg/day) were reintroduced. All lesions healed after 4-5 weeks. The PubMed search did not identify any articles that described inflammatory exacerbations of dermatomycoses induced by oral Antifungals. Inflammatory flare-up of dermatomycoses is a rare but potentially severe cutaneous complication of oral Antifungal use. Occupational contact with animals, inflammatory dermatomycoses, and zoophilic fungi represent common features in these patients. Although evidence-based data are not available, clinical experience shows that, in addition to Antifungal therapy, topical and/or systemic corticosteroids are helpful to reduce the inflammatory reactions. The cases described in this article represent the first published report of oral Antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis in patients taking itraconazole or terbinafine.
Arjen Nikkels - One of the best experts on this subject based on the ideXlab platform.
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oral Antifungal exacerbated inflammatory flare up reactions of dermatomycosis case reports and review of the literature
American Journal of Clinical Dermatology, 2006Co-Authors: Arjen Nikkels, Nazli Nikkelstassoudji, Gerald PierardAbstract:Inflammatory flare-up reactions of some dermatomycoses, particularly those caused by zoophilic fungi, are typical and potentially severe adverse effects following the intake of some oral Antifungals. However, this condition has not previously been reported with the most frequently used Antifungals in dermatology, namely fluconazole, itraconazole, and terbinafine. In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral Antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral Antifungal agents. Details of the patients' age, sex, occupation, and atopic background; the site of the lesion, its clinical and histologic features, and any systemic signs; the identity of the fungal pathogen; the Antifungal agent taken by the patient; the time between drug intake and occurrence of the flare-up; the approach to management; and the outcome were documented for each patient. A PubMed literature search was also conducted, focusing on inflammatory exacerbations induced by griseofulvin, ketoconazole, itraconazole, fluconazole, and terbinafine. The patients were four farmers and one veterinarian (all male). All primary lesions were inflammatory dermatophytoses, including one kerion. Inflammatory exacerbation of the skin lesions started 12-24 hours after the intake of oral Antifungals. Mild systemic changes, including slight fever and malaise, occurred in two cases. Itraconazole 400 mg/day was implicated as the causative agent in four cases and terbinafine 250 mg/day in one case. Mycologic cultures grew Trichophytonverrucosum in four cases. Antifungal treatment was discontinued in all patients. Oral and topical corticosteroids were administered to the two patients with systemic changes; the other three patients were treated with topical corticosteroids only. Two days after the onset of corticosteroids, lower doses of itraconazole (100 mg/day) and terbinafine (125 mg/day) were reintroduced. All lesions healed after 4-5 weeks. The PubMed search did not identify any articles that described inflammatory exacerbations of dermatomycoses induced by oral Antifungals. Inflammatory flare-up of dermatomycoses is a rare but potentially severe cutaneous complication of oral Antifungal use. Occupational contact with animals, inflammatory dermatomycoses, and zoophilic fungi represent common features in these patients. Although evidence-based data are not available, clinical experience shows that, in addition to Antifungal therapy, topical and/or systemic corticosteroids are helpful to reduce the inflammatory reactions. The cases described in this article represent the first published report of oral Antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis in patients taking itraconazole or terbinafine.
Raymond Sacks - One of the best experts on this subject based on the ideXlab platform.
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Antifungal therapy in the treatment of chronic rhinosinusitis a meta analysis
American Journal of Rhinology & Allergy, 2012Co-Authors: Petalee Sacks, Richard J Harvey, Janet Rimmer, Richard Gallagher, Raymond SacksAbstract:Background Chronic rhinosinusitis (CRS) is an inflammatory disorder of the nose and sinuses. Because fungi were postulated as a potential cause of CRS in the late 1990s, contrasting articles have advocated and refuted the use of Antifungal agents in its management. Although good research shows an interaction of the immune system with fungus in CRS, e.g., allergic fungal sinusitis (AFS), this does not imply that fungi are the cause of CRS or that Antifungals will be effective in management. This study was designed to assess the potential advantage of either topical or systemic Antifungal therapy in the symptomatic treatment of CRS to aid physicians in making informed decisions about treating patients with CRS. Methods A systematic review of the literature was performed with meta-analysis. All studies obtained from searches were reviewed and trials meeting the eligibility criteria were selected. CRS was defined using either the European Position Paper on Rhinosinusitis and Nasal Polyps or American Academy of Otolaryngology-Head and Neck Surgery criteria. Authors were contacted and original data were used for data analysis. Results Five studies investigating topical Antifungals and one investigating systemic Antifungals met the inclusion criteria. All trials were double blinded and randomized. Pooled meta-analysis showed no statistically significant benefit of topical or systemic Antifungals over placebo. Symptoms scores statistically favored the placebo group for this outcome. Adverse event reporting was higher in the Antifungal group. Conclusion Reported side-effects of Antifungal therapies may outweigh any potential benefits of treatment based on this meta-analysis and the authors therefore do not advocate the use Antifungal treatment in the management of CRS.
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topical and systemic Antifungal therapy for the symptomatic treatment of chronic rhinosinusitis
Cochrane Database of Systematic Reviews, 2011Co-Authors: Petalee Sacks, Richard J Harvey, Janet Rimmer, Richard Gallagher, Raymond SacksAbstract:Background Chronic rhinosinusitis (CRS) is an inflammatory disorder of the nose and sinuses. Since fungi were postulated as a potential cause of CRS in the late 1990s, there has been increasing controversy about the use of both topical and systemic Antifungal agents in its management. Although interaction between the immune system and fungus has been demonstrated in CRS, this does not necessarily imply that fungi are the cause of CRS or that Antifungals will be effective its management. Objectives To assess the effectiveness of topical or systemic Antifungal therapy in the treatment of CRS. Search methods We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 8 March 2011. Selection criteria All randomised, placebo-controlled trials considering the use of topical or systemic Antifungal therapy in the treatment of CRS and allergic fungal sinusitis (AFS). CRS was defined using either the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) or American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) criteria. Data collection and analysis We reviewed the titles and abstracts of all studies obtained from the searches and selected trials that met the eligibility criteria. We extracted data using a pre-determined data extraction form. There was significant heterogeneity of outcome data reporting with reports containing both parametric and non-parametric representations of data for the same outcomes. Means and standard deviations for change data were unavailable for a number of trials. Due to the limited reported data, we contacted authors and used original data for data analysis. Main results Six studies were included (380 participants). Five studies investigated topical Antifungals and one study investigated systemic Antifungals. The risk of bias in all included studies was low, with all trials being double-blinded and randomised. Pooled meta-analysis showed no statistically significant benefit of topical or systemic Antifungals over placebo for any outcome. Symptom scores in fact statistically favoured the placebo group. Adverse event reporting was statistically significantly higher in the Antifungal group. Authors' conclusions On the basis of this meta-analysis, there is no evidence to support the use of either topical or systemic Antifungal treatment in the management of CRS.
Cornelia Lassflorl - One of the best experts on this subject based on the ideXlab platform.
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combined Antifungal approach for the treatment of invasive mucormycosis in patients with hematologic diseases a report from the seifem and fungiscope registries
Haematologica, 2013Co-Authors: Livio Pagano, Raoul Herbrecht, Werner J Heinz, Oliver A Cornely, Alessandro Busca, Morena Caira, Simone Cesaro, Cristiana Gasbarrino, Corrado Girmenia, Cornelia LassflorlAbstract:Invasive mucormycosis (IM) in patients with acute leukemia and allogeneic stem cell transplant (allo-SCT) recipients treated with Antifungal monotherapy is associated with high mortality rates of 44–49%.[1][1]–[3][2] Among the available Antifungals, amphotericin B (AmB) formulations and
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Antifungal susceptibility testing in aspergillus spp according to eucast methodology
Medical Mycology, 2006Co-Authors: Cornelia Lassflorl, Manuel Cuencaestrella, David W Denning, Juan L RodrigueztudelaAbstract:The availability of new Antifungal agents has multiplied the demand for in vitro Antifungal susceptibility testing for Aspergillus spp. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) has charged its Antifungal Susceptibility Testing Subcommittee (AFST-EUCAST) with the preparation of new guidelines for in vitro susceptibility testing of Antifungals against Aspergillus spp (EUCAST-AST-ASPERGILLUS). This committee has modified the reference method for broth dilution Antifungal susceptibility testing of filamentous fungi (M38-A) as follows: (i) RPMI 1640 supplemented with 2% glucose (RPMI 2%G) as assay medium, (ii) inoculum preparation by conidium counting in a haemocytometer and (iii) an inoculum size of 2×105–5×105 CFU/ml. The incubation time is about 48 h at 35°C and MIC is read visually. The MIC value is a no-growth visual endpoint. The standard method described herein is intended to provide a valid and economic method for testing the susceptibility to Antifungal agents of Aspergi...
Ioannis K Kostakis - One of the best experts on this subject based on the ideXlab platform.
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hydroxytyrosol ht analogs act as potent Antifungals by direct disruption of the fungal cell membrane
Frontiers in Microbiology, 2018Co-Authors: George Diallinas, Nausica Rafailidou, Ioanna Kalpaktsi, Aikaterini Christina Komianou, Vivian Tsouvali, Iliana Zantza, Emmanuel Mikros, Alexiosleandros Skaltsounis, Ioannis K KostakisAbstract:Fungal infections constitute an emerging threat and a prevalent health problem due to increasing number of immunocompromised people and pharmacological or other treatments aiming at viral infections, cancer or allergies. Currently used Antifungals suffer from inefficiency, toxic side effects and developing drug-resistance. Additionally, over the last two decades no new classes of Antifungals have been approved, emphasizing the urgent need for developing a novel generation of Antifungals. Here, we investigate the Antifungal activity of a series of chemically synthesized Hydroxytyrosol (HT) analogs. HT is one of the major phenolic compounds in olive oil, shown to possess radical-scavenging antioxidant, antiproliferative, proapoptotic and anti-inflammatory activities. No previous report has studied HT analogs as Antifungals. We show that specific analogs have broad and strong Antifungal activity, significantly stronger than the parent compound HT. Using Aspergillus nidulans as an in vivo cellular model system, we show that Antifungal HT analogs have an unprecedented efficiency in fungal plasma membrane destruction. Importantly, Antifungal HT analogs did not show toxicity in a mammalian cell line, whereas no resistance to HT analogs was obtained by standard mutagenesis. Our results open the way for the development of a novel, efficient and safer class of Antifungals.
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hydroxytyrosol ht analogues act as potent Antifungals by direct disruption of the fungal cell membrane
bioRxiv, 2018Co-Authors: George Diallinas, Nausica Rafailidou, Ioanna Kalpaktsi, Aikaterini Christina Komianou, Vivian Tsouvali, Iliana Zantza, Emmanuel Mikros, Alexiosleandros Skaltsounis, Ioannis K KostakisAbstract:Fungal infections constitute an emerging threat and a prevalent health problem due to increasing number of immunocompromised people and pharmacological or other treatments aiming at viral infections, cancer or allergies. Currently used Antifungals suffer from inefficiency, toxic side effects and developing drug-resistance. Additionally, over the last two decades no new classes of Antifungals have been approved, emphasizing the urgent need for developing a novel generation of Antifungals. Here we investigate the Antifungal activity of a series of chemically synthesized Hydroxytyrosol (HT) analogues. HT is one of the major phenolic compounds in olive oil, shown to possess radical-scavenging antioxidant, antiproliferative, proapoptotic and anti-inflammatory activities. No previous report has studied HT analogues as Antifungals. We show that specific analogues have broad and strong Antifungal activity, significantly stronger than the parent compound HT. Using A. nidulans as an in vivo cellular model system, we show that Antifungal HT analogues have an unprecedented efficiency in fungal plasma membrane destruction. Importantly, Antifungal HT analogues did not show toxicity in a mammalian cell line, whereas no resistance to HT analogues was obtained by standard mutagenesis. Our results open the way for the development of a novel, efficient and safer class of Antifungals.
