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Carol A. Kauffman - One of the best experts on this subject based on the ideXlab platform.
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epidemiology of Oral Candidiasis in hiv infected patients colonization infection treatment and emergence of fluconazole resistance
The American Journal of Medicine, 1994Co-Authors: Jon A Sangeorzan, Suzanne F Bradley, Lidija T Zarins, George L Ridenour, Robert N Tiballi, Xiaogang He, Carol A. KauffmanAbstract:PURPOSE: To study the epidemiology of Oral Candidiasis and the effect of treatment of thrush in human immunodeficiency virus (HIV)-infected patients. PATIENTS AND METHODS: We conducted a prospective observational study of 92 patients over 1 year, including a nonblinded, randomized treatment trial of thrush with clotrimazole troches or Oral fluconazole. Oral sites were cultured monthly and when thrush occurred. Candida albicans strains were typed by contour-clamped homogeneous electric field (CHEF) electrophoresis. Changes in strains were evaluated over time and in regard to their associations with particular sites, episodes of thrush, relapse after treatment, and colonization of sexual partners. Susceptibility to fluconazole was tested and CHEF analysis was done on these strains to determine the epidemiology of fluconazole resistance. RESULTS: Yeasts colonized 84% of patients. C albicans accounted for 81% of all isolates and was separated into 34 distinct strains. Most patients had persistent carriage of 1 or 2 dominant strains of C albicans. Three couples shared strains. Nineteen different C albicans strains caused 82 episodes of thrush in 45 patients. CD4 or = 64 micrograms/mL in 3 patients, and with an MIC of 8 micrograms/mL in 1 patient. In 2 of these 4 patients, the prior colonizing strain developed fluconazole resistance. In the other 2, new resistant strains were acquired. CONCLUSIONS: Many different strains of C albicans colonize and cause thrush in patients infected with HIV. Patients are usually persistently colonized with a single strain, and recurrences following treatment are usually due to the same strain. Transmission of strains may occur between couples. Fluconazole and clotrimazole are equally effective in treating thrush, but mycologic cure occurs more often with fluconazole. Fluconazole resistance in C albicans occurs most often in patients who have low CD4 counts and are taking fluconazole prophylactically for recurrent thrush. Fluconazole resistance may occur through acquisition of a new resistant strain or by development of resistance in a previously susceptible strain.
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epidemiology of Oral Candidiasis in hiv infected patients colonization infection treatment and emergence of fluconazole resistance
The American Journal of Medicine, 1994Co-Authors: Jon A Sangeorzan, Suzanne F Bradley, Lidija T Zarins, George L Ridenour, Robert N Tiballi, Carol A. KauffmanAbstract:Abstract purpose: To study the epidemiology of Oral Candidiasis and the effect of treatment of thrush in human immunodeficiency virus (HIV)-infected patients. patients and methods: We conducted a prospective observational study of 92 patients over 1 year, including a nonblinded, randomized treatment trial of thrush with clotrimazole troches or Oral fluconazole. Oral sites were cultured monthly and when thrush occurred. Candida albicans strains were typed by contour-clamped homogeneous electric field (CHEF) electrophoresis. Changes in strains were evaluated over time and in regard to their associations with particular sites, episodes of thrush, relapse after treatment, and colonization of sexual partners. Susceptibility to fluconazole was tested and CHEF analysis was done on these strains to determine the epidemiology of fluconazole resistance. results: Yeasts colonized 84% of patients. C albicans accounted for 81% of all isolates and was separated into 34 distinct strains. Most patients had persistent carriage of 1 or 2 dominant strains of C albicans . Three couples shared strains. Nineteen different C albicans strains caused 82 episodes of thrush in 45 patients. CD4 Torulopsis glabrata and Saccharomyces cerevisiae increased after treatment with either drug, but these organisms were never a sole cause of thrush. In a subset of 35 patients followed for over 3 months in whom fluconazole susceptiblities were performed, minimum inhibitory concentrations (MICs) to fluconazole increased only in those on fluconazole prophylaxis. Clinical failure of fluconazole was associated with an MIC ≥ 64 μg/mL in 3 patients, and with an MIC of 8 μg/mL in 1 patient. In 2 of these 4 patients, the prior colonizing strain developed fluconazole resistance. In the other 2, new resistant strains were acquired. conclusions: Many different strains of C albicans colonize and cause thrush in patients infected with HIV. Patients are usually persistently colonized with a single strain, and recurrences following treatment are usually due to the same strain. Transmission of strains may occur between couples. Fluconazole and clotrimazole are equally effective in treating thrush, but mycologic cure occurs more often with fluconazole. Fluconazole resistance in C albicans occurs most often in patients who have low CD4 counts and are taking fluconazole prophylactically for recurrent thrush. Fluconazole resistance may occur through acquisition of a new resistant strain or by development of resistance in a previously susceptible strain.
Lauren L Patton - One of the best experts on this subject based on the ideXlab platform.
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risk indicators for hiv associated jointly occurring Oral Candidiasis and Oral hairy leukoplakia
Aids Patient Care and Stds, 2007Co-Authors: Amit Chattopadhyay, Lauren L PattonAbstract:Joint occurrence of two or more diseases may impact their transmission, clinical presentation, management approaches, and treatment efficacy. Although Oral Candidiasis (OC) and Oral hairy leukoplak...
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risk indicators for Oral Candidiasis and Oral hairy leukoplakia in hiv infected adults
Community Dentistry and Oral Epidemiology, 2005Co-Authors: Amit Chattopadhyay, Daniel J Caplan, Gary D Slade, Diane C Shugars, Hsaio Chuan Tien, Lauren L PattonAbstract:– Objectives: Oral Candidiasis (OC) and Oral hairy leukoplakia (OHL) are the most common Oral mucosal diseases associated with HIV infection. Independent risk indicators associated with these sentinel opportunistic diseases have not been established in mixed race and gender adult populations in the southeast USA. The purposes of this study were 1) to estimate prevalence of OC and OHL among an HIV-1 positive adult population, and 2) to develop explanatory multivariable models for each disease outcome. Methods: This cross-sectional study evaluated 631 adult dentate HIV-1 seropositive persons examined for HIV-associated Oral mucosal diseases between 1995 and 2000 at University of North Carolina Hospitals in Chapel Hill, North Carolina using data collected from medical record review, interview questionnaire and clinical examination. We analyzed the data using t-tests, anova, and unconditional logistic regression. Results: Prevalent OC was associated with low CD4+ cell count [<200 cells/μl, adj. OR=12.7 (95%CI: 4.9–32.9)], antiretroviral combination therapy [OR=0.6 (0.3–0.9)], and current smoking [OR=2.5 (1.3–4.8)]. Prevalent OHL was associated with low CD4+ cell count [<200 cells/μl, OR=7.2 (2.7–18.9)], antifungal medication use [OR=1.8 (1.1–2.9)], current recreational drug use [OR=2.5 (1.3–4.9)], and male gender [OR=2.5 (1.3–4.8)]. Conclusions: While CD4+ cell count, and antiretroviral medication were important risk indicators for OC, and OHL, cigarette smoking appears to be an important risk indicator for OC in HIV-1-infected populations.
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incidence of Oral Candidiasis and Oral hairy leukoplakia in hiv infected adults in north carolina
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2005Co-Authors: Amit Chattopadhyay, Daniel J Caplan, Gary D Slade, Diane C Shugars, Hsaio Chuan Tien, Lauren L PattonAbstract:Objectives To establish incidence rates and risk factors for HIV-associated Oral Candidiasis (OC), Oral hairy leukoplakia (OHL), and any HIV-associated Oral diseases (HIV-OD). Design This prospective, cumulative case-control study followed 283 initially Oral disease–free HIV-1–infected men and women for 2 years. Incidence rate ratios (IRR) and incidence proportions for OC, OHL, and HIV-OD were estimated. Multivariable analyses using Poisson regression determined the most parsimonious best-fitting model explaining the outcomes. Results Incidence rate (per 1000 person-months) was 9.3 for OC, 6.8 for OHL, and 13.5 for HIV-OD. Incidence of OC was associated with low CD4 count (adjusted IRR = 3.0 (95% CI = 1.7, 5.1)), smoking (IRR = 1.9 (1.0, 3.8)) and combination antiretroviral therapy (IRR = 0.3 (0.1, 0.8)). Incidence of OHL was associated with low CD4 count, conditional upon smoking status. Conclusions Low CD4 count and smoking are important risk factors for HIV-associated OC and OHL. Antiretroviral medications are protective for OC but not for OHL.
Jon A Sangeorzan - One of the best experts on this subject based on the ideXlab platform.
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epidemiology of Oral Candidiasis in hiv infected patients colonization infection treatment and emergence of fluconazole resistance
The American Journal of Medicine, 1994Co-Authors: Jon A Sangeorzan, Suzanne F Bradley, Lidija T Zarins, George L Ridenour, Robert N Tiballi, Xiaogang He, Carol A. KauffmanAbstract:PURPOSE: To study the epidemiology of Oral Candidiasis and the effect of treatment of thrush in human immunodeficiency virus (HIV)-infected patients. PATIENTS AND METHODS: We conducted a prospective observational study of 92 patients over 1 year, including a nonblinded, randomized treatment trial of thrush with clotrimazole troches or Oral fluconazole. Oral sites were cultured monthly and when thrush occurred. Candida albicans strains were typed by contour-clamped homogeneous electric field (CHEF) electrophoresis. Changes in strains were evaluated over time and in regard to their associations with particular sites, episodes of thrush, relapse after treatment, and colonization of sexual partners. Susceptibility to fluconazole was tested and CHEF analysis was done on these strains to determine the epidemiology of fluconazole resistance. RESULTS: Yeasts colonized 84% of patients. C albicans accounted for 81% of all isolates and was separated into 34 distinct strains. Most patients had persistent carriage of 1 or 2 dominant strains of C albicans. Three couples shared strains. Nineteen different C albicans strains caused 82 episodes of thrush in 45 patients. CD4 or = 64 micrograms/mL in 3 patients, and with an MIC of 8 micrograms/mL in 1 patient. In 2 of these 4 patients, the prior colonizing strain developed fluconazole resistance. In the other 2, new resistant strains were acquired. CONCLUSIONS: Many different strains of C albicans colonize and cause thrush in patients infected with HIV. Patients are usually persistently colonized with a single strain, and recurrences following treatment are usually due to the same strain. Transmission of strains may occur between couples. Fluconazole and clotrimazole are equally effective in treating thrush, but mycologic cure occurs more often with fluconazole. Fluconazole resistance in C albicans occurs most often in patients who have low CD4 counts and are taking fluconazole prophylactically for recurrent thrush. Fluconazole resistance may occur through acquisition of a new resistant strain or by development of resistance in a previously susceptible strain.
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epidemiology of Oral Candidiasis in hiv infected patients colonization infection treatment and emergence of fluconazole resistance
The American Journal of Medicine, 1994Co-Authors: Jon A Sangeorzan, Suzanne F Bradley, Lidija T Zarins, George L Ridenour, Robert N Tiballi, Carol A. KauffmanAbstract:Abstract purpose: To study the epidemiology of Oral Candidiasis and the effect of treatment of thrush in human immunodeficiency virus (HIV)-infected patients. patients and methods: We conducted a prospective observational study of 92 patients over 1 year, including a nonblinded, randomized treatment trial of thrush with clotrimazole troches or Oral fluconazole. Oral sites were cultured monthly and when thrush occurred. Candida albicans strains were typed by contour-clamped homogeneous electric field (CHEF) electrophoresis. Changes in strains were evaluated over time and in regard to their associations with particular sites, episodes of thrush, relapse after treatment, and colonization of sexual partners. Susceptibility to fluconazole was tested and CHEF analysis was done on these strains to determine the epidemiology of fluconazole resistance. results: Yeasts colonized 84% of patients. C albicans accounted for 81% of all isolates and was separated into 34 distinct strains. Most patients had persistent carriage of 1 or 2 dominant strains of C albicans . Three couples shared strains. Nineteen different C albicans strains caused 82 episodes of thrush in 45 patients. CD4 Torulopsis glabrata and Saccharomyces cerevisiae increased after treatment with either drug, but these organisms were never a sole cause of thrush. In a subset of 35 patients followed for over 3 months in whom fluconazole susceptiblities were performed, minimum inhibitory concentrations (MICs) to fluconazole increased only in those on fluconazole prophylaxis. Clinical failure of fluconazole was associated with an MIC ≥ 64 μg/mL in 3 patients, and with an MIC of 8 μg/mL in 1 patient. In 2 of these 4 patients, the prior colonizing strain developed fluconazole resistance. In the other 2, new resistant strains were acquired. conclusions: Many different strains of C albicans colonize and cause thrush in patients infected with HIV. Patients are usually persistently colonized with a single strain, and recurrences following treatment are usually due to the same strain. Transmission of strains may occur between couples. Fluconazole and clotrimazole are equally effective in treating thrush, but mycologic cure occurs more often with fluconazole. Fluconazole resistance in C albicans occurs most often in patients who have low CD4 counts and are taking fluconazole prophylactically for recurrent thrush. Fluconazole resistance may occur through acquisition of a new resistant strain or by development of resistance in a previously susceptible strain.
Zhimin Yan - One of the best experts on this subject based on the ideXlab platform.
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effects of streptococcus salivarius k12 with nystatin on Oral Candidiasis rct
Oral Diseases, 2019Co-Authors: Qinghua Mao, Hong Hua, Peiru Zhou, Zhimin YanAbstract:Objective To evaluate the efficacy and safety of Streptococcus salivarius K12 as an adjuvant in treating Oral Candidiasis. Methods A total of 56 patients were participated in the randomized, double-blinded, placebo-controlled clinical trial. The S. salivarius K12 or placebo lozenges plus nystatin tablets were given for up to 4 weeks at 1-week interval and then followed up for 1 week thereafter. We collected and analyzed the mycological and clinical data, treatment course, and safety data. Results At the end of the treatment, significant differences were found in the mycological cure rates between K12 group and control group (90.48% and 55.56%, respectively, p = 0.008). Survival analysis demonstrated no statistical difference in overall cure rates comprehensively considering mycological cure, clinical improvement, and recurrence (p = 0.078), while statistical difference was found in mycological cure (p = 0.013) between the two groups. The median treatment courses of K12 group and control group were 3 weeks and 4 weeks, respectively. No severe events were reported during the study. Conclusion Streptococcus salivarius K12 exhibited potential efficacy and safety as an adjuvant in treating Oral Candidiasis by enhancing mycological cure and shortening the treatment course of conventional antifungal therapy in this randomized, double-blinded, placebo-controlled clinical trial. Further large-scale clinical studies are desired to accumulate more evidence for its clinical applications.
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efficacy and safety of miconazole for Oral Candidiasis a systematic review and meta analysis
Oral Diseases, 2016Co-Authors: L W Zhang, Hong Hua, Zhimin YanAbstract:The objective of this study is to assess the efficacy and safety of miconazole for treating Oral Candidiasis. Twelve electronic databases were searched for randomized controlled trials evaluating treatments for Oral Candidiasis and complemented by hand searching. The clinical and mycological outcomes, as well as adverse effects, were set as the primary outcome criteria. Seventeen trials were included in this review. Most studies were considered to have a high or moderate level of bias. Miconazole was more effective than nystatin for thrush. For HIV-infected patients, there was no significant difference in the efficacy between miconazole and other antifungals. For denture wearers, microwave therapy was significantly better than miconazole. No significant difference was found in the safety evaluation between miconazole and other treatments. The relapse rate of miconazole Oral gel may be lower than that of other formulations. This systematic review and meta-analysis indicated that miconazole may be an optional choice for thrush. Microwave therapy could be an effective adjunct treatment for denture stomatitis. Miconazole Oral gel may be more effective than other formulations with regard to long-term results. However, future studies that are adequately powered, large-scale, and well-designed are needed to provide higher-quality evidence for the management of Oral Candidiasis.
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efficacy of nystatin for the treatment of Oral Candidiasis a systematic review and meta analysis
Drug Design Development and Therapy, 2016Co-Authors: Xin Lyu, Zhimin Yan, Chen Zhao, Hong HuaAbstract:Objective To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating Oral Candidiasis.
Amit Chattopadhyay - One of the best experts on this subject based on the ideXlab platform.
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risk indicators for hiv associated jointly occurring Oral Candidiasis and Oral hairy leukoplakia
Aids Patient Care and Stds, 2007Co-Authors: Amit Chattopadhyay, Lauren L PattonAbstract:Joint occurrence of two or more diseases may impact their transmission, clinical presentation, management approaches, and treatment efficacy. Although Oral Candidiasis (OC) and Oral hairy leukoplak...
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risk indicators for Oral Candidiasis and Oral hairy leukoplakia in hiv infected adults
Community Dentistry and Oral Epidemiology, 2005Co-Authors: Amit Chattopadhyay, Daniel J Caplan, Gary D Slade, Diane C Shugars, Hsaio Chuan Tien, Lauren L PattonAbstract:– Objectives: Oral Candidiasis (OC) and Oral hairy leukoplakia (OHL) are the most common Oral mucosal diseases associated with HIV infection. Independent risk indicators associated with these sentinel opportunistic diseases have not been established in mixed race and gender adult populations in the southeast USA. The purposes of this study were 1) to estimate prevalence of OC and OHL among an HIV-1 positive adult population, and 2) to develop explanatory multivariable models for each disease outcome. Methods: This cross-sectional study evaluated 631 adult dentate HIV-1 seropositive persons examined for HIV-associated Oral mucosal diseases between 1995 and 2000 at University of North Carolina Hospitals in Chapel Hill, North Carolina using data collected from medical record review, interview questionnaire and clinical examination. We analyzed the data using t-tests, anova, and unconditional logistic regression. Results: Prevalent OC was associated with low CD4+ cell count [<200 cells/μl, adj. OR=12.7 (95%CI: 4.9–32.9)], antiretroviral combination therapy [OR=0.6 (0.3–0.9)], and current smoking [OR=2.5 (1.3–4.8)]. Prevalent OHL was associated with low CD4+ cell count [<200 cells/μl, OR=7.2 (2.7–18.9)], antifungal medication use [OR=1.8 (1.1–2.9)], current recreational drug use [OR=2.5 (1.3–4.9)], and male gender [OR=2.5 (1.3–4.8)]. Conclusions: While CD4+ cell count, and antiretroviral medication were important risk indicators for OC, and OHL, cigarette smoking appears to be an important risk indicator for OC in HIV-1-infected populations.
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incidence of Oral Candidiasis and Oral hairy leukoplakia in hiv infected adults in north carolina
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2005Co-Authors: Amit Chattopadhyay, Daniel J Caplan, Gary D Slade, Diane C Shugars, Hsaio Chuan Tien, Lauren L PattonAbstract:Objectives To establish incidence rates and risk factors for HIV-associated Oral Candidiasis (OC), Oral hairy leukoplakia (OHL), and any HIV-associated Oral diseases (HIV-OD). Design This prospective, cumulative case-control study followed 283 initially Oral disease–free HIV-1–infected men and women for 2 years. Incidence rate ratios (IRR) and incidence proportions for OC, OHL, and HIV-OD were estimated. Multivariable analyses using Poisson regression determined the most parsimonious best-fitting model explaining the outcomes. Results Incidence rate (per 1000 person-months) was 9.3 for OC, 6.8 for OHL, and 13.5 for HIV-OD. Incidence of OC was associated with low CD4 count (adjusted IRR = 3.0 (95% CI = 1.7, 5.1)), smoking (IRR = 1.9 (1.0, 3.8)) and combination antiretroviral therapy (IRR = 0.3 (0.1, 0.8)). Incidence of OHL was associated with low CD4 count, conditional upon smoking status. Conclusions Low CD4 count and smoking are important risk factors for HIV-associated OC and OHL. Antiretroviral medications are protective for OC but not for OHL.