RESUMO
Genital herpes, an incurable viral disease that can have a devastating impact on affected patients, is a serious public health concern affecting one in four Americans. Episodic treatment with nucleoside analogs for 3-5 days is the most common method of treatment; however, since maximum viral replication occurs within 24 hours after the onset of symptoms, single-day patient-initiated episodic treatment may be a better option. A recent study evaluated the effectiveness of patient-initiated single-day famciclovir versus placebo in the treatment of genital herpes and found that single-day famciclovir decreased healing time and the duration of pain and other symptoms, and increased the proportion of patients who did not progress to a full outbreak. Compared with previous studies, the results of single-day therapy are similar to or better than the results of conventional therapies of 2-5 days' duration. In addition, the convenience of single-day treatment may lead to greater patient adherence and improved overall management of recurrent herpes outbreaks.
Assuntos
2-Aminopurina/análogos & derivados , Antivirais/farmacologia , Herpes Genital/tratamento farmacológico , 2-Aminopurina/farmacologia , Relação Dose-Resposta a Droga , Famciclovir , Humanos , RecidivaRESUMO
We present the case of a 31-year-old patient who developed widespread mycetoma across her back and shoulders caused by Cladophialophora bantiana 16 years after injury to those sites from tornado debris. The patient also had a history of systemic lupus erythematosus treated with systemic steroids. Systemic antifungal treatment with fluconazole and itraconazole proved ineffective, and surgical debridement was required. Nine other culture-confirmed cases of cutaneous infection with this organism have been reported worldwide. This type of infection can occur in immunocompromised or immunocompetent patients, and may respond to systemic antifungals or surgery.
Assuntos
Cladosporium , Lúpus Eritematoso Sistêmico/complicações , Micetoma/etiologia , Pele/lesões , Pele/microbiologia , Adulto , Antifúngicos/uso terapêutico , Desastres , Feminino , Humanos , Terapia de Imunossupressão/efeitos adversos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/imunologia , Micetoma/tratamento farmacológico , Micetoma/microbiologia , Esteroides/efeitos adversos , Fatores de TempoRESUMO
The incidence of human papillomavirus (HPV) and HPV-related anal cancer has been increasing at an alarming rate. Human immunodeficiency virus-positive patients are at a particularly high risk, with prevalence increasing rapidly in this population as life expectancies have increased. Screening has been very effective in reducing the morbidity and mortality of HPV-related cervical cancer, which suggests its role in reducing the burden of HPV-related anal cancer as well. With appropriate screening, patient education and treatment, the incidence of HPV-related anal cancer may be greatly reduced.