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1.
Rev. esp. enferm. dig ; 109(6): 430-434, jun. 2017. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-163251

RESUMO

Background: Helicobacter pylori eradication rates with standard triple therapy in many countries are clinically unacceptable. Fluoroquinolone resistance is increasing and jeopardizing secondline regimens. There is a growing need for an effective strategy in patients who failed previous therapies. Methods: This is a single-center, non-randomized clinical study conducted in the central region of Portugal. Sixty-four patients were included with a positive 13C-urea breath test (UBT) or histology for H. pylori, and at least one failed eradication attempt. The patient cohort included 71.7% of females with a median of age of 52 (range 23-87). They were treated with a twelve-day regimen consisting of a proton-pump inhibitor (PPI) bid, amoxicillin at 1,000 mg 12/12h and levofloxacin at 500 mg bid during the first seven days, followed by PPI bid, clarithromycin at 500 mg 12/12 h and either tinidazole or metronidazole at 500 mg bid/tid for five days. Eradication was assessed by UBT. The local Ethics Committee approved this study. Results: Eradication therapy was prescribed due to dyspepsia (66.7%), peptic ulcer (10%) and thrombocytopenia (8.3%). The median number of failed therapies was one (range 1-4). The eradication rate was 64.6% according to an intention-to-treat analysis (95% CI: 53-77%), and 70% by the per-protocol analysis (95% CI: 58-82%). Age, smoking, indication for eradication, previous therapies and the use of a second-generation or full-dose PPI did not affect success rates. Conclusions: Even though treatment with four antibiotics was used, this «reinforced» therapy achieved suboptimal results. This fact highlights the lack of effective H. pylori antimicrobials and suggests that second-line treatment in our region should be prescribed according to susceptibility testing (AU)


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Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Helicobacter pylori , Helicobacter pylori/isolamento & purificação , Levofloxacino/uso terapêutico , Amoxicilina/uso terapêutico , Tinidazol/uso terapêutico , Metronidazol/uso terapêutico , Fatores de Risco , Erradicação de Doenças/tendências , Análise Fatorial
2.
Artigo em Espanhol | IBECS | ID: ibc-99825

RESUMO

La giardiasis es una de las parasitosis más frecuentes del mundo que se ha de considerar en todo paciente con persistencia de diarrea o sintomatología digestiva y/o malabsortiva tras un viaje o en población inmigrante, aunque su forma de presentación no es siempre la típica. Se describe un caso de una mujer natural de Guinea Ecuatorial de 25 años de edad presenta un cuadro de astenia de varios meses de evolución. Como hallazgos analíticos relevantes presenta una anemia normocítica y normocrómica con elevación de la velocidad de sedimentación globular (VSG). A lo largo de la exposición se plantea como se consideraron los diagnósticos diferenciales de la astenia, anemia normocítica normocrómica y elevación de VSG hasta llegar al diagnóstico de giardiasis (AU)


Giardiasis is one of the most frequent parasitic infections in the world that must be considered in every patient with persistent diarrhoea or digestive tract and/or malabsorption symptoms after a foreign trip or in the immigrant population, although its presentation is not always the typical. A 25 year old woman from Equatorial Guinea was seen at the clinic due to several months of asthenia. The laboratory analyses showed normocytic and normochromic anaemia and high erythrocyte sedimentation rate (ESR). Throughout the presentation of the case report the differential diagnoses of asthenia, normocytic and normochromic anemia and high ESR will be discussed until the final diagnosis of giardiasis was made (AU)


Assuntos
Humanos , Feminino , Adulto , Astenia/complicações , Astenia/diagnóstico , Diagnóstico Diferencial , Giardíase/complicações , Anemia/complicações , Anemia/etiologia , Anemia/parasitologia , Metronidazol/uso terapêutico , Tinidazol/uso terapêutico , Paromomicina/uso terapêutico , Astenia/fisiopatologia , Sedimentação Sanguínea , Radiografia Torácica/métodos , Radiografia Torácica/tendências
4.
Rev. esp. quimioter ; 22(2): 106-114, jun. 2009. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-136604

RESUMO

El tinidazol es un 5-nitroimidazol activo in vitro frente a una amplia variedad de bacterias y protozoos anaerobios. Sus características farmacocinéticas (Cmáx 51 μg/ml, t1⁄2 12,5 h) y su actividad in vitro frente a microorganismos anaerobios hacen de tinidazol un tratamiento eficaz para muchas infecciones causadas por estos microorganismos en dosis única o una vez al día. El tinidazol es tan eficaz como metronidazol en infecciones por T. vaginalis, giardiasis y amebiasis intestinal o hepática, así como en vaginosis bacterianas, malaria, infecciones odontógenas e infecciones por bacterias anaerobias (enfermedad inflamatoria pélvica o pie diabético). Además se ha empleado en la profilaxis antibiótica de la cirugía abdominal y ginecológica y figura en todos los protocolos de erradicación de Helicobacter pylori. Tinidazol ha recibido recientemente la aprobación de la Food and Drug Administration (FDA) para el tratamiento de infecciones por Trichomonas vaginalis, Entamoeba histolytica y Giardia lamblia (AU)


Tinidazole is a 5-nitroimidazole active in vitro against a wide variety of anaerobic bacteria and protozoa. Tinidazole is an effective treatment against anaerobic microorganisms based on its pharmacokinetic characteristics (Cmáx 51 μg/ml, t1⁄2 12.5 h) and its excellent in vitro activity. Its long half-life allows once a day regimens. Tinidazole is as effective as metronidazole in the treatment of infections caused by T. vaginalis, giardiasis and amebiasis and bacterial vaginosis, malaria, odontogenic infections, anaerobic bacterial infections (pelvic inflammatory disease, diabetic foot), surgical prophylaxis (abdominal and hysterectomy) and Helicobacter pylori eradication. Tinidazole was recently approved by the Food and Drug Administration (FDA) for the treatment of infections caused by Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia (AU)


Assuntos
Humanos , Animais , Masculino , Feminino , Antibacterianos/uso terapêutico , Antiprotozoários/uso terapêutico , Bactérias Anaeróbias , Eucariotos , Eucariotos/metabolismo , Tinidazol/uso terapêutico , Giardíase/tratamento farmacológico , Infecções por Helicobacter/tratamento farmacológico , Periodontite/tratamento farmacológico , Complicações Pós-Operatórias/prevenção & controle , Anaerobiose , Antibacterianos/efeitos adversos , Antibacterianos/química , Antibacterianos/farmacologia , Antibioticoprofilaxia , Antiprotozoários/efeitos adversos , Antiprotozoários/química , Antiprotozoários/farmacologia , Ensaios Clínicos como Assunto , Tinidazol/efeitos adversos , Tinidazol/química , Tinidazol/farmacologia , Tricomoníase/tratamento farmacológico , Vaginose Bacteriana/tratamento farmacológico
5.
Rev. esp. quimioter ; 21(3): 189-202, sept. 2008.
Artigo em Espanhol | IBECS | ID: ibc-77593

RESUMO

Tinidazole is a 5-nitroimidazole initially introduced intoclinical medicine in 1969 for the treatment of unicellular parasites.Tinidazole offers selective bactericidal activity, not influencedby the inoculum size, against anaerobic bacteria,that make it of theoretical interest against periodontopathogeninfections. This article reviews the required characteristicsof an antibiotic directed to odontogenic anaerobic infections,as well as the pharmacodynamic pitfalls of commonantibiotic treatments. In addition the in vitro, pharmacokineticand pharmacodynamic properties of tinidazole are reviewed,assessing the degree of its adhesion to the required characteristics,as well as identifying the gaps to be fulfilled priorto its use in this medical field. Tinidazole offers interestingcharacteristics making worthy investigations as a candidatefor the treatment of anaerobic odontogenic infections (AU)


El tinidazol es un 5-nitroimidazol que se introdujo en1969 en la clínica para el tratamiento de infestaciones porparásitos unicelulares. El tinidazol ofrece una actividadbactericida selectiva, no influida por el tamaño del inóculo,frente a bacterias anaerobias, por lo que presenta un interésteórico en infecciones producidas por odontopatógenos. Esteartículo revisa las características que requiere un antibióticodirigido al tratamiento de infecciones odontogénicas por bacterias anaerobias, así como las carencias farmacodinámicasde los antibióticos habitualmente utilizados en estetipo de infecciones. Asimismo se revisan las propiedades invitro, farmacocinéticas y farmacodinámicas de tinidazol,valorándose el grado de adhesión de este compuesto a lascaracterísticas requeridas para un antibiótico dirigido a estetipo de infecciones. También se identifican las lagunas deconocimiento sobre tinidazol que deben resolverse antes desu utilización en este campo. Tinidazol ofrece unas característicasinteresantes que posibilitan realizar investigacionescomo candidato al tratamiento de infecciones odontogénicasanaerobias (AU)


Assuntos
Humanos , Masculino , Feminino , Doenças Periodontais/classificação , Doenças Periodontais/enzimologia , Doenças Periodontais/terapia , Tinidazol/administração & dosagem , Tinidazol/síntese química , Tinidazol/farmacologia , Tinidazol/farmacocinética , Tinidazol/uso terapêutico , Controle de Infecções Dentárias/métodos , Controle de Infecções Dentárias/normas , Controle de Infecções Dentárias/tendências , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 99(3): 190-198, abr. 2008. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-62823

RESUMO

Las vulvovaginitis de repetición son un problema común en la práctica clínica. El manejo de estas pacientes se complica a menudo con una larga anamnesis de tratamientos tan tentativos como inadecuados, ya que parten a menudo de un procedimiento diagnóstico incompleto. En este artículo revisamos las causas más frecuentes de estos cuadros, los pasos adecuados para establecer su diagnóstico, desde la anamnesis hasta las pruebas complementarias necesarias, y por último, las medidas terapéuticas oportunas. Nos centramos, por ser de mayor interés para el dermatólogo, en las de causa infecciosa, irritativa, alérgica y hormonal. Prestamos especial atención a los cuadros de etiología infecciosa y a su diagnóstico diferencial, por ser la causa más común de estos procesos y también frecuente motivo de tratamientos intempestivos (AU)


Recurrent vulvovaginitis is a common problem in clinical practice. Management is often complicated by a long history of inappropriate treatments based on tentative diagnoses after an incomplete diagnostic workup. We review the most common causes of recurrent vulvovaginitis; the appropriate steps with which to establish a diagnosis, from the medical history through to the additional tests needed; and, finally, the best therapeutic options. We will focus on infectious, irritant, allergic, and hormonal causes as the ones of most interest to the dermatologist. Given that infection is the most frequent cause of these processes and also a common reason for inopportune treatment, we will pay particular attention to infectious etiologies and their differential diagnosis (AU)


Assuntos
Humanos , Feminino , Adulto , Vulvovaginite/diagnóstico , Vulvovaginite/terapia , Diagnóstico Diferencial , Fatores de Risco , Tricomoníase/complicações , Herpes Simples/complicações , Metronidazol/uso terapêutico , Povidona-Iodo/uso terapêutico , Clindamicina/uso terapêutico , Anamnese/métodos , Candida/isolamento & purificação , Candida/patogenicidade , Candida albicans/isolamento & purificação , Vulvovaginite/epidemiologia , Vulvovaginite/etiologia , Leucorreia/complicações , Tinidazol/uso terapêutico , Azóis/uso terapêutico
7.
Int. microbiol ; 7(2): 139-142, jun. 2004. ilus
Artigo em Inglês | IBECS | ID: ibc-98756

RESUMO

The susceptibility of mobile and cystic forms of Borrelia burgdorferi to tinidazole (TZ) was examined. The minimal bactericidal concentration (MBC) of TZ against the mobile spirochetes was >128 microg/ml at 37 degrees C in micro-oxic atmosphere when incubated for 14 days. TZ significantly reduced the conversion of mobile spirochetes to cystic forms during incubation. The MBC for older (10-months-old) cysts at 37 degrees C in a micro-oxic atmosphere was >0.5 microg/ml, but >0.125 microg/ml for young (1-day-old) cysts. Acridine orange staining, dark-field microscopy and transmission electron microscopy revealed that, when the concentration of TZ was > or = MBC, the contents of the cysts were partly degraded, core structures did not develop inside the young cysts, and the amount of RNA in these cysts decreased significantly. When cysts were exposed to TZ, both the spirochetal structures and core structures inside the cysts dissolved, and the production of blebs was significantly reduced. These observations may be valuable in the treatment of resistant infections caused by B. burgdorferi, and suggest that a combination of TZ and a macrolide antibiotic could eradicate both cystic and mobile forms of B. burgdorferi (AU)


Este estudio examina la susceptibilidad al tinidazol (TZ) de las formas móviles y císticas de Borrelia burgdorferi. La concentración bactericida mínima (CBM) de TZ para las espiroquetas móviles era >128 mg/ml a 37°C en atmosfera microóxica e incubación durante 14 días. El TZ redujo significativamente la conversión de espiroquetas móviles a la forma cística durante la incubación. La CBM para los cistos viejos (de 10 meses) a 37°C y en atmosfera microóxica era >0.5 mg/ml, mientras para los cistos jóvenes (de un día) era >0.125 mg/ml. La tinción con naranja de acridina, la microscopia de campo oscuro, y la microscopia electrónica de transmisión mostraron que cuando la concentración de TZ era ≥MBC el contenido de los cistos se degradaba parcialmente, no se desarrollaban las estructuras nucleares en el interior de los cistos jóvenes, y la cantidad de RNA en dichos cistos disminuía significativamente. Cuando los cistos se exponían a TZ, las estructuras espiroquetales y nucleares de su interior se disolvían, y la producción de vesículas se reducía significativamente. Estas observaciones pueden ser importantes en el tratamiento de infecciones resistentes causadas por B. burgdorferi, y sugieren que la combinación de TZ con un antibiótico macrólido podría erradicar tanto las formas císticas de B. burgdorferi como las móviles (AU)


Assuntos
Humanos , Borrelia burgdorferi , Tinidazol/farmacocinética , Testes de Sensibilidade Microbiana , Spirochaetales , Microscopia Eletrônica de Transmissão/métodos , Esferoplastos
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