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1.
J Eur Acad Dermatol Venereol ; 33(10): 1863-1873, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287594

RESUMO

Cutaneous candidiasis is a common skin disease, and several treatments have been investigated within the last fifty years. Yet, systematic reviews are lacking, and evidence-based topical and systemic treatment strategies remain unclear. Thus, the aim of this review was to summarize efficacy and adverse effects of topical and oral therapies for cutaneous candidiasis in all age groups. Two individual researchers searched PubMed and EMBASE for 'cutaneous candidiasis' and 'cutaneous candidiasis treatment', 'intertrigo', 'diaper dermatitis' and 'cheilitis'. Searches were limited to 'English language', 'clinical trials' and 'human subjects', and prospective clinical trials published in abstracts or articles were included. In total, 149 studies were identified, of which 44 were eligible, comprising 41 studies of 19 topical therapies and four studies of three systemic therapies for cutaneous candidiasis. Topical therapies were investigated in infants, children, adolescents, adults and elderly, while studies of systemic therapies were limited to adolescents and adults. Clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated similar efficacy with complete cure rates of 73%-100%. Single-drug therapy was as effective as combinations of antifungal, antibacterial and topical corticosteroid. Four studies investigated systemic therapy, and oral fluconazole demonstrated similar efficacy to oral ketoconazole and topical clotrimazole. Limitations to this review were mainly that heterogeneity of studies hindered meta-analyses. In conclusions, clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated equal good efficacy and mild adverse effects similar to combinations of antifungal, antibacterial and topical corticosteroids. Oral fluconazole was as effective as topical clotrimazole and is the only commercially available evidence-based option for systemic treatment of cutaneous candidiasis.


Assuntos
Antifúngicos/uso terapêutico , Candidíase Cutânea/tratamento farmacológico , Clotrimazol/uso terapêutico , Fluconazol/uso terapêutico , Miconazol/uso terapêutico , Nistatina/uso terapêutico , Administração Oral , Administração Tópica , Antifúngicos/administração & dosagem , Clotrimazol/administração & dosagem , Quimioterapia Combinada , Medicina Baseada em Evidências , Fluconazol/administração & dosagem , Humanos , Cetoconazol/uso terapêutico , Miconazol/administração & dosagem , Nistatina/administração & dosagem
2.
Hautarzt ; 70(11): 888-896, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31098692

RESUMO

A 6 month-old-female infant from Bahrain visiting Germany with her family for a holiday was seen by us for extensive dermatophytosis of the back, buttocks, chest and groins. Topical treatment by terbinafine for over 2 months was not successful. Other family members including adults and children were treated in Bahrain with topical antifungals and oral voriconazole which was not helpful. Mycological examination performed in Germany revealed the detection of the zoophilic dermatophyte Trichophyton (T.) mentagrophytes. The newly described genotype VIII within the species T. mentagrophytes was identified by sequencing of the "internal transcribed spacer" (ITS) region of the fungal rDNA. This genotype of T. mentagrophytes is the main causative agent of the current epidemic of chronic recalcitrant dermatophytoses in India. Transmission of this Indian genotype of T. mentagrophytes to other countries due to globalization is a serious issue to be considered. Moreover, a significant percentage of these Indian T. mentagrophytes strains are resistant to terbinafine both in vitro and by the way of genetic point mutations in the squalene epoxidase (SQLE) gene. Some are also found to be partially resistant against itraconazole and voriconazole. The point mutation TTC/TTA was found by SQLE mutation analysis in this particular T. mentagrophyte isolate from Bahrain. This point mutation is closely associated with F397L amino acid substitution of the enzyme indicative of in vitro resistance of the dermatophyte against terbinafine. The girl was successfully treated by topical miconazole and later by ciclopirox olamine. This is the first report on an infection due to a terbinafine-resistant T. mentagrophytes strain of the ITS genotype VIII from India in Germany.


Assuntos
Antifúngicos/farmacologia , Ciclopirox/uso terapêutico , Miconazol/uso terapêutico , Terbinafina/farmacologia , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha/tratamento farmacológico , Trichophyton/genética , Trichophyton/isolamento & purificação , Adulto , Antifúngicos/uso terapêutico , Barein , Feminino , Genótipo , Alemanha , Humanos , Lactente , RNA Fúngico , Análise de Sequência de RNA , Terbinafina/uso terapêutico , Tinha/diagnóstico , Tinha do Couro Cabeludo/diagnóstico , Trichophyton/classificação
3.
Med Oral Patol Oral Cir Bucal ; 24(2): e172-e180, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30818309

RESUMO

BACKGROUND: Candidiasis is one of the most common opportunistic oral infections that presents different acute and chronic clinical presentations with diverse diagnostic and therapeutic approaches. The present study carries out a bibliographic review on the therapeutic tools available against oral candidiasis and their usefulness in each clinical situation. MATERIAL AND METHODS: Recent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library. RESULTS: Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection. The pharmacological presentations of miconazole are more comfortable for patients but this drug may interact with other drugs and this fact should be assessed before use. Other topical alternatives for oral candidiasis, such as amphotericin B or clotrimazole, are not available in many countries. Oral fluconazole is effective in treating oral candidiasis that does not respond to topical treatment. Other systemic treatment alternatives, oral or intravenous, less used are itraconazole, voriconazole or posaconazole. Available novelties include echinocandins (anidulafungin, caspofungin) and isavuconazole. Echinocandins can only be used intravenously. Isavuconazole is available for oral and intravenous use. Other hopeful alternatives are new drugs, such as ibrexafungerp, or the use of antibodies, cytokines and antimicrobial peptides. CONCLUSIONS: Nystatin, miconazole, and fluconazole are very effective for treating oral candidiasis. There are systemic alternatives for treating recalcitrant infections, such as the new triazoles, echinocandins, or lipidic presentations of amphotericin B.


Assuntos
Antifúngicos/administração & dosagem , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candidíase Bucal/tratamento farmacológico , Administração Intravenosa , Administração Oral , Administração Tópica , Anfotericina B/uso terapêutico , Anidulafungina/uso terapêutico , Azóis/uso terapêutico , Caspofungina/uso terapêutico , Clotrimazol/uso terapêutico , Bases de Dados Factuais , Interações Medicamentosas , Equinocandinas/uso terapêutico , Fluconazol/uso terapêutico , Humanos , Miconazol/uso terapêutico , Nitrilos/uso terapêutico , Nistatina/uso terapêutico , Piridinas/uso terapêutico , Triazóis/uso terapêutico
4.
Med. oral patol. oral cir. bucal (Internet) ; 24(2): e172-e180, mar. 2019.
Artigo em Inglês | IBECS | ID: ibc-180640

RESUMO

Background: Candidiasis is one of the most common opportunistic oral infections that presents different acute and chronic clinical presentations with diverse diagnostic and therapeutic approaches. The present study carries out a bibliographic review on the therapeutic tools available against oral candidiasis and their usefulness in each clinical situation. Material and Methods: Recent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library. Results: Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection. The pharmacological presentations of miconazole are more comfortable for patients but this drug may interact with other drugs and this fact should be assessed before use. Other topical alternatives for oral candidiasis, such as amphotericin B or clotrimazole, are not available in many countries. Oral fluconazole is effective in treating oral candidiasis that does not respond to topical treatment. Other systemic treatment alternatives, oral or intravenous, less used are itraconazole, voriconazole or posaconazole. Available novelties include echinocandins (anidulafungin, caspofungin) and isavuconazole. Echinocandins can only be used intravenously. Isavuconazole is available for oral and intravenous use. Other hopeful alternatives are new drugs, such as ibrexafungerp, or the use of antibodies, cytokines and antimicrobial peptides. Conclusions: Nystatin, miconazole, and fluconazole are very effective for treating oral candidiasis. There are systemic alternatives for treating recalcitrant infections, such as the new triazoles, echinocandins, or lipidic presentations of amphotericin B


No disponible


Assuntos
Humanos , Candida/isolamento & purificação , Candidíase Bucal/tratamento farmacológico , Antifúngicos/uso terapêutico , Miconazol/uso terapêutico , Nistatina/uso terapêutico , Anfotericina B/uso terapêutico , Fluconazol/uso terapêutico , Equinocandinas/uso terapêutico
6.
Med Mycol ; 57(1): 52-62, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29361177

RESUMO

Vulvovaginal candidiasis (VVC) is caused mainly by the opportunistic fungus Candida albicans, and its yeast to hyphae transition is considered a major virulence factor. Farnesol is a molecule that inhibits yeast to hyphae transition. The increased incidence of VVC has influenced a need for developing new therapeutic strategies. The objective was to develop a mucoadhesive nanostructured system composed of miconazole and farnesol co-encapsulated within chitosan nanoparticles. The miconazole presented a minimal inhibitory concentration (MIC) of 1 µg/ml against C. albicans. The farnesol was capable of inhibiting yeast to hyphae transition at levels greater or equal to 300 µM. The combination of miconazole and farnesol showed no change in miconazole MIC. Chitosan nanoparticles containing miconazole and farnesol were prepared by ionic gelation and showed favorable characteristics for use on mucous membranes. They showed size variation and polydispersion index (PDI) after 30 days, but the efficiency of drug encapsulation was maintained. Regarding toxicity in cultured fibroblasts (BALB/c 3T3) the nanoparticles were considered nontoxic. The nanoparticles showed antifungal activity against the C. albicans strain used with MICs of 2.5 µg/ml and 2 µg/ml for nanoparticles containing miconazole or miconazole/farnesol, respectively. Nanoparticles containing farnesol inhibited yeast to hyphae transition at concentrations greater than or equal to 240 µM. The in vivo antifungal activity was assessed in the murine model for VVC. The results suggested that chitosan nanoparticles containing miconazole and farnesol were effective at inhibiting fungal proliferation. Additionally, chitosan nanoparticles containing farnesol were capable of decreasing the pathogenicity of infection, demonstrated through the absence of inflammation.


Assuntos
Candida albicans/efeitos dos fármacos , Candidíase Vulvovaginal/tratamento farmacológico , Farneseno Álcool , Miconazol , Nanopartículas/química , Animais , Antifúngicos/síntese química , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Células 3T3 BALB , Candida albicans/crescimento & desenvolvimento , Candidíase Vulvovaginal/patologia , Cápsulas , Quitosana/química , Modelos Animais de Doenças , Farneseno Álcool/química , Farneseno Álcool/farmacologia , Farneseno Álcool/uso terapêutico , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Miconazol/química , Miconazol/farmacologia , Miconazol/uso terapêutico , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Nanopartículas/uso terapêutico
7.
Artigo em Inglês | MEDLINE | ID: mdl-30231166

RESUMO

Tinea nigra is an infrequent, superficial fungal infection, mainly caused by Hortaea werneckii, which is still underreported in Ethiopia. An asymptomatic 62-year-old male patient sought a rural hospital of Ethiopia, showing dark plaques on the palms of both hands. A superficial mycosis was suspected and a direct light microscopic mycological examination from skin scrapings revealed short brownish hyphae. To our knowledge, this is the first case of tinea nigra from the Ethiopian highlands. This may be due to the actual rarity of the condition or to underreporting.


Assuntos
Dermatoses da Mão/diagnóstico , Tinha/diagnóstico , Antifúngicos/uso terapêutico , Dermatoses da Mão/tratamento farmacológico , Dermatoses da Mão/microbiologia , Humanos , Masculino , Miconazol/análogos & derivados , Miconazol/uso terapêutico , Pessoa de Meia-Idade , Serviços de Saúde Rural , Tinha/tratamento farmacológico
8.
Neurosci Lett ; 687: 94-98, 2018 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-30253223

RESUMO

Miconazole, a frequently used antifungal drug, has been identified with new functions to promote oligodendrocyte progenitor cells differentiation and to enhance remyelination. However, the neuroregenerative and therapeutic benefit of miconazole on ischemic stroke model have not been tested. In the present study, the effects of miconazole on a rat model of transient middle cerebral artery occlusion were evaluated. Rats received miconazole (10 mg/kg) or saline by intravenous administration for 7 days after stroke. A battery of neurobehavioral assessments, including rotarod test, open-field test, neurological severity score and novel object recognition task were evaluated. The results revealed a significant functional improvement in miconazole-treated rats compared with vehicle-treated control. Animals were sacrificed at 7 and 28 days after stroke. Double immunofluorescence staining for NeuN+/BrdU+, DCX+/BrdU+ and Nestin+/BrdU+ cells indicated miconazole significantly promoted neurogenesis. Western blotting analysis revealed miconazole upregulated the protein expression of brain derived neurotrophic factor, myocyte enhancer factor 2D, synaptophysin, and postsynaptic density protein 95, while downregulated the expression of cyclin-dependent kinase 5. Taken together, miconazole promoted functional recovery on ischemic stroke model via stimulating post-ischemic neurogenesis.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Miconazol/uso terapêutico , Neurogênese/efeitos dos fármacos , Recuperação de Função Fisiológica/efeitos dos fármacos , Animais , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Isquemia Encefálica/metabolismo , Isquemia Encefálica/patologia , Masculino , Miconazol/farmacologia , Neurogênese/fisiologia , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica/fisiologia
9.
Arch Soc Esp Oftalmol ; 93(10): 491-493, 2018 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29859733

RESUMO

CASE REPORT: The case is presented of a 3-year-old girl with an erythematous oedematous plaque associated with blepharitis, and chalazion in the right upper eyelid. She received empirical treatment with topical corticosteroids, as well as an antifungal and antibiotic, without observing any improvement. The culture of the eyelid scrape showed Microsporum canis. Therefore, she was prescribed oral terbinafine and topical miconazole-betamethasone, achieving a clinical and microbiological recovery. DISCUSSION: Eyelid infection due to dermatophytes is uncommon, but it should be considered among the diagnostic suspicions of palpebral skin lesions. The microbiological study is a key factor for its diagnosis and appropriate treatment.


Assuntos
Blefarite/microbiologia , Dermatomicoses/microbiologia , Microsporum/isolamento & purificação , Tinha/microbiologia , Antifúngicos/uso terapêutico , Betametasona/uso terapêutico , Blefarite/tratamento farmacológico , Calázio/microbiologia , Pré-Escolar , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Miconazol/uso terapêutico , Terbinafina/uso terapêutico , Tinha/diagnóstico , Tinha/tratamento farmacológico
10.
Parasitol Res ; 117(7): 2327-2331, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29721656

RESUMO

The liver fluke Opisthorchis felineus (Rivolta, 1884) is the causative agent of opisthorchiasis felinea in Eurasia. Opisthorchiasis is a serious human and fish-eating animal's disease affecting bile ducts and the gall bladder. Currently, the main drug for specific therapy of opisthorchiasis is praziquantel. We have previously shown that azole inhibitors of O. felineus cytochrome P450 significantly reduced survival of the worms in vitro. Here, we studied in vitro anthelmintic effects of drug combinations involving azole substances approved by the US Food and Drug Administration together with praziquantel against adult or juvenile O. felineus liver flukes. A synergistic interaction was shown for praziquantel-clotrimazole (CI = 0.68) combination and for praziquantel-miconazole (CI = 0.68) combination against adult helminths in vitro. Praziquantel-miconazole (CI = 0.30) had a strongly synergistic effect against newly excysted metacercariae. We also tested anthelmintic effects of azole substances and their combinations with praziquantel in vivo in an animal model of chemotherapy. The treatment of juvenile worms (1 day postinfection) with 100 mg/kg miconazole resulted in a worm burden reduction (WBR) of 37.5% (P = 0.049), with 100 mg/kg clotrimazole causing a WBR of 31.25% (P = 0.025). The treatment of adult worms (5-6 weeks postinfection) with 100 mg/kg or 200 mg/kg miconazole yielded a WBR of 23.8% (P = 0.01) and 21.4% (P = 0.006), respectively. When praziquantel was administered together with clotrimazole or with miconazole, a WBR slightly greater than the effect of ED50 praziquantel was observed (WBR of 59.5 and 54.7%, respectively).In conclusion, the synergistic effect of the praziquantel-clotrimazole and praziquantel-miconazole combinations observed in vitro was not confirmed in vivo. Thus, this combination chemotherapy revealed no benefits over praziquantel monotherapy in the treatment of opisthorchiasis felinea.


Assuntos
Anti-Helmínticos/uso terapêutico , Clotrimazol/uso terapêutico , Miconazol/uso terapêutico , Opistorquíase/tratamento farmacológico , Opistorquíase/veterinária , Opisthorchis/efeitos dos fármacos , Praziquantel/uso terapêutico , Animais , Cricetinae , Modelos Animais de Doenças , Quimioterapia Combinada , Fasciola hepatica/efeitos dos fármacos , Humanos , Metacercárias/efeitos dos fármacos , Opistorquíase/parasitologia
11.
An Bras Dermatol ; 93(1): 141-142, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29641719

RESUMO

Dermatophytes are fungi capable of invading keratinized tissues. Isolation of the fungus with the culture is essential to guide the treatment, because there are more resistant species like Microsporum canis. The chronic use of corticosteroids leads to the deregulation of immunity, promoting atypical manifestations of infections. Topical antifungal therapy is often insufficient, requiring systemic medications. We describe the case of a patient undergoing systemic corticosteroid therapy with a large figurate lesion who presented complete response to exclusively topical treatment.


Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Eritema/tratamento farmacológico , Hospedeiro Imunocomprometido , Miconazol/análogos & derivados , Administração Cutânea , Adulto , Dermatomicoses/microbiologia , Eritema/microbiologia , Feminino , Humanos , Miconazol/uso terapêutico , Microsporum/isolamento & purificação
12.
Am J Obstet Gynecol ; 218(6): 601.e1-601.e7, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29510088

RESUMO

BACKGROUND: Spontaneous abortions are the most common complication of pregnancy. Clotrimazole and miconazole are widely used vaginal-antimycotic agents used for the treatment of vulvovaginal candidiasis. A previous study has suggested an increased risk of miscarriage associated with these azoles, which may lead health professionals to refrain from their use even if clinically indicated. OBJECTIVE: The aim of the current study was to assess the risk for spontaneous abortions following first trimester exposure to vaginal antimycotics. STUDY DESIGN: A historical cohort study was conducted including all clinically apparent pregnancies that began from January 2003 through December 2009 and admitted for birth or spontaneous abortion at Soroka Medical Center, Clalit Health Services, Beer-Sheva, Israel. A computerized database of medication dispensation was linked with 2 computerized databases containing information on births and spontaneous abortions. Time-varying Cox regression models were constructed adjusting for mother's age, diabetes mellitus, hypothyroidism, obesity, hypercoagulable or inflammatory conditions, recurrent miscarriages, intrauterine contraceptive device, ethnicity, tobacco use, and the year of admission. RESULTS: A total of 65,457 pregnancies were included in the study: 58,949 (90.1%) ended with birth and 6508 (9.9%) with a spontaneous abortion. Overall, 3246 (5%) pregnancies were exposed to vaginal antimycotic medications until the 20th gestational week: 2712 (4.2%) were exposed to clotrimazole and 633 (1%) to miconazole. Exposure to vaginal antimycotics was not associated with spontaneous abortions as a group (crude hazard ratio, 1.11; 95% confidence interval, 0.96-1.29; adjusted hazard ratio, 1.11; 95% confidence interval, 0.96-1.29) and specifically for clotrimazole (adjusted hazard ratio, 1.05; 95% confidence interval, 0.89-1.25) and miconazole (adjusted hazard ratio, 1.34; 95% confidence interval, 0.99-1.80). Furthermore, no association was found between categories of dosage of vaginal antimycotics and spontaneous abortions. CONCLUSION: Exposure to vaginal antimycotics was not associated with spontaneous abortions.


Assuntos
Aborto Espontâneo/epidemiologia , Antifúngicos/uso terapêutico , Candidíase Vulvovaginal/tratamento farmacológico , Clotrimazol/uso terapêutico , Miconazol/uso terapêutico , Administração Intravaginal , Adulto , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Fertilização In Vitro/estatística & dados numéricos , Humanos , Hipotireoidismo/epidemiologia , Israel/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Adulto Jovem
13.
An. bras. dermatol ; 93(1): 141-142, Jan.-Feb. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-887158

RESUMO

Abstract: Dermatophytes are fungi capable of invading keratinized tissues. Isolation of the fungus with the culture is essential to guide the treatment, because there are more resistant species like Microsporum canis. The chronic use of corticosteroids leads to the deregulation of immunity, promoting atypical manifestations of infections. Topical antifungal therapy is often insufficient, requiring systemic medications. We describe the case of a patient undergoing systemic corticosteroid therapy with a large figurate lesion who presented complete response to exclusively topical treatment.


Assuntos
Humanos , Feminino , Adulto , Hospedeiro Imunocomprometido , Dermatomicoses/tratamento farmacológico , Eritema/tratamento farmacológico , Miconazol/análogos & derivados , Antifúngicos/uso terapêutico , Administração Cutânea , Dermatomicoses/microbiologia , Eritema/microbiologia , Miconazol/uso terapêutico , Microsporum/isolamento & purificação
14.
Muscle Nerve ; 57(5): 821-828, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29211920

RESUMO

INTRODUCTION: Improving axonal outgrowth and remyelination is crucial for peripheral nerve regeneration. Miconazole appears to enhance remyelination in the central nervous system. In this study we assess the effect of miconazole on axonal regeneration using a sciatic nerve crush injury model in rats. METHODS: Fifty Sprague-Dawley rats were divided into control and miconazole groups. Nerve regeneration and myelination were determined using histological and electrophysiological assessment. Evaluation of sensory and motor recovery was performed using the pinprick assay and sciatic functional index. The Cell Counting Kit-8 assay and Western blotting were used to assess the proliferation and neurotrophic expression of RSC 96 Schwann cells. RESULTS: Miconazole promoted axonal regrowth, increased myelinated nerve fibers, improved sensory recovery and walking behavior, enhanced stimulated amplitude and nerve conduction velocity, and elevated proliferation and neurotrophic expression of RSC 96 Schwann cells. DISCUSSION: Miconazole was beneficial for nerve regeneration and functional recovery after peripheral nerve injury. Muscle Nerve 57: 821-828, 2018.


Assuntos
Inibidores de 14-alfa Desmetilase/uso terapêutico , Miconazol/uso terapêutico , Regeneração Nervosa/efeitos dos fármacos , Recuperação de Função Fisiológica/efeitos dos fármacos , Neuropatia Ciática/tratamento farmacológico , Neuropatia Ciática/fisiopatologia , Potenciais de Ação/efeitos dos fármacos , Animais , Contagem de Células , Linhagem Celular Transformada , Proliferação de Células/efeitos dos fármacos , Citocinas/metabolismo , Modelos Animais de Doenças , Masculino , Fibras Nervosas Mielinizadas/patologia , Fibras Nervosas Mielinizadas/ultraestrutura , Condução Nervosa/efeitos dos fármacos , Proteínas de Neurofilamentos/metabolismo , Ratos , Ratos Sprague-Dawley , Células de Schwann/efeitos dos fármacos , Células de Schwann/metabolismo , Sincalida/metabolismo
15.
J Dermatolog Treat ; 29(2): 200-201, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28753055

RESUMO

BACKGROUND: Tinea corporis is a common mycotic infection in children. Staphylococcus aureus superinfections may be observed in atopic children with tinea corporis suffering from severe pruritus and consequent scratching. OBJECTIVE: From 2006 to 2011, we observed 288 children with mycologically proven tinea corporis. In 39 of them (13.5%) tinea corporis was superinfected by S. aureus: all these children were affected by atopic dermatitis. We interpreted these bacterial superinfections as the clinical result of scratching due to pruritus. METHODS: In 2012, we decided to treat all children with a single lesion of tinea corporis with a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate cream (one application/day for 5-7 days), followed by a treatment with isoconazole or clotrimazole or ciclopirox cream (two applications/day for two weeks). RESULTS: From 2012 to 2014, we observed 108 children with tinea corporis confirmed by mycological examinations. Clinical and mycological recovery was observed in 93 of them (86.1%). Only four of these children (3.7%) developed S. aureus superinfections. CONCLUSIONS: Our study in atopic children with tinea corporis superinfected by S. aureus confirms that a topical therapy with the association isoconazole-diflucortolone is useful and safe.


Assuntos
Antifúngicos/uso terapêutico , Diflucortolona/uso terapêutico , Miconazol/análogos & derivados , Tinha/tratamento farmacológico , Administração Tópica , Criança , Pré-Escolar , Dermatite Atópica/complicações , Diflucortolona/química , Esquema de Medicação , Feminino , Humanos , Masculino , Miconazol/química , Miconazol/uso terapêutico , Pomadas/química , Pomadas/uso terapêutico , Staphylococcus aureus/isolamento & purificação , Superinfecção/diagnóstico , Superinfecção/tratamento farmacológico , Superinfecção/microbiologia , Resultado do Tratamento
16.
Eur J Pharm Sci ; 111: 358-375, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28986195

RESUMO

The use of conventional vaginal formulations of miconazole nitrate (MN) in the treatment of deep-seated VVC (vulvovaginal candidiasis) is limited by poor penetration capacity and low solubility of MN, short residence time and irritation at the application site. Surface-modified mucoadhesive microgels were developed to minimize local irritation, enhance penetration capacity and solubility and prolong localized vaginal delivery of MN for effective treatment of deep-seated VVC. Solid lipid microparticles (SLMs) were prepared from matrices consisting of hydrogenated palm oil (Softisan® 154, SF) and super-refined sunseed oil (SO) with or without polyethylene glycol (PEG)-4000, characterized for physicochemical performance and used to prepare mucoadhesive microgels (MMs) encapsulating MN, employing Polycarbophil as bioadhesive polymer. The MMs were evaluated for physicochemical performance and in vitro drug release in simulated vaginal fluid (pH=4.2), whereas mucoadhesive, rheological and stability tests, anticandidal efficacy in immunosuppressed estrogen-dependent female rats and vaginal tolerance test in rabbits were performed with optimized formulation. The amorphicity of 1:9 phytolipid blend (SO:SF) was increased in the presence of PEG-4000. The physicochemical properties of the SLMs and MMs indicated their suitability for vaginal drug delivery. Overall, MN-loaded PEGylated MMs exhibited significantly (p<0.05) more prolonged drug release than non-PEGylated MMs. Additionally, optimized PEGylated MMs was stable at 40±2°C over a period of 6months, viscoelastic, mucoadhesive, non-sensitizing, histopathologically safe and gave remarkably (p<0.05) higher reduction in Candida albicans load (86.06%) than Daktarin® (75.0%) and MN-loaded polymeric-hydrogel (47.74%) in treated rats in 12days. Thus, PEGylated MMs is promising for effective and convenient treatment of VVC.


Assuntos
Candidíase Vulvovaginal/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Miconazol/uso terapêutico , Adesividade , Administração Intravaginal , Animais , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Candida albicans/efeitos dos fármacos , Preparações de Ação Retardada/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Concentração de Íons de Hidrogênio , Lipídeos , Miconazol/administração & dosagem , Distribuição Aleatória , Ratos
17.
Med. clín (Ed. impr.) ; 149(8): 351-362, oct. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-167662

RESUMO

En la presente revisión sistemática se analizaron 55 artículos estructurados sobre la eficacia terapéutica frente al dolor y a los signos clínicos del liquen plano oral (LPO). La búsqueda bibliográfica se elaboró siguiendo los criterios del sistema PRISMA, seleccionando los ensayos realizados mediante alguno de los siguientes diseños metodológicos: entre fármaco (principio activo) vs. mismo fármaco en diferente excipiente o concentración, fármaco vs. diferente principio activo, fármaco vs. fitoterapia y fármaco vs. tratamiento con fototerapia. Basándonos en los resultados se propone un algoritmo que sirva de guía para establecer el tratamiento del LPO en sus formas clínicas atrófica y erosiva. Se destaca el empleo del propionato de clobetasol al 0,025-0,05% de aplicación tópica como primera alternativa terapéutica. En segundo lugar, el tacrolimús al 0,1% y pimecrolimús al 1% también formulado para su pauta tópica. Y, finalmente, se aborda el empleo de corticosteroide sistémico y la aplicación de láser de diodo (AU)


In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analysed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy. Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025-0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers (AU)


Assuntos
Humanos , Líquen Plano Bucal/terapia , Clobetasol/uso terapêutico , Triancinolona Acetonida/uso terapêutico , Calcineurina/uso terapêutico , Terapia a Laser , Protocolos Clínicos , Manejo da Dor/métodos , Padrões de Prática Odontológica/tendências , Resultado do Tratamento , Miconazol/uso terapêutico , Dexametasona/uso terapêutico
18.
J Zoo Wildl Med ; 48(2): 549-553, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28749293

RESUMO

A female North American porcupine ( Erethizon dorsatum ) was evaluated for a unilateral pedal crusting and alopecic dermatopathy. Fungal culture and histopathology testing revealed Microsporum gypseum dermatophytosis. Treatment with topical miconazole was initiated and then discontinued after 9 days and changed to oral terbinafine. Twenty-eight days after initial examination, clinical signs were improving, and fungal cultures of the front foot, muzzle, and noninfected area along the dorsum were negative for M. gypseum. Visual exams were conducted on a regular basis. Eighty-three days after initial evaluation, clinical signs had completely resolved and repeat fungal cultures were negative. One of the animal's keepers was suspected to have acquired a dermal fungal infection 3 days after contact with this porcupine, and lesions had resolved after treatment with topical ketoconazole. To the authors' knowledge, this is the first report of M. gypseum diagnosed and treated in a captive North American porcupine. Veterinary staff and zookeepers should be aware of this potentially zoonotic infection.


Assuntos
Animais de Zoológico , Porcos-Espinhos , Tinha/veterinária , Zoonoses , Administração Oral , Administração Tópica , Animais , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Feminino , Humanos , Miconazol/administração & dosagem , Miconazol/uso terapêutico , Naftalenos/administração & dosagem , Naftalenos/uso terapêutico , Terbinafina , Tinha/diagnóstico , Tinha/microbiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-28438926

RESUMO

In an effort to increase the efficacy of topical medications for treating onychomycosis, several new nail penetration enhancers were recently developed. In this study, the ability of 10% (wt/wt) miconazole nitrate combined with a penetration enhancer formulation to permeate the nail is demonstrated by the use of a selection of in vitro nail penetration assays. These assays included the bovine hoof, TurChub zone of inhibition, and infected-nail models.


Assuntos
Antifúngicos/farmacocinética , Miconazol/farmacocinética , Unhas/microbiologia , Onicomicose/tratamento farmacológico , Administração Tópica , Animais , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Bovinos , Casco e Garras/microbiologia , Humanos , Miconazol/administração & dosagem , Miconazol/uso terapêutico , Onicomicose/microbiologia
20.
Dis Model Mech ; 10(3): 337-348, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28153846

RESUMO

Hemorrhagic stroke accounts for 10-15% of all strokes and is strongly associated with mortality and morbidity worldwide, but its prevention and therapeutic interventions remain a major challenge. Here, we report the identification of miconazole as a hemorrhagic suppressor by a small-molecule screen in zebrafish. We found that a hypomorphic mutant fn40a, one of several known ß-pix mutant alleles in zebrafish, had the major symptoms of brain hemorrhage, vessel rupture and inflammation as those in hemorrhagic stroke patients. A small-molecule screen with mutant embryos identified the anti-fungal drug miconazole as a potent hemorrhagic suppressor. Miconazole inhibited both brain hemorrhages in zebrafish and mesenteric hemorrhages in rats by decreasing matrix metalloproteinase 9 (MMP9)-dependent vessel rupture. Mechanistically, miconazole downregulated the levels of pErk and Mmp9 to protect vascular integrity in fn40a mutants. Therefore, our findings demonstrate that miconazole protects blood vessels from hemorrhages by downregulating the pERK-MMP9 axis from zebrafish to mammals and shed light on the potential of phenotype-based screens in zebrafish for the discovery of new drug candidates and chemical probes for hemorrhagic stroke.


Assuntos
Hemorragia Cerebral/enzimologia , Hemorragia Cerebral/prevenção & controle , Metaloproteinase 9 da Matriz/metabolismo , Miconazol/uso terapêutico , Animais , Vasos Sanguíneos/patologia , Vasos Sanguíneos/ultraestrutura , Hemorragia Cerebral/tratamento farmacológico , Hemorragia Cerebral/patologia , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Matriz Extracelular/efeitos dos fármacos , Matriz Extracelular/metabolismo , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Miconazol/farmacologia , Mutação/genética , Ruptura , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/patologia , Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Peixe-Zebra
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