真菌病

20090064他汀类降血脂药物对曲霉的体外抗真菌作用;20090065住院患者真菌感染的现况调查及病原学分析;20090066黄石地区宠物及其豢养者皮肤真菌感染情况调查;20090067抗真菌药物联合治疗深部真菌感染的临床应用     

中药单体与抗真菌药物协同作用的研究进展

随着真菌感染发生率的逐年上升以及真菌耐药性问题的日益突出,其治疗一直是国内外研究关注的重点。近年来,研究发现多种中药单体具有抗真菌活性且与目前临床应用的抗真菌药物有协同作用。该文对生物碱类、酚类、黄酮类中药单体与抗真菌药物的协同作用及其机制进行综述。     

儿童真菌病的系统治疗进展

儿童真菌病包括真菌感染性皮肤病和系统性真菌感染。灰黄霉素仍是目前治疗头癣的主要药物,但剂量大,疗程长,新的抗真菌药物对头癣及其他儿童真菌性皮肤病安全有效,且疗程更短;深部真菌病的治疗仍较困难。系统治疗儿童真菌病时要强调安全性。     

抗真菌药物的新进展

近年来抗真菌药物研究进展包括以下几方面 :临床上需要新方法治疗真菌病 :由于少见的皮下真菌病如足菌肿、着色真菌病主要只存在于发展中国家 ,故目前在研制新的抗浅部真菌药物方面投入很少。重点研制新的系统性抗真菌药物的原因是系统性真菌病变化多 ,治疗上存在严重而未解决的问题 ,比如与ＨＩＶ有关的真菌感染 ,部分念珠菌属对唑类产生耐药等。文章中 ,作者呼吁应研究浅部真菌病的新疗法 ,并分析了甲癣治疗失败的原因 ,指出目前甲癣的实验室诊断准确率低于 5 0 % ,解决问题关键是要找到快速诊断深、浅部真菌病的新方法 ,从而减少因误诊造…     

系统性真菌感染的治疗进展

在免疫功能抑制的患者中，系统性真菌感染治疗有一定难度，致死率较高。近来有毒副作用小、抗菌性强的脂质体两性霉素B、伏力康唑和卡斯波菌素等新抗真菌药问世，有效改善了系统性真菌感染的治疗和预后。     

儿童真菌病的系统治疗进展

儿童真菌病包括真菌感染性皮肤病和系统性真菌感染。灰黄霉素仍是目前治疗头癣的主要药物，但剂量大，疗程长，新的抗真菌药物对头癣及其他几童真菌性皮肤病安全有效，且疗程更短；深部真菌病的治疗仍较困难。系统治疗儿童真菌病时要强调安全性。     

抗真菌治疗：希望与挑战

真菌感染尤其是浅部真菌感染属于常见病，病情虽不严重但人群中分布广泛且容易再发．而深部真菌感染的发病率由于免疫低下人群的急剧扩大也迅速升高。抗真菌治疗的基础与临床研究以及抗真菌药物的研制近几十年进展颇快，现就当今抗真菌治疗的几个热点问题进行讨论。     

中药成分抗白念珠菌的实验研究进展

近年来随着抗生素、激素、免疫抑制剂等药物的广泛应用,临床上以白念珠菌为代表的真菌感染的比例也相对提高,真菌对药物的耐药问题也越来越突出。因此,开发研究既可有效对抗真菌感染,毒副作用又较小,适合免疫力低下人群使用的抗真菌药物显得越来越重要。我国有着丰富的中药资源,医药工作者近几年对此作了大量的研究,希望找出有效的抗真菌药物,笔者通过搜索大量的文献资料总结了近几年的研究成果。     

真菌感染对尖锐湿疣转归的影响

目的了解生殖器真菌感染对尖锐湿疣复发及预后的影响。方法比较观察，回顾性分析258例尖锐湿疣患者的临床资料，将尖锐湿疣伴真菌感染者128例分为A组，单纯尖锐湿疣者130例分为B组，进行病史、症状、治疗前后对比分析。结果加用抗真菌药物后复发率降低到31％，而未用抗真菌治疗组复发率仍然达到72％，说明合并真菌感染对尖锐湿疣的转归有很大影响。结论生殖器真菌感染对尖锐湿疣的复发及预后有很大影响，真菌感染是尖锐湿疣复发的重要原因之一。     

伊曲康唑在儿童真菌病中的应用

伊曲康唑为新一代三唑类广谱抗真菌药,虽然目前尚未被美国食品药品管理局批准在儿童使用,但临床已经应用于儿童浅部真菌及系统性真菌感染。多数临床研究认为,伊曲康唑每天5mg/kg,对儿童多种真菌病有很好的疗效,不良反应少。在治疗儿童浅部真菌感染性疾病中,间歇冲击疗法能缩短疗程、减少不良反应。伊曲康唑在儿童中使用的不良反应与成人基本一致,但更轻微和短暂。与伊曲康唑有相互作用的药物应注意避免在儿童同时使用。     

Advances in topical and systemic antifungals

Topical antifungal agents are generally used for the treatment of superficial fungal infections unless the infection is widespread, involves an extensive area, or is resistant to initial therapy. Systemic antifungals are often reserved for the treatment of onychomycosis, tinea capitis, superficial and systemic candidiasis, and prophylaxis and treatment of invasive fungal infections. With the development of resistant fungi strains and the increased incidence of life-threatening invasive fungal infections in immunocompromised patients, some previously effective traditional antifungal agents are subject to limitations including multidrug interactions, severe adverse effects, and their fungistatic mechanism of actions. Several new antifungal agents have demonstrated significant therapeutic benefits and have broadened clinicians' choices in the treatment of superficial and systemic invasive fungal infections.     

Invasive synergistic fungal infection after motor vehicle collision

Primary invasive fungal infections occur after direct contact or direct inoculation of the skin with fungal spores. Rhizopus species and Aspergillus terreus are opportunistic fungal species that rarely cause disease in immunocompetent hosts. In susceptible patients, infection may progress rapidly. Aggressive surgical debridement and use of systemic antimycotic agents may successfully control disease and prevent systemic dissemination. We describe the case of a patient with a scalp infection, caused by Rhizopus species and A. terreus, that occurred after contact with pavement during a motor vehicle collision. Control was achieved with repeated debridement and use of systemic antifungal therapy.     

Therapy of common superficial fungal infections

Superficial fungal infections are common, especially onychomycosis, dermatophytoses, and superficial Candida infections. Most superficial fungal infections are treated with topical antifungal agents unless the infection covers an extensive area or is resistant to initial therapy. Onychomycosis often requires systemic therapy with griseofulvin, itraconazole, or terbinafine. The objective of this review is to provide the practicing dermatologist with the recommended available therapy for the treatment of common superficial fungal infections.     

Tinea capitis: current concepts

Tinea capitis is an important fungal infection that may at times be a clinical, diagnostic and therapeutic challenge. It is common in childhood around the world, becoming almost epidemic in some communities. The central European and American experience with it is somewhat variable, due to different etiologic fungi. The use of topical antifungal agents and other approaches is stressed as of value alongside the use of systemic antifungal medication.     

白念珠菌抗体疫苗研究进展

白念珠菌是免疫力低下患者黏膜和系统的真菌致病源,侵袭性念珠菌感染有很强的致死性.即使是健康的个体,也容易感染阴道念珠菌病和其他皮肤黏膜念珠菌病.传统抗真菌药的疗效有一定的局限性和毒副作用,并且容易产生耐药.近年来,一些新型抗体疫苗已经研发并应用于动物模型和临床,表现出很好的对抗白念珠菌和协同传统抗真菌药物的作用.尽管其疗效和安全性还需要进一步验证,念珠菌抗体疫苗仍具有较好的临床应用前景,有望成为念珠菌病的辅助治疗手段.     

The diagnosis and treatment of nail disorders: systemic antifungal therapy

Systemic antifungals have been used in the treatment of fungal infections since the introduction of griseofulvin in 1958. Since then, new antifungal medications have been introduced, broadening the spectrum of therapies available. Onychomycosis is one of the most common complaints presented to the dermatologist. Fungal infection of the nails, though usually not an urgent medical condition, can be extremely distressing to the patient. Since current topical antifungal medications have little or no efficacy in the treatment of fungal infections of the nail, it is incumbent upon the dermatologist to be familiar with the use of systemic antifungals in the treatment of onychomycosis. In this article, the treatment of fungal infections of the nail with systemic antifungals is discussed. A brief review of the most common types of nail fungal infection is presented and the use of systemic antifungals relevant to dermatology is addressed.     

Treatments for common superficial fungal infections

Fungal infection of keratinized tissue is caused by any of the dermatophyte species. The topical allylamines and benzylamines have been especially effective in treating these infections because of their in vitro fungicidal activity and short treatment duration. With the development of new oral azoles and allylamine antifungal agents, there has been a renewed interest in treating superficial skin fungal infections. The use of topical and oral antifungal agents in treating cutaneous fungal infections is examined.     

中药单体成分抗白念珠菌实验的研究进展

 近年来随着激素、生物制剂的广泛使用以及HIV、癌症发病率的升高,免疫低下人群逐渐增多,条件致病菌白念珠菌的感染逐年增多,其对抗真菌药物的耐药作用也日渐突出。中药单体成分具有良好的抗真菌作用,毒副作用小,可与抗真菌药物协同作用,降低真菌耐药性,越来越引起重视。本文就中药单体成分小檗碱、黄芩苷、苦参碱等抗白念珠菌的相关实验研究进展作一综述。      

Systemic candidiasis

Systemic candidiasis is a disease of increasing incidence and proportions, which appears to be associated with the advances in modern medicine. It involves primarily patients with severe debilitating and malignant disease who are receiving immunosuppressive, cytotoxic, antimetabolite, and antibiotic therapy. Side effects of these otherwise major therapeutic agents predispose patients to opportunistic fungal infections, of which candidiasis is the most common. The high morbidity and mortality of disseminated candidiasis in neutropenic patients are difficult obstacles to obtaining the optimal, if not full, potential of modern chemotherapy for cancer. The inability to diagnose early invasive and systemic candidiasis is a major handicap that delays timely initiation of antifungal therapy. The paucity of highly efficacious antifungal agents with low toxicity severely limits the ability to successfully cure systemic fungal infections in cancer patients. Aggressive research into the basic biology of Candida spp. is necessary for directing the development of better diagnostic methods and improved antifungal drugs.     

Pediatric Tinea Capitis

Tinea capitis (ringworm of the head) is the most common dermatophytosis of childhood with an increasing incidence worldwide. If suspected clinically, further diagnostic procedures, including direct microscopy and culture, should be performed. Other scalp alterations, such as seborrheic dermatitis, atopic eczema, psoriasis, alopecia areata, folliculitis, and pseudopelade, may mimic ringworm of the head and must be identified. A proven fungal infection of scalp skin and hairs warrants immediate initiation of systemic treatment. At present, only oral griseofulvin is approved for therapy of scalp ringworm in children by health authorities. However, the advent of several newer antifungal agents such as itraconazole, fluconazole, and terbinafine has broadened the therapeutic armamentarium in recent years. These agents offer shorter treatment intervals, and their adverse effects and drug interaction profiles appear to be well within acceptable limits. In patients with tinea capitis, systemic therapy at weight-dependent dosages for an appropriate amount of time in conjunction with topical supportive measures will help to prevent disfiguring hair loss, permanent formation of scar tissue, spread of fungal organisms to other cutaneous regions, and infection of other persons.