ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Fungal infections are common and serious complications of AIDS; nearly all patients will experience mucosal candidiasis and up to 20% of patients will experience more difficult problems with esophagitis or fluconazole-resistant infection. Systemic infection withCryptococcus neotormans, Histoplasma capsulatum, other endemic mycoses, or opportunistic molds includingAspergillusspp. andMucorspp. are less common but more serious than candidiasis. Treatment with the new triazoles is effective for many cases but mortality and treatment failure remains common in cryptococcosis, more effective antifungal agents are needed. Although most patients do respond to therapy, relapse is common; suppressive therapy is required to prevent recurrence of systemic infection and in some cases of mucosal candidiasis. Studies in progress will determine the role of primary antifungal prophylaxis to prevent fungal infection in AIDS.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Otitis media is one of the most common diseases in infants and children. Although long-term and life-threatening intracranial complications of this infection are now rare, cholesteatomas are still prevalent. Importantly, otitis media may lead to more subtle, and difficult to detect consequences, such as hearing loss, which may adversely impact on the child's speech development, language, cognition and behaviour. Controversies remain on the role of viral versus bacterial pathogens in the pathogenesis of otitis media and the predisposing factors in the progression from acute to recurrent or chronic infection. New antibiotics are being tested in clinical trials, but methodologic considerations may bring the validity of many of these studies into serious question. Studies are also being conducted to define the role of various modalities of medical and surgical management in chronic or recurrent otitis media. Otitis externa usually runs a more benign course. New studies have looked at the predisposing conditions, etiological factors as well as medical therapy. Necrotizing or malignant otitis media is a life-threatening infection which tends to involve older diabetic patients or others with underlying immunosuppression. Current management has moved more towards medical therapy (including hyperbaric oxygen), with surgery reserved for those not responding to antibiotics or with intracranial complications.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Bacterial meningitis remains common and devastating; despite recent advances in antimicrobial therapy, the overall morbidity and mortality remains high. Recent advances in the understanding of the pathogenesis and pathophysiology of bacterial meningitis have led to the development of innovative treatment strategies in the hopes of improving outcome from this disorder. Studies in animal models have demonstrated that attenuation of the subarachnoid space inflammatory response by anti-inflammatory agents may be useful in preventing many of the pathophysiologic consequences of bacterial meningitis such as cerebral edema and increased intracranial pressure. In addition, several recent clinical trials have shown that the anti-inflammatory agent dexamethasone is beneficial in certain patients with bacterial meningitis. Administration of adjunctive dexamethasone, in conjunction with antimicrobial agents, is recommended for infants and children withHaemophilus influenzaetype b meningitis. Pending the results of ongoing studies, adjunctive dexamethasone is not recommended in adults, in infants less than 2 months old, or in patients with meningitis caused by bacteria other thanH. influenzae. Other agents that reduce subarachnoid space inflammation, specifically monoclonal antibodies directed against the CD18 family of leukocyte receptors, may also prove to be beneficial in improving outcome in patients with bacterial meningitis.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Prophylactic peroral acyclovir 400 mg twite daily is effective for frequently recurrent herpes lahialis. New information has emerged concerning the roles of latency-associated transcripts and L-particles in the pathogenesis of herpes simplex virus infections The use of systemic acyclovir for varicella and herpes zoster is appropriate in some patient populations. A live, attenuated varicella vaccine has been tested extensively and may soon be available to prevent or decrease the severity of varicella-zoster virus infections. Male homosexual patients with AIDS are subject to high rates of anogenital infection with human papillomavirus and progression to neoplasia relatively common in these patients. New treatments and progress towards development of a vaccine for human papillomavirus infection are reviewed. Two new antiviral drugs, famciclovir and BV-araU, have shown promise in the treatment of experimental herpes virus infections.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This review summarizes the information published in the past year on the treatment of fungal and parasitic skin infestations. The literature on fungal skin infections has been dominated by reports defining the efficacy, frequency, duration, side effects and drug interactions as well as the costs of treatment for the superficial and deep dermatophytoses. The main antifungal agents now under clinical investigation include the newly developed drugs amorolfine, terbmafme, itraconazole, fluconazole, naftifine and saperconazole. There is also renewed interest in older agents, re-defining their use and suitability with new information relating to different methods of administration. Trials have included comparisons of different vehicles to maximize efficacy and minimize side effects, including systemic treatment with liposomal amphotericin B. The search continues for the most effective therapy against the onychomycoses. From the wealth of publications in the past year, this review concentrates on three areas of therapy for parasite skin infestations; the treatment for cutaneous leishmaniasis; permethrin as a treatment for scabies; and pediculosis infestation and the use of ivermectin in treating onchocerciais.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

During the past year the medical literature has been enriched with further reports on the epidemiology, clinical presentation, aetiopathogenesis and treatment of several HIV-associated mucocutaneous conditions. The majority of these studies are cited in this review and the most interesting ones have been briefly summarized.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In the past decade the traditional methods of evaluating and treating skin and soft tissue infections have required significant re-assessment. There has been a resurgence of serious group A streptococcal infections including severe skin and soft tissue infections. Organisms not typically responsible for skin infections continue to be isolated from the skin as pathogens in patients with both normal and compromised immune systems. The development of new antibiotics for the treatment of skin infections with broader spectrums of activity and more convenient dosing regimens continues.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The recent literature on skin and soft tissue infections is reviewed, focusing on the development of an accurate definition of surgical skin and soft tissue infection such that true figures can he reported and compared with different management protocols. Guidelines from the Center tor Disease Control contribute to this definition, giving a clear account of exactly which infections constitute surgical wound infections. The necessity tor regimented surveillance of pen- and postoperative surgical wounds is stressed, incidence is increased in well recognized host- and procedure-related scenarios, which are introduced as potential risk factors, to be taken into account when planning therapy. The rationale and appropriate use of prophylactic antibiotics in various situations is explained with recommendations on procedures, choice and administration. Bacterial flora of surgical wound infections is described, and specific sites of soft tissue infection – the neck, the skeletal muscle, and the perineum are addressed. The most relevant articles have been summarized.

ISSN:0951-7375    

出版商:OVID    

年代:1993

数据来源: OVID