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Biomedical subjects

D Borelli

Publications and source records attributed to D Borelli.

At least 37 records · Page 2Linked to original sources

[Opportunistic fungi as producers of gray colonies and mycetomata].

Madurella grisea Mackinnon, Ferrada and Montemayor, 1949, is not the unique species that produces gray colonies and black-grained mycetomata. Perhaps, it is not one species, because its grains and colonies may be confounded with those of several species that can be distinguished through their fertile structures. I take this opportunity to compare some characters of Pyrenochaeta romeroi, Phoma-Phillosticta sp., Chaetosphaeronema larense, Pyrenochaeta mackinnonii, Plendomus avramii and of another aleurisopores Dematiacea with those assigned to Madurella grisea. The need is stressed for the search, the introduction and the divulgation of new methods fostering the formation of disseminating structures (pycnidospores in this case), in order to ensure the proper specification of the agent in every case of mycetoma.

Fungi↗

[Chromomycosis in Iberia].

A 66 year old, Spaniard, born at Sueca (Valencia Province), was found infected with "Fonsecaea pedrosoi". His lesion, located in the inner aspect of the right arm, appeared when he was 7-8 years old, and progressed very slowly until he migrated to Venezuela, at 42. Thereafter it progressed more rapidly and started to hurt. Treatment included administration of 5-flucytosine at the daily dose of 150 mg./kg. during 4 and a half months and thermotherapy by means of a permanent adhesive tape on the lesion during 6 months. Eleven months after completion of the treatment, the patient is asymptomatic. This is the second case of chromomycosis originating in the Iberian peninsula. The importance of climate, clothing and age is discussed with reference to epidemiology of chromomycosis. The isolated strain of "F. pedrosoi" is the first one from the same region: its cultural characteristics and virulence among mice are studied and reported with some details. We think that in Europe, and especially in the Mediterranean countries, cases of chromomycosis did possibly occur, which were labelled as tuberculosis verrugosa or vegetans pyoderma owing to their histological picture.

Aged↗

[Miconazole per os in tinea and deep mycosis].

For the last 6 years we have been using Miconazole cream in the treatment of tinea and vaginal candidiasis. We think that it is at least as good as the best drugs for this purpose, but consider it difficult to decide about its superiority. Therefore we refrain from describing this part of our experience in detail. We have employed Miconazole "per os" at the daily doses of 24-28 mg./kg. in treating 3 cases of tinea corporis or cruris by "Trichophyton rubrum". Symptoms ceased in 3 days; mycologic examination turned negative in 2 weeks; treatment ended in apparent cure in 3 weeks. We have employed Miconazole "per venam" and "per os" in the treatment of: mycetomata (2) by "Streptomyces somaliensis", without success; mycetoma by "Madurella grisea" (1), without success; chromomycosis by a 5-flucytosine resistant strain of "Cladosporium carrionii" (1), without success; paracoccidioidosis (5) with lesions in mouth and lungs, with good results; leishmaniasis by "Leishmania brasiliensis" (1), without success; mucocutaneous disseminated candidiasis (1), with very good results. Tolerance has been excellent: but pruritus appeared from the third week with 600 or more mg. "per venam", in several patients. Doses varied between 10 and 50 mg./kg./day. One patient, who suffered with candidiasis, is taking 50 to 30 mg./kg./day since more than a year ago and, being a child, he is feeling well and growing to be normal. We recommend employing Miconazole against systemic canidiasis, sulpharesistant paracoccidioidosis and assaying it further in tinea (at least, in griseofulvin-resistant cases).

Administration, Oral↗

Treatment of pityriasis versicolor with ketoconazole.

Eighty-two patients with pityriasis versicolor were treated orally with ketoconazole in tablet form (200 mg). The tablets were taken at least 90 min before a meal, and patients who received only one tablet daily were told to refrain from bathing except immediately before ingestion of the drug and only once a day. Dosage of ketoconazole varied from a single dose of 400 mg to 200--400 mg per day for four weeks. Seventy-seven patients reported no adverse effects. There were reports from others of headache, gastralgia, nausea, dyspnea, dizziness, or tinnitus. In most affected patients, these symptoms stopped with the first meal eaten after initiation of treatment. Follow-up examinations were performed at different intervals. The maximal therapeutic effect of ketoconazole was seen three to six weeks after initiation of therapy. Seventy-eight patients were considered cured; one had received only one tablet. Only hypopigmented macules remained. Examination of these areas with a Wood lamp revealed no fluorescence, and scrapings examined with the light microscope did not contain Malassezia furfur. These results indicate that ketoconazole is effective in the treatment of pityriasis versicolor, but the problem of protecting susceptible persons from infection and reinfection remains.

Follow-Up Studies↗

A clinical trial of itraconazole in the treatment of deep mycoses and leishmaniasis.

Itraconazole was administered orally to two patients with sporotrichosis, 10 patients with paracoccidioidomycosis, three with mycetomas (due to Madurella grisea, Streptomyces madurae, and Pseudochaetosphaeronema larense, respectively), nine with chromomycosis due to Cladosporium carrionii, five with chromomycosis due to Fonsecaea pedrosoi and five with leishmaniasis (including one with the nodular disseminated form). The clinical and laboratory tests showed excellent tolerance to the drug with a total absence of adverse reactions. Satisfactory results were achieved against paracoccidioidomycosis, sporotrichosis, and chromomycosis due to C. carrionii (apparent cure was achieved in a short time). Encouraging improvement was noted in the treatment of mycetoma due to M. grisea. Among the five cases of leishmaniasis, a complete clearing was achieved in one and an encouraging improvement in two, including the one with the nodular disseminated form. Two patients with F. pedrosoi infection were apparently cured after the addition of thermotherapy and flucytosine, respectively, to the treatment regimen.

Adolescent↗

Safety evaluation of chronic fluconazole therapy. Fluconazole Pan-American Study Group.

The possible adverse effects of chronic, high-dose fluconazole therapy are detailed from analysis of a multicenter, dose-escalating study of the therapy of invasive mycoses. Ninety-three adult patients were studied, 48 of these received > or = 6 months therapy and 20 received > or = 1 year. Fifty-eight patients received > or = 300 mg/day, and 7 received > or = 600 mg/day. One patient received 1,997 g over 86 months. Twenty-seven percent experienced possible symptomatic side effects, which resulted in 2 patients discontinuing therapy, and 42% had asymptomatic laboratory abnormalities, none of which were progressive. Headache, hair loss and anorexia were the most common symptoms experienced (each by 3% of patients), and eosinophilia and aspartate aminotransferase increases were the most common laboratory findings (12 and 10%, respectively). Fluconazole appears well tolerated and safe in these doses and durations.

Adult↗