RESUMEN
The authors report the first case of dermatophytosis caused by Trichophyton raubitschekii in a patient from the State of São Paulo with Tinea corporis lesions localized on the buttocks. Culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of Alberta, Canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature.
Asunto(s)
Tiña/microbiología , Trichophyton/aislamiento & purificación , Antifúngicos/uso terapéutico , Brasil/epidemiología , Femenino , Fluconazol/uso terapéutico , Humanos , Miconazol/análogos & derivados , Miconazol/uso terapéutico , Tiña/tratamiento farmacológico , Tiña/epidemiología , Trichophyton/clasificación , Trichophyton/citologíaRESUMEN
To test the effects of exchanging dietary complex and simple carbohydrate for fat calories on lipoprotein metabolism, guinea pigs were fed two different fat/carbohydrate ratios: 2.5:58% (w/w) or 25:29% (w/w) with either sucrose or starch as the carbohydrate source. Animals fed high-fat had higher plasma low-density lipoprotein (LDL) and hepatic cholesterol concentrations than animals fed low-fat diets (P < 0.01). The cholesteryl ester content per particle was higher, and the number of triacylglycerol (TAG) molecules was lower in very low density lipoprotein (VLDL) and LDL from animals fed high-fat diets. Intake of high-fat/sucrose resulted in higher plasma LDL concentrations than intake of high-fat/starch, and animals fed low-fat/starch had the highest plasma TAG concentrations associated with VLDL particles containing more TAG molecules, as well as a TAG-enriched LDL. The activity of plasma lecithin cholesteryl:acyl transferase (LCAT) was highest in animals fed high-fat/sucrose, and heart lipoprotein lipase (LPL) activity was higher in animals fed high-fat diets. Hepatic apoprotein B/E (apo B/E) receptor number (Bmax) was increased 21% with low-fat diets (P < 0.01). These results suggest that the hypercholesterolemia induced by high-fat and by sucrose intake are associated with a higher plasma LCAT activity which results in a cholesteryl ester-enriched VLDL which, by the action of LPL, might be more readily converted to LDL through the delipidation cascade leading to downregulation of hepatic apo B/E receptors. The hypertriglyceridemia associated with low-fat intake may result from increased production of VLDL TAG, which would explain the increased TAG content and the higher TAG/CE ratio of VLDL from animals fed the low-fat/starch diet.
Asunto(s)
Carbohidratos de la Dieta/farmacología , Lipoproteínas/sangre , Animales , Apolipoproteínas B/sangre , Colesterol/sangre , Ésteres del Colesterol/sangre , Ésteres del Colesterol/metabolismo , Carbohidratos de la Dieta/administración & dosificación , Grasas de la Dieta/administración & dosificación , Ingestión de Energía , Cobayas , Lipoproteína Lipasa/metabolismo , Lipoproteínas LDL/sangre , Lipoproteínas VLDL/sangre , Hígado/metabolismo , Masculino , Miocardio/enzimología , Fosfatidilcolina-Esterol O-Aciltransferasa/sangre , Receptores de LDL/metabolismo , Almidón/administración & dosificación , Sacarosa/administración & dosificación , Triglicéridos/sangreRESUMEN
Male Hartley guinea pigs were fed semipurified diets containing various levels of psyllium and cholesterol to determine mechanisms by which psyllium lowers plasma low density lipoprotein (LDL) concentrations. Four diets were tested: control diets with 12.5% (w/w) cellulose, and psyllium diets in which cellulose was partially replaced with 7.5% (w/w) psyllium. Two levels of dietary cholesterol were used, either low (LC, 0.04%, w/w) or high (HC, 0.25%, w/w). Plasma LDL was reduced by 30 and 54% with psyllium intake in the LC and HC groups, respectively (P < 0.001), while plasma very low density lipoprotein (VLDL) was lowered only in the HC group (P < 0.001). Psyllium intake modified LDL composition and size compared to LDL from control animals with a lower proportion of cholesteryl ester and higher proportion of triacylglycerol, lower molecular weight, smaller diameter, and higher peak density (P < 0.001). Plasma VLDL from animals fed the psyllium-HC diet compared to the control-HC contained lower relative proportions of free and esterified cholesterol and a higher proportion of triacylglycerol, compositional characteristics similar to VLDL from animals fed LC diets. Hepatic free and esterified cholesterol concentrations were significantly reduced by psyllium an average of 25 and 55%, respectively, while hepatic HMG-CoA reductase activity was increased in both psyllium groups compared to the respective controls (P < 0.001). In addition, psyllium intake reduced hepatic acyl-CoA:cholesterol acyltransferase (ACAT) activity in both the LC and HC groups (P < 0.001) and increased hepatic membrane apoB/E receptor number (Bmax) by 17 and 52% for animals fed LC and HC diets, respectively (P < 0.005). Significant psyllium-induced increases in cholesterol 7 alpha-hydroxylase of 4- and 1.6-fold were also observed in animals fed the LC and HC diets respectively (P < 0.001). These results indicate that psyllium generates a negative cholesterol balance across the liver which results in induction of cholesterol 7 alpha-hydroxylase and HMG-CoA reductase and suppression of ACAT activities, upregulation of apoB/E receptors, and secretion of smaller VLDL particles, metabolic alterations that contribute to a lowering of plasma LDL cholesterol levels.
Asunto(s)
Colesterol/sangre , Lipoproteínas LDL/sangre , Hígado/efectos de los fármacos , Psyllium/uso terapéutico , Animales , Cobayas , Homeostasis/efectos de los fármacos , Lípidos/sangre , Lipoproteínas/sangre , Hígado/metabolismo , Masculino , Receptores de Lipoproteína/efectos de los fármacosRESUMEN
We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesions was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.
Asunto(s)
Acremonium/aislamiento & purificación , Micetoma/diagnóstico , Anciano , Brasil , Femenino , Humanos , Itraconazol/uso terapéutico , Micetoma/tratamiento farmacológico , Micetoma/patología , Microbiología del SueloRESUMEN
Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pe interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoco, durante 15 dias. Foram realizadas 3 avaliacoes clinicas e micologicas: no pre-tratamento, no final do tratamento e 2 semanas apos o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100 por cento de cura micologica. Em relacao a evolucao clinica, houve diminuicao estatistica significante (teste de Friedman-p < 0.001) dos sinais e sintomas avaliados. Nao foi observada ocorrencia de efeitos colaterais
Asunto(s)
Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Antifúngicos/uso terapéutico , Tiña/diagnóstico , Tiña/terapia , Ergosterol/biosíntesis , Tiña del Pie/terapiaRESUMEN
The authors studied 31 patients with Tinea cruris, corporis or pedis interdigital. The patients were treated with 100 mg of itraconazole, once a day, during the lunch, for 15 days. Mycological and clinical evaluations were performed at the pre-treatment, by the end of treatment and 2 weeks after finishing the treatment. The results showed that itraconazole is effective for the treatment of dermatophytosis, at the studied posology, with 100% of mycological cure. Clinical evaluation showed a significant reduction (Friedman test--p less than 0.001) of signs and symptoms.