nystatin-a1 and Necrosis

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Biopsy; ChAdOx1 nCoV-19; Clobetasol; Combined Modality Therapy; Compression Bandages; COVID-19; Diagnosis, Differential; Humans; Male; Necrosis; Neomycin; Nystatin; SARS-CoV-2; Skin; Skin Diseases; Thrombosis; Treatment Outcome

Concern persists that prednisone-free maintenance immunosuppression in kidney transplant recipients will be associated with an increase in late allograft dysfunction and graft loss. We herein report 5-year follow-up of a trial of prednisone-free maintenance immunosuppression. From October 1, 1999, through January 31, 2005, at our center, 589 kidney transplant recipients were treated with a protocol incorporating discontinuation of their prednisone on postoperative day 6. At 5 years, actuarial patient survival was 91%; graft survival, 84%; death-censored graft survival, 92%; acute rejection-free graft survival, 84% and chronic rejection-free graft survival, 87%. The mean serum creatinine level (+/-SD) at 1 year was 1.6 +/- 0.6; at 5 years, 1.7 +/- 0.8. In all, 86% of kidney recipients with functioning grafts remain prednisone-free as of April 30, 2005. As compared with historical controls, recipients on prednisone-free maintenance immunosuppression had a significantly lower rate of a number of complications, including cataracts (p < 0.001), posttransplant diabetes mellitus (p < 0.001), avascular necrosis (p = 0.001), and fractures (p = 0.004). We conclude that prednisone-related side effects can be minimized in a protocol incorporating prednisone-free maintenance immunosuppression. Five-year graft outcome remains good.

Topics: Anti-Infective Agents; Antifungal Agents; Antiviral Agents; Cataract; Clotrimazole; Cohort Studies; Creatinine; Dapsone; Diabetes Mellitus; Fractures, Bone; Ganciclovir; Graft Rejection; Graft Survival; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Kidney Transplantation; Necrosis; Nystatin; Pentamidine; Prednisone; Time Factors; Transplantation, Homologous; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Valganciclovir

The clinicopathologic characteristics of invasive oral aspergillosis in 16 immunocompromised patients who developed this infection during antileukemic chemotherapy are described. The primary site of the infection was the marginal gingiva, there was severe spontaneous pain, and the patients developed spiking fever and granulocytopenia. Necrotic ulceration of the gingiva rapidly extended to the contiguous mucosa, muscle, and bone. Microscopically, the necrotic tissue contained thrombotic vascular infarcts and there were hyphae that showed frequent transverse septa and dichotomous branching. The invasive organisms were not responsive to amphotericin B in the absence of remission of the leukemia and restoration of the depressed host defenses. In 15 patients who showed improvement of hematologic status, oral aspergillosis was controlled by the combination of antifungal chemotherapy and debridement of necrotic tissues.

Topics: Adult; Aged; Agranulocytosis; Amphotericin B; Aspergillosis; Female; Humans; Immunocompromised Host; Leukemia; Male; Middle Aged; Mouth Diseases; Necrosis; Nystatin

The toxicity of an oral antibiotic mixture used to decontaminate the gastrointestinal tract of experimental animals was compared in rats with a normal sodium intake to rats on a sodium-deficient diet. Sodium-depleted rats are quite sensitive to the oral antibiotic mixture. The antibiotic mixture was nephrotoxic, resulting in necrosis of the proximal tubules. Therefore, since the parenteral administration of antibiotics also produced necrosis of the proximal tubules, the mechanism of antibiotic toxicity in sodium-deficient rats is not influenced by the route of antibiotic administration.

Topics: Administration, Oral; Animals; Anti-Bacterial Agents; Bacitracin; Framycetin; Hyponatremia; Kidney; Male; Necrosis; Nystatin; Rats; Rats, Inbred Strains