nystatin-a1 and Pain

The hypothesis that an immunologic reaction to Candida yeasts, present in the gastrointestinal tract, causes a diffuse collection of multisystem symptoms is not generally accepted within conventional medicine. A questionnaire, the Fungus Related Disease Questionnaire (FRDQ-7), was previously developed and used to identify patients for a randomized, placebo-controlled trial of the nonabsorbed antifungal drug nystatin. Nystatin was superior to placebo in relieving these symptoms. This provides some support for the hypotheses that underpin the "Candida syndrome".. The aim of this study was to identify a population with a high (>9) FRDQ-7 score and symptom-free controls and, subsequently, to explore the relationship between FRDQ-7 scores and Candida immunoglobulin (Ig)A, IgG, and IgM levels.. This was a case-controlled study.. Santelmann has suggested that the FRDQ-7 describes people with Candida syndrome if the FRDQ-7 score is >9; 35 patients with medically unexplained symptoms, between ages 18 and 64, were selected for the study if they scored > 9 on the FRDQ-7 questionnaire. Serum Candida IgA, IgG, and IgM measurements were undertaken both for this group and a group of 45 healthy age- and gender-matched controls, and the Ig concentrations were compared.. Candida IgG concentration was significantly higher in the noncontrol group than in the control group (p < 0.001). No significant difference was found for Candida IgA or IgM concentrations.. Further studies are required to identify whether there is a causal link for the elevation of serum IgG found in this subgroup of patients with increased FRDQ-7 scores, or whether these two observations are parallel manifestations of a common underlying disorder.

Topics: Adult; Aged; Antifungal Agents; Candida; Candidiasis; Fatigue; Female; Gastrointestinal Diseases; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Male; Medical History Taking; Memory Disorders; Middle Aged; Nystatin; Pain; Pilot Projects

Antifungal therapy has been claimed to be effective in polysymptomatic patients with diffuse symptoms from multiple body systems and even well defined diseases, traditionally not related to fungi. Hypersensitivity to fungus proteins and mycotoxins has been proposed as the cause.. We conducted a 4-week randomized, double-blind, placebo-controlled study in 116 individuals selected by a 7-item questionnaire to determine whether the antifungal agent nystatin given orally was superior to placebo. At the onset of the study, the patients were free to select either their regular diet or a sugar- and yeast-free diet, which resulted in four different subgroups: nystatin + diet (ND); placebo + diet (PD); nystatin (N); and placebo (P).. Nystatin was significantly better than placebo in reduction of the overall symptom score (P < 0.003). In six of the 45 individually recorded symptoms, the improvement was significant (P < 0.01). All three active treatment groups reduced their overall symptom scores significantly (P < 0.0001), while the placebo regimen had no effect (P = 0.83). The benefit of diet was significant within both the nystatin (ND > N) and the placebo groups (PD > P).. Nystatin is superior to placebo in reducing localized and systemic symptoms in individuals with presumed fungus hypersensitivity as selected by a 7-item questionnaire. This superiority is probably enhanced even further by a sugar- and yeast-free diet.

Topics: Adult; Aged; Analysis of Variance; Antifungal Agents; Dietary Sucrose; Double-Blind Method; Family Practice; Fatigue; Female; Female Urogenital Diseases; Gastrointestinal Diseases; Humans; Male; Male Urogenital Diseases; Medical History Taking; Memory Disorders; Middle Aged; Multiple Carboxylase Deficiency; Mycoses; Nystatin; Pain; Respiratory Tract Diseases; Skin Diseases; Surveys and Questionnaires; Treatment Outcome

Cordia verbenacea D.C. (Borraginaceae) is a perennial bush plant that grows widely along the southeastern coast of Brazil. Its leaves have been used in folk medicine for their anti-ulcer, anti-inflammatory and cicatrizing activities. We have already described the anti-inflammatory properties of C. verbenacea and its low toxicity in different acute animal models. In the present study, we investigated the anti-inflammatory activity in sub-chronic animal models of a crude leaf lyophilized extract when administered by oral route or topically applied, and concomitantly, its analgesic potency and toxicity to the fetus. Topical administration of the extract inhibited nystatin-induced edema proportionally to the doses used, and this effect at a dose of 4.56 mg/kg body wt. was similar to that observed with 6.0 mg/kg body wt. of naproxen. In miconazole-induced edema, the leaf extract at a dose of 1.24 mg/kg body wt., orally administered, has a very similar effect as compared to nimezulide (2.5 mg/kg body wt.) and dexamethasone (0.2 mg/kg body wt.). At an oral dose of 2.48 mg/kg body wt. the extract showed a very low analgesic effect, and total absence of fetus toxicity at doses of less than 7.44 mg/kg body wt.

Topics: Administration, Cutaneous; Administration, Oral; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cordia; Dose-Response Relationship, Drug; Edema; Estrus; Female; Fetus; Male; Miconazole; Nystatin; Pain; Pain Measurement; Phytotherapy; Plant Extracts; Plant Leaves; Rats; Rats, Wistar

Topics: Antifungal Agents; Breast Diseases; Candida albicans; Candidiasis; Candidiasis, Oral; Female; Fluconazole; Humans; Infant; Infant, Newborn; Lactation; Male; Nipples; Nystatin; Pain; Weaning