nystatin-a1 and Syndrome

The oral cavity and the oesophagus are the main sites of involvement in orointestinal candidosis. The clinical pictures of these manifestations are characterized. Involvement of the stomach as well as the small and large intestine is an exceedingly rare but possible manifestation. There are obviously no repeatedly occurring characteristical symptoms, neither have controlled studies confirmed such characteristics. Recently a discussion has arised-undoubtedly to a large extent influenced by public media-to explain a variety of in particular gastrointestinal symptoms as a consequence of an apparent "mycotic infection of the orointestinal tract" as "a new mass disease". These reports lack any scientific basis supported by experimental or clinical studies. There are similarities to the "candidiasis hypersensitivity syndrome" or "the yeast connection", the existence of which has been critically denied by experts. Corresponding references are given. The author realizes the necessity to oppose this public debate on a critical scientific basis and to answer open questions by controlled studies.

Topics: Antifungal Agents; Candidiasis; Candidiasis, Oral; Esophagitis; Humans; Intestinal Diseases; Nystatin; Stomach Diseases; Syndrome

Topics: Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Hypersensitivity; Nystatin; Research Design; Syndrome

Candida albicans infection has been proposed to cause a chronic hypersensitivity syndrome characterized by fatigue, premenstrual tension, gastrointestinal symptoms, and depression. Long-term antifungal therapy has been advocated as treatment for the syndrome, which is most often diagnosed in women with persistent or recurrent candida vaginitis.. To determine the efficacy of nystatin therapy for presumed candidiasis hypersensitivity syndrome, we conducted a 32-week randomized, double-blind, cross-over study using four different combinations of nystatin or placebo given orally or vaginally in 42 premenopausal women who met present criteria for the syndrome and had a history of candida vaginitis. The outcomes studied were the changes from base line in scores for vaginal, systemic, and overall symptoms and in the results of standardized psychological tests.. The three active-treatment regimens (oral and vaginal nystatin, oral nystatin and vaginal placebo, and oral placebo and vaginal nystatin) and the all-placebo regimen significantly reduced both vaginal and systemic symptoms (P less than 0.001), but nystatin did not reduce the systemic symptoms significantly more than placebo. On average, the scores for systemic symptoms improved 25 percent with the three active-treatment regimens and 23 percent with the all-placebo regimen, a difference of only 2 percent (95 percent confidence interval, -3 to 7 percent). As expected, the three active-treatment regimens were more effective than placebo in relieving vaginal symptoms (P less than 0.001). All four regimens reduced psychological symptoms and global indexes of distress; there were no significant differences among the treatment regimens.. In women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo. Consequently, the empirical recommendation of long-term nystatin therapy for such women appears to be unwarranted.

Topics: Administration, Oral; Adult; Candidiasis, Vulvovaginal; Capsules; Double-Blind Method; Drug Administration Schedule; Female; Humans; Hypersensitivity; Nystatin; Syndrome

Liddle's syndrome is a genetic form of hypertension linked to Na(+) retention caused by activating mutations in the COOH terminus of the beta or gamma subunit of the epithelial sodium channel (ENaC). In this study, we used the short-circuit current (I(sc)) method to investigate the effects of deamino-8-d-arginine vasopressin (dDAVP) on Na(+) and Cl(-) fluxes in primary cultures of cortical collecting ducts (CCDs) microdissected from the kidneys of mice with Liddle's syndrome carrying a stop codon mutation, corresponding to the beta-ENaC R(566) stop mutation (L) found in the original pedigree. Compared to wild-type (+/+) CCD cells, untreated L/+ and L/L CCD cells exhibited 2.7- and 4.2-fold increases, respectively, in amiloride-sensitive (Ams) I(sc), reflecting ENaC-dependent Na(+) absorption. Short-term incubation with dDAVP caused a rapid and significant increase (approximately 2-fold) in Ams I(sc) in +/+, but not in L/+ or L/L CCD cells. In sharp contrast, dDAVP induced a greater increase in 5-nitro-2-(3-phenylpropamino)benzoate (NPPB)-inhibited apical Cl(-) currents in amiloride-treated L/L and L/+ cells than in their +/+ counterparts. I(sc) recordings performed under apical ion substituted conditions revealed that the dDAVP-stimulated apical secretion of Cl(-), which was absent in cultured CCDs lacking CFTR, was 1.8-fold greater in L/+ and 3.7-fold greater in L/L CCD cells than in their +/+ CCD counterparts. After the basal membrane had been permeabilized with nystatin and a basal-to-apical Cl(-) gradient had been imposed, dDAVP also stimulated larger Cl(-) currents across L/L and L/+ CCD layers than +/+ CCD layers. These findings demonstrate that vasopressin stimulates greater apical CFTR Cl(-) conductance in the renal CCD cells of mice with Liddle's syndrome than in wild-type mice. This effect could contribute to the enhanced NaCl reabsorption observed in the distal nephron of patients with Liddle's syndrome.

Topics: Animals; Cells, Cultured; Chloride Channel Agonists; Chloride Channels; Chlorides; Codon; Cystic Fibrosis Transmembrane Conductance Regulator; Deamino Arginine Vasopressin; Electrophysiology; Epithelial Sodium Channels; Hypertension; Kidney Tubules, Collecting; Mice; Mice, Knockout; Nephrons; Nystatin; Organ Culture Techniques; Phenotype; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sodium; Sodium Channels; Syndrome; Vasopressins

Topics: Antifungal Agents; Candida; Candidiasis; Controlled Clinical Trials as Topic; Gastrointestinal Diseases; Humans; Hypersensitivity; Immunoglobulin E; Nystatin; Reproducibility of Results; Research Design; Syndrome

Topics: Candidiasis; Humans; Hypersensitivity; Nystatin; Syndrome

A case of a 38-year-old male with the diagnosis of Sweet's Syndrome is reported. The most significant feature of the patient was manifested by serious lesions in the oral mucosa which persisted throughout the course of the disease. They only improved after the administration of prednisone. Special emphasis is made on the characteristics of the oral manifestations of Sweet's syndrome since they have not been described in detail in the literature.

Topics: Adult; Humans; Male; Mouth Diseases; Neutrophils; Nystatin; Prednisone; Skin Diseases; Syndrome