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Results: 14

Fact sheet: Fungal infection of the mouth in people who have cancer or HIV/AIDS

Oral hygiene and enjoying good food are important for most people. It follows that it can be very unpleasant to have a cottony feeling in your mouth, loss of taste and trouble swallowing. An oral infection by Candida fungus can cause these symptoms. The medical term of this condition is “oral thrush” or “oral candidiasis”. This often affects people who have serious diseases, but it may also be a side effect of some treatments. This fact sheet will explain how people with cancer or HIV/AIDS may develop oral thrush and what options they have for prevention and treatment.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 10, 2012

Antifungal agents for preventing fungal infections in non‐neutropenic critically ill patients

Critically ill patients are at risk of invasive fungal infections, such as those affecting the bloodstream and other organs. Once established, such infections are difficult to treat and result in a high mortality. Results from 12 randomized trials demonstrate that the administration of antifungal drugs to critically ill patients reduces the incidence of invasive fungal infections by about one half and reduces mortality by about one quarter. Although no increase in adverse effects or resistance amongst fungi was reported by these studies, such effects are not excluded. However, concerns that the widespread use of antifungal drugs may promote resistance amongst fungi justify their selective use in patients at greatest risk of fungal infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Prevention of fungal infections in patients with cancer with antifungal drugs

Cancer patients receiving chemotherapy or a bone marrow transplant are at risk of fungal infections. These can be life‐threatening, especially when spread throughout the body. Those with low white cell counts (neutropenia) are particularly at risk. Antifungal drugs are often given as a routine preventive measure, or when people at risk have a fever. The review found that intravenous amphotericin B could reduce number of deaths. Three of the drugs, amphotericin B, fluconazole and itraconazole reduced fungal infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions for the prevention and management of oral thrush associated with HIV infection in adults and children

Oral candidiasis (thrush) associated with human immunodeficiency virus (HIV) infection occurs commonly and recurs frequently, often presenting as an initial manifestation of the disease. Interventions aimed at preventing and treating HIV‐associated oral thrush form an integral component of maintaining the quality of life for affected individuals. This review evaluated the effects of interventions in preventing or treating oral thrush in children and adults with HIV infection. Thirty three trials (n=3445) were included. Twenty two trials investigated treatment and eleven trials investigate prevention. There was no difference with regard to clinical cure between fluconazole compared to ketoconazole, itraconazole, clotrimazole and posaconazole. Fluconazole, gentian violet and ketoconazole were superior to nystatin. Compared to placebo and no treatment, fluconazole was effective in preventing clinical episodes from occurring. Continuous fluconazole was better than intermittent treatment. Insufficient evidence was found to come to any conclusion about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole, ketoconazole or chlorhexidine with regard to OC prophylaxis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Oral antifungal drugs for treating athlete's foot (tinea pedis)

Athlete's foot (tinea pedis) is a fungal infection of the feet that is easily spread and difficult to get rid of. This review compared different oral antifungal drugs (i.e. drugs taken by mouth), and it included 15 trials, involving 1438 participants. There are several different kinds of oral treatments, and the trials we found considered all the oral drugs used to treat athlete's foot. We found terbinafine and itraconazole to be more effective than placebo. And we found terbinafine to be more effective than griseofulvin. Griseofulvin is a treatment that was developed much earlier than the new treatments, such as terbinafine and itraconazole; these newer treatments tend to be most evaluated. Trials of other drugs were not large enough to show differences between them. All drugs had side‐effects; gastrointestinal effects were the most common.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antifungal drugs (azoles) for allergic bronchopulmonary aspergillosis associated with asthma

Allergic bronchopulmonary aspergillosis is a condition that complicates some people with chronic asthma. Standard treatment for this condition is high doses of oral steroids. The azole antifungal drugs attack the fungus that causes this condition and short term studies suggest that they may have some benefit when added to standard therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antiglucocorticoid treatments for mood disorders

Many patients with mood disorders report problems with memory and concentration, alongside their mood symptoms. There is some evidence that a possible cause of these problems is an overactivity of the hypothalamic‐pituitary‐adrenal (HPA) axis, the body's natural stress system. This leads to an overproduction of the stress‐hormone, cortisol. Therefore, it is possible that drugs which target the HPA axis may be of benefit. The efficacy and safety of antiglucocorticoids in the treatment of mood disorders was the subject of this systematic review. Nine studies met criteria for inclusion. Of these, a number of drugs were examined, including: mifepristone [RU‐486] (n=4), ketoconazole (n=2), metyrapone (n=2), and DHEA (n=1). Three of the trials were in patients with psychotic major depression (pMDD), five trials in non‐psychotic major depression and one trial in patients with bipolar disorder (currently depressed; non‐psychotic). Overall, when examining all trials together over all affective episodes, there was no significant difference in the overall proportion of patients responding (HAM‐D 50% reduction) to treatment with antiglucocorticoids over placebo. However the mean change (WMD; baseline to end‐point) in HAM‐D scores indicated a significant difference in favour of treatment . There is clearer evidence of efficacy in specific diagnostic subtypes. Of the five trials in non‐psychotic depression (unipolar or bipolar), there was a significant difference in favour of treatment. In psychotic depression, there was no evidence of an overall antidepressant effect or an effect on overall psychopathology (BPRS 30% reduction). In these subtypes the mean change (WMD) in scores indicated a significant difference in favour of treatment . To date only one trial has examined the impact of antiglucocorticoids on neuropsychological functioning. There are limited reports on side effects; overall, the only event to reach significance was the incidence of a rash occurring more often after active treatment, and this was reported in two studies . In summary, the use of antiglucocorticoids in the treatment of mood disorders and psychosis is very much at the proof‐of‐concept stage. A great deal of difference exists between studies with respect to the compounds used, patient cohort under investigation and methodology. Results in some diagnostic subtypes are promising and warrant further examination to better examine the clinical utility of this class of drug.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antifungal drugs used for prevention can significantly reduce the number of invasive fungal infections in liver transplant patients

Invasive fungal infections ‐ infections of the bloodstream and organs within the body (e.g. meningitis, pneumonia, peritonitis) ‐ are important causes of morbidity and mortality in liver, pancreas, heart, kidney and lung (i.e. solid organ) transplant recipients. This review found that fluconazole, used as a preventive drug, significantly reduced the number of invasive fungal infections in liver transplant patients. More studies are needed to determine how effective antifungal drugs are for pancreas, heart, kidney and lung transplant patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Not enough good quality trials to assess the most effective drug treatment for paracoccidioidomycosis

Paracoccidioidomycosis is a fungal infection that causes ulcers, swelling, fever, and pain. If it also gets into the lungs, it can produce coughing, shortage of breath, chest pain, weight loss, and sometimes death. Without treatment, those suffering this disease may die in a few months or years. There are endemic areas between Mexico and southern Argentina. Drug treatments need to go on for many months and maybe years. There are various drugs that are used, but this review found only two small trials with too few data to say which drug was best, and the drugs all seem to have adverse effects. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions for American cutaneous and mucocutaneous leishmaniasis.

American cutaneous and mucocutaneous leishmaniasis, a disfiguring and stigmatising disease affecting Central and South American regions, is caused by a parasite transmitted by sandflies. Pentavalent antimonial drugs (sodium stibogluconate (Pentostam, Stibanate, SSG) and meglumine antimoniate (Glucantime, MA)) have been used since the 1940s as first‐line therapeutic agents for cutaneous leishmaniasis worldwide. However, other treatments have been used because these are expensive, toxic and painful, and because resistance is emerging.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Interventions for treating oral candidiasis for patients with cancer receiving treatment

Cancer treatment can lead to severe fungal infections (candidiasis, called thrush) in the mouth. This can cause pain, difficulties in eating and longer hospital stays. Infection can sometimes spread through the body and become life‐threatening. Different drugs are used to try and relieve candidiasis. There is insufficient evidence that any of the antifungal drugs may cure fungal infections in the mouth for people with cancer and more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Cyproterone acetate appears to be as effective as other medications for hirsutism in women caused by excessive androgen production by the ovaries

One of the causes of hirsutism (excessive hair growth) in women is excessive production of the hormone androgens by the ovaries. A variety of medications can be used to counter the effects of the androgen. Cyproterone acetate is an anti‐androgen drug. Adverse effects that have been reported with its use include weight gain, depression, fatigue, breast symptoms and sexual dysfunction. The review of trials found that cyproterone acetate appears to have a similar impact on hirsutism as other drugs used for hirsutism caused by excessive androgen. There was not enough evidence to compare adverse effects of the treatment options.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Topical anti‐inflammatory agents for seborrhoeic dermatitis of the face or scalp

Seborrhoeic dermatitis is an inflammation of the skin that most often affects areas of the body that have a lot of sebaceous glands. These include the skin of the scalp; face; chest; and flexure areas such as the armpits, groin, and abdominal folds. The most typical symptoms of seborrhoeic dermatitis are scaling of the skin and reddish patches. Seborrhoeic dermatitis is fairly common: one to three in 100 people have seborrhoeic dermatitis. The disease is more common in men than in women. Anti‐inflammatory, antifungal, and antikeratolytic treatments can be used to treat seborrhoeic dermatitis. The treatment does not cure the disease but relieves the symptoms.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Prostate Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of prostate cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 2, 2014

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