Search PubMed⌕ Search

Biomedical subjects

R J Hay

Publications and source records attributed to R J Hay.

At least 127 records · Page 7Linked to original sources
PubMed1993

Risk/benefit ratio of modern antifungal therapy: focus on hepatic reactions.

The purpose of this article is to review the risk/benefit ratio of the oral antifungals: griseofulvin, ketoconazole, fluconazole, itraconazole, and terbinafine. The reported side effects of each drug have been listed with particular emphasis on the possibility of hepatic damage. All oral antifungal agents cause minor gastrointestinal upset, as well as headache and skin reactions. There is also a rare incidence of reversible hepatic damage. Although the incidence of abnormal liver function tests from oral antifungal therapy is extremely low, patients should be advised to inform their physician if any warning symptoms are noticed.

Antifungal Agents↗
PubMed1993

Skin disease.

Skin disease is one of the common causes of illness in most tropical countries and tropical skin diseases are often regarded as exotic. Most patients presenting with lesions acquired abroad however have either developed a condition common in their own environment or one that has been aggravated by the climatic conditions. Sun exposure in particular is a major source of skin damage. Specific disorders seen in visitors to the tropics are often infective in aetiology. They include specific fungal infections as well as parasitic disease, such as leishmaniasis and onchocerciasis. In many of such cases the infections are more readily acquired by those visiting rural areas but this is not always the case.

Dermatomycoses↗
PubMed1993

A case of chromoblastomycosis responding to treatment with itraconazole.

Chromoblastomycosis is a rare, chronic, cutaneous infection caused by a group of dematiacaeous fungi. We report a case which, in addition to characteristic clinical and histopathological features of chromoblastomycosis, displayed atypical, deep dermal/subcutaneous involvement, and showed a good response to itraconazole.

Antifungal Agents↗
PubMed1993

A clinical classification and grading system of the cutaneous changes in onchocerciasis.

Although onchocerciasis is one of the most important diseases of the skin and eye in the tropical world, to date there has been no formal consensus regarding the description and terminology of skin lesions. Furthermore, the contribution of cutaneous pathology to the morbidity and socio-economic effects of the disease has been largely neglected. We present a clinical classification and grading system for recording the cutaneous changes of onchocerciasis, and propose that this system be used as a standard method of description to convey clinical information between workers in all endemic areas to assist local and comparative research.

Acute Disease↗
PubMed1993

Histoplasmosis.

Histoplasmosis is an infection caused by the dimorphic fungus, Histoplasma capsulatum. The initial site of entry is usually the lung, but dissemination to skin occurs in some patients, particularly those with human immunodeficiency virus (HIV) infection in whom it is part of a widespread infection. The organisms have to be distinguished from other yeasts in skin such as Cryptococcus neoformans and small forms of Blastomyces dermatitidis.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Onychomycosis. Agents of choice.

The management of onychomycosis has changed considerably in the past few years. The main trends have been improvement in the choice of evidence and cover of infections other than dermatophytosis, shortening of periods of oral therapy, and introduction of topical agents designed to treat nail disease. At present there have been almost no comparative studies of these different approaches, and choice is therefore largely based on enlightened guesswork coupled with personal experience. It is hoped that within the next few years such studies will be carried out to allow dermatologists to make an accurate choice based on appropriate scientific data.

Administration, Cutaneous↗
PubMed1992

Genetic susceptibility to dermatophytosis.

Clustering of cases of dermatophytosis suggests that inherited susceptibility may play a part in determining the epidemiology of some forms of this infection, notably tinea imbricata. Some studies of T. concentricum infection show that autosomal recessive susceptibility may provide an answer although this is not the case in all endemic areas. Further support comes from the association between dermatophytosis in man and inherited conditions such as atopy, chronic mucocutaneous candidosis and tylosis as well as experimental data showing that susceptibility to dermatophytosis in mice varies in different inbred strains. Possible mechanisms are discussed.

Adolescent↗
PubMed1992

Nomenclature of fungal diseases: a report and recommendations from a Sub-Committee of the International Society for Human and Animal Mycology (ISHAM).

The ISHAM Mycoses Nomenclature Committee has considered the present status of fungal disease names. It suggests that the traditional approach to mycoses nomenclature in which the name of a causative taxon is suffixed with '-asis', '-iasis', '-osis' or '-mycosis' leads to names that are frequently unstable with respect to subsequent taxonomic and clinico-epidemiological changes. It is therefore recommended that individual mycoses should be named as often as possible in the form 'pathology A due to/caused by fungus X' or '[adjectival] fungus X pathology A' in preference to construction of names based solely on fungal taxa. A list of recommended mycosis names retained for their long tradition or intrinsic convenience is provided, together with a combined index and list of rejected names.

Animals↗
PubMed1992

Mycetoma.

Explore the source record for details and available documents.

Humans↗
PubMed1992

Possible mechanisms of immune modulation in chronic dermatophytoses: an in vitro study.

It has been suggested that patients with chronic superficial Trichophyton rubrum infection have defective cellular immunity to dermatophyte antigens. This may be due to a selective anergy to dermatophyte antigens or reflect the activity of dermatophyte-derived lymphocyte inhibitory factors. To explore these possibilities, we assessed lymphocyte transformation to a variety of recall antigens, including a cytoplasmic and exoantigen preparation of Trichophyton rubrum in 15 patients with chronic dermatophyte infection and 15 age- and sex-matched positive controls. In a duplicate set of experiments, autologous serum was replaced by heat-inactivated fetal calf serum. In addition, the direct effect of Trichophyton rubrum extracts on lymphoproliferation was assessed in vitro. Comparable lymphocyte transformation to each recall antigen was observed in patients and controls. Moreover, we found no evidence for a circulating dermatophyte-derived lymphocyte inhibitory factor in sera from patients with chronic superficial infection. A direct inhibitory effect of Trichophyton rubrum on lymphocyte proliferation to recall antigens was observed, however, at protein concentrations of > 10 micrograms/ml (exoantigen preparation) and > 25 micrograms/ml (cytoplasmic preparation). This inhibitory effect was rapidly reversible, not associated with loss of cell viability and maximal when added within 24 h of antigen to cultured lymphocytes. Class II MHC antigen HLA-DR, a surface marker of T-cell activation, was observed on inhibited lymphocytes co-cultured with antigen, suggesting the primary target for the inhibitory effect in vitro is the lymphocyte rather than the antigen-presenting cell.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Treatment of dermatomycoses and onychomycoses--state of the art.

We have reached a stage whereby many of the superficial mycoses are treatable with short courses of antifungal drugs. However, the minimum duration of therapy has still not been well defined and there remain some mycoses which do not respond to conventional therapy. It may be possible to introduce more radical approaches to therapy such as the single-dose oral or topical therapy for tinea pedis or short-duration therapy for onychomycosis. Amongst these options, topical therapies still have a part to play in the management of onychomycosis, and the role of amorolfine in this respect is of potential value. The ability of the drug to produce lasting remissions after short courses of treatment is also of great interest. Last, but not least, amorolfine has an in-vitro spectrum of activity which covers some of the less common cutaneous pathogens, and hence it may prove of benefit in those infections for which treatment at present is limited.

Antifungal Agents↗
PubMed1992

A 34- to 38-kilodalton Cryptococcus neoformans glycoprotein produced as an exoantigen bearing a glycosylated species-specific epitope.

Three monoclonal antibodies (MAbs), all of the immunoglobulin G1 subclass, were raised against Cryptococcus neoformans by using the technique of cyclophosphamide ablation of B-cell responses against shared epitopes of the cross-reactive fungus Trichosporon beigelii. MAb 3C2 was reactive against the encapsulated and nonencapsulated isolates of C. neoformans var. neoformans by enzyme-linked immunosorbent assay (ELISA) and Western blot (immunoblot), and in addition to a 34- to 38-kDa determinant, it recognized a series of lower-molecular-weight species. 3C2 also reacted strongly with culture supernatant preparations of C. neoformans var. neoformans by ELISA. 3C2 showed no recognition of either T. beigelii or C. neoformans var. gattii antigens. Enzymatic deglycosylation followed by reaction with 3C2 on Western blots revealed that sialic acid was an integral part of the determinant, together with N-acetylglucosaminyl-asparagine and alpha-mannose. Proteolytic digestion showed that the epitope was pepsin sensitive and that it also contained tryptophan and glycine and/or leucine as determinants of recognition by 3C2. The pI of the glycoprotein was 7.1. Affinity chromatography-purified antigen did not exhibit proteolytic activity on sodium dodecyl sulfate-polyacrylamide substrate gels. Indirect fluorescence antibody tests revealed that 3C2 labelling was confined to the cell membrane and cytoplasm of yeasts. The remaining MAbs, 7H4 and 5G5, recognized both capsulated and nonencapsulated strains of C. neoformans var. neoformans by both ELISA and Western Blot, identifying linear determinants with molecular masses of 36 and 30 kDa. They were unreactive against culture supernatant antigen (exoantigen) from either variant of C. neoformans.

Animals↗