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S Nolting

Publications and source records attributed to S Nolting.

At least 19 recordsLinked to original sources
PubMed2005

No influence of immunosuppression on insulin sensitivity and beta-cell function in living donor liver transplantation.

In liver transplantation alterations of glucose metabolism are common but not well understood. Influence of immunosuppression is widely presumed but has not proven until now. Using a frequently sampled intravenous glucose tolerance test with a minimal modeling technique of glucose disappearance we analyzed insulin sensitivity (SI) and beta-cell function (first and second phase of pancreatic beta-cell secretion, Phi 1 and Phi 2) in living donor liver transplantation of the right lobe. Initial immunosuppression in recipients was done with tacrolimus, prednisolone, and basiliximab induction. Donors and recipients were investigated before and 10 days, 6 months, and 1 year after operation. Normal SI of controls (donors before operation) decreased markedly 10 days after right lobectomy to SI 2.22 +/- 0.35 x 10(-4) min(-1) x microU/mL (P < .001); Phi 2 was compensatory increased. All parameters normalized within 1 year. Recipients were insulin-resistant with hyperinsulinemia before transplantation. After transplantation no parameter was significantly different from donors; all normalized equally to donors over 1-year follow-up. Thus, immunosuppression in recipients has no influence on glucose metabolism because liver function itself seems to play a more pronounced role than known until now.

Adult↗
PubMed2001

[Incidence of fungal involvement in nail psoriasis].

BACKGROUND AND OBJECTIVE: Because it is clinically so similar, onychomycosis is one of the most important differential diagnostic considerations in psoriatic nail changes. We determined the frequency of fungal involvement in nails of psoriatic patients. PATIENTS/METHODS: Fungal colonization of the nails of psoriatic patients with and without clinically obvious nail changes was investigated in a collective of 250 patients compared to a group of 102 non-psoriatic persons. RESULTS: There was no significant difference in the frequency of nail colonization with dermatophytes and moulds between healthy persons and psoriatics. Yeasts were more commonly found in psoriatic nails. CONCLUSIONS: Nail changes in psoriatic patients are mostly caused by psoriasis. However secondary colonization by yeasts is more common in psoriatic nails than in the general population. It remains to be clarified why dermatophytes are not more common in psoriatic nails.

Comorbidity↗
PubMed1999

The use of itraconazole to treat cutaneous fungal infections in children.

BACKGROUND: Cutaneous mycoses such as tinea capitis, onychomycosis and some cases of tinea corporis/cruris, and tinea pedis/manus require oral antifungal therapy. There is relatively limited data regarding the use of the newer oral antifungal agents, e.g. itraconazole, in the treatment of these mycoses in children. OBJECTIVE: We wished to determine the efficacy and safety of itraconazole continuous therapy in the management of cutaneous fungal infections in children. METHODS: Children with cutaneous mycoses were treated with itraconazole in an open-label manner in 4 studies. For tinea capitis, the treatment regimens using itraconazole continuous therapy were: study 1, 3 mg/kg/day for 4 or 8 weeks; study 2, 5 mg/kg/day for 6 weeks, and study 3, 5 mg/kg/ day for 4 weeks. In a different trial, study 4, itraconazole continuous therapy 5 mg/kg/day was used to treat toenail onychomycosis (duration: 12 weeks), tinea corporis/ cruris (duration: 1 week) and tinea pedis/manus (duration: 2 weeks). RESULTS: The efficacy rates at follow-up 12 weeks from the start of therapy in children with tinea capitis treated using the itraconazole continuous regimen were: clinical cure (CC) and mycological cure (MC) in study 1 (n = 10, Trichophyton violaceum all patients), CC 50%, MC 86%; in study 2 (n = 35, Microsporum canis 22 patients, Trichophyton sp. 12 patients), CC 82.8%, MC 80%, and in study 3 (n = 16, M. canis 11 patients, Trichophyton sp. 5 patients), (CC 66.7%, MC 78.5%. Itraconazole was also effective in the treatment of dermatomycoses in 24 children (study 4). The CC and MC rates at the follow-up 8 weeks from the start of therapy in children with dermatomycoses and 12 months in children treated for onychomycosis were: onychomycosis (n = 1, T. rubrum), CC 100%, MC 100%; tinea corporis (n = 12, M. canis 10 patients), CC 100%, MC 90%; tinea cruris (n = 3, Trichophyton sp. 2 patients), CC 100%, MC 100%; tinea manus (n = 1, T. rubrum), CC 100%, MC 100%, and tinea pedis (n = 7, T. rubrum), CC 100%, MC 100%). Adverse effects consisted of a cutaneous eruption in 1 (1.2%) of the 85 children, with mild, transient, asymptomatic elevation of liver function tests (less than twice the upper limit of normal) in 2 (3.4%) of 58 children in whom monitoring was performed. CONCLUSIONS: Itraconazole is effective and safe in the treatment of tinea capitis and other cutaneous fungal infections in children.

Antifungal Agents↗
PubMed1998

[Candida and the gastrointestinal tract. A medical-research evaluation].

In immunocompetent persons, Candida species are members of the normal flora of the gastrointestinal tract. Budding yeasts, in particular Candida albicans, can, however, in patients with a corresponding disposition, spread topically and systemically, that is, they may become pathogenic. In hematological/oncological patients with severe immunodeficiency, for example, the mycelium may infiltrate the muscularis mucosae, with involvement also of the vascular system. The relationships between recurrent diarrhea and Candida are still discussed controversial; various data do, however, suggest that massive colonization with Candida might well represent a(n additional) diarrhea-provoking factor. Similar considerations may also be assumed to apply to diarrhea induced by antibiotic therapy. For immunocompetent persons, guidelines exist for the yeast cell count in the stools. The interpretation of quantitative findings must, however, always be made on an individual basis and against the background of clinical symptoms and/or any particular predisposition of the patient. Reliable treatment of superficial candidasis can be achieved with oral polyene antifungal antibiotics (nystatin, amphotericin B).

Candidiasis↗
PubMed1996

German randomized double-blind multicentre comparison of terbinafine and itraconazole for the treatment of toenail tinea infection.

One-hundred and ninety-five patients with toenail tinea unguium were recruited to a multicentre double-blind clinical trial. Patients were given 250 mg terbinafine or 200 mg itraconazole daily for 12 weeks, with follow-up for a further 40 weeks. At the end of the study, mycological cure rates were 81% (70/86 assessed) for terbinafine and 63% (53/84 assessed) for itraconazole (two-tailed, P < 0.01). The length of unaffected nail was 9.44 mm in the terbinafine group and 7.85 mm in the itraconazole group (two-tailed, P < 0.05). Patient self-assessment also favoured terbinafine, with 65% evaluating it as good to very good, compared with 58% for itraconazole. Before treatment the terbinafine group had a mean of 6.7 and the itraconazole group 6.3 affected nails per patient. Total cure was achieved in 69% of terbinafine and 61% of itraconazole affected nails. We conclude that terbinafine is more effective than itraconazole in the treatment of toenail tinea infection.

Adult↗
PubMed1995

Randomised double blind comparison of terbinafine and itraconazole for treatment of toenail tinea infection. Seventh Lamisil German Onychomycosis Study Group.

OBJECTIVE: To compare the efficacy and tolerability of terbinafine and itraconazole in the treatment of toenail tinea unguium. DESIGN: Multicentre, double blind, parallel group study. SETTING: 17 university hospitals, one army hospital, and five dermatology practices. PATIENTS: 195 patients with clinically suspected toenail tinea and growth of dermatophytes in baseline culture; data on 86 patients in the terbinafine group and 84 patients in the itraconazole group were fully evaluated for efficacy. INTERVENTIONS: Daily dose of 250 mg terbinafine or 200 mg itraconazole for 12 weeks, with follow up for a further 40 weeks. MAIN OUTCOME MEASURES: Mycological cure (negative results on microscopy and culture) and clinical improvement (length and area of unaffected nail) at week 52 or at discontinuation of treatment. RESULTS: At the end of the study mycological cure rates were 81% (70 out of 86) for terbinafine and 63% (53 out of 84) for itraconazole (2P < 0.01). Negative culture was achieved in 92% (79 out of 86) in the terbinafine group and 67% (56 out of 84) in the itraconazole group (2P < 0.0001). Length of unaffected nail was 9.44 mm in the terbinafine group and 7.85 mm in the itraconazole group (2P < 0.05). CONCLUSION: Terbinafine is more effective than itraconazole in the treatment of toenail tinea infection.

Adult↗
PubMed1994

Terbinafine in onychomycosis with involvement by non-dermatophytic fungi.

Sixty-five patients with onychomycosis involving the yeasts Candida albicans or C. parapsilosis, or the mould Scopulariopsis brevicaulis, were treated for up to 48 weeks with terbinafine 250 mg daily. At the end of therapy mycological and clinical cure rates were 70% and 54% for C. albicans, and 85% and 63% for C. parapsilosis, respectively. Three out of seven S. brevicaulis infections were cured. Within 6 months of therapy, relapses occurred in 45.5% of the cured patients in the case of C. albicans infections and in 12.5% of the cured patients in the case of C. parapsilosis infections. Treatment was generally well tolerated and, although adverse events occurred in 43% of the patients, they were responsible for cessation of therapy in only 8.6%. These results indicate that the use of terbinafine in onychomycosis is not restricted to dermatophyte infections.

Administration, Oral↗
PubMed1993

Amorolfine spray in the treatment of foot mycoses (a dose-finding study).

A total of 382 patients with foot mycosis were entered into a dose-finding study. Patients were randomly treated with amorolfine spray 0.5% or 2% (double-blind) or cream 0.5% (open; used as a reference agent). The spray or cream was applied once daily for 4 weeks on average. At screening, in 348 patients evaluable for efficacy, a total of 381 fungi were isolated: Trichopyton rubrum (196), T. mentagrophytes (73), other dermatophytes (17), Candida albicans (65), other yeasts (23), and moulds (7). In 33 patients the fungal infection was mixed. Two weeks after the end of treatment, the culture was negative in 94.1% and 97.4% of patients treated with 0.5% or 2% amorolfine spray, respectively. The difference was not statistically significant. In the 0.5% cream group the culture was negative in 86.6% of patients. Nine out of 380 patients evaluable for safety had local adverse events: four (3.2%) in each of the spray groups, and one (0.8%) in the cream group. The most common local adverse events in the patients treated with spray were a burning sensation and dryness of the skin. In conclusion, both spray concentrations were highly efficacious and well tolerated. Further studies should show if more widely spaced treatment with amorolfine spray is as effective as daily administration.

Adult↗
PubMed1992

Clinical relevance of the antibacterial activity of terbinafine: a contralateral comparison between 1% terbinafine cream and 0.1% gentamicin sulphate cream in pyoderma.

The antibacterial efficacy of 1% terbinafine cream and 0.1% gentamicin sulphate cream was evaluated in 33 patients with superficial staphylococcal pyoderma in a double-blind contralateral comparison. After 12 days of active treatment, Staphylococcus aureus could be grown from only one out of 33 patients using terbinafine vs no patient using gentamicin. At the end of the study, a marked improvement in clinical symptoms was observed with no significant difference between the two therapies. Despite reviewing the patients three times during the course of the study, no adverse events were reported. The results of this study demonstrate that terbinafine has clinically relevant antibacterial properties which may be useful not only in pyoderma, but also in mixed fungal/bacterial infections, such as athlete's foot.

Adolescent↗
PubMed1992

Double-blind comparison of amorolfine and bifonazole in the treatment of dermatomycoses.

A total of 232 patients with mycoses of skin folds, body, or feet were entered into a double-blind, parallel group-study. Therapy with 0.125, 0.25, 0.5% amorolfine cream or 1% bifonazole cream was randomly allocated to patients. The cream was applied once daily for 4 weeks on average. At screening, in 208 patients evaluated for efficacy, a total of 225 fungi were isolated: T. rubrum (77), T. mentagrophytes (65), other dermatophytes (15), C. albicans (34), other yeasts (26) and moulds (8). One to three weeks after ending therapy, the percentage of patients with negative cultures were as follows: 87.3, 91.7, 90.7 and 92.2% in the amorolfine cream 0.125%, 0.25%, 0.5% and bifonazole cream 1% groups respectively. The differences were not statistically significant. Six out of 223 patients evaluated for safety had local adverse events: one (1.7%), two (3.6%) and three (5.4%) in the amorolfine cream 0.125%, 0.25% and bifonazole cream 1% groups respectively. The most common local adverse events were burning and increased itching, erythema or weeping. A once-daily application of amorolfine cream can be recommended for the treatment of dermatomycoses on the basis of the results from this study. However, a further and similar study with a larger number of patients was required to select the concentration of amorolfine cream for therapeutic use.

Antifungal Agents↗
PubMed1990

[Mycoses in adolescent patients].

Mycoses affect people of all ages world wide. Furthermore, different fungi can produce the same clinical signs and symptoms, equally similar fungi can produce many different clinical pictures. Despite of this, particular fungal infections are found more common in people of certain age groups than in others. For example, candidosis is seen frequently in babies whereas fungal infections of the feet rarely occur in children. However, there is little difference in the fungi affecting adolescents and adults. Then again, elderly people are more vulnerable to candidal infections. Besides this, there is a current increase in fungal infections in immunosuppressed patients of any age.

Adolescent↗
PubMed1989

[Onychomycoses and their successful therapy].

Fungus-infected nail material in onychomycoses can be very well removed with a combination of 1% Bifonazol and 40% urea cream, thus eliminating other methods of treatment. It is to be stressed however, that the effectiveness of this therapeutic measure is not only due to the successful galenic and dual combination of these therapeutics, but also requires expert dermatological guidance and consequent cooperation by the affected patient to achieve a satisfactory and permanent result.

Administration, Topical↗
PubMed1989

[Urea treatment of mycoses].

Urea has been neglected up to now as a therapeutic agent in the field of mycology. This does not have to remain so in the future since urea preparations do have properties which improve the prospects for successfully treating mycoses. Moreover, urea does not produce any undesirable side effects on human skin.

Administration, Topical↗