scholarly journals Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and Candida albicans in breastfeeding women

2021 ◽  
Vol 17 ◽  
pp. 174550652110314
Author(s):  
Pamela Douglas
Keyword(s):  
Candida Albicans ◽  
Human Milk ◽  
Signs And Symptoms ◽  
Breast Pain ◽  
Breastfeeding Support ◽  
Candida Spp ◽  
Healthy Human ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
The Relationship

Background: Breastfeeding mothers commonly experience nipple pain accompanied by radiating, stabbing or constant breast pain between feeds, sometimes associated with pink shiny nipple epithelium and white flakes of skin. Current guidelines diagnose these signs and symptoms as mammary candidiasis and stipulate antifungal medications. Aim: This study reviews existing research into the relationship between Candida albicans and nipple and breast pain in breastfeeding women who have been diagnosed with mammary candidiasis; whether fluconazole is an effective treatment; and the presence of C. albicans in the human milk microbiome. Method: The author conducted three searches to investigate (a) breastfeeding-related pain and C. albicans; (b) the efficacy of fluconazole in breastfeeding-related pain; and (c) composition of the human milk mycobiome. These findings are critiqued and integrated in a narrative review. Results: There is little evidence to support the hypothesis that Candida spp, including C. albicans, in maternal milk or on the nipple-areolar complex causes the signs and symptoms popularly diagnosed as mammary candidiasis. There is no evidence that antifungal treatments are any more effective than the passage of time in women with these symptoms. Candida spp including C. albicans are commonly identified in healthy human milk and nipple-areolar complex mycobiomes. Discussion: Clinical breastfeeding support remains a research frontier. The human milk microbiome, which includes a mycobiome, interacts with the microbiomes of the infant mouth and nipple-areolar complex, including their mycobiomes, to form protective ecosystems. Topical or oral antifungals may disrupt immunoprotective microbial homeostasis. Unnecessary use contributes to the serious global problem of antifungal resistance. Conclusion: Antifungal treatment is rarely indicated and prolonged courses cannot be justified in breastfeeding women experiencing breast and nipple pain. Multiple strategies for stabilizing microbiome feedback loops when nipple and breast pain emerge are required, in order to avoid overtreatment of breastfeeding mothers and their infants with antifungal medications.

scholarly journals Relação Gênero Candida e Afecções Respiratórias em Pacientes Pediátricos / Candida Gender Relationship and Respiratory Diseases in Pediatric Patients

2021 ◽  
Vol 15 (58) ◽  
pp. 11-21
Author(s):  
Raquel Carlos de Brito ◽  
Leandro Januário de Lima ◽  
Eliane De Sousa Leite ◽  
Maria do Carmo Andrade Duarte de Farias ◽  
Jose Ferreira Lima Junior
Keyword(s):  
Candida Albicans ◽  
Room Temperature ◽  
Pediatric Patients ◽  
Immune Status ◽  
University Hospital ◽  
Candida Spp ◽  
Colony Forming Units ◽  
Icd 10 ◽  
Oral Colonization ◽  
The Relationship

Resumo: O objetivo foi detectar fatores de risco associados à colonização por Candida na cavidade oral de pacientes pediátricos, com diagnóstico de afecção respiratória, em Hospital Universitário em virtude de enfermidade cujo diagnóstico se enquadrasse no Capítulo X da CID-10. Método: foram coletadas amostras de saliva de 31 crianças com auxílio de swab estéril e encaminhadas para processamento no laboratório de Microbiologia da Universidade Federal de Campina Grande, campus Cajazeiras, onde foram semeadas em Agar Sabouraud Dextrose com cloranfenicol e, em seguida, foram incubadas a 35°C±2/ 24h e mais 2 dias à temperatura ambiente para verificação de crescimento de unidades formadoras de colônia por mililitro (UFC.mL-1). Resultado: A taxa de colonização oral por Candida entre os pacientes submetidos à coleta foi de 25,8%, destes, 50% pertencentes à espécie Candida albicans. Conclusão: os dados do presente estudo refletem achados amplamente divulgados, como a relação inversa entre a colonização oral e a idade do paciente e a prevalência da espécie C. albicans. Ressalta ainda a relevância da relação entre o estado imunológico do paciente e a susceptibilidade deste à colonização por tais agentes. Palavras-chave: Candida spp; infecção hospitalar; criança. Abstract: To detect risk factors associated with Candida colonization in the oral cavity of pediatric patients diagnosed with respiratory disease at a University Hospital due to a disease whose diagnosis falls under Chapter X of the ICD-10. Method: Saliva samples were collected from 31 children with the aid of a sterile swab and sent for processing in the Microbiology laboratory of the Federal University of Campina Grande, campus Cajazeiras, where they were seeded in Agar Sabouraud Dextrose with chloramphenicol and then incubated to 35°C±2/ 24h plus 2 days at room temperature to verify the growth of colony forming units per milliliter (CFU.mL-1). Results: The rate of oral colonization by Candida among patients submitted to collection was 25.8%, of which 50% belonged to the Candida albicans species. Conclusion: the data from this study reflect widely publicized findings, such as the inverse relationship between oral colonization and patient age and the prevalence of the species C. albicans. It also emphasizes the relevance of the relationship between the patient's immune status and their susceptibility to colonization by such agents. Keywords: Candida spp; hospital infection; child. 

scholarly journals Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center

2021 ◽  
pp. 112067212199104
Author(s):  
Giuseppe D’Amico Ricci ◽  
Claudia Del Turco ◽  
Elena Belcastro ◽  
Marco Palisi ◽  
Mario R Romano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Time Span ◽  
Nasopharyngeal Swab ◽  
Eye Disorders ◽  
Eye Examination ◽  
The Relationship ◽  
Acute Conjunctivitis ◽  
Piedmont Region

Purpose: Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. Methods: In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. Results: Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed −0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions ( p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9–12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. Conclusion: Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. Synopsis The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.

scholarly journals Orodispersible Film Loaded with Enterococcus faecium CRL183 Presents Anti-Candida albicans Biofilm Activity In Vitro

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 998
Author(s):  
Virgínia Barreto Lordello ◽  
Andréia Bagliotti Meneguin ◽  
Sarah Raquel de Annunzio ◽  
Maria Pía Taranto ◽  
Marlus Chorilli ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Antifungal Activity ◽  
Enterococcus Faecium ◽  
Potato Starch ◽  
Oral Candidiasis ◽  
Candida Spp ◽  
Sem Images ◽  
Control Film ◽  
In Vitro Antifungal Activity

Background: Probiotic bacteria have been emerging as a trustworthy choice for the prevention and treatment of Candida spp. infections. This study aimed to develop and characterize an orodispersible film (ODF) for delivering the potentially probiotic Enterococcus faecium CRL 183 into the oral cavity, evaluating its in vitro antifungal activity against Candida albicans. Methods and Results: The ODF was composed by carboxymethylcellulose, gelatin, and potato starch, and its physical, chemical, and mechanical properties were studied. The probiotic resistance and viability during processing and storage were evaluated as well as its in vitro antifungal activity against C. albicans. The ODFs were thin, resistant, and flexible, with neutral pH and microbiologically safe. The probiotic resisted the ODF obtaining process, demonstrating high viability (>9 log10 CFU·g−1), up to 90 days of storage at room temperature. The Probiotic Film promoted 68.9% of reduction in fungal early biofilm and 91.2% in its mature biofilm compared to the group stimulated with the control film. Those results were confirmed through SEM images. Conclusion: The probiotic ODF developed is a promising strategy to prevent oral candidiasis, since it permits the local probiotic delivery, which in turn was able to reduce C. albicans biofilm formation.

Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms

2017 ◽  
Vol 17 (6) ◽  
pp. 496-504 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K Moser ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Self Care ◽  
Signs And Symptoms ◽  
Comprehensive Understanding ◽  
Behavior Scale ◽  
Heart Failure Exacerbation ◽  
The Relationship ◽  
Different Levels ◽  
Care Behavior

Background: Although incomplete understanding of heart failure and its signs and symptoms appears to be a barrier to successful self-care, there are few studies examining the relationship between self-care and levels of comprehensive understanding of heart failure and its signs and symptoms. Aim: To determine whether incomplete understanding of heart failure and its signs and symptoms is associated with self-care in heart failure patients who were recently discharged from the hospital due to heart failure exacerbation. Methods: Patients completed the nine-item European Heart Failure Self-care Behavior scale and questionnaire to assess knowledge of heart failure and its signs and symptoms. Three groups were formed by their different levels of understanding of heart failure and its signs and symptoms. Multivariable linear regression was used to determine whether these three levels of understanding groups predicted self-care after controlling for demographic and clinical variables. Results: Of 571 patients 22.1%, 40.1% and 37.8% had poor, moderate, and complete understanding, respectively. Compared with patients in the poor understanding group, patients in complete and moderate understanding groups were more likely to have better adherence to self-care activities (standardized β = −0.14, 95% confidence interval −3.41, −0.47; standardized β = −0.19, 95% confidence interval −4.26, −1.23, respectively). Conclusions: Fewer than half of the patients had a comprehensive understanding of heart failure and its signs and symptoms, which was associated with poor self-care. Our study suggests that patient education should include contents to promote comprehensive understanding of heart failure and its symptoms, as well as the importance of self-care behaviors.

Candida albicans Shunt Infection: Report of Two Cases

Neurosurgery ◽  
1986 ◽  
Vol 19 (1) ◽  
pp. 111-113 ◽  
Author(s):  
David J. Gower ◽  
Kerry Crone ◽  
Eben Alexander ◽  
David L. Kelly
Keyword(s):  
Candida Albicans ◽  
Blood Cells ◽  
White Blood Cells ◽  
Shunt Infection ◽  
Cerebrospinal Fluid Shunts ◽  
Previous Therapy ◽  
Relationship Of ◽  
The Relationship ◽  
Overall Mortality

Abstract Infection of cerebrospinal fluid shunts with Candida albicans is reported in two patients. Scanning electron microscopy in one case demonstrates the relationship of the Candida hyphae to the white blood cells and to silicone plastic. A review of 10 previously reported cases of Candida shunt infection indicates that the infection usually follows a major bacterial infection or direct contamination or occurs spontaneously, Previous therapy has usually involved removal of the shunt, and the role of parenteral antifungal therapy is still unclear. Overall mortality to date is 25%.

THE RELATIONSHIP OF THE SODIUM, POTASSIUM, AND CHLORIDE CONCENTRATION OF THE FEEDING TO THE WEIGHT GAIN OF PREMATURE INFANTS

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 909-916
Author(s):  
Herbert I. Goldman ◽  
Samuel Karelitz ◽  
Hedda Acs ◽  
Eli Seifter
Keyword(s):  
Weight Gain ◽  
Sodium Chloride ◽  
Human Milk ◽  
Premature Infants ◽  
Chloride Concentration ◽  
The Other ◽  
Milk Formula ◽  
Sodium Potassium ◽  
Relationship Of ◽  
The Relationship

One hundred four healthy premature infants, of birth weight 1,000 to 1,800 gm, were fed one of five feedings: (1) human milk; (2) human milk plus 13 meq/l of sodium chloride; (3) human milk plus 13 meq/l of sodium chloride and 18 meq/l of potassium chloride; (4) a half-skimmed cows milk formula; and (5) a partially-skimmed vegetable oil, cows milk formula. The infants fed any of the three human milk formulas gained weight at a slower rate than the infants fed either of the two cows milk formulas. Infants whose diets were changed from unmodified human milk to the half-skimmed cows milk gained large amounts of weight, and at times were visibly edematous. Infants whose diets were changed from the human milks with added sodium chloride, to the half-skimmed cows milk, gained lesser amounts of weight and did not become edematous. The infants fed the two cows milk diets gained similar amounts of weight, although one diet provided 6.5 gm/kg/day, the other 3.1 gm/kg/day of protein.

Is duodenal biopsy always necessary for the diagnosis of coeliac disease in adult patients with high anti-tissue transglutaminase (TTG) antibody titres?

2021 ◽  
pp. flgastro-2020-101728
Author(s):  
Junaid Beig ◽  
Kamran Rostami ◽  
David T S Hayman ◽  
Summer Hassan ◽  
Stephen Gerred ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Linear Models ◽  
Tissue Transglutaminase ◽  
Signs And Symptoms ◽  
Duodenal Biopsy ◽  
Adult Patients ◽  
Antibody Titres ◽  
Red Flag ◽  
The Relationship ◽  
Duodenal Biopsies

ObjectiveAvoiding duodenal biopsy in adults for coeliac disease (CD) diagnosis is controversial. Some retrospective and prospective studies have shown that CD can be reliably diagnosed in adults with serology rather than duodenal biopsies. This study aimed to check the accuracy of a cut-off value of ≥10 upper limit of normal of anti-tissue transglutaminase antibody (anti-TTG IgA) titres for CD diagnosis in adult patients.MethodWe retrospectively analysed adult patients (≥16 years) who underwent gastroscopy from 2013 to 2018 for positive coeliac serology. The relationship between titres and disease was determined by using linear models, whereas sensitivity and specificity were assessed by receiver operator curve.ResultsWe analysed 144 newly anti-TTG antibody-positive adult patients with a median age of 48.5 years (IQR 32–62); among them, 86 (60%) patients had CD (Marsh III: n=68 and Marsh II and I: n=18) with a higher prevalence in females (n=59 (69%)) and Europeans (n=60 (70%)). Fifty (58%) patients with CD had colonoscopy and five (6%) had imaging; only six patients were diagnosed with additional conditions. An anti-TTG IgA titre cut-off value of 150 U/L was 100% specific for CD in our dataset, with 70% (95% CI: 60% to 88%) sensitivity for this patient group.ConclusionCoeliac serology using anti-TTG IgA with titres ≥10× normal value is an excellent predictor of CD, irrespective of age, gender and ethnicity. Duodenal biopsy may not be necessary in selected adult patients with CD, especially younger than 50 years of age without additional gastrointestinal red-flag signs and symptoms.

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