Search results for "INOCA"

Choosing the Right Antifungal Agent in ICU Patients

2019

Fungi are responsible for around 20% of microbiologically documented infections in intensive care units (ICU). In the last decade, the incidence of invasive fungal infections (IFI), including candidemia, has increased steadily because of increased numbers of both immunocompromised and ICU patients. To improve the outcomes of patients with IFI, intensivists need to be aware of the inherent challenges. This narrative review summarizes the features of routinely used treatments directed against IFI in non-neutropenic ICU patients, which include three classes of antifungals: polyenes, azoles, and echinocandins. ICU patients' pathophysiological changes are responsible for deep changes in the phar…

Therapeutic tools for oral candidiasis : current and new antifungal drugs

2019

Background Candidiasis is one of the most common opportunistic oral infections that presents different acute and chronic clinical presentations with diverse diagnostic and therapeutic approaches. The present study carries out a bibliographic review on the therapeutic tools available against oral candidiasis and their usefulness in each clinical situation. Material and Methods Recent studies on treatment of oral candidiasis were retrieved from PubMed and Cochrane Library. Results Nystatin and miconazole are the most commonly used topical antifungal drugs. Both antifungal drugs are very effective but need a long time of use to eradicate the infection. The pharmacological presentations of mico…

Candida bloodstream infections in intensive care units: Analysis of the extended prevalence of infection in intensive care unit study

2011

Objectives: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. Design: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. Setting: EPIC II included 1265 intensive care units in 76 countries. Patients: Patients in partic…

Synthesis of monodisperse oligomers of ɛ-aminocaproic acid up to a degree of polymerization of 25 by the Merrifield method (1)

1967

Review of the safety, tolerability, and drug interactions of the new antifungal agents caspofungin and voriconazole

2003

Managing invasive fungal infections often presents a challenge for clinicians in the treatment of immunocompromised patients. Two very different systemic antifungal agents, voriconazole and caspofungin, have recently been introduced into the market place. Voriconazole is a new triazole antifungal, while caspofungin is the first echinocandin antifungal. Voriconazole acts by inhibiting the synthesis of ergosterol in the fungal cell membrane. Caspofungin inhibits beta-1,3-D-glucan synthesis in the cell wall, a target present in fungal cells, but absent from mammalian cells. Both agents are broad-spectrum, with efficacy against invasive Aspergillus and Candida infections. The safety and tolerab…

In vitro activity of fluconazole, voriconazole and caspofungin against clinical yeast isolates.

2007

Predicting the clinical outcome of a systemic mycosis is often a difficult task, especially when microbiological resistance is one of the factors contributing to therapeutic failure. Some of these factors are host-related--e.g. immune state, site and severity of infection, poor compliance to therapy--while others are associated with the drug's characteristics--e.g. dosage, type of compound (fungistatic/fungicidal), pharmacokinetic properties and drug-drug interactions. In the last few years, clinicians have been confronted with the problem of selecting the most appropriate antifungal therapy for systemic infections and have highlighted the need for a reliable method to assay the in vitro su…

L'ontogenèse complexe du spatangue Echinocardium cordatum: Un test des standards des trajectoires hétérochroniques

1991

The growth of the spatangoid echinoid Echinocardium cordatum is described by using the three standards (size,shape and age) that are classicaly involved in analyses of heterochronies. A population from Normandy, including all the growth stages, allows an ontogenetic reference to be established, while comparisons are performed with adult samples from other localities (Brittany, Aquitaine, and New-Zealand). The morphology of E. cordatum is characterized by 23 measured parameters and 13 calculated indexes. The ontogenetic trajectory of the species is depicted from the measurements of the size increments, from the analysis of the shape changes, and from an estimate of age. An estimate of the ag…

C,N-chelated diaminocarbene platinum(II) complexes derived from 3,4-diaryl-1H-pyrrol-2,5-diimines and cis-dichlorobis(isonitrile)platinum(II): Synthe…

2020

The reaction of 3,4-diaryl-1H-pyrrol-2,5-diimines with cis-dichlorobis(isonitrile)platinum(II) affords the C,N-chelated diaminocarbene platinum(II) complexes, which have been fully characterized including molecular spectroscopy, single crystal X-ray diffraction and DFT calculations. The obtained platinum(II) complexes are effective catalysts for the hydrosilylation of alkynes and alkenes. Thus, the reaction of phenylacetylene with triethoxysilane leads to the formation of α- and β-(E)-vinylsilanes, generating TON's in the range of 103 to 104 and TOF's in the range of 102 to 103 h−1. Also, the cross-linked silicones, possessing the luminescence properties, were obtained by the hydrosilylatio…

Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving or…

2015

Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving > 40 days who engrafted and were discharged without prior IFD. All patients who received >= 20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to constr…

Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis

2006

Background: Micafungin (FK463) is a new lipopeptide compound (echinocandin) with activity against Aspergillus and Candida species. This study evaluated the safety and efficacy of micafungin in patients with proven or probable invasive aspergillosis (IA). Methods: A multinational, non-comparative study was conducted to examine proven or probable (pulmonary only) Aspergillus species infection in a wide variety of patient populations. The study employed an open-label design utilizing micafungin alone or in combination with another systemic antifungal agent. Criteria for IA and therapeutic responses were judged by an independent panel. Results: Of the 331 patients enrolled, only 225 met diagnos…