scholarly journals Autopsy findings after long-term treatment of COVID-19 patients with microbiological correlation

2021 ◽  
Author(s):  
Katja Evert ◽  
Thomas Dienemann ◽  
Christoph Brochhausen ◽  
Dirk Lunz ◽  
Matthias Lubnow ◽  
...  
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Fungal Infections ◽  
Diffuse Alveolar Damage ◽  
Fungal Species ◽  
Term Treatment ◽  
University Hospital ◽  
Long Term Treatment ◽  
The University

AbstractBetween April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e.g., thrombosis, endothelitis, capillaritis) are less prevalent at this stage, while severe diffuse alveolar damage and especially coinfection with different fungal species were the most conspicuous finding. In addition, signs of macrophage activation syndrome was detected in 7 of 8 patients. Thus, fungal infections were a leading cause of death in our cohort of severely ill patients and may alter clinical management of patients, particularly in long-term periods of treatment.

Rotigotine use in long-term treatment of restless legs syndrome: Experience in General University Hospital of Castellon

2013 ◽  
Vol 14 ◽  
pp. e251-e252
Author(s):  
P. Ruiz-Elena ◽  
J. Pinzon-Martinez ◽  
A. Gomis-Devesa ◽  
I. Barreda-Altaba ◽  
J. Ortega-Albas ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Term Treatment ◽  
University Hospital ◽  
Restless Legs ◽  
Long Term Treatment

Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

2007 ◽  
Vol 46 (6) ◽  
pp. 817-827 ◽  
Author(s):  
Zahra Taheri-Kadkhoda ◽  
Thomas Björk-Eriksson ◽  
Karl-Axel Johansson ◽  
Claes Mercke
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Term Treatment ◽  
University Hospital ◽  
Treatment Results ◽  
Hospital Experience ◽  
Long Term Treatment

scholarly journals Severe Allergic Bronchopulmonary Mycosis and Long-Term Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Hossein Esmaeilzadeh ◽  
Sara Kashef ◽  
Hamid Reza Hatami ◽  
Soheila Alyasin ◽  
Hesamodin Nabavizadeh ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Fungal Species ◽  
Term Treatment ◽  
High Resolution Computed Tomography ◽  
Asthmatic Patients ◽  
Long Term Treatment ◽  
Allergic Bronchopulmonary Mycosis ◽  
Fungal Allergen

Allergic bronchopulmonary aspergillosis (ABPA) is the most common immunologic reaction following fungal allergen exposure in asthmatic patients. A less frequent syndrome in response to other fungal species like candida is allergic bronchopulmonary mycosis (ABPM). This reaction is mostly associated with asthma exacerbation, changes in Immunoglobulin E levels, and nonspecific findings in high resolution computed tomography (HRCT). This study presents a 9-year-old girl, a known case of childhood asthma, resolved 4 years ago as a novel case of ABPM due to Candida albicans manifested by severe emphysema, bronchiectasis, and pneumothorax which consequently required long-term treatment to get relieved.

scholarly journals Zygomycoses - urgency in diagnosis

2015 ◽  
Vol 4 (4) ◽  
pp. 371
Author(s):  
Dilip Abraham ◽  
Aroma Oberoi ◽  
Eshani Dewan ◽  
Sangeetha Mohan
Keyword(s):  
Fungal Infections ◽  
Common Species ◽  
Term Treatment ◽  
Diabetic Patients ◽  
Absidia Corymbifera ◽  
Tertiary Centre ◽  
Long Term Treatment ◽  
Diagnostic Modalities ◽  
Chronic Wound Infections

<p><strong>Introduction:</strong> Zygomycoses is an angioinvasive infection most commonly seen in immunocompromised and diabetic patients. We undertook this study to determine the prevalence of Zygomycoses, in patients with a suspected Invasive Zygomycoses Infection in a tertiary centre and to identify the most common species isolated from culture.</p><p><strong>Materials and Methods:</strong> A retrospective analysis was done from January 1, 2012 to December 8, 2014; the clinical data of the suspected patients and the positive cultures were collected.</p><p><strong>Results and Discussion:</strong> A total of 50 samples of 27 patients with suspected Zygomycoses were sent during the 3 year period. In 25 of these patients, the samples sent were tissue biopsies from nasal cavity and 2 wound swabs from burns. Of these, 18 tissue biopsies of 13 patients and two wound swabs were detected positive for Zygomycetes. (2-Absidia corymbifera; 1-Rhizopus, 15-Mucor). Of the remaining 12 patients whose cultures were negative, 1–bacterial 1–bacterial sinusitis, 5-Invasive aspergillosis; 6-treated as Invasive fungal infections due to Zygomycetes as the imaging diagnostics and histopathological features favored that diagnosis. The majority of the patients (80%) were diabetic, and the two from the burn unit were under long-term treatment for chronic wound infections. Multiple diagnostic modalities must be used in view of the aggressive nature of the disease, but microbiological diagnosis remains the Gold Standard.</p>

Long-Term Treatment and Survival in Three Apparently Immunocompetent Dogs with Disseminated Fungal Infection Caused by Phialosimplex caninus

2018 ◽  
Vol 54 (6) ◽  
Author(s):  
Marlene Townsell ◽  
Alfred M. Legendre ◽  
David A. Bemis ◽  
Ellen Behrend ◽  
Stephanie Phillips
Keyword(s):  
Quality Of Life ◽  
Clinical Course ◽  
Fungal Infections ◽  
Case Reports ◽  
Term Treatment ◽  
Long Term Outcomes ◽  
Disease Remission ◽  
Long Term Treatment

ABSTRACT Disseminated fungal infections cause morbidity and mortality in dogs. The prognosis varies depending on the infecting agent. Phialosimplex caninus is a recently recognized type of hyalohyphomyces. Knowledge regarding the clinical course of P caninus infection in dogs is limited to two previous case reports. The clinical features, diagnostic findings, responses to medical therapy, and long-term outcomes of three dogs with disseminated P caninus are presented in this study. All dogs had improved quality of life once itraconazole administration, with or without terbinafine, was instituted. Long-term disease remission was maintained even after discontinuation of antifungal therapy in a single dog.

scholarly journals Prevalence and clinical features of COVID-19 in a large cohort of 199 patients with sarcoidosis

2020 ◽  
Author(s):  
Anne-Claire Desbois ◽  
Cindy Marques ◽  
Leila Lefèvre ◽  
Serge Barmo ◽  
Camille Lorenzo ◽  
...  
Keyword(s):  
General Population ◽  
Clinical Features ◽  
Cardiac Involvement ◽  
Term Treatment ◽  
Hospitalized Patients ◽  
Large Cohort ◽  
University Hospital ◽  
Long Term Treatment ◽  
Higher Doses

Abstract Objective: To investigate the prevalence, clinical features and outcomes of coronavirus disease 2019 (COVID-19) among sarcoidosis patients. Methods: We retrospectively collected features of COVID-19 in a cohort of patients with sarcoidosis followed in a single tertiary university hospital. Results: Among 199 sarcoidosis patients [mean age 58.8 (±14) years, 86 (43.2%) men], 26 (13%) were diagnosed with COVID-19 [definite (n=7), probable (n=12) and possible (n=7)]. Twenty-four out of 26 patients (92%) had at least one comorbidity, and 11/26 (42%) had two or more comorbidities. Demographic and clinical features of COVID-19 positive patients were similar to those of COVID-19 negative patients. The administration of hydroxychloroquine or immunosuppressant was not associated with the occurrence or the severity of COVID-19. Four out of 26 (15.4%) COVID-19 positive patients required admission to hospital and two of them died. Hospitalized patients [mean age of 61 (±11.5) years] were receiving higher doses of long term treatment with corticosteroids than non-hospitalized patients; 4/4 had pulmonary and 2/4 cardiac involvement of sarcoidosis, and all one or more comorbidity. Conclusion: The prevalence of COVID-19 in sarcoidosis is slightly higher to that of the general population. Almost half of the COVID-19 positive patients have two or more comorbidities and about 15% present a severe course.

scholarly journals A Glucan Synthase FKS1 Homolog inCryptococcus neoformans Is Single Copy and Encodes an Essential Function

1999 ◽  
Vol 181 (2) ◽  
pp. 444-453 ◽  
Author(s):  
John R. Thompson ◽  
Cameron M. Douglas ◽  
Weili Li ◽  
Chong K. Jue ◽  
Barnali Pramanik ◽  
...  
Keyword(s):  
Cell Wall ◽  
Mammalian Cells ◽  
Fungal Infections ◽  
Single Copy ◽  
Fungal Species ◽  
Term Treatment ◽  
Fungal Cell ◽  
Glucan Synthase ◽  
Long Term Treatment

ABSTRACT Cryptococcal meningitis is a fungal infection, caused byCryptococcus neoformans, which is prevalent in immunocompromised patient populations. Treatment failures of this disease are emerging in the clinic, usually associated with long-term treatment with existing antifungal agents. The fungal cell wall is an attractive target for drug therapy because the syntheses of cell wall glucan and chitin are processes that are absent in mammalian cells. Echinocandins comprise a class of lipopeptide compounds known to inhibit 1,3-β-glucan synthesis, and at least two compounds belonging to this class are currently in clinical trials as therapy for life-threatening fungal infections. Studies ofSaccharomyces cerevisiae and Candida albicansmutants identify the membrane-spanning subunit of glucan synthase, encoded by the FKS genes, as the molecular target of echinocandins. In vitro, the echinocandins show potent antifungal activity against Candida and Aspergillusspecies but are much less potent against C. neoformans. In order to examine why C. neoformans cells are less susceptible to echinocandin treatment, we have cloned a homolog of S. cerevisiae FKS1 from C. neoformans. We have developed a generalized method to evaluate the essentiality of genes inCryptococcus and applied it to the FKS1 gene. The method relies on homologous integrative transformation with a plasmid that can integrate in two orientations, only one of which will disrupt the target gene function. The results of this analysis suggest that the C. neoformans FKS1 gene is essential for viability. The C. neoformans FKS1 sequence is closely related to the FKS1 sequences from other fungal species and appears to be single copy in C. neoformans. Furthermore, amino acid residues known to be critical for echinocandin susceptibility in Saccharomyces are conserved in theC. neoformans FKS1 sequence.

scholarly journals Long-Term Safety of Anti-TNF Adalimumab in HBc Antibody-Positive Psoriatic Arthritis Patients: A Retrospective Case Series of 8 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
R. Laurenti ◽  
F. Giovannangeli ◽  
E. Gubinelli ◽  
M. T. Viviano ◽  
A. Errico ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Fungal Infections ◽  
Case Series ◽  
Liver Function Tests ◽  
Immunosuppressive Drugs ◽  
Term Treatment ◽  
Retrospective Case ◽  
Long Term Treatment ◽  
History Of

Immunosuppressive drugs commonly used in the treatment of psoriatic arthritis make patients more susceptible to viral, bacterial, and fungal infections because of their mechanism of action. They not only increase the risk of new infections but also act altering the natural course of preexisting infections. While numerous data regarding the reactivation of tuberculosis infection are available in the literature, poor information about the risk of reactivation or exacerbation of hepatitis viruses B and C infections during treatment with biologics has been reported. Furthermore, reported series with biological therapy included short periods of followup, and therefore, they are not adequate to verify the risk of reactivation in the long-term treatment. Our study evaluated patients with a history of hepatitis B and psoriatic arthritis treated with adalimumab and monitored up to six years. During the observation period, treatment was effective and well tolerated in all patients, and liver function tests and viral load levels remained unchanged.

scholarly journals STUDY OF ADHERENCE TO DRUG THERAPY OF PATIENTS WITH CARDIOVASCULAR DISEASES IN DISTRICT HOSPITAL OF SMALL TOWN IN SARATOV REGION AND IN CARDIOLOGY DEPARTMENT OF UNIVERSITY CLINIC IN SARATOV

2018 ◽  
Vol 14 (3) ◽  
pp. 337-343
Author(s):  
Yu. V. Bulaeva ◽  
E. A. Naumova ◽  
O. N. Semenova
Keyword(s):  
Drug Therapy ◽  
Cardiovascular Diseases ◽  
Small Town ◽  
District Hospital ◽  
University Hospital ◽  
Saratov Region ◽  
Long Term Treatment ◽  
The University ◽  
Attending Physician

Aim. To study the relation of various factors with adherence to long-term drug therapy in patients with cardiovascular diseases in district hospital of small town in Saratov Region and patients from clinical hospital of Saratov medical university.Material and methods. The hospitalized patients with cardiovascular diseases were included into the prospective study of long-term adherence to treatment. Questioning of patients with the determination of the attitude of respondents to their health, the desire to receive information about the disease, the level of awareness of the therapy, the degree of participation in the treatment process, the nature of the relationship with the attending physician was performed. A year after discharge, control calls were made to patients to learn whether the patient was continuing treatment prescribed a year ago in the hospital. The data on patient adherence in both hospitals were analyzed.Results. 108 patients in the district hospital (58% of selected patients) and 70 in the Saratov hospital (33% of selected patients) responded to all questions in the questionnaire during hospitalization. Successful reaching by phone 12 months after discharge from the hospital took place in 74 patients of the small town and 40 patients of the regional center. The continuation of treatment was found in 28 (38%) and 24 (50%) patients, respectively. Patients who continued treatment significantly differed from those, who stopped therapy, by presence of myocardial infarction in anamnesis [14 (78%) patients in the university hospital and 6 (60%) patients in the district hospital; p<0.01] as well as acute cerebrovascular accident [6 (78%) patients in the university hospital and 4 (75%) patients in the district hospital; p<0.05] and stable angina class I-III [22 (61%) patients in Saratov and 28 (44%) patients in the small town; p<0.01]. Adherence to recommendations after 12 months was found in patients who considered that doctor or relatives were responsible for their health (6 patients in Saratov and 12 – in the small town; p<0.05) and believed that attending physician determines the portion of information provided to the patient [20 (60%) patients of the district hospital and 11 (63%) patients in the university clinic; p<0.05 for university clinic].Conclusion. The adherence to long-term treatment after discharge remained low and did not exceed 50% among patients in both groups. The paternalistic model continued to dominate in the doctor-patient interconnection system.

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