scholarly journals 732. Evaulation of Micafungin Treatment at Pediatric Patients: A cross-sectional Study from Tertiary Pediatric Centre

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S416-S417
Author(s):  
Kamile Arıkan ◽  
Nuri Bayram ◽  
İlker devrim ◽  
Ayküke Akaslan-Kara

Abstract Background Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia. Methods Children who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included. Results In this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage. Characteristics of patients who received micafungin.and cultured Candida spp Antifungal resistance patterns of Candida spp. Laboratory change before and after micafungin treatment Conclusion Increase in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasis Disclosures All Authors: No reported disclosures

2020 ◽  
Vol 30 (11) ◽  
pp. 4505-4509
Author(s):  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Krzysztof Czajkowski ◽  
Maciej Walędziak

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.


Author(s):  
Harold Rumopa ◽  
Freddy W. Wagey ◽  
Eddy Suparman

  Objective: Determine differences plasma levels MDA in preeclampsiabefore and 2 hours after delivery.   Methods: This was an analytic cross-sectional study. Subjectconsists of 23 pregnancies with preeclampsia, where 23 bloodsamples taken before delivery and 23 were taken 2 hours afterdelivery. This study was conducted from August 2016 untilDecember 2016 at Department of Obstetrics and GynecologyFaculty of Medicine Universitas Sam Ratulangi / Prof. Dr. R. D.Kandou Hospital Manado and satellite hospital. Samples weretaken from plasma and analysed using HPLC method at Prodiaclinical laboratory.   Results: In patients with severe preeclampsia before deliverywe found average value (1.4796  0.40819 nmol/ml), minimumvalue (1.03 nmol/ml) and maximal value (2.77 nmol/ml)and 2 hours after delivery with average value (1.2470 0.34324 nmol/ml), minimum value (0.91 nmol/ml), and maximumvalue (2.47 nmol/ml). by using Wilcoxon test, we foundthere were significant differences in plasma levels of MDA (p =0.000).   Conclusion: This significant difference suggests that decreasedplasma levels of MDA 2 hours after delivery and gives the sense thatthere is a relationship between oxidative stress of cells with severepreeclampsia before and shortly after delivery, that MDA is an indicatorof oxidative stress.   Keywords: malondialdehyde, oxidative stress, peroxidation lipid,preeclampsia


2021 ◽  
pp. tobaccocontrol-2020-056160
Author(s):  
Yanhui Liao ◽  
Jinsong Tang ◽  
Ann McNeill ◽  
Brian C Kelly ◽  
Joanna E Cohen

BackgroundSharing and gifting cigarettes are common in China. These social practices promote cigarette consumption, and consequently may reduce quit rates in China. This study investigated sharing and gifting cigarettes, and the relationship of observing pictorial health warnings to attitudes towards sharing and gifting cigarettes in China.MethodsWe conducted an online nationwide cross-sectional study of 9818 adults in China. Experiences of sharing and gifting cigarettes, and attitudes towards sharing and gifting cigarettes before and after viewing text and pictorial health warnings on the packages were assessed, and compared between smokers and non-smokers.ResultsMost current smokers reported experiences of sharing (97%) and gifting (around 90%) cigarettes. Less than half of non-smokers reported sharing cigarettes and receiving gifted cigarettes, but over half (61.4%) gave cigarettes as a gift to others. More than half of non-smokers but less than 10% of smokers disagreed with sharing and gifting cigarettes. After observing both text and pictorial health warnings on the packages, disagreement with sharing and gifting cigarettes increased by more than 10 percentage points among both smokers and non-smokers.ConclusionHaving pictorial health warnings on cigarette packages may reduce sharing and gifting cigarettes in China.


2019 ◽  
Vol 8 (9) ◽  
pp. 1290 ◽  
Author(s):  
Leila Jahangard ◽  
Thorsten Mikoteit ◽  
Saman Bahiraei ◽  
Mehrangiz Zamanibonab ◽  
Mohammad Haghighi ◽  
...  

Background: Within three to six months after delivery, 13%–19% of women suffer from post-partum depression (PPD), understood as a dysfunctional adaptation to the postpartum condition and motherhood. In the present cross-sectional study, we compared the hair steroid levels of women 12 weeks before and after delivery and with or without PPD. Method: The present study was a cross-sectional study conducted twelve weeks after delivery. At that time, 48 women (mean age: 25.9 years) with PPD and 50 healthy controls (mean age: 25.2 years) completed questionnaires on depressive symptoms. Further, at the same time point, 6 cm lengths of hair strands were taken, providing samples of hair steroids 12 weeks before and 12 weeks after delivery in order to analyze hair steroids (cortisol, cortisone, progesterone, testosterone, and dehydroepiandrosterone (DHEA)). Results: Compared to those of women without PPD, hair steroid levels (cortisol, cortisone, progesterone) were significantly lower in women with PPD both before and after delivery. Lower prenatal cortisone and progesterone levels predicted higher depression scores 12 weeks after delivery. Lower prenatal levels of cortisol and progesterone and higher levels of DHEA, and postnatal lower levels of cortisol, cortisone, and progesterone, along with higher levels of DHEA predicted PPD-status with an accuracy of 98%. Conclusions: PPD is associated with blunted hair cortisol, cortisone, and progesterone secretions both pre- and postpartum. Such blunted steroid levels appear to reflect a stress responsivity that is less adaptive to acute and transient stressors. It follows that prenatally assessed low hair cortisol and progesterone levels, along with high DHEA levels, are reliable biomarkers of post-partum depression 12 weeks after delivery.


2018 ◽  
Vol 31 (5) ◽  
pp. 346-352 ◽  
Author(s):  
Albert R Dreijer ◽  
Jeroen Diepstraten ◽  
Vera E Bukkems ◽  
Peter G M Mol ◽  
Frank W G Leebeek ◽  
...  

Abstract Objective To assess the proportion of all medication error reports in hospitals and primary care that involved an anticoagulant. Secondary objectives were the anticoagulant involved, phase of the medication process in which the error occurred, causes and consequences of 1000 anticoagulant medication errors. Additional secondary objectives were the total number of anticoagulant medication error reports per month, divided by the total number of medication error reports per month and the proportion of causes of 1000 anticoagulant medication errors (comparing the pre- and post-guideline phase). Design A cross-sectional study. Setting Medication errors reported to the Central Medication incidents Registration reporting system. Participants Between December 2012 and May 2015, 42 962 medication errors were reported to the CMR. Intervention N/A. Main outcome measure Proportion of all medication error reports that involved an anticoagulant. Phase of the medication process in which the error occurred, causes and consequences of 1000 anticoagulant medication errors. The total number of anticoagulant medication error reports per month, divided by the total number of medication error reports per month (comparing the pre- and post-guideline phase) and the total number of causes of 1000 anticoagulant medication errors before and after introduction of the LSKA 2.0 guideline. Results Anticoagulants were involved in 8.3% of the medication error reports. A random selection of 1000 anticoagulant medication error reports revealed that low-molecular weight heparins were most often involved in the error reports (56.2%). Most reports concerned the prescribing phase of the medication process (37.1%) and human factors were the leading cause of medication errors mentioned in the reports (53.4%). Publication of the national guideline on integrated antithrombotic care had no effect on the proportion of anticoagulant medication error reports. Human factors were the leading cause of medication errors before and after publication of the guideline. Conclusions Anticoagulant medication errors occurred in 8.3% of all medication errors. Most error reports concerned the prescribing phase of the medication process. Leading cause was human factors. The publication of the guideline had no effect on the proportion of anticoagulant medication errors.


Author(s):  
Lingtao Wu ◽  
Dominique Lord ◽  
Srinivas Reddy Geedipally

Horizontal curves have been identified as experiencing more crashes than tangent sections on roadways, especially on rural two-lane highways. The first edition of the Highway Safety Manual provides crash modification functions (CM functions) for curves on rural two-lane highways. The CM functions proposed in the manual may suffer from both outdated data and analysis technique. Before-and-after studies are usually the preferred method for estimating the safety effects of treatments. Unfortunately, this method is not feasible for curves. Previous studies have frequently used regression models for developing CM functions for horizontal curves. As recently documented in the literature, some potential problems exist with using regression models to develop crash modification factors. This research utilized a cross-sectional study to develop curvature CM functions. Curves located on Texas rural two-lane undivided highways were divided into a number of bins based on the curve radius. Safety was predicted with the assumption that these curves had been tangents. The observed number of crashes that occurred on the curves was compared with the dummy tangents and for different bins. The results showed that the horizontal curve radius has a significant role in the risk of a crash. From these results, a new CM function was developed. The prediction performance of the Highway Safety Manual CM function was compared with the new CM function in this study and another function that was recently proposed in the literature. It was found that the new CM function documented in this study outperformed both.


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