scholarly journals A Case of Linezolid Toxicity Presenting as a Sepsis Mimic

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Rashmi Mishra ◽  
Harish Patel ◽  
Bindu Goel ◽  
Trupti Vakde
Keyword(s):  
Lactic Acidosis ◽  
Antimicrobial Agents ◽  
Clinical Status ◽  
Polymyxin B ◽  
Gradual Improvement ◽  
Laboratory Parameters ◽  
Coagulation Profile ◽  
Loss Of Appetite ◽  
Possible Cause

Linezolid is an efficacious and well tolerated antimicrobial but can have serious adverse effects including myelo-suppression, serotonin syndrome, neuropathy, hypoglycemia, liver dysfunction, and lactic acidosis. The side effects are generally duration dependent; linezolid use is not recommended for more than 28 days. Case. A 59-year-old female presented with malaise, loss of appetite, and altered mentation. She had multiple medical comorbidities and required long-term anticoagulation with warfarin for venous thromboembolism. She had multiple medication allergies. Prior to admission, she was on linezolid for cellulitis of foot due to Methicillin-resistant Staphylococcus aureus (MRSA). On physical exam, she was drowsy and required endotracheal intubation for airway protection. Initial laboratory parameters showed lactic acidosis, thrombocytopenia, supra-therapeutic coagulation profile, low blood glucose, and transaminitis. Her altered mentation was due to hypoglycemia. The interaction with warfarin led to altered coagulation profile. She developed shock and vasopressors were initiated. Given her presentation, she was managed as severe sepsis. There were no active infectious foci attributing to decline of her clinical status. Linezolid was discontinued and she was managed with intravenous polymyxin B, aztreonam, and vancomycin. Her hemodynamic status improved within one day. She was extubated on Day 5 of her presentation. Her laboratory parameters showed gradual improvement over 12 days after discontinuation of linezolid. Retrospective evaluation revealed linezolid toxicity as possible cause of presentation. Linezolid toxicity can present as sepsis mimic and should be considered as a differential diagnosis while managing sepsis with other antimicrobial agents.

scholarly journals Facile Use of ZnO Nanopowders to Protect Old Manual Paper Documents

Materials ◽  
2020 ◽  
Vol 13 (23) ◽  
pp. 5452
Author(s):  
Ludmila Motelica ◽  
Aurelian Popescu ◽  
Anca-Gabriela Răzvan ◽  
Ovidiu Oprea ◽  
Roxana-Doina Truşcă ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antimicrobial Agents ◽  
Storage Conditions ◽  
Human Pathogens ◽  
Accessible Method

One of the main problems faced by libraries, archives and collectors is the mold degradation of the paper-based documents, books, artworks etc. Microfungi (molds) emerge in regular storage conditions of such items (humidity, usually over 50%, and temperatures under 21 °C). If the removal of the visible mycelium is relatively easy, there is always the problem of the subsequent appearance of mold as the spores remain trapped in the cellulosic, fibrillary texture, which acts as a net. Moreover, due to improper hand hygiene bacteria contamination, old books could represent a source of biohazard, being colonized with human pathogens. An easy and accessible method of decontamination, which could offer long term protection is therefore needed. Here, we present a facile use of the ZnO nanopowders as antimicrobial agents, suitable for cellulose-based products, conferring an extended antibacterial and anti-microfungal effect. The proposed method does not adversely impact on the quality of the cellulose documents and could be efficiently used for biodegradation protection.

scholarly journals COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Myriam Calle Rubio ◽  
◽  
Juan Luis Rodriguez Hermosa ◽  
Juan P. de Torres ◽  
José María Marín ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Clinical Status ◽  
Airflow Limitation ◽  
Psychological Status ◽  
Prognostic Information ◽  
Clinical Control ◽  
All Cause Mortality ◽  
Long Term Follow Up

Abstract Background Control in COPD is a dynamic concept that can reflect changes in patients’ clinical status that may have prognostic implications, but there is no information about changes in control status and its long-term consequences. Methods We classified 798 patients with COPD from the CHAIN cohort as controlled/uncontrolled at baseline and over 5 years. We describe the changes in control status in patients over long-term follow-up and analyze the factors that were associated with longitudinal control patterns and related survival using the Cox hazard analysis. Results 134 patients (16.8%) were considered persistently controlled, 248 (31.1%) persistently uncontrolled and 416 (52.1%) changed control status during follow-up. The variables significantly associated with persistent control were not requiring triple therapy at baseline and having a better quality of life. Annual changes in outcomes (health status, psychological status, airflow limitation) did not differ in patients, regardless of clinical control status. All-cause mortality was lower in persistently controlled patients (5.5% versus 19.1%, p = 0.001). The hazard ratio for all-cause mortality was 2.274 (95% CI 1.394–3.708; p = 0.001). Regarding pharmacological treatment, triple inhaled therapy was the most common option in persistently uncontrolled patients (72.2%). Patients with persistent disease control more frequently used bronchodilators for monotherapy (53%) at recruitment, although by the end of the follow-up period, 20% had scaled up their treatment, with triple therapy being the most frequent therapeutic pattern. Conclusions The evaluation of COPD control status provides relevant prognostic information on survival. There is important variability in clinical control status and only a small proportion of the patients had persistently good control. Changes in the treatment pattern may be relevant in the longitudinal pattern of COPD clinical control. Further studies in other populations should validate our results. Trial registration: Clinical Trials.gov: identifier NCT01122758.

scholarly journals A Rare Case of Persistent Lactic Acidosis in the ICU: Glycogenic Hepatopathy and Mauriac Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kirsten S. Deemer ◽  
George F. Alvarez
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Rare Case ◽  
Hemoglobin A1c ◽  
Blood Glucose Control ◽  
Primary Treatment ◽  
High Dose ◽  
Single Feature ◽  
Mauriac Syndrome

Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome. This case demonstratesexacerbationof lactic acidosis in a patient with glycogenic hepatopathy treated for diabetic ketoacidosis with high dose insulin and dextrose.

scholarly journals Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
George G. Zhanel ◽  
Michael A. Zhanel ◽  
James A. Karlowsky
Keyword(s):  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Second Line ◽  
Pharmacological Interactions ◽  
Term Administration ◽  
Excellent Safety Profile ◽  
Tract Infections ◽  
Systemic Infections

Fosfomycin is a bactericidal agent that inhibits cell wall synthesis using a mechanism of action distinct from β-lactams or other antimicrobial agents. It is a broad-spectrum agent that is frequently active against antimicrobial-resistant bacterial pathogens including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Enterobacteriaceae, and some isolates of MDR Pseudomonas aeruginosa. Intravenous fosfomycin has been prescribed for a wide variety of infections in many countries for >40 years. It is most frequently used in combination with other antimicrobial agents (e.g., β-lactams, carbapenems, and aminoglycosides) and has an excellent safety profile, including in neonates and children, even with long-term administration (weeks). Fosfomycin achieves extensive tissue distribution including difficult to reach compartments such as aqueous humor, vitreous humor, abscess fluid, and CSF. Available data, to date, suggest no clinically relevant pharmacological interactions between fosfomycin and other agents, including drugs, stimulants, or food. Intravenous fosfomycin’s role in therapy in Canada is likely as an agent used alone or in combination for complicated urinary tract infections in hospitalized patients as well as hospitalized patients with MDR infections who have not responded to first-, and potentially, second-line antimicrobials or in patients who cannot tolerate (due to adverse effects) first- and second-line antimicrobials.

Synergism of the Antimicrobial Agents Miconazole, Bacitracin and Polymyxin B

Chemotherapy ◽  
1983 ◽  
Vol 29 (6) ◽  
pp. 419-427 ◽  
Author(s):  
F. Cornelissen ◽  
H. Van den Bossche
Keyword(s):  
Antimicrobial Agents ◽  
Polymyxin B

Significance of Extreme Temperament in Infancy for Clinical Status in Preschool Years

1989 ◽  
Vol 154 (4) ◽  
pp. 544-551 ◽  
Author(s):  
Michel Maziade ◽  
Jacques Thivierge ◽  
Robert Côté ◽  
Pierrette Boutin ◽  
Hugues Bernier
Keyword(s):  
Longitudinal Study ◽  
Birth Cohort ◽  
Clinical Status ◽  
Environmental Parameters ◽  
Positive Change ◽  
Stability And Change ◽  
Cognitive Characteristics ◽  
One Year ◽  
Long Term Prediction

Few, if any, of children's behavioural or cognitive characteristics assessed in the first years of life demonstrate stability until later childhood; early characteristics have so far failed to show an association with future psychopathology. This longitudinal study, from 4–8 months to 4.7 years old, focused on stability and change of extreme temperamental traits in groups of infants subselected from a large birth cohort. Persistent extreme temperament at four and eight months old did not increase stability of temperament to four years of age, relative to other children in the whole population. Sizeable change occurred, and the environmental parameters associated with negative temperamental change did not seem to be the same as those related to positive change. Boys with extreme scores were more stable, while girls appeared more prone to positive change. It is hypothesised that the direction of temperamental change in the first years could be more meaningful for long-term prediction of disorders than any one assessment of temperament taken at any one year.

scholarly journals Effective management of patients with electrical storm – networking and VT unit as essential parts for a successful outcome

2021 ◽  
Vol 30 (4) ◽  
pp. 583-588
Author(s):  
Elena Ene ◽  
Karin Nentwich ◽  
Phillipp Halbfaß ◽  
Kai Sonne ◽  
Arthur Berkovitz ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Systolic Function ◽  
Clinical Status ◽  
Successful Outcome ◽  
Electrical Storm ◽  
Effective Management ◽  
General Hospitals ◽  
Long Term Prognosis ◽  
Ventricular Tachycardias

Ventricular tachycardias (VT) represents worldwide one of the leading causes of sudden cardiac death. The increasing number of implanted ICDs have reduced signifi cantly the number of sudden cardiac deaths SCDs); however recurrent VTs episodes might lead to a rapid deterioration of patient’s clinical status and systolic function. An early intervention after a successful patient stabilization in a dedicated VT unit is mandatory for the mid- and long term prognosis of the patient. Nevertheless, a tight collaboration between general hospitals and highly specialized centers in treatment of patients with electrical storm is essential for an effi cient and successful outcome.

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