scholarly journals Successful treatment of a chemo-resistant gestational trophoblastic neoplasia using GEMOX. Clinical case

2020 ◽  
Vol 25 (1) ◽  
pp. 42-46
Author(s):  
A. A. Meshcheryakov ◽  
T. E. Tikhomirova ◽  
L. A. Meshcheryakova
Keyword(s):  
Successful Treatment ◽  
Clinical Case ◽  
Treatment Approach ◽  
Multidrug Resistant ◽  
Gestational Trophoblastic Neoplasia ◽  
Standard Chemotherapy ◽  
Adequate Treatment ◽  
Rare Malignancy ◽  
Almost All

Gestational trophoblastic neoplasia is a rare malignancy. The main treatment approach is chemotherapy. Almost all patients can be cured if the diagnosis is established timely and adequate treatment is provided in specialized centers. In a small part of patients, the tumor progresses despite the use of all standard chemotherapy regimens. Treatment of such patients is difficult for all oncologists, including ones working in specialized centers for the treatment of gestational trophoblastic neoplasia. This article presents a clinical case of the successful treatment of a patient with multidrug resistant gestational trophoblastic neoplasia using GEMOX regimen.

Clinical case of successful treatment of compartment syndrome, complicated by fat embolism syndrome

2018 ◽  
Vol 16 (7(part 1)) ◽  
pp. 81-84
Author(s):  
I. O. Pankov ◽  
◽  
M. M. Gabdullin ◽  
S. D. Sirazitdinov ◽  
◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Successful Treatment ◽  
Clinical Case ◽  
Fat Embolism ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome

scholarly journals Susceptibility of the Candida haemulonii Complex to Echinocandins: Focus on Both Planktonic and Biofilm Life Styles and a Literature Review

2020 ◽  
Vol 6 (4) ◽  
pp. 201
Author(s):  
Lívia S. Ramos ◽  
Laura N. Silva ◽  
Marta H. Branquinha ◽  
André L. S. Santos
Keyword(s):  
Literature Review ◽  
Therapeutic Potential ◽  
Multidrug Resistant ◽  
Antifungal Drugs ◽  
Clinical Isolates ◽  
Published Data ◽  
Life Styles ◽  
Fungal Isolates ◽  
Candida Haemulonii ◽  
Almost All

Candida haemulonii complex (C. haemulonii, C. duobushaemulonii and C. haemulonii var. vulnera) is well-known for its resistance profile to different available antifungal drugs. Although echinocandins are the most effective class of antifungal compounds against the C. haemulonii species complex, clinical isolates resistant to caspofungin, micafungin and anidulafungin have already been reported. In this work, we present a literature review regarding the effects of echinocandins on this emergent fungal complex. Published data has revealed that micafungin and anidulafungin were more effective than caspofungin against the species forming the C. haemulonii complex. Subsequently, we investigated the susceptibilities of both planktonic and biofilm forms of 12 Brazilian clinical isolates of the C. haemulonii complex towards caspofungin and micafungin (anidulafungin was unavailable). The planktonic cells of all the fungal isolates were susceptible to both of the test echinocandins. Interestingly, echinocandins caused a significant reduction in the biofilm metabolic activity (viability) of almost all fungal isolates (11/12, 91.7%). Generally, the biofilm biomasses were also affected (reduction range 20–60%) upon exposure to caspofungin and micafungin. This is the first report of the anti-biofilm action of echinocandins against the multidrug-resistant opportunistic pathogens comprising the C. haemulonii complex, and unveils the therapeutic potential of these compounds.

scholarly journals NEW INSIGHT ON EPIDEMIOLOGY AND MANAGEMENT OF BACTERIAL BLOODSTREAM INFECTION IN PATIENTS WITH HEMATOLOGICAL MALIGNACIES

2015 ◽  
Vol 7 ◽  
pp. e2015044 ◽  
Author(s):  
Sara Lo Menzo ◽  
Giulia La Martire ◽  
Giancarlo Ceccarelli ◽  
Mario Venditti
Keyword(s):  
Febrile Neutropenia ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Empirical Treatment ◽  
Rational Approach ◽  
Attributable Mortality ◽  
Low Grade ◽  
Gram Positive ◽  
Adequate Treatment ◽  
Gram Negative

Bloodstream infections (BSI) are an important cause of morbidity and mortality in onco-hematologic patients. The Gram-negative etiology was the main responsible of the febrile neutropenia in the sixties and its impact declined due to the use of fluoroquinolone prophylaxis; this situation was followed by the gradual emergence of Gram-positive bacteria also following of the increased use of intravascular devices and the introduction of new chemotherapeutic strategies. In the last decade the Gram-negative etiology is raising again because of the emergence of resistant strains that make questionable the usefulness of currentstrategies for prophylaxis and empirical treatment. Gram-negative BSI attributable mortality is relevant and the appropriate empirical treatment significantly improves the prognosis; on the other hand the delayed adequate treatment of Gram-positive BSI does not seem to have an high impact on survival. The clinician has to be aware of the epidemiology of his institution and of colonizations of his patients in order to choose the most appropriate empiric therapy. Ina setting of high endemicity of multidrug-resistant infections, even the choice of a targeted therapy can be a challenge, often requiring strategies based on off-label prescriptions and low grade evidences.In this review we summarize the current evidences for the best targeted therapies for difficult to treat bacteria BSIs and future perspectives in this topic. We also provide a flow chart for a rational approach to the empirical treatment of febrile neutropenia in a multidrug resistant high prevalence setting.

scholarly journals Management of Health-Care Associated Pneumonia (HCAP)

2013 ◽  
pp. 87-90
Author(s):  
Alessia Rosato ◽  
Claudio Santini
Keyword(s):  
Health Care ◽  
Treatment Approach ◽  
Multidrug Resistant ◽  
Outpatient Setting ◽  
Community Acquired Pneumonia ◽  
Traditional Classification ◽  
Hospital Acquired Pneumonia ◽  
Health Care Associated Pneumonia ◽  
Hospital Acquired

Introduction The traditional classification of Pneumonia as either community acquired (CAP) or hospital acquired (HAP) reflects deep differences in the etiology, pathogenesis, approach and prognosis between the two entities. Health-Care Associated Pneumonia (HCAP) develops in a heterogeneous group of patients receiving invasive medical care or surgical procedures in an outpatient setting. For epidemiology and outcomes, HCAP closely resembles HAP and possibly requires an analogous therapeutic regimen effective against multidrug-resistant pathogens. Materials and methods We reviewed the pertinent literature and the guidelines for the diagnosis and management of HCAP to analyze the evidence for the recommended approach. Results Growing evidence seems to confirm the differences in epidemiology and outcome between HCAP and CAP but fails to confirm any real advantage in pursuing an aggressive treatment for all HCAP and CAP patients. Discussion Further investigations are needed to establish the optimal treatment approach according to the different categories of patients and the different illness severities. Keywords Health Care Associated Pneumonia (HCAP); Community Acquired Pneumonia (CAP); Hospital Acquired Pneumonia (HAP); Multidrug-resistant (MDR) Pathogens

PHYTOCHEMICAL INVESTIGATION AND ANTIMICROBIAL PROPERTIES OF DIOSCOREA BULBIFERA TUBER

2017 ◽  
Vol 10 (12) ◽  
pp. 317
Author(s):  
Dahiya P
Keyword(s):  
Antimicrobial Properties ◽  
Inhibition Zone ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Phytochemical Analysis ◽  
Phytochemical Investigation ◽  
Dioscorea Bulbifera ◽  
Acinetobacter Sp ◽  
Almost All

  Objective: The inhibitory properties of successive extracts from Dioscorea bulbifera (Dioscoreaceae) tubers have been evaluated for the presence of phytochemical constituents and antimicrobial efficacy against multidrug-resistant (MDR) clinical isolates was evaluated.Methods: The tuber of D. bulbifera was oven dried and extracted successively with n-hexane, chloroform, methanol, ethanol, and water. The antimicrobial potential of successive extracts against MDR isolates was studied by agar well-diffusion method. Qualitative phytochemical analysis was performed.Results: Qualitative phytochemical analysis demonstrated the presence of steroids, flavonoids, cardiac glycosides, saponins, and reducing sugars in almost all the extracts tested. Anthraquinones, phlobatanins, and tannins were not reported in any extracts tested. The in vitro antimicrobial activity of various solvents and water extracts of D. bulbifera was further investigated against ten MDR bacteria and three fungi, respectively. Aqueous and chloroform extracts were found to be more potent being capable of exerting significant inhibitory activities against the majority of the isolates such as Escherichia coli, Acinetobacter sp., Salmonella paratyphi, Klebsiella pneumoniae, and Candida albicans. The highest inhibitory activity was observed for K. pneumoniae with wide inhibition zone diameters (17 ± 0.15 mm), followed by E. coli 1(13 ± 0.11) mm, and Acinetobacter sp. (11 ± 0.12).Conclusion: Based on the present study, the extracts of D. bulbifera tubers have shown excellent activity against MDR microbial cultures tested. Further study is recommended for clinical evaluation, of the efficacy of crude extract in herbal medicine that can serve as a base for the development of novel potent drugs and phytomedicines.

scholarly journals Application of the damage control principles and the use of a local negative pressure system for the prevention of infectious complications in a patient with traumatic separation of the upper limb and massive damage to soft tissues

2020 ◽  
Vol 6 (4) ◽  
pp. 22-25
Author(s):  
I. M. Batyrshin ◽  
M. I. Kizyavka ◽  
D. S. Sklizkov ◽  
Yu. S. Ostroumova ◽  
E. P. Mikhelson ◽  
...  
Keyword(s):  
Upper Limb ◽  
Successful Treatment ◽  
Negative Pressure ◽  
Clinical Case ◽  
Soft Tissues ◽  
Damage Control ◽  
Infectious Complications ◽  
Pressure System

The article presents a clinical case of the successful treatment of a patient with traumatic separation of the upper limb and massive damage to the soft tissues of the upper shoulder and chest. The effectiveness of applying the damage control principles and the method of local negative pressure for the prevention of local and systemic infectious complications is emphasized.

scholarly journals Boromycin has Rapid-Onset Antibiotic Activity Against Asexual and Sexual Blood Stages of Plasmodium falciparum

2022 ◽  
Vol 11 ◽  
Author(s):  
Laís Pessanha de Carvalho ◽  
Sara Groeger-Otero ◽  
Andrea Kreidenweiss ◽  
Peter G. Kremsner ◽  
Benjamin Mordmüller ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Plasmodium Knowlesi ◽  
Rapid Onset ◽  
Multidrug Resistant ◽  
Antiplasmodial Activity ◽  
Onset Of Action ◽  
Streptomyces Antibioticus ◽  
Life Cycle Stages ◽  
Almost All

Boromycin is a boron-containing macrolide antibiotic produced by Streptomyces antibioticus with potent activity against certain viruses, Gram-positive bacteria and protozoan parasites. Most antimalarial antibiotics affect plasmodial organelles of prokaryotic origin and have a relatively slow onset of action. They are used for malaria prophylaxis and for the treatment of malaria when combined to a fast-acting drug. Despite the success of artemisinin combination therapies, the current gold standard treatment, new alternatives are constantly needed due to the ability of malaria parasites to become resistant to almost all drugs that are in heavy clinical use. In vitro antiplasmodial activity screens of tetracyclines (omadacycline, sarecycline, methacycline, demeclocycline, lymecycline, meclocycline), macrolides (oleandomycin, boromycin, josamycin, troleandomycin), and control drugs (chloroquine, clindamycin, doxycycline, minocycline, eravacycline) revealed boromycin as highly potent against Plasmodium falciparum and the zoonotic Plasmodium knowlesi. In contrast to tetracyclines, boromycin rapidly killed asexual stages of both Plasmodium species already at low concentrations (~ 1 nM) including multidrug resistant P. falciparum strains (Dd2, K1, 7G8). In addition, boromycin was active against P. falciparum stage V gametocytes at a low nanomolar range (IC50: 8.5 ± 3.6 nM). Assessment of the mode of action excluded the apicoplast as the main target. Although there was an ionophoric activity on potassium channels, the effect was too low to explain the drug´s antiplasmodial activity. Boromycin is a promising antimalarial candidate with activity against multiple life cycle stages of the parasite.

scholarly journals Characterisation of Plasmids in Multidrug Resistant Uropathogenic Gram-negative Bacterial Isolates

2021 ◽  
Author(s):  
Manish Ranjan ◽  
Mahadevan Kumar ◽  
Sourav Sen ◽  
Parijat Das ◽  
Kunal Kanti Lahiri
Keyword(s):  
Acquired Resistance ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Bacterial Isolates ◽  
Cross Sectional ◽  
Gram Negative ◽  
Hospital Stays ◽  
Tract Infections ◽  
Almost All ◽  
Prolonged Hospital

Introduction: Urinary Tract Infections (UTI) are one of the commonest conditions for which people seek medical care with an estimated 150 million episodes per annum worldwide. An unprecedented upsurge in the rate of development of antimicrobial resistance has reduced the therapeutic options leading to increased morbidity, prolonged hospital stays, development of complications. Majority of these infections are attributable to Gram negative bacteria which have now acquired resistance to almost all classes of antibiotics. Aim: To analyse the plasmid-mediated drug resistance and characterise the major plasmid families that are in circulation. Materials and Methods: A cross-sectional study comprising of a total of 95 non consecutive multidrug-resistant gram-negative bacterial isolates were subjected to Plasmid based replicon typing from January 2017 to June 2018. The 18 major replicons were divided in five multiplex and three uniplex Polymerase Chain Reaction (PCR) formats and the samples were subjected for plasmid characterisation and further sequencing of the plasmid Deoxyribonucleic Acid (DNA). The data obtained was analysed by Microsoft Excel software. Results: Escherichia coli, accounted for maximum n=51 (53.7%), Klebsiella pneumoniae n=19 (20%), Citrobacter sp n=11 (11.6%), miscellaneous gram negative n=14 (14.7%) The isolates exhibited a high degree of resistance to almost all tested antibiotics, sparing a few like Fosfomycin, Chloramphenicol, Imipenem, Amikacin. A total of 154 different plasmid families were detected from the 95 isolates. FIB replicon (24%), FIA (21%), F, W (20%), FIC, B/O (14%), Y (12%), I1 replicon (10.5%) were the major plasmid families detected in the present study. Conclusion: Many isolates exhibited the presence of more than one Incompatibility (Inc.) group plasmids, conferring multidrug resistance to the isolates. The study highlights the need for further research to study the association between plasmid families and their respective antibiotic resistance profiles for a given geographical niche and the need to devise further methods to target these epidemic plasmids.

scholarly journals Modern views on the problem of sepsis

2020 ◽  
pp. 18-26
Author(s):  
V.S. Kopcha
Keyword(s):  
Infectious Disease ◽  
Inflammatory Response ◽  
Clinical Case ◽  
Conservative Therapy ◽  
Medical Community ◽  
Etiological Factors ◽  
Systemic Reactions ◽  
Almost All ◽  
Increased Activity

BACKGROUND. By defining the cornerstone of sepsis as the “systemic” of the inflammatory response in the form of cytokine violations, the authors of the corresponding concept are forced to recognize the etiological factors almost all pathogens of infectious diseases, which naturally go with the increased activity of cytokines in serum. Without diminishing the importance of these components of inflammation, one should pay attention to the postulate that not only viruses and protozoa never cause sepsis, but also all non-bacterial pathogens are not etiological factors of this disease, although they lead to severe systemic reactions accompanied by an increase in the level of proinflammatory cytokines. OBJECTIVE. The purpose of the work is to draw the attention of physicians to the discrepancy between the new notions about sepsis imposed on the medical community and accepted not only by anesthetists, resuscitative surgeons and surgeons, but also by many infectionists. MATERIALS AND METHODS. A detailed analysis of the clinical case of sepsis in a young woman is presented, which, due to adequate surgical and long-term conservative therapy, has safely recovered. CONCLUSIONS. Sepsis is a generalized acyclic infectious disease of the bacterial and/or fungal etiology that develops in an immunodeficient organism with characteristic pathomorphological and pathologist changes in organs and tissues.

scholarly journals CYSTOSTOMY DUE TO URETHRAL OBSTRUCTION IN A CAT: CLINICAL CASE

2021 ◽  
Vol 245 (1) ◽  
pp. 215-218
Author(s):  
N.V. Shamsutdinova ◽  
◽  
Keyword(s):  
Veterinary Medicine ◽  
Clinical Case ◽  
Complete Recovery ◽  
Treatment Method ◽  
Anatomical Structure ◽  
Urethral Obstruction ◽  
Common Reason ◽  
Adequate Treatment ◽  
Urgent Task

Violation of the process of urination in cats is a fairly common reason for owners to contact veterinary clinics. The development of an adequate treatment method for urethral obstruction, based on the pathogenesis of the disease and taking into account the anatomical structure of the cat's urinary sys-tem, remains an urgent task of modern veterinary medicine. Cystotomy with suturing of the catheter and subsequent detoxification therapy can achieve complete recovery, as the cause of blockage of the urethra is eliminated.

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