scholarly journals A Mycological and Molecular Epidemiologic Study on Onychomycosis and Determination In Vitro Susceptibilities of Isolated Fungal Strains to Conventional and New Antifungals

2021 ◽  
Vol 11 ◽  
Author(s):  
Samaneh Halvaee ◽  
Roshanak Daie-Ghazvini ◽  
Seyed Jamal Hashemi ◽  
Sadegh Khodavaisy ◽  
Abbas Rahimi-Foroushani ◽  
...  
Keyword(s):  
Antifungal Activity ◽  
Antifungal Susceptibility ◽  
Epidemiologic Study ◽  
Cross Sectional Study ◽  
Fungal Culture ◽  
Saprophytic Fungi ◽  
Cross Sectional ◽  
First Line Therapy ◽  
Antimycotic Activity

BackgroundOnychomycosis is one of the most common and recurrent dermatological diseases worldwide. The antimycotic activity of prescribed medications varies according to the causative agents, and treatment failure rates exceeding 30%. This study aimed to assess the epidemiological profile of onychomycosis in Iran. Also, the susceptibilities to conventional and new antifungals were investigated.MethodsIn this descriptive cross-sectional study, during the period of 18 months starting from September 2019 until March 2020, 594 nail specimens were obtained from patients who presented nail changes compatible with a clinical diagnosis of onychomycosis. The patients were referred from different cities, including Tehran, Kermanshah, Arak, Kashan, Rasht, Qom, Urmia, Zahedan, Hamadan, Zanjan, Borujerd, Bushehr, and Yazd. All the samples were subjected to microscopic examination and fungal culture. Fungi identified were confirmed through the PCR-sequencing method. The susceptibility to itraconazole, fluconazole, terbinafine, griseofulvin, posaconazole, ravuconazole, efinaconazole, luliconazole, and tavaborole was evaluated according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, document M38-A2 for filamentous fungi, and document M27-A3 for yeasts.Results594 patients were included. Of these, in 179 cases (30.1%) (95% CI:0.3 ± 0.037) onychomycosis was confirmed. The majority of patients were ≥ 60 years of age (n=58, 32.6%) and female (n=113, 63.1%). Saprophytic fungi accounted for the vast majority of the nail isolates (n=92, 51.4%) (95% CI:0.051 ± 0.0.073), followed by dermatophytes (n=45, 25.1%) (95% CI:0.25 ± 0.063), and yeasts (n=42, 23.5%) (95% CI:0.23 ± 0.061). Diabetes mellitus (77.3%), hypothyroidism (18.2%), and solid tumors (4.5%) were documented as the most prevalent underlying conditions. Antifungal susceptibility testing was performed against 60 fungal isolates (20 each of Candida species, saprophytic fungi, and dermatophytes). Efinaconazole, ravuconazole, and luliconazole were the most active agents against Candida species. Also, luliconazole, posaconazole, and efinaconazole were most potent against dermatophytes. Luliconazole had the greatest antifungal activity against saprophytic fungi.ConclusionsThe prevalence of onychomycosis in Iranian patients was relatively high. LUL exhibited potent antifungal activity against the three groups of fungi tested, determining its broad-spectrum antimycotic activity and its probable use as the first-line therapy for onychomycosis.

scholarly journals Antifungal activity of Ventilago maderspatana on Trichophyton rubrum - An in vitro study

2020 ◽  
Vol 5 (05) ◽  
pp. 179-185
Author(s):  
Rajalekshmi S ◽  
Beni PB ◽  
Gopikrishna S
Keyword(s):  
Antifungal Activity ◽  
Specific Treatment ◽  
In Vitro Study ◽  
Cross Sectional Study ◽  
Chloroform Extract ◽  
Diffusion Method ◽  
Cross Sectional ◽  
Dermatophyte Species ◽  
Agar Well Diffusion Method

The aim of the study was to contribute a single drug for specific dermatophyte species to encourage diagnosis specific treatment. The study had two arms one clinical part consisting of cross-sectional study of 80 participants and other part invitro study. The survey was conducted to know the prevalence of dermatophyte species among cutaneous dermatophytosis patients in Kottakkal population there by collecting the skin scrapings of the patients. As the second part of the study these skin scrapings were cultured in sabouraud dextrose agar (SDA) and the species were inoculated from their and identified. Thus from 80 participants 2-genus and 6 different species were obtained. Trichophyton and microsporum were the genus and among Trichophyton 4 species like T.rubrum, T.mentagrophytes, T.tonsurans and T.verrucossum and Microsporum genus consists of M.canis and Microsporumaudouinii. First MIC was calculated and after that antifungal activity was done through the agar well diffusion method using ventilago maderaspattana extracts against fluconazole. Three different extracts were used chloroform, methanol and ethanol. In this article the action of easily available low polarity chloroform extract against the most prevalent species T. rubrum is highlighted because it shows the highest mean zone of inhibition in agar well diffusion method.

scholarly journals Use of Ceftaroline in Hospitalized Patients with and without COVID-19: A Descriptive Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 763
Author(s):  
Daniele Roberto Giacobbe ◽  
Chiara Russo ◽  
Veronica Martini ◽  
Silvia Dettori ◽  
Federica Briano ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Bloodstream Infections ◽  
Cross Sectional Study ◽  
Primary Objective ◽  
Sectional Study ◽  
Cross Sectional ◽  
First Line Therapy ◽  
Large Teaching Hospital ◽  
Secondary Objective ◽  
Medical Wards

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period also including the first months of the coronavirus disease 2019 (COVID-19) pandemic. The primary objective was to describe the use of ceftaroline in terms of indications and characteristics of patients. A secondary objective was to describe the rate of favorable clinical response in patients with bloodstream infections (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA-BSI) receiving ceftaroline. Overall, 200 patients were included in the study. Most of them had COVID-19 (83%, 165/200) and were hospitalized in medical wards (78%, 155/200). Included patients with COVID-19 pneumonia were given empirical ceftaroline in the suspicion of bacterial co-infection or superinfection. Among patients with MRSA-BSI, ceftaroline was used as a first-line therapy and salvage therapy in 25% (3/12) and 75% (9/12) of cases, respectively, and as a monotherapy or in combination with daptomycin in 58% (7/12) and 42% (5/12) of patients, respectively. A favorable response was registered in 67% (8/12) of patients. Improving etiological diagnosis of bacterial infections is essential to optimize the use of ceftaroline in COVID-19 patients. The use of ceftaroline for MRSA-BSI, either as a monotherapy or in combination with other anti-MRSA agents, showed promising rates of favorable response.

Time to Positivity of Bacteria Cultures in Peritoneal Dialysis Fluid: Evaluation of Different Laboratory Techniques

2017 ◽  
Vol 37 (3) ◽  
pp. 342-344
Author(s):  
Roberta M. Katzap ◽  
Vany Elisa Pagnussatti ◽  
Ana Elizabeth Figueiredo ◽  
Julia Gabriela Motta ◽  
Domingos O. d'Avila ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Antibiotic Sensitivity ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Essential Elements ◽  
Coagulase Negative Staphylococcus ◽  
Cross Sectional ◽  
Peritoneal Dialysis Fluid

Patients with chronic kidney disease on peritoneal dialysis (PD) are susceptible to infections, with peritonitis being the primary cause of dropout. Peritoneal fluid culture is one of the essential elements for proper diagnosis and peritonitis treatment. The aim of this study was to compare the time required to obtain a positive culture using different laboratory methods. An in vitro cross-sectional study was conducted comparing different techniques for preparation and culture of bacteria in peritoneal fluid. The research was carried out with 21 sterile dialysis bags and 21 PD bags containing peritoneal fluid drained from patients without peritonitis. Fluids from the 42 PD bags were contaminated by injecting a coagulase-negative Staphylococcus suspension and then prepared for culture using 4 distinct techniques: A - direct culture; B - post-centrifugation culture; C - direct culture after 4 h sedimentation; and D - culture after 4 h sedimentation and centrifugation. This was followed by seeding. In the 21 contaminated sterile bags, mean times to obtain a positive culture with techniques D (19.6 h ± 2.6) and C (19.1 h ± 2.3) were longer than with technique A (15.8 h ± 3.0; p < 0.01), but not statistically different from group B (19.0 h ± 3.2). The same occurred in the 21 bags drained from patients, with mean times for techniques D (14.0 h ± 1.9) and C (14.5 h ± 1.7) being longer than technique A (12.22 h ± 1.94; p < 0.05) but not statistically different from technique B (13.2 h ± 1.3). The sedimentation and centrifugation steps seem to be unnecessary and may delay antibiotic sensitivity test results by approximately 8 hours.

scholarly journals HIV infection is associated with reduced serum alpha-1-antitrypsin concentrations

2010 ◽  
Vol 33 (6) ◽  
pp. 384 ◽  
Author(s):  
Courtney L Bryan ◽  
K Scott Beard ◽  
Gregory B Pott ◽  
Jeremy Rahkola ◽  
Edward M Gardner ◽  
...  
Keyword(s):  
T Cell ◽  
Hiv Infection ◽  
Fluid Phase ◽  
Cross Sectional Study ◽  
Infected Group ◽  
Cd4 T Cell ◽  
Cross Sectional ◽  
Clinically Significant ◽  
Alpha 1 Antitrypsin

Purpose: Several observations suggest the presence of HIV-suppressive factors in the fluid phase of blood. Alpha-1-antitrypsin (AAT), the most abundant serine protease inhibitor in the circulation, has potent anti-HIV activity in vitro, and may function as an endogenous HIV suppressor. Therefore, we assessed serum AAT concentrations for association with HIV infection. Methods: In this cross-sectional study, serum AAT concentrations were measured in 66 persons with HIV infection and in 45 healthy persons (Controls). In the HIV-infected group, antiretroviral therapy (ART) use was assessed and CD4+ T cell levels and plasma HIV RNA were quantified. Results: Median AAT concentration was significantly lower in the HIV-infected group (1.64 mg/mL) in comparison with Controls (1.94 mg/mL; p=0.001). AAT reduction was most pronounced in the HIV-infected subgroup with CD4+ T cell levels > 200 cells/µL in comparison with Controls (p < 0.01). Serum AAT concentrations < 1.0 mg/mL are clinically significant, and concentrations below this level were identified in 4.5% of the HIV-infected group and in no Control subjects. No association between AAT levels and viral load or use of ART was observed in HIV-infected subjects. Conclusion: The association between reduced serum AAT concentration and HIV infection is consistent with a role for AAT as an endogenous HIV suppressor.

scholarly journals Epidemiologic study of chronic osteomyelitis in Paktya and Kabul, Afghanistan

2020 ◽  
Vol 8 (9) ◽  
pp. 3183
Author(s):  
Oryakhil Walikhan ◽  
Nejrabi Bismellah
Keyword(s):  
Chronic Osteomyelitis ◽  
Epidemiologic Study ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
General Information ◽  
Regional Hospital ◽  
Male Population ◽  
Humid Climate ◽  
Cross Sectional ◽  
Female Population

Background: Osteomyelitis is an infection of the bone that can occur from direct or indirect invasion by a pathogens, both of these types can potentially progress to subacute and chronic osteomyelitis that lasts longer than 4 weeks. This disease has important characteristics such as long-term clinical course, long periods of silence, the treatment of the recurrence of serious complications of the disease is difficult financially and it takes a lot of money epidemiology of chronic osteomyelitis in the Afghanistan is largely unknown. The aim of this study was epidemiologic study of chronic osteomyelitis in adult clients of Paktya city regional hospital and Wazir Akbar Khan Hospital in Kabul city of Afghanistan.Methods: This descriptive cross-sectional study was performed in patients' with chronic osteomyelitis who referred in this two hospitals in Paktya city regional hospital and the Wazir Akbar Khan hospital in Kabul During the March 2019 to March 2020, 70 patients were identified with chronic osteomyelitis. The information required for the study, such as general information, underlying diseases of the patients collected from these two medical centers. After encoding, the necessary information was entered into the computer and analyzed.Results: According to the findings of this study the prevalence of chronic bone infections in male were 64% (n=45) in female were 36% (n=25), current findings showed 44.3% of all patient involved with tibial (n=31) chronic osteomyelitis and the most common underlying disease causing chronic osteomyelitis is the direct entry of infection as a result of trauma.Conclusions: Our study showed the chronic osteomyelitis is higher in the male population than in the female population and highest incidence of chronic osteomyelitis site was tibia result of trauma because of humid climate, poor personal and hospital environmental health status and relatively poor medical facilities in Afghanistan may contribute to higher morbidity.

scholarly journals Community Pharmacists’ Perceptions towards the Misuse and Abuse of Pregabalin: A Cross-Sectional Study from Aseer Region, Saudi Arabia

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1281
Author(s):  
Sultan M. Alshahrani ◽  
Khalid Orayj ◽  
Ali M. Alqahtani ◽  
Mubarak A. Algahtany
Keyword(s):  
Saudi Arabia ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Male Dominance ◽  
Community Pharmacies ◽  
First Line ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
First Line Therapy ◽  
Structured Questionnaire

Pregabalin is a first-line therapy for neuropathic pain and for chronic pain. It has abuse potential. This study was conducted to assess community pharmacists’ perceptions towards pregabalin abuse and misuse in the Aseer region, Saudi Arabia, and identify predictors and associated factors. A cross-sectional survey using a structured questionnaire following a self-administrative study was conducted across community pharmacies in the Aseer region (Abha, Khamis Mushait, Mahayel, Sarat Abeeda, Ahad-Rufaida, and Bishah). A total of 206 respondents from community pharmacists participated in the study. Over the last six months, 136 respondents (66.0%) suspected pregabalin abuse in community pharmacies; male dominance in pregabalin abusers was also recorded (n = 165, 80.1%). Additionally, 40 (19.4%) respondents stated that a prescription was not issued for pregabalin demands. Over half (61.7%) of community pharmacists recorded an increased change in pregabalin abuse compared to the previous year. This is the first study to explore pharmacists’ perceptions in the community of the Aseer region towards customers’ misuse and abuse of pregabalin. Further monitoring and regulations on the prescribing and procurement of pregabalin are needed to avoid abuse.

scholarly journals Transferrin and antioxidants partly prevented mouse oocyte oxidative damage induced by exposure of cumulus-oocyte complexes to endometrioma fluid

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Zi Ren ◽  
Jiana Huang ◽  
Chuanchuan Zhou ◽  
Lei Jia ◽  
Manchao Li ◽  
...  
Keyword(s):  
Oxidative Damage ◽  
Oocyte Retrieval ◽  
Cross Sectional Study ◽  
Human Oocyte ◽  
Cross Sectional ◽  
Vitro Fertilization ◽  
Good Quality Embryo ◽  
Damage Process ◽  
Human And Mouse

Abstract Background Exposure of oocytes to the endometrioma fluid has an adverse effect on embryonic quality. To determine whether adding transferrin and antioxidants to culture medium could counteract detrimental effects on mouse cumulus-oocyte complexes (COCs) induced by exposure to endometrioma fluid or not, we conducted an in vitro cross-sectional study using human and mouse COCs. Methods Eighteen women who had their oocytes exposed to endometrioma fluid during oocyte retrieval were enrolled. COCs from superovulated ICR female mice were collected. They were first exposed to human endometrioma fluid and then treated by transferrin and/or antioxidants (cysteamine + cystine). Subsequently, COCs function was assessed by molecular methods. Results This study observed that human COCs inadvertently exposed to endometrioma fluid in the in vitro fertilization (IVF) group led to a lower good quality embryo rate compared to intracytoplasmic sperm injection (ICSI) group. Exposure of mouse COCs to endometrioma fluid accelerated oocyte oxidative damage, evidenced by significantly reduced CCs viability, defective mitochondrial function, decreased GSH content and increased ROS level, associated with the significantly higher pro-portion of abnormal spindles and lower blastocyst formation (p < 0.05, respectively). This damage could be recovered partly by treating COCs with transferrin and antioxidants (cysteamine + cystine). Conclusions Transferrin and antioxidants could reduce the oxidative damage caused by COCs exposure to endometrioma fluid. This finding provides a promising new possibility for intervention in the human oocyte oxidative damage process induced by endometrioma fluid during oocyte pick-up.

scholarly journals Ciclopirox and Efinaconazole Transungual Permeation, Antifungal Activity, and Proficiency To Induce Resistance in Trichophyton rubrum

2019 ◽  
Vol 63 (10) ◽  
Author(s):  
Daniela Monti ◽  
Diletta Mazzantini ◽  
Silvia Tampucci ◽  
Alessandra Vecchione ◽  
Francesco Celandroni ◽  
...  
Keyword(s):  
Antifungal Activity ◽  
Trichophyton Rubrum ◽  
Nail Plate ◽  
Content Type ◽  
Nail Bed ◽  
Antimycotic Activity ◽  
Frequent Relapses ◽  
Induce Resistance ◽  
Over Time

ABSTRACT Onychomycosis is a nail fungal infection, mostly caused by dermatophytes. The treatment efficacy is impaired by difficulties of reaching effective drug levels at the site of infection; frequent relapses occur after cessation of antifungal therapy. The aim of the study was to compare two commercial products containing ciclopirox or efinaconazole for antimycotic activity and antifungal drug resistance. A study of permeation and penetration through bovine hoof membranes, as a nail model, was performed to evaluate the antimycotic activity of permeates against clinical isolates of selected fungi, and the frequency of spontaneous in vitro Trichophyton rubrum-resistant strains was assessed by broth microdilution assays. The results suggest that ciclopirox creates a depot in the nail, leading to a gradual release of the drug over time with action on both the nail plate and bed. Conversely, efinaconazole, mildly interacting with nail keratin, mainly exerts its antifungal activity in the nail bed. However, in the case of T. rubrum, the antifungal activities of the drugs in the nail plate seem comparable. Finally, efinaconazole showed a potential for induction of resistance in T. rubrum, which may limit its efficacy over time. Ciclopirox did not show any potential to induce resistance in T. rubrum and appears endowed with a more complete activity than efinaconazole in the management of onychomycosis as the nail keratin is a substrate for the growth of fungal cells, and the availability of drug in large concentration just in the nail bed may not be sufficient to guarantee the complete eradication of pathogens.

scholarly journals Placenta growth factor in sickle cell disease: association with hemolysis and inflammation

Blood ◽  
2010 ◽  
Vol 115 (10) ◽  
pp. 2014-2020 ◽  
Author(s):  
Julia E. Brittain ◽  
Ben Hulkower ◽  
Susan K. Jones ◽  
Dell Strayhorn ◽  
Laura De Castro ◽  
...  
Keyword(s):  
Growth Factor ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Predictive Accuracy ◽  
Cross Sectional Study ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Placenta Growth Factor ◽  
Cross Sectional

Abstract Placenta growth factor (PlGF) is released by immature erythrocytes and is elevated in sickle cell disease (SCD). Previous data generated in vitro suggest that PlGF may play a role in the pathophysiology of SCD-associated pulmonary hypertension (PHT) by inducing the release of the vasoconstrictor, endothelin-1. In this cross-sectional study of 74 patients with SCD, we confirm that PlGF is significantly elevated in SCD compared with healthy control subjects. We found significantly higher levels of PlGF in SCD patients with PHT but observed no association of PlGF with the frequency of acute pain episodes or history of acute chest syndrome. The observed correlation between PlGF and various measures of red cell destruction suggests that hemolysis, and the resultant erythropoietic response, results in the up-regulation of PlGF. Although relatively specific, PlGF, as well as N-terminal pro-brain natriuretic peptide and soluble vascular cell adhesion molecule, has low predictive accuracy for the presence of PHT. Prospective studies are required to conclusively define the contribution of PlGF to the pathogenesis of PHT and other hemolytic complications in SCD.

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