Base de dados : LILACS
Pesquisa : D10.477 [Categoria DeCS]
Referências encontradas : 7 [refinar]
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Id: biblio-887383
Autor: Ozdemir, Abdurrahman A.
Título: Activador tisular del plasminógeno recombinante para el tratamiento de la vegetación intracardíaca en un lactante de muy bajo peso al nacer / Recombinant tissue plasminogen activator treatment for intracardiac vegetation in a very low birth weight infant
Fonte: Arch. argent. pediatr;115(5):307-310, oct. 2017. ilus.
Idioma: en; es.
Resumo: Las nuevas opciones de tratamiento prolongan la hospitalización y aumentan las infecciones intrahospitalarias bacterianas y fúngicas, pero también mejoran la sobrevida de los recién nacidos hospitalizados en la unidad de cuidados intensivos neonatales. Las infecciones fúngicas invasivas en neonatos están asociadas con una morbimortalidad significativa. También pueden diseminarse a órganos específicos y causar endocarditis, endoftalmitis, artritis séptica, nefropatía obstructiva y meningitis. En el caso de la endocarditis, se recomiendan tratamientos antimicóticos sistémicos agresivos y, en algunos casos, la intervención quirúrgica del neonato. Informamos el caso de un lactante prematuro, de bajo peso al nacer, con vegetación intracardíaca. Esta es una complicación rara y potencialmente mortal de infecciones fúngicas invasivas. El paciente recibió tratamiento con caspofungina y un activador tisular del plasminógeno recombinante, en vez de una intervención quirúrgica.

Developing treatment options have resulted in prolonged admission and increased bacterial and fungal nosocomial infections as well as improved survival in neonatal intensive care unit. Invasive fungal infections in newborns are associated with significant morbidity and mortality and can cause endorgan dissemination such as endocarditis, endophthalmitis, septic arthritis, obstructive nephropathy and meningitis. Endocarditis requires aggressive systemic antifungal therapy and sometimes surgical intervention in neonates. We report a low birth weight premature infant with intracardiac vegetation that is rare and a life-threatening complication of invasive fungal infections. He was treated with caspofungin and recombinant tissue plasminogen activator in stead of surgical intervention.
Descritores: Candidíase/tratamento farmacológico
Ativador de Plasminogênio Tecidual
Endocardite/microbiologia
Endocardite/tratamento farmacológico
Equinocandinas/uso terapêutico
Lipopeptídeos/uso terapêutico
Candida parapsilosis
Antifúngicos/uso terapêutico
-Proteínas Recombinantes/uso terapêutico
Recém-Nascido de muito Baixo Peso
FRONTAL SINUS0
Limites: Seres Humanos
Masculino
Recém-Nascido
Tipo de Publ: Relatos de Casos
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-838238
Autor: Rosanova, María T; Bes, David; Serrano Aguilar, Pedro; Cuellar Pompa, Leticia; Sberna, Norma; Lede, Roberto.
Título: Eficacia y seguridad de la caspofungina en pediatría: revisión sistemática y metaanálisis / Efficacy and safety of caspofungin in children: systematic review and meta-analysis
Fonte: Arch. argent. pediatr;114(4):305-312, ago. 2016. graf, tab.
Idioma: en; es.
Resumo: Las infecciones fúngicas invasivas son una importante causa de morbimortalidad en pediatría. La caspofungina es una equinocandina utilizada como alternativa en la prevención y/o tratamiento de ciertas infecciones fúngicas invasivas en niños, aunque con poca evidencia sobre su eficacia y seguridad en comparación con el tratamiento habitual. Objetivos. Evaluar la eficacia y seguridad de la caspofungina comparada con otros antifúngicos en la prevención y/o tratamiento de infecciones fúngicas invasivas en pediatría. Material y métodos. La estrategia de búsqueda inicial tuvo como objetivo identificar estudios controlados aleatorizados de aceptable calidad metodológica (escala de Jadad > 3) mediante la palabra clave "caspofungin" realizados en pacientes de entre los 0 y los 18 años. Resultados. Solo 3 publicaciones cumplieron los criterios de inclusión. De ellas, 2 fueron en población pediátrica y una en neonatal. No se documentó una mayor incidencia de efectos adversos para la caspofungina y su eficacia no se diferenció de otros antifúngicos (RR típico 1,47; IC 95%: 0,78-2,79). Conclusiones. Esta revisión sistemática sugiere que la caspofungina podría considerarse como una alternativa para su indicación en pediatría en la prevención y tratamiento de las infecciones fúngicas invasivas. Sin embargo, dado el pequeño número de publicaciones existentes, se requieren más estudios para alcanzar conclusiones definitivas.

Invasive fungal infections are a significant cause of morbidity and mortality in children. Caspofungin is an echinocandin used as an alternative treatment in the prevention and/or treatment of certain invasive fungal infections in children, although compared to the standard treatment there is little evidence on its efficacy and safety. Objectives. To evaluate the efficacy and safety of caspofungin compared with other antifungal drugs for the prevention and/or treatment of invasive fungal infections in children. Material and methods. The objective of the initial search strategy was to identify randomized controlled studies of acceptable methodological quality (Jadad scale >3), through the key word "caspofungin", conducted in patients with an age range from 0 to 18 years old. Results. Only 3 publications met the inclusion criteria. Two of them were studies conducted in children and one in newborn infants. A higher incidence of adverse events was not documented for caspofungin and its efficacy was not different from that of other antifungal drugs (typical RR 1.47; CI 95%: 0.78-2.79). Conclusions. This systematic review suggests that caspofungin could be considered as an alternative drug in children for the prevention and treatment of invasive fungal infections. However, given the small number of existing publications, more studies are required to reach definite conclusions.
Descritores: Equinocandinas/uso terapêutico
Lipopeptídeos/uso terapêutico
FRONTAL SINUS0
Micoses/tratamento farmacológico
Antifúngicos/uso terapêutico
-Resultado do Tratamento
Limites: Seres Humanos
Criança
Tipo de Publ: 57788
Responsável: AR94.1 - Centro de Información Pediatrica


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Texto completo SciELO Brasil
Texto completo
Id: lil-797151
Autor: Tótoli, Eliane Gandolpho; Salgado, Hérida Regina Nunes.
Título: A green approach for the quantification of daptomycin in pharmaceutical formulation by UV spectrophotometry
Fonte: Braz. j. pharm. sci;51(4):811-821, Oct.-Dec. 2015. ilus, tab.
Idioma: en.
Resumo: Daptomycin is the first approved drug from a new class of antimicrobials, the cyclic lipopeptides, and is a very important antimicrobial agent in current clinical practice. Currently, there are no "green" analytical methods described in the literature to analyze the typical pharmaceutical dosage form of daptomycin. Thus, the aim of this work was to validate an environment-friendly spectrophotometric method in the UV region, for the analysis of daptomycin as a lyophilized powder. Water was used as diluent and the analyses were carried out on a spectrophotometer at 221 nm. The method met all validation requirements of the ICH guidelines, over a concentration range of 6-21 µg mL-1. A Student's t-test demonstrated that the proposed method was comparable to an HPLC method previously validated. Thus, the validated spectrophotometric method could quantify daptomycin in a powder form for injectable solutions, while being an economical, rapid, and "green" alternative for routine analysis in quality control...

A daptomicina é o primeiro membro aprovado de uma nova classe de antimicrobianos, os lipopeptídeos cíclicos, e é muito importante para a prática clínica atualmente. Não existem métodos analíticos "verdes" descritos na literatura para a análise da daptomicina na forma farmacêutica. Desta forma, o objetivo deste trabalho foi a validação de método espectrofotométrico na região do UV ambientalmente favorável para análise da daptomicina em pó liofilizado. A água foi escolhida como diluente e as análises foram realizadas em 221 nm. O método atendeu a todas as exigências de validação dos guias do ICH, na faixa de 6-21 µg mL-1. Teste t de Student mostrou que o método proposto é intercambiável com método de HPLC previamente validado. Assim, o método espectrofotométrico validado é capaz de quantificar a daptomicina em pó para solução injetável e é uma opção econômica, rápida e "verde" para análises de rotina do controle de qualidade deste fármaco...
Descritores: Daptomicina/análise
Espectrofotometria Ultravioleta/métodos
-Anti-Infecciosos/análise
Lipopeptídeos
Controle de Qualidade
Limites: Seres Humanos
Responsável: BR40.1 - DBD - Divisão de Biblioteca e Documentacão do Conjunto das Químicas


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Texto completo SciELO Brasil
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Id: lil-742902
Autor: Lamari, Neuseli Marino.
Título: Effectiveness of a cardiac rehabilitation program during hospital stay / Efetividade de um programa reabilitação cardíaca durante a fase hospitalar
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);30(1):VIII-IX, Jan-Mar/2015.
Idioma: en.
Descritores: Apoptose
Células Secretoras de Insulina/efeitos dos fármacos
Transdução de Sinais
/metabolismo
TOLL-LIKE RECEPTOR ABBREVIATIONS AS TOPIC/metabolismo
-Linhagem Celular Tumoral
/metabolismo
CASPASE ABATTOIRS/metabolismo
Fragmentação do DNA
Ativação Enzimática
Proteínas I-kappa B/metabolismo
Imunoprecipitação
Células Secretoras de Insulina/metabolismo
Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo
Lipopeptídeos/farmacologia
/metabolismo
MYELOID DIFFERENTIATION FACTOR ACETATE KINASE/metabolismo
Palmitatos
Ligação Proteica
Fosfoproteínas/metabolismo
Poli(ADP-Ribose) Polimerases/metabolismo
Interferência de RNA
/genética
TOLL-LIKE RECEPTOR ABBREVIATIONS AS TOPIC/genética
/agonistas
TOLL-LIKE RECEPTOR TEMEFOS/agonistas
/genética
TOLL-LIKE RECEPTOR TEMEFOS/genética
/metabolismo
TOLL-LIKE RECEPTOR TEMEFOS/metabolismo
Limites: Animais
Ratos
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


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ALVES, Sydney Hartz
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Id: lil-624029
Autor: Mario, Débora Alves Nunes; Denardi, Laura Bedin; Bandeira, Laíssa Arévalo; Antunes, Milene Silva; Santurio, Janio Morais; Severo, Luiz Carlos; Alves, Sydney Hartz.
Título: The activity of echinocandins, amphotericin B and voriconazole against fluconazole-susceptible and fluconazole-resistant Brazilian Candida glabrata isolates
Fonte: Mem. Inst. Oswaldo Cruz;107(3):433-436, May 2012. tab.
Idioma: en.
Resumo: The extensive use of azole antifungal agents has promoted the resistance of Candida spp to these drugs. Candida glabrata is a problematic yeast because it presents a high degree of primary or secondary resistance to fluconazole. In Brazil, C. glabrata has been less studied than other species. In this paper, we compared the activity of three major classes of antifungal agents (azoles, echinocandins and polyenes) against fluconazole-susceptible (FS) and fluconazole-resistant (FR) C. glabrata strains. Cross-resistance between fluconazole and voriconazole was remarkable. Among the antifungal agents, the echinocandins were the most effective against FS and FR C. glabrata and micafungin showed the lowest minimal inhibitory concentrations.
Descritores: Anfotericina B/farmacologia
Antifúngicos/farmacologia
Candida glabrata/efeitos dos fármacos
Equinocandinas/farmacologia
Fluconazol/farmacologia
Pirimidinas/farmacologia
Triazóis/farmacologia
-Candida glabrata/isolamento & purificação
Farmacorresistência Fúngica/efeitos dos fármacos
Lipopeptídeos/farmacologia
Testes de Sensibilidade Microbiana
Limites: Seres Humanos
Tipo de Publ: Estudo Comparativo
Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
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Id: lil-612151
Autor: Cortés L, Jorge A; Russi N, July A.
Título: Equinocandinas / Echinocandins
Fonte: Rev. chil. infectol;28(6):529-536, dic. 2011. ilus, tab.
Idioma: es.
Resumo: The echinocandins, caspofugin, micafungin, and anidulafungin, are lipopeptides that inhibit fungal growth by binding to β - (1.3) d glucan synthase. This enzyme is responsible for the formation of the peptidoglycan cell wall, and it is essential in fungi such as Candida spp, but less important in the case of Aspergillus and Fusarium species. We review the history, pharmacology and clinical trials that have showed clinical efficacy similar to amphotericin B for the management of fungal infections such as candidemia, invasive candidiasis and aspergillosis, even in cases refractory to initial treatment. These drugs have less toxicity and discontinuation is uncommonly required. Despite similar spectrum and tolerability, there are several pharmacological differences. Only a few clinical trials compare the clinical efficacy between them and their clinical application cannot be generalized. However, the echinocandins have demonstrated clinical efficacy in patients with invasive candidiasis and in others forms of systemic mycoses.

Las equinocandinas -caspofugina, micafungina y ani-dulafungina- son lipopéptidos que inhiben el crecimiento fúngico al unirse a la β-(1,3) d glucano sintetasa, enzima esencial para la síntesis en la pared celular de hongos como Candida spp, y menos importante en el caso de especies de Aspergillus y Fusarium. Se revisa la historia, farmacología y los diferentes ensayos clínicos que han evidenciado similar eficacia clínica a la de anfotericina B para el manejo de infecciones micóticas como candidemia, candidiasis invasora y aspergilosis, inclusive en casos refractarios al manejo inicial. Estos medicamentos tienen menor toxicidad y en pocos casos hay necesidad de retiro del tratamiento. Dado su espectro y tolerabilidad similar, su farmacología permite diferenciarlas. Se dispone de información limitada de estudios clínicos que las comparen entre ellas, limitando la extrapolación de la información a todo el grupo. Sin embargo, presentan eficacia clínica comprobada en pacientes con varias micosis invasoras.
Descritores: Antifúngicos/farmacologia
Aspergillus/efeitos dos fármacos
Candida/efeitos dos fármacos
Equinocandinas/farmacologia
Lipopeptídeos/farmacologia
-Aspergillus/classificação
Ensaios Clínicos como Assunto
Candida/classificação
Testes de Sensibilidade Microbiana
Limites: Seres Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Revisão
Responsável: BR1.1 - BIREME


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Texto completo SciELO Brasil
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Id: lil-556867
Autor: Fernandes, M. L; Mendes, M. E; Brunialti, M. K. C; Salomão, R.
Título: Human monocytes tolerant to LPS retain the ability to phagocytose bacteria and generate reactive oxygen species
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;43(9):860-868, Sept. 2010. ilus.
Idioma: en.
Resumo: Tolerance to lipopolysaccharide (LPS) occurs when animals or cells exposed to LPS become hyporesponsive to a subsequent challenge with LPS. This mechanism is believed to be involved in the down-regulation of cellular responses observed in septic patients. The aim of this investigation was to evaluate LPS-induced monocyte tolerance of healthy volunteers using whole blood. The detection of intracellular IL-6, bacterial phagocytosis and reactive oxygen species (ROS) was determined by flow cytometry, using anti-IL-6-PE, heat-killed Staphylococcus aureus stained with propidium iodide and 2',7'-dichlorofluorescein diacetate, respectively. Monocytes were gated in whole blood by combining FSC and SSC parameters and CD14-positive staining. The exposure to increasing LPS concentrations resulted in lower intracellular concentration of IL-6 in monocytes after challenge. A similar effect was observed with challenge with MALP-2 (a Toll-like receptor (TLR)2/6 agonist) and killed Pseudomonas aeruginosa and S. aureus, but not with flagellin (a TLR5 agonist). LPS conditioning with 15 ng/mL resulted in a 40 percent reduction of IL-6 in monocytes. In contrast, phagocytosis of P. aeruginosa and S. aureus and induced ROS generation were preserved or increased in tolerant cells. The phenomenon of tolerance involves a complex regulation in which the production of IL-6 was diminished, whereas the bacterial phagocytosis and production of ROS was preserved. Decreased production of proinflammatory cytokines and preserved or increased production of ROS may be an adaptation to control the deleterious effects of inflammation while preserving antimicrobial activity.
Descritores: Lipopeptídeos/farmacologia
Lipopolissacarídeos/farmacologia
Monócitos/imunologia
Pseudomonas aeruginosa/imunologia
Espécies Reativas de Oxigênio/metabolismo
Staphylococcus aureus/imunologia
-/imunologia
INTERLEUKIN-ABDOMEN, ACUTE/imunologia
Monócitos/efeitos dos fármacos
Monócitos/metabolismo
Fagocitose/imunologia
Pseudomonas aeruginosa/metabolismo
Espécies Reativas de Oxigênio/imunologia
Staphylococcus aureus/metabolismo
Receptores Toll-Like/antagonistas & inibidores
Limites: Adulto
Feminino
Seres Humanos
Masculino
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME



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