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Id: biblio-991037
Autor: Miranda Rodríguez, Aymara.
Título: Falla o resistencia en la anestesia espinal para cesárea / Failure or resistance in spinal anesthesia for cesarean section
Fonte: Rev. cuba. anestesiol. reanim;17(3):1-7, set.-dic. 2018. ilus.
Idioma: es.
Resumo: Introducción: La anestesia regional es la más empleada en la cesárea obstétrica. En particular, el uso de la anestesia intratecal tiene sus ventajas. Aunque la tasa de falla es baja, la aparición de este evento genera dificultades que merecen atención. Objetivo: Describir la conducta anestésica en una paciente obstétrica en la que falla la anestesia regional intratecal. Caso clínico: Paciente femenina, de 20 años a la que se le administró anestesia intratecal por el especialista. No hubo errores en la punción lumbar, esta se realizó con trócar 25 punta Whitacre. No se constató bloqueo sensitivo, motor ni simpático, por lo que se realizó anestesia general endotraqueal, la cual transcurrió sin dificultades. En el posoperatorio inmediato se observa hiperlaxitud articular lo que llevó a sospechar el diagnóstico. Este fue positivo conjuntamente con el servicio de Neurología, se determinó Síndrome de Ehlers danlos tipo III. Conclusiones: El índice de falla es muy bajo en anestesia suaracnoidea pero si se presenta un paciente de este tipo, debe descartarse por completo. Existen pocos casos documentados de resistencia a la anestesia local; pero si así fuera, debe estudiarse exhaustivamente para buscar estrategias que permitan un acto anestésico óptimo(AU)

Introduction: Regional anesthesia is the most used in obstetric caesarean section. In particular, the use of intrathecal anesthesia has its advantages. Although the failure rate is low, the onset of this event generates difficulties that deserve attention. Objective: To describe the anesthetic management in an obstetric patient with failure of regional intrathecal anesthesia. Clinical case: Female patient, aged 20 years, who was administered intrathecal anesthesia by the specialist. There were no errors in the lumbar puncture, this was done with a trocar 25 of Whitacre tip. No sensory, motor or sympathetic block was observed, so general endotracheal anesthesia was performed, which went on smoothly. In the immediate postoperative period, joint hypermobility was observed, leading to suspicion of the diagnosis. This was positive in conjunction with the Neurology service, Ehlers-Danlos syndrome type 3 was determined. Conclusions: The failure rate is very low for subarachnoid anesthesia. However, for a patient of this type, it should be completely ruled out. There are few documented cases of resistance to local anesthesia. If it were the case, it should be studied exhaustively to look for strategies that allow an optimal anesthetic management(AU)
Descritores: Resistência a Medicamentos/genética
Cesárea/métodos
Raquianestesia/métodos
-Síndrome de Ehlers-Danlos/complicações
Anestesia Obstétrica/métodos
Tipo de Publ: Relatos de Casos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-417378
Autor: Dussaillant N., Gastón; Zapata M., Mario; Fardella B., Patricia; Conte L., Guillermo; Cuneo V., Marianela.
Título: Frecuencia y características de la resistencia a aspirina en pacientes cardiovasculares chilenos / Frequency and characteristics of aspirin resistance in Chilean cardiovascular patients
Fonte: Rev. méd. Chile;133(4):409-417, abr. 2005. tab, graf.
Idioma: es.
Projeto: SOCHICAR.
Resumo: Background: Studies performed in Anglo-Saxon countries show that 5 percent of patients are resistant to the antiplatelet effects of aspirin. Aim: To assess the prevalence of aspirin resistance in a sample of Chilean cardiovascular patients and its association with clinical and laboratory characteristics. Patients and Methods: Ninety nine patients (30 women, 63n10 years) treated for stable cardiovascular diseases with aspirin 100-325 mg/day were studied. Clinical and basic coagulation variables were assessed. Platelet aggregation was studied with platelet rich plasma using three different agonists in an optical aggregometer. Aspirin resistance was defined as an aggregation >20 percent with arachidonic acid and an aggregation >70 percent with ADP or collagen. Results: Eleven patients (11.11 percent, 95 percent CI= 4.95-17.27 percent) complied with both criteria and were classified as aspirin resistant. Current smoking was more common in aspirin resistant patients (63.6 vs 29.6 percent, p=0.039). Conclusions: Aspirin resistance was found in a significant proportion of cardiovascular patients and was more common among current smokers.
Descritores: Aspirina/administração & dosagem
Aspirina/farmacologia
Doenças Cardiovasculares/tratamento farmacológico
-ANCIANOS DE ACETABULARIA ANOS Y MAS
Chile
Resistência a Medicamentos
Limites: Masculino
Adulto
Seres Humanos
Feminino
Meia-Idade
Responsável: CL12.1 - Biblioteca


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Id: lil-762053
Autor: SHIKANAI-YASUDA, Maria Aparecida.
Título: Paracoccidioidomycosis treatment / Tratamento da paracoccidioidomicose
Fonte: Rev. Inst. Med. Trop. Säo Paulo;57(supl.19):31-37, Sept. 2015.
Idioma: en.
Projeto: Fundação de Amparo à Pesquisa do Estado de São Paulo.
Resumo: SUMMARYConsidered to be an emerging endemic mycosis in Latin America, paracoccidioidomycosis is characterized by a chronic course and involvement of multiple organs in immunocompromised hosts. Infection sequelae are mainly related to pulmonary and adrenal insufficiency. The host-parasite interaction results in different expressions of the immune response depending on parasite pathogenicity, fungal load and genetic characteristics of the host. A few controlled and case series reports have shown that azoles and fast-acting sulfa derivatives are useful treatment alternatives in milder forms of the disease. For moderate/severe cases, more prolonged treatments or even parenteral routes are required especially when there is involvement of the digestive tract mucosa, resulting in poor drug absorption. Although comparative studies have reported that shorter treatment regimens with itraconazole are able to induce cure in chronically-infected patients, there are still treatment challenges such as the need for more controlled studies involving acute cases, the search for new drugs and combinations, and the search for compounds capable of modulating the immune response in severe cases as well as the paradoxical reactions.

RESUMOConsiderada micose endêmica emergente na América Latina, a paracoccidioidomicose é caracterizada por uma evolução crônica e envolvimento de múltiplos órgãos em pacientes com comprometimento imunológico. Sequelas da infecção estão relacionadas principalmente à insuficiência pulmonar e adrenal. A interação hospedeiro-parasito resulta em diferentes expressões da resposta imune dependendo da patogenicidade do parasito, carga fúngica e características genéticas do hospedeiro. Alguns estudos controlados e séries de casos têm demonstrado que azóis de ação rápida e derivados de sulfa constituem alternativas terapêuticas úteis nas formas mais leves da doença. Para casos moderados/graves, tratamentos mais prolongados ou mesmo por via parenteral são necessários especialmente quando há envolvimento de mucosa do trato digestivo, resultando em absorção deficiente de drogas. Embora estudos comparativos tenham relatado que esquemas terapêuticos mais curtos com itraconazol sejam capazes de induzir cura em pacientes cronicamente infectados, ainda existem desafios no tratamento, tais como a necessidade de maior número de estudos controlados envolvendo casos agudos, busca por novas drogas e combinações, compostos capazes de modular a resposta imune nos casos graves, e reações paradoxais.
Descritores: Paracoccidioidomicose/tratamento farmacológico
Sulfonamidas/uso terapêutico
Azóis/uso terapêutico
Anfotericina B/uso terapêutico
Antifúngicos/uso terapêutico
Naftalenos/uso terapêutico
-Índice de Gravidade de Doença
Resistência a Medicamentos
Ensaios Clínicos Controlados Aleatórios como Assunto
Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico
Limites: Seres Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Revisão
Responsável: BR1.1 - BIREME


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Id: lil-623564
Autor: Cioli, Donato; Pica-Mattoccia, Livia; Archer, Sydney.
Título: Resistance of schistosomes to hycanthone and oxamniquine
Fonte: Mem. Inst. Oswaldo Cruz;84(supl.1):38-45, 1989. tab.
Idioma: en.
Conferência: Apresentado em: Simpósio Internacional de Esquistossomose, 2, Apresentado em: Reunião Nacional de Esquistossomose2, Belo Horizonte, 22-27 out. 1989.
Resumo: Genetic crosses between phenotypically resistant and sensitive schistosomes demonstrated that resistance to hycanthone and oxamniquine behaves like a recessive trait, thus suggesting that resistance is due to the lack of some factor. We hypothesized that, in order to kill schistosomes, hycanthone and oxamniquine need to be converted into an active metabolite by some parasite enzyme wich, if inactive, results in drug resistance. Esterification of the drugs seemed to be the most likely event as it would lead to the production of an alkylating agent upon dissociation of the ester. An artificial ester of hycanthone was indeed active even in resistant worms, thus indirectly supporting our hypothesis. In addition, several lines of evidence demonstrated that exposure to hycanthone and oxamniquine results in alkylation of worm macromolecules. Thus, radioactive drugs formed covalent bonds with the DNA of sensitive (but not of resistant) schistosomes; an antiserum raised against hycanthone detected the presence of the drug in the purified DNA fraction of sensitive (but not of resistant) schistosomes; a drug-DNA adduct was isolated from hycanthone-treated worms and fully characterized as hycanthone-deoxyguanosine.
Descritores: Schistosoma mansoni/efeitos dos fármacos
Resistência a Medicamentos/genética
Hicantone/farmacologia
-Genes de Helmintos
Cruzamentos Genéticos
Limites: Animais
Cobaias
Camundongos
Responsável: BR1.1 - BIREME


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Id: lil-623561
Autor: Mott, Kenneth E.
Título: Contrasts in the control of schistosomiasis
Fonte: Mem. Inst. Oswaldo Cruz;84(supl.1):3-19, 1989.
Idioma: en.
Conferência: Apresentado em: Simpósio Internacional de Esquistossomose, 2, Apresentado em: Reunião Nacional de Esquistossomose2, Belo Horizonte, 22-27 out. 1989.
Descritores: Contagem de Ovos de Parasitas
Esquistossomose/diagnóstico
Esquistossomose/epidemiologia
Análise por Conglomerados
-Schistosoma/classificação
Schistosoma/metabolismo
Resistência a Medicamentos
Educação em Saúde
Limites: Seres Humanos
Animais
Responsável: BR1.1 - BIREME


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Id: lil-623597
Autor: Beverley, Stephen M; Petrillo-Peixoto, Maria.
Título: Naturally-occurring gene amplifications conferring drug resistance in Leishmania Tarentolae
Fonte: Mem. Inst. Oswaldo Cruz;83(supl.1):330-333, Nov. 1988.
Idioma: en.
Conferência: Apresentado em: Annual Meeting on Basic Research in Chagas's disease, 15, Apresentado em: Meeting of the Brazilian Society of Protozoology4, Caxambu, 7-10 Nov. 1988.
Descritores: Resistência a Medicamentos/genética
Leishmania/efeitos dos fármacos
Leishmania/genética
-Amplificação de Genes
Responsável: BR1.1 - BIREME


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Id: lil-623681
Autor: Kinoti, G. K.
Título: The significance of variation in the susceptibility of Schistosoma mansoni to the antischistosomal drug oxamniquine
Fonte: Mem. Inst. Oswaldo Cruz;82(supl.4):151-156, 1987. tab.
Idioma: en.
Conferência: Apresentado em: International Symposium on Schistosomiasis, Apresentado em: Reunião Nacional de Esquistossomose, 1, Rio de Janeiro, Oct. 25-30, 1987.
Resumo: Clinical and laboratory evidence is reviewed which shows that there is a great deal of variation in the susceptibility of Schistosoma mansoni to oxamniquine. This variation occurs both among endemic regions and within endemic regions in Brazil and Kenya. It is genetically controlled. It is suggested that the parasite possesses a large capacity for developing resistance to the drug and that resistance will develop where sufficient drug pressure is maintained.
Descritores: Schistosoma mansoni/efeitos dos fármacos
Schistosoma mansoni/genética
Nitroquinolinas/farmacologia
-Oxamniquine
Resistência a Medicamentos
Responsável: BR1.1 - BIREME


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Id: lil-623680
Autor: Bruce, John I; Dias, Luiz Candido de Souza; Yung-San, Liang; Coles, Gerald C.
Título: Drug resistance in Schistosomiasis: a review
Fonte: Mem. Inst. Oswaldo Cruz;82(supl.4):143-150, 1987. tab.
Idioma: en.
Conferência: Apresentado em: International Symposium on Schistosomiasis, Apresentado em: Reunião Nacional de Esquistossomose, 1, Rio de Janeiro, Oct. 25-30, 1987.
Projeto: FAPESP; . United States of America. National Institutes of Health. National Institute of Allergy and Infectious Diseases.
Resumo: Drug resistance associated with the treatment of human schistosomiasis appears to be an emerging problem requiring more attention from the scientific community than the subject currently receives. Drug-resistant strains of Schistosoma mansoni have been isolated by various investigators as a result of laboratory experimentation or from a combination of field and laboratory studies. Review of this data appears to indicate that the lack of susceptibility observed for some of the isolated strains cannot be ascribed solely to previous administration of antischistosome drugs and thus further studies are required to elucidate this phenomena. Strains of S. mansoni have now been identified from Brazil which are resistant to oxamniquine, hycanthone and niridazole; from Puerto Rico which are resistant to hycanthone and oxamniquine; and from Kenya which are resistant to niridazole and probably oxamniquine. Strains derived by in vitro selection and resistant to oxamniquine and possibly to oltipraz are also available. All of these strains are currently maintained in the laboratory in snails and mice, thus providing for the first time an opportunity for indepth comparative studies. Preliminary data indicates that S. haematobium strains resistant to metrifonate may be occurring in Kenya. This problem could poise great difficulty in the eventual development of antischistosomal agents. Biomphalaria glabrata from Puerto Rico and Brazil were found to be susceptible to drug-resistant S. mansoni from each country.
Descritores: Esquistossomicidas/uso terapêutico
Resistência a Medicamentos/efeitos dos fármacos
Anti-Helmínticos/farmacologia
-Schistosoma mansoni
Esquistossomose mansoni/transmissão
Responsável: BR1.1 - BIREME


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Id: biblio-1020081
Autor: Rugani, Jeronimo Nunes; Gontijo, Célia Maria Ferreira; Frézard, Frédéric; Soares, Rodrigo Pedro; Monte-Neto, Rubens Lima do.
Título: Antimony resistance in Leishmania (Viannia) braziliensis clinical isolates from atypical lesions associates with increased ARM56/ARM58 transcripts and reduced drug uptake
Fonte: Mem. Inst. Oswaldo Cruz;114:e190111, 2019. tab, graf.
Idioma: en.
Projeto: CNPq; . CAPES; . RPS; . RLMN; . CMG; . FF; . CNPq; . RLMN.
Resumo: BACKGROUND In addition to the limited therapeutic arsenal and the side effects of antileishmanial agents, drug resistance hinders disease control. In Brazil, Leishmania braziliensis causes atypical (AT) tegumentary leishmaniasis lesions, frequently refractory to treatment. OBJECTIVES The main goal of this study was to characterise antimony (Sb)-resistant (SbR) L. braziliensis strains obtained from patients living in Xakriabá indigenous community, Minas Gerais, Brazil. METHODS The aquaglyceroporin 1-encoding gene (AQP1) from L. braziliensis clinical isolates was sequenced, and its function was evaluated by hypo-osmotic shock. mRNA levels of genes associated with Sb resistance were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Atomic absorption was used to measure Sb uptake. FINDINGS Although clinical isolates presented delayed recovery time in hypo-osmotic shock, AQP1 function was maintained. Isolate 340 accumulated less Sb than all other isolates, supporting the 65-fold downregulation of AQP1 mRNA levels. Both 330 and 340 isolates upregulated antimony resistance marker (ARM) 56/ARM58 and multidrug resistant protein A (MRPA); however, only ARM58 upregulation was an exclusive feature of SbR field isolates. CA7AE seemed to increase drug uptake in L. braziliensis and represented a tool to study the role of glycoconjugates in Sb transport. MAIN CONCLUSIONS There is a clear correlation between ARM56/58 upregulation and Sb resistance in AT-harbouring patients, suggesting the use of these markers as potential indicators to help the treatment choice and outcome, preventing therapeutic failure.
Descritores: Leishmania braziliensis/efeitos dos fármacos
Leishmania braziliensis/genética
Resistência a Medicamentos/efeitos dos fármacos
Leishmaniose Cutânea/parasitologia
Aquagliceroporinas/metabolismo
Antimônio/farmacologia
-Resistência a Medicamentos/genética
Reação em Cadeia da Polimerase em Tempo Real
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1020078
Autor: Brasiliense, Danielle; Cayô, Rodrigo; Streling, Ana Paula; Nodari, Carolina S; Barata, Rafael R; Lemos, Poliana S; Massafra, Janaina M; Correa, Yan; Magalhães, Igor; Gales, Ana C; Sodré, Roberta.
Título: Diversity of metallo-B-lactamase-encoding genes found in distinct species of Acinetobacter isolated from the Brazilian Amazon Region
Fonte: Mem. Inst. Oswaldo Cruz;114:e190020, 2019. tab, graf.
Idioma: en.
Projeto: CAPES; . APS; . CSN; . DS-CAPES; . CNPq; . ACG.
Resumo: BACKGROUND The multidrug resistance (MDR) phenotype is frequently observed in Acinetobacter baumannii, the most clinically relevant pathogenic species of its genus; recently, other species belonging to the A. calcoaceticus-A. baumannii complex have emerged as important MDR nosocomial pathogens. OBJECTIVES The present study aimed to verify the occurrence of metallo-β-lactamase genes among distinct Acinetobacter species in a hospital located in the Brazilian Amazon Region. METHODS Antimicrobial susceptibility profiles were determined by broth microdilution. The genetic relationships among these isolates were assessed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Pyrosequencing reads of plasmids carrying the bla NDM-1 gene were generated using the Ion Torrent™ platform sequencing. FINDINGS A total of six isolates carried bla NDM-1: A. baumannii (n = 2), A. nosocomialis (n = 3), and A. pittii (n = 1); three carried bla IMP-1: A. baumannii, A. nosocomialis, and A. bereziniae. Resistance to colistin was observed for an NDM-1-producing A. nosocomialis isolate. Diverse PFGE patterns and sequence types were found among A. nosocomialis and A. baumannii isolates. The bla NDM-1 sequence was inserted in a Tn125 transposon, while the bla IMP-1 was found as a gene cassette of the class 1 integron In86. MAIN CONCLUSIONS To the best of our knowledge, this is the first report describing the dissemination of bla NDM-1 among distinct Acinetobacter species recovered from the same hospital in South America.
Descritores: Acinetobacter/isolamento & purificação
Acinetobacter/efeitos dos fármacos
Acinetobacter/química
beta-Lactamases/isolamento & purificação
DNA Bacteriano
Resistência a Medicamentos
Carbapenêmicos/farmacologia
Eletroforese
Antibacterianos/farmacologia
-Brasil
Limites: Seres Humanos
Responsável: BR1.1 - BIREME



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