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[PMID]:29441972
[Au] Autor:Sakurada H; Yasuhara K; Kato K; Asano S; Yoshida M; Yamamura M; Tachi T; Teramachi H
[Ti] Título:An investigation of visual hallucinations associated with voriconazole administration to patients with hematological malignancies.
[So] Source:Pharmazie;71(11):660-664, 2016 Nov 02.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Voriconazole (VRCZ) is commonly administered to treat fungal infections in patients with hematological malignancies. Some of these patients experience VRCZ-associated visual hallucinations. We conducted a retrospective survey to investigate the characteristic features of this side effect. Patients with hematological malignancies who were treated with VRCZ for a fungal infection after hospitalization at Ichinomiya municipal hospital between 1 October 2005 and 31 December 2015 were included in this study (n = 103). Fifteen of these (14.6%) reported visual hallucinations that started on day 1-7. Seven of these 15 patients developed this symptom rapidly (day 1 or 2). Three patients had transient symptoms (lasting 2-12 days), 6 patients experienced hallucinations throughout the treatment, and the duration was unknown in 6 patients. Eleven patients experienced visual hallucinations when their eyes were closed (73 %) and these disappeared when they opened their eyes. One patient had visual hallucinations with open eyes, while the state of the eyes was unknown in 3 patients. The patients saw a range of images including people, animals, landscapes, and foods; several reported seeing images like those found in movies. In addition, 9 of 15 patients (60%) with visual hallucinations had visual disturbances. This was a higher proportion than that observed in patients who did not develop hallucinations (17 of 88; 19.3 %; P < 0.05). However, we found no significant difference between the blood VCRZ concentrations of patients who developed or did not develop visual hallucinations. This study indicated that most of these patients had visual hallucinations that manifested on eye closure, and they did not progress to serious mental illness. Our findings emphasized the importance of fully explaining the features of this symptom to each patient prior to starting VRCZ administration in order to reduce anxiety. In addition, since VRCZ discontinuation will compromise patient management, therapeutic drug monitoring should be used to increase the likelihood of successful therapy.
[Mh] Termos MeSH primário: Antifúngicos/efeitos adversos
Alucinações/induzido quimicamente
Neoplasias Hematológicas/complicações
Neoplasias Hematológicas/psicologia
Voriconazol/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antifúngicos/sangue
Antifúngicos/uso terapêutico
Feminino
Alucinações/epidemiologia
Alucinações/psicologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Micoses/complicações
Micoses/prevenção & controle
Estudos Retrospectivos
Transtornos da Visão/induzido quimicamente
Transtornos da Visão/epidemiologia
Voriconazol/sangue
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6725


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[PMID]:29202140
[Au] Autor:Nawrot U; Sulik-Tyszka B; Kurzyk E; Mroczynska M; Wlodarczyk K; Wróblewska M; Basak GW; Brillowska-Dabrowska A
[Ad] Endereço:Department of Pharmaceutical Microbiology and Parasitology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland.
[Ti] Título:Relation of the polymorphism of cyp51A sequence and the susceptibility of Aspergillus fumigatus isolates to triazoles determined by commercial gradient test (Etest) and by reference methods.
[So] Source:Acta Biochim Pol;64(4):631-634, 2017.
[Is] ISSN:1734-154X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to evaluate the accuracy of commercial gradient test (Etest) in the detection of triazole resistant Aspergillus fumigatus isolates using reference microdilution methods and the analysis of sequences of the cyp 51A gene. The study was performed on twenty clinical isolates which were identified as Aspergillus fumigatus based on the DNA sequences of the ITS1-2 fragment of ribosomal DNA and the ß-tubulin gene, out of them seventeen isolates showed wild-type cyp51A sequence and three were positive for the mutation TR34/L98H. All isolates were tested for the susceptibility to itraconazole (ITZ), voriconazole (VOR) and posaconasole (POS) using microdilution methods, according to EUCAST and CLSI protocols, as well as using Etest. The results of microdilution and Etests were analysed separately according to clinical breakpoints (CBP) defined by EUCAST version 7.0 and epidemiological cut off values (ECV). Etest as well as reference methods excellently recognised the WT isolates, which were susceptible to all tested triazoles, regardless of the method and CBP or ECV criteria used. The Etest recognized three non-WT isolates as resistant or intermediately sensitive to ITZ and POS and one as resistant to VOR. The categorical concordance between Etests and EUCAST and Etests and the CLSI method ranged from 90 to 100%. The interpretation of the results obtained from routine A. fumigatus Etests requires great caution. The use of the confirmative examinations with reference AST methods as well as with molecular tests is recommended.
[Mh] Termos MeSH primário: Antifúngicos/farmacologia
Aspergillus fumigatus/efeitos dos fármacos
Sistema Enzimático do Citocromo P-450/genética
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/métodos
Farmacorresistência Fúngica/efeitos dos fármacos
Proteínas Fúngicas/genética
[Mh] Termos MeSH secundário: Aspergillus fumigatus/genética
Farmacorresistência Fúngica/genética
Itraconazol/farmacologia
Testes de Sensibilidade Microbiana/métodos
Polimorfismo Genético
Triazóis/farmacologia
Voriconazol/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Fungal Proteins); 0 (Triazoles); 304NUG5GF4 (Itraconazole); 9035-51-2 (Cytochrome P-450 Enzyme System); EC 1.14.14.- (cytochrome P-450 CYP51A, Aspergillus); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.18388/abp.2017_1571


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[PMID]:29433463
[Au] Autor:Todokoro D; Hoshino J; Yo A; Makimura K; Hirato J; Akiyama H
[Ad] Endereço:Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. dtodokor@gunma-u.ac.jp.
[Ti] Título:Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review.
[So] Source:BMC Ophthalmol;18(1):40, 2018 Feb 13.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ubiquitous fungi of the Scedosporium apiospermum species complex (SASC) cause various opportunistic infections. Posterior subtenon triamcinolone acetonide (STTA) injection is a standard therapy for intraocular inflammation and macular edema. We report a case of Scedosporium apiospermum infectious scleritis after a posterior STTA injection. CASE PRESENTATION: A 75-year-old man received a posterior STTA injection to treat macular edema in his left eye. After 3 months, he complained of ocular pain and hyperemia in his left eye. Examination showed a subtenon abscess in the site corresponding with the STTA injection. After incising the abscess, the smear revealed numerous conidia-like structures. Although we suspected fungal infection and started topical voriconazole (VRCZ) and levofloxacin, the inflammation of the eye worsened. Fungal culture revealed filamentous fungus growth. Subsequently, we added systemic VRCZ and performed surgical debridement of the infected sclera and Tenon's capsule. Pathology of the sclera showed fungal hyphae. The antifungal susceptibility test revealed low minimum inhibitory concentrations for micafungin, VRCZ and miconazole (0.06, 0.25 and 0.5 µg/mL, respectively). After 2 months, the ciliary injection subsided and VRCZ therapy was stopped. However, subtenon abscess recurred 1 month after discontinuation of topical VRCZ. Surgical debridement and topical VRCZ were resumed, with the eye finally improving after 5 months of management. The fungal species was identified as Scedosporium apiospermum sensu stricto morphologically and by DNA sequencing. CONCLUSIONS: This case was successfully treated by topical and systemic VRCZ and repeated surgical debridement. Infectious scleritis caused by SASC rarely develops after posterior STTA. SASC can produce conidia in the enclosed subtenon space. Late-onset infectious scleritis after a posterior STTA injection suggests the presence of a fungal infection, including SASC, thereby requiring extensive and prolonged medical and surgical treatment.
[Mh] Termos MeSH primário: Infecções Oculares Fúngicas/microbiologia
Imunossupressores/administração & dosagem
Micoses/microbiologia
Complicações Pós-Operatórias
Scedosporium/isolamento & purificação
Esclerite/microbiologia
Triancinolona Acetonida/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Antifúngicos/uso terapêutico
Terapia Combinada
Desbridamento
Infecções Oculares Fúngicas/diagnóstico
Infecções Oculares Fúngicas/terapia
Seres Humanos
Injeções Intraoculares
Edema Macular/tratamento farmacológico
Imagem por Ressonância Magnética
Masculino
Testes de Sensibilidade Microbiana
Micoses/diagnóstico
Micoses/terapia
Esclerite/diagnóstico
Esclerite/terapia
Cápsula de Tenon/efeitos dos fármacos
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Immunosuppressive Agents); F446C597KA (Triamcinolone Acetonide); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180218
[Lr] Data última revisão:
180218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0707-4


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[PMID]:29382019
[Au] Autor:Wang Y; Li D; Qiao L; Zhao F
[Ad] Endereço:Department of Pediatric.
[Ti] Título:Infant Central Nervous System Aspergillosis with First-episode of Intracranial Hemorrhage: A case report.
[So] Source:Medicine (Baltimore);96(47):e8893, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Central nervous system (CNS) aspergillosis has the characteristics of multifocality, polymorphism, and coexistence of pathological types, and missed diagnosis and misdiagnosis frequently occur at the initial stage. The thesis reports a rare case of infant infection of CNS aspergillosis with the first-episode of intracranial hemorrhage. PATIENT CONCERNS: An 11-month-old female infant suffered convulsion and coma two days after the onset of fever and emesis. Its cranial computed tomography (CT) displayed subdural hemorrhage in the left tentorium cerebelli and tests indicated normal cerebrospinal fluid (CSF). Three days after being hospitalized, the infant had difficulty breathing and its CT presents consolidation in the right lung. However, treatment with ceftriaxone (ivgtt) had no effect on the baby. DIAGNOSIS: The patient's bronchoalveolar lavage fluid (BALF) was cultured into Aspergillus spp, its galactomannan (GM) antigen in CSF counted 3.0, higher than that in BALF which counted 2.6, and cranial magnetic resonance imaging (MRI) revealed multiple ring reinforced tubercles in sulci. Hence it was clinically diagnosed with CNS aspergillosis. INTERVENTIONS: Voriconazole for intravenous injection. After the intravenous injection, its trough concentration was 4.2 µg/mL, and it was within the recommended range. OUTCOMES: After one week's treatment with voriconazole, the infant's consciousness was improved. Four weeks later, with normothermia and clear consciousness, the patient was discharged. With oral administration of voriconazole up to 16 weeks, its physical state suggests no relapse and cranial MRI indicated disappearance of nodules in sulci. LESSONS: CNS aspergillosis with first-episode of intracranial hemorrhage probably leads to misdiagnosis and GM test combined with cranial MRI can augment its accuracy in the early diagnosis.
[Mh] Termos MeSH primário: Infecções Fúngicas do Sistema Nervoso Central/complicações
Hemorragias Intracranianas/parasitologia
Neuroaspergilose/complicações
[Mh] Termos MeSH secundário: Antifúngicos/administração & dosagem
Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico
Seres Humanos
Lactente
Neuroaspergilose/tratamento farmacológico
Voriconazol/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008893


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[PMID]:29218389
[Au] Autor:Mellinghoff SC; Panse J; Alakel N; Behre G; Buchheidt D; Christopeit M; Hasenkamp J; Kiehl M; Koldehoff M; Krause SW; Lehners N; von Lilienfeld-Toal M; Löhnert AY; Maschmeyer G; Teschner D; Ullmann AJ; Penack O; Ruhnke M; Mayer K; Ostermann H; Wolf HH; Cornely OA
[Ad] Endereço:Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany. sibylle.mellinghoff@uk-koeln.de.
[Ti] Título:Primary prophylaxis of invasive fungal infections in patients with haematological malignancies: 2017 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO).
[So] Source:Ann Hematol;97(2):197-207, 2018 Feb.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Immunocompromised patients are at high risk of invasive fungal infections (IFI), in particular those with haematological malignancies undergoing remission-induction chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) and recipients of allogeneic haematopoietic stem cell transplants (HSCT). Despite the development of new treatment options in the past decades, IFI remains a concern due to substantial morbidity and mortality in these patient populations. In addition, the increasing use of new immune modulating drugs in cancer therapy has opened an entirely new spectrum of at risk periods. Since the last edition of antifungal prophylaxis recommendations of the German Society for Haematology and Medical Oncology in 2014, seven clinical trials regarding antifungal prophylaxis in patients with haematological malignancies have been published, comprising 1227 patients. This update assesses the impact of this additional evidence and effective revisions. Our key recommendations are the following: prophylaxis should be performed with posaconazole delayed release tablets during remission induction chemotherapy for AML and MDS (AI). Posaconazole iv can be used when the oral route is contraindicated or not feasible. Intravenous liposomal amphotericin B did not significantly decrease IFI rates in acute lymphoblastic leukaemia (ALL) patients during induction chemotherapy, and there is poor evidence to recommend it for prophylaxis in these patients (CI). Despite substantial risk of IFI, we cannot provide a stronger recommendation for these patients. There is poor evidence regarding voriconazole prophylaxis in patients with neutropenia (CII). Therapeutic drug monitoring TDM should be performed within 2 to 5 days of initiating voriconazole prophylaxis and should be repeated in case of suspicious adverse events or of dose changes of interacting drugs (BIItu). General TDM during posaconazole prophylaxis is not recommended (CIItu), but may be helpful in cases of clinical failure such as breakthrough IFI for verification of compliance or absorption.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Hospedeiro Imunocomprometido
Infecções Fúngicas Invasivas/prevenção & controle
Leucemia Mieloide Aguda/terapia
Síndromes Mielodisplásicas/terapia
Prevenção Primária/métodos
[Mh] Termos MeSH secundário: Ensaios Clínicos como Assunto
Monitoramento de Medicamentos
Hematologia
Transplante de Células-Tronco Hematopoéticas
Seres Humanos
Quimioterapia de Indução
Infecções Fúngicas Invasivas/imunologia
Infecções Fúngicas Invasivas/microbiologia
Leucemia Mieloide Aguda/imunologia
Leucemia Mieloide Aguda/patologia
Oncologia
Síndromes Mielodisplásicas/imunologia
Síndromes Mielodisplásicas/patologia
Sociedades Médicas
Triazóis/uso terapêutico
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Triazoles); 6TK1G07BHZ (posaconazole); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3196-2


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[PMID]:29049191
[Au] Autor:Liu X; Su H; Tong J; Chen J; Yang H; Xiao L; Hu J; Zhang L
[Ad] Endereço:Liver Failure Treatment and Research Center, 302 Hospital of PLA, Xisihuanzhonglu, Beijing, China.
[Ti] Título:Significance of monitoring plasma concentration of voriconazole in a patient with liver failure: A case report.
[So] Source:Medicine (Baltimore);96(42):e8039, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Invasive pulmonary aspergillosis is associated with significant morbidity and mortality in patients with liver failure. Voriconazole (VRCZ) is recommended as a primary therapeutic agent for the treatment of invasive aspergillosis and metabolized in the liver. Now, data are still lacking on the safety and appropriate dosage of VRCZ in patients with liver failure. Here, we report a representative case of invasive pulmonary fungal infection in a patient with liver failure who was treated with low-dose VRCZ. PATIENT CONCERNS: A 21-year-old man, presented with subacute liver failure caused suspected by viral infection, was admitted on June 22, 2014. Liver function was not improved by the treatment of gancicolovir and methylprednisolone. The patient presented with fever, cough, and hyperpyrexia on July 14. Laboratory tests revealed raised neutrophil percentage (82.1%, normal range [NR] 50-70), international normalized ratio (INR) (2.32, NR 0.8-1.2) and levels of serum lactic acid (4.308 mmol/L, NR 0.6-2.2), alanine transaminase (165 U/L,NR 0-40), aspartate transaminase (99 U/L, NR 8-40), and total bilirubin (654 mmol/L, NR 3.4-20.5). Furthermore, CD4+ T cell, CD8+T cell, and B cell count were low (169, 221, and l8/mL, respectively). Sputum smear microscopy for bacteria was negative, but the direct observation for fungal elements was positive. Thoracic CT scan revealed bilateral pulmonary high-density shadow. Sputum cultures were positive 2 days later with the presence of Aspergillus fumigatus. DIAGNOSES: Therefore, this patient diagnosed with suspected pulmonary a spergillosis. INTERVENTIONS: VRCZ was used on July 15th and its dosage was 400 mg twice on day 1 followed by a maintenance dose of 100 mg twice daily according to drug usage instruction. However, some side effects, such as tremors, lips twitching, and hair loss, occurred. Plasma VRCZ trough concentration was 8.1 mg/mL which was much higher than the recommend level. Therefore, VRCZ dosage was adjusted according to its plasma concentration. VRCZ plasma concentration fluctuated between 2.5 to 4.7 mg/mL when its dosage was 100 mg once daily and side effects disappeared. OUTCOMES: VRCZ was administered for 2 months. This patient's symptoms and liver function were improved. A follow-up CT scan performed at the end of VRCZ therapy indicated that the high-density shadow had diminished. LESSONS: This case demonstrated that low-dose VRCZ (maintenance dose, 100 mg/day) can achieve effective plasma concentration and reduce side effects without liver damage. We believe that VRCZ is safe to be administered in patients with liver failure, but its plasma concentration should be carefully monitored.
[Mh] Termos MeSH primário: Antifúngicos/sangue
Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle
Monitoramento de Medicamentos/métodos
Aspergilose Pulmonar Invasiva/tratamento farmacológico
Falência Hepática/sangue
Voriconazol/sangue
[Mh] Termos MeSH secundário: Antifúngicos/administração & dosagem
Doença Hepática Induzida por Substâncias e Drogas/parasitologia
Seres Humanos
Aspergilose Pulmonar Invasiva/parasitologia
Falência Hepática/tratamento farmacológico
Falência Hepática/parasitologia
Masculino
Resultado do Tratamento
Voriconazol/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008039


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[PMID]:29016668
[Au] Autor:Won EJ; Choi MJ; Shin JH; Park YJ; Byun SA; Jung JS; Kim SH; Shin MG; Suh SP
[Ad] Endereço:Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
[Ti] Título:Diversity of clinical isolates of Aspergillus terreus in antifungal susceptibilities, genotypes and virulence in Galleria mellonella model: Comparison between respiratory and ear isolates.
[So] Source:PLoS One;12(10):e0186086, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We analyzed the antifungal susceptibility profiles, genotypes, and virulence of clinical Aspergillus terreus isolates from six university hospitals in South Korea. Thirty one isolates of A. terreus, comprising 15 respiratory and 16 ear isolates were assessed. Microsatellite genotyping was performed, and genetic similarity was assessed by calculating the Jaccard index. Virulence was evaluated by Galleria mellonella survival assay. All 31 isolates were susceptible to itraconazole, posaconazole, and voriconazole, while 23 (74.2%) and 6 (19.4%) showed amphotericin B (AMB) minimum inhibitory concentrations (MICs) of ≤ 1 mg/L and > 4 mg/L, respectively. Notably, respiratory isolates showed significantly higher geometric mean MICs than ear isolates to AMB (2.41 vs. 0.48 mg/L), itraconazole (0.40 vs. 0.19 mg/L), posaconazole (0.16 vs. 0.08 mg/L), and voriconazole (0.76 vs. 0.31 mg/L) (all, P <0.05). Microsatellite genotyping separated the 31 isolates into 27 types, but the dendrogram demonstrated a closer genotypic relatedness among isolates from the same body site (ear or respiratory tract); in particular, the majority of ear isolates clustered together. Individual isolates varied markedly in their ability to kill infected G. mellonella after 72 h, but virulence did not show significant differences according to source (ear or respiratory tract), genotype, or antifungal susceptibility. The current study shows the marked diversity of clinical isolates of A. terreus in terms of antifungal susceptibilities, genotypes and virulence in the G. mellonella model, and ear isolates from Korean hospitals may have lower AMB or triazole MICs than respiratory isolates.
[Mh] Termos MeSH primário: Aspergilose/genética
Aspergillus/efeitos dos fármacos
Farmacorresistência Fúngica/genética
Orelha/microbiologia
Sistema Respiratório/microbiologia
[Mh] Termos MeSH secundário: Animais
Antifúngicos/farmacologia
Aspergilose/tratamento farmacológico
Aspergilose/microbiologia
Aspergillus/patogenicidade
Orelha/patologia
Genótipo
Hospitais Universitários
Seres Humanos
Itraconazol/farmacologia
Lepidópteros/microbiologia
Repetições de Microssatélites/genética
Sistema Respiratório/patologia
Triazóis/farmacologia
Voriconazol/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Triazoles); 304NUG5GF4 (Itraconazole); 6TK1G07BHZ (posaconazole); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186086


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[PMID]:28917461
[Au] Autor:Chansky PB; Wanat K; Pappas-Taffer L; Rosenbach M; Micheletti RG
[Ad] Endereço:Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:A cross-sectional survey of voriconazole prescribers: Assessing current practice and knowledge of cutaneous side effects.
[So] Source:J Am Acad Dermatol;77(4):769-770, 2017 10.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antifúngicos/efeitos adversos
Erupção por Droga/etiologia
Uso de Medicamentos
Neoplasias Cutâneas/induzido quimicamente
Voriconazol/efeitos adversos
[Mh] Termos MeSH secundário: Antifúngicos/uso terapêutico
Atitude do Pessoal de Saúde
Estudos Transversais
Erupção por Droga/epidemiologia
Erupção por Droga/prevenção & controle
Feminino
Seres Humanos
Incidência
Masculino
Padrões de Prática Médica
Prognóstico
Medição de Risco
Neoplasias Cutâneas/epidemiologia
Neoplasias Cutâneas/fisiopatologia
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


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[PMID]:28817744
[Au] Autor:Prajna NV; Krishnan T; Rajaraman R; Patel S; Shah R; Srinivasan M; Das M; Ray KJ; Oldenburg CE; McLeod SD; Zegans ME; Acharya NR; Lietman TM; Rose-Nussbaumer J; Mycotic Ulcer Treatment Trial Group
[Ad] Endereço:Aravind Eye Care System, Madurai, Pondicherry, Tirunelveli and Coimbatore, India.
[Ti] Título:Predictors of Corneal Perforation or Need for Therapeutic Keratoplasty in Severe Fungal Keratitis: A Secondary Analysis of the Mycotic Ulcer Treatment Trial II.
[So] Source:JAMA Ophthalmol;135(9):987-991, 2017 Sep 01.
[Is] ISSN:2168-6173
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Identifying patients with infectious keratitis who are at risk of experiencing a poor outcome may be useful to allocate resources toward high-risk patients, particularly in resource-poor settings. Objective: To determine baseline patient and ulcer characteristics that predict a high risk of developing corneal perforation and/or the need to undergo therapeutic penetrating keratoplasty (TPK). Design, Setting, and Participants: This is a secondary analysis of Mycotic Ulcer Treatment Trial II, a multicenter, double-masked, placebo-controlled randomized clinical trial that enrolled 240 patients with smear-positive filamentous fungal corneal ulcers who enrolled between May 2010 and August 2015. Participants had a baseline visual acuity of 20/400 or worse and were randomized to receive oral voriconazole or a placebo (all participants received topical voriconazole, 1%). After 39 participants (16.3%) were enrolled, topical natamycin, 5%, was also added. Main Outcomes and Measures: The primary outcome of this secondary analysis was the rate of corneal perforation or the need to undergo TPK. Results: The mean (SD) age at enrollment was 49 (13) years, 104 participants (43.3%) were women, and all were of Southeast Asian descent. The presence of hypopyon at baseline indicated 2.28 times the odds of the patient developing corneal perforation and/or needing TPK (95% CI, 1.18-4.40; P = .01). Study participants whose infiltrate involved the posterior one-third had a 71.4% risk of developing corneal perforation and/or needing TPK. For each 1-mm increase in the geometric mean of the infiltrate, there was 1.37 (95% CI, 1.12-1.67; P = .002) increased odds of developing perforation and/or needing TPK. Other clinical features such as visual acuity, baseline culture positivity, type of filamentous fungal organism and duration of symptoms, and demographic characteristics, such as sex and occupation, were not significant predictors in the multivariable regression analysis. Conclusions and Relevance: These results suggest that risk stratification from baseline ulcer characteristics can identify those at highest risk for developing corneal perforation and/or needing TPK. Trial Registration: clinicaltrials.gov Identifier: NCT00996736.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Perfuração da Córnea/diagnóstico
Úlcera da Córnea/diagnóstico
Infecções Oculares Fúngicas/diagnóstico
Ceratoplastia Penetrante
Micoses/diagnóstico
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Perfuração da Córnea/cirurgia
Úlcera da Córnea/tratamento farmacológico
Úlcera da Córnea/microbiologia
Método Duplo-Cego
Quimioterapia Combinada
Infecções Oculares Fúngicas/tratamento farmacológico
Infecções Oculares Fúngicas/microbiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Micoses/tratamento farmacológico
Micoses/microbiologia
Natamicina/uso terapêutico
Supuração/diagnóstico
Acuidade Visual/fisiologia
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antifungal Agents); 8O0C852CPO (Natamycin); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1001/jamaophthalmol.2017.2914


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[PMID]:28780363
[Au] Autor:Kuklinski LF; Li S; Karagas MR; Weng WK; Kwong BY
[Ad] Endereço:Department of Pathology, Stanford University School of Medicine, Stanford, California.
[Ti] Título:Effect of voriconazole on risk of nonmelanoma skin cancer after hematopoietic cell transplantation.
[So] Source:J Am Acad Dermatol;77(4):706-712, 2017 Oct.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Voriconazole has previously been associated with increased risk for cutaneous squamous cell carcinoma (SCC) in solid organ transplant recipients. Less is known about the risk in patients after hematopoietic cell transplantation (HCT). OBJECTIVE: We evaluated the effect of voriconazole on the risk for nonmelanoma skin cancer (NMSC), including SCC and basal cell carcionoma, among those who have undergone allogeneic and autologous HCT. METHODS: In all, 1220 individuals who had undergone allogeneic HCT and 1418 who had undergone autologous HCT were included in a retrospective cohort study. Multivariate analysis included voriconazole exposure and other known risk factors for NMSC. RESULTS: In multivariate analysis, voriconazole use increased the risk for NMSC (hazard ratio, 1.82; 95% confidence interval, 1.13-2.91) among those who had undergone allogeneic HCT, particularly for SCC (hazard ratio, 2.25; 95% confidence interval, 1.30-3.89). Voriconazole use did not appear to confer increased risk for NMSC among those who had undergone autologous HCT. LIMITATIONS: This is a retrospective study. CONCLUSION: Voriconazole use represents an independent factor that may contribute to increased risk specifically for SCC in the allogeneic HCT population.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Carcinoma Basocelular/epidemiologia
Carcinoma de Células Escamosas/epidemiologia
Transplante de Células-Tronco Hematopoéticas
Neoplasias Cutâneas/epidemiologia
Voriconazol/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Feminino
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Micoses/prevenção & controle
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
Transplante Autólogo
Transplante Homólogo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170807
[St] Status:MEDLINE



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