Curtisweaver7830

Paracoccidioidomycosis is a fungal disease of systemic involvement that can invade any organ and is of high mortality if it is not diagnosed in a timely manner. We present the case of a farmer male with a history of diabetes mellitus, who previously develops lingual ulcers and subsequently presents severe lung disease associated with septic shock, without response to antituberculous and antibacterial treatment. The bronchial secretion smear shows evidence of yeasts in multiple budding, compatible with Paracoccidioidomycosis. The patient had a satisfactory recovery to the administration of amphotericin B deoxycholate.The doctor has been from de Antiquity a victim of the people's affective ambivalence, who loves and hates him accord his success or failures. Some rant against the medical guild, but are proud to be patients of one or another doctor, more o less celebrated, referring familiarly to him as Tony or Jim. A certain envy hurts the doctor's image, countered by gratitude, but finally, as times goes by, the continuous progress of medicine has been improving the public perception about the medical work. A quick review of the Modern Age literature, personal, whimsical and may be imperfect, from Michel de Montaigne, in the sixteenth century until. Telaprevir cell line A. J. Cronin in the twentieth, shows the evolution of the doctor as a literary character, first as a tricky ignorant, after like a clown, later fighting epidemics and ending as a self-sacrificing medical researcher.

Carbapenemase-producing Enterobacteriaceae (CPE) has become a significant problem in terms of public health and clinical outcome.

To assess the epidemiology, treatment and mortality in patients with infection due to CPE.

A retrospective analysis of 163 patients with CPE infection was carried out in a university hospital from July 2013 to October 2015.

A total of 163 patients were included over the study period. Klebsiella pneumoniae was isolated in 95.1% of cases, and most of carbapenemases belonged to the OXA-48 group (93.0%). Acquisition was nosocomial in 124 cases (77.0%), healthcare-associated in 30 (18.6%), and 7 cases (4.3%) were community-acquired. The most frequent infections identified in this study were urinary tract (48.4%) and respiratory (19.5%) infections. Approximately half of the patients received antibiotic monotherapy. The 30-day mortality rate was 23.3%. Multivariate analysis revealed that the presence of septic shock at diagnosis (OR 4.2; IC 95% 1.5-11) was independently associated with an increase in death during the first month, unable to identify association with inappropriate antibiotic treatment.

Further studies are needed to clarify whether antibiotic treatment of EPC infections should be combined or if monotherapy might be sufficient in mild infections.

Further studies are needed to clarify whether antibiotic treatment of EPC infections should be combined or if monotherapy might be sufficient in mild infections.

Candidemia is a nosocomial bloodstream infection and an important cause of comorbidity and mortality. Elderly patients present the highest rates of candidemia but data about this population is scarce.

To describe characteristics of candidemia in elderly patients, to identify risk factors associated with mortality and to evaluate the usefulness of a predictive score.

A retrospective observational study of candidemia in elderly patients from a tertiary care hospital was carried out. We analyzed all Candida bloodstream infections during an eight-year period in patients older than 60 years.

Fifty-nine episodes were included. Diabetes was the most frequent comorbidity. Most candidemia were catheter related infections (45%). Only 17% of patients had a Candida score > 2.5. Overall mortality at 48 hours was 20%, and at 15 days was 49%. Mortality-related factors were shock, assisted mechanical ventilation, thrombocytopenia, renal failure and leukocytosis (p range < 0.0001-0.006). On multivariate analysis septic shock was independently associated with mortality (HR 4.02 [CI 95% 1.18-13.72] p = 0.026).

Nearly half of patients with candidemia died during the first fifteen days. Shock, assisted mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis were factors associated with mortality. The predictive score was not useful in this population.

Nearly half of patients with candidemia died during the first fifteen days. Shock, assisted mechanical ventilation, thrombocytopenia, renal failure, and leukocytosis were factors associated with mortality. The predictive score was not useful in this population.The global shortage of reagents and kits for nucleic acid extraction and molecular detection of SARS-CoV-2 requires new cost-effective strategies for the diagnosis of suspected COVID-19 cases, especially in countries that need to increase detection capacity. Pooled nucleic acid testing has been extensively used as a cost-effective strategy for HIV, HepB, HepC and influenza. Also, protocols dispensing of RNA extraction appears as an attractive option for detection of SARS-CoV-2. In this study, we found that pooling of 5 samples showed that CT variations were in the range of 1.0-4,5 units, with less likelihood of a false negative result. Results of the sample without nucleic acid ex-traction, was unsatisfactory, with a significant increase in CT values, and thus for risk of a false negative result. In conclusion, pooling nasopharyngeal samples with both automated and manual extraction proved reliable, and thus a potential efficient alternative for the diagnosis of suspected COVID-19 in developing countries.SARS-CoV-2 is the pathogen responsible for COVID-19, an infectious disease that can evolve from a mild viral illness to multiple organ failure and death. This disease is characterized by a high transmissibility rate, which has lead to its spread throughout the world. There are no clear prognostic markers to guide the severity of the condition; however, some clinical elements could be considered possible predictors of severity. Knowing its viral structure and pathogenesis has allowed to recognize specific molecular pathways candidates as therapeutic targets for various drugs, which are still under investigation and will set the guidelines for future protocols.