Participation of Clinical Pharmacists in the Therapy for a Case of AECOPD Complicated with Pulmonary In-fection / 中国药房

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for acute exacerbation of chronic obstruc-tive pulmonary diseases (AECOPD) complicated with pulmonary infection. METHODS:Clinical pharmacists participated in the therapy for a case of acute exacerbation of AECOPD complicated with pulmonary infection. According to the patients’signs,assis-tant examination and disease condition,clinical pharmacists provided suggestions,i.e. Piperacillin sodium and sulbactam sodium for injection (4∶1) 5.0 g,ivgtt,q12 h,for anti-infective treatment;Bisacodyl enteric-coated tablet 5 mg,po,qd,for promoting defecation;Clostridium butyricum viable bacteria tablet 20 mg,po,tid,for regulating gastrointestinal flora;Pinaverium bromide tablet 50 mg,po,tid,for regulating gastrointestinal smooth muscle tension;Shexiang baoxin pills 22.5 mg,po,tid,instead of flu-id infusion for protecting heart,and isosorbide 5-mononitrate 20 mg,po,tid,for preventing angina pectoris;Cefminox capsule 100 mg,po,tid,for anti-infective treatment;fluconazol 0.4 g,ivgtt,qd,for antifungal treatment,and Bacillus licheniformis 500 mg,po, tid,for preventing alteration of intestinal flora. RESULTS:The physicians adopted clinical pharmacist’s suggestions. No ADR was found during treatment,and the patients transferred to ordinary ward after the disease condition had been controlled. CONCLU-SIONS:The participating of clinical pharmacists in pharmaceutical care can promote rational drug use in the clinic and guarantee the safety of drug use.

Population pharmacokinetics study of voriconazole and dosing regimen optimization in patients with invasive fungus infections / 中国药学杂志

OBJECTIVE: To characterize the pharmacokinetics of voriconazole, find the factors influencing pharmacokinetics and optimize dosing regimen in patients with invasive fungus infections(IFIs). METHODS: To prospectively quantitate the relationship between VRC parameters and covariates, a population pharmacokinetics analysis was conducted on pooled data from patients with invasive fungus infections. The list of covariates tested included demographic factors, biochemistry, concomitant medications and CYP2C19 genotype. The final model was internally evaluated using bootstrap method. Monte Carlo simulation was used to evaluate the effective of currently recommended dosing regimen and to design an optimized pharmacodynamics dosing strategy for VRC. RESULTS: Four hundred and six samples from 151 patients were collected for population pharmacokinetics analysis. A one-compartment model with first-order absorption and elimination as the basic structural model appropriately fitted the data. VRC clearance was 6.95 L·h-1, volume of distribution was 200 L. The clearance was significantly association with age, alkaline phosphatase and CYP2C19 genotype. Bootstrap method confirmed that the pharmacokinetics parameters was accurate and the final model was robust. Monte Carlo simulation suggests that recommended dosing regimen for treat Aspegllius infections and 300 mg q12 h po or 200 mg q12 h iv. drip for treat Candida infections are effective. CONCLUSION: This study is able to show that the optimal VRC dosage regimens are successfully determined using prospective population pharmacokinetics analysis and Monte Carlo simulation.

Natural occurrence of the Fusarium solani on Tityus stigmurus (Thorell, 1876) (Scorpiones: Buthidae) / Ocorrência natural de Fusarium solani em Tityus stigmurus (Thorell, 1876) (Scorpions: Buthidae)

Members of the Fusarium solani species complex are agents of human mycoses, also affecting plants and other animals. Nevertheless, this fungus has not been reported on scorpions. Ten specimens of Tityus stigmurus collected in the field and showing their surface covered by white mycelia were used to assess fungus presence in the animal after its death. Identification of the fungi was based upon the cultural and morphological characteristics. The fungus was isolated from chelicerae and intersegmental regions. Infected individuals had their behaviour modified by reducing feeding and locomotion. None of the infected individuals survived. It is likely that this fungus may have a role in the regulation of field scorpion populations.

Ocorrência natural de Fusarium solani em Tityus stigmurus (Thorell, 1876) (Scorpiones: Buthidae). Membros do complexo de espécies de Fusarium solani são freqüentemente referidos como agentes de micoses humanas, podendo também afetar plantas e outros animais. Contudo, esse fungo ainda não foi registrado como causador de infecções em escorpiões. Dez espécimes de Tityus stigmurus coletados em campo e apresentando micélio branco cobrindo a superfície do corpo foram usados para analisar a presença de fungo após a sua morte. A identificação do fungo foi baseada nas características da cultura e morfológicas. O fungo foi isolado de quelíceras e regiões intersegmentais. Indivíduos infectados tiveram seu comportamento modificado, reduzindo sua alimentação e locomoção. Nenhum dos indivíduos infectados sobreviveu. É possível que este fungo possa ter um papel na regulação da população de campo desse escorpião.

Fungal Infection in 81 Patients with Diabetes / 中华医院感染学杂志

OBJECTIVE To investigate the status of fungus infection in the department of diabetes in order to analyze the risk factors,and to find out the approach for prevention.METHODS The review investigation method was used to collect clinical material of 81 cases with diabetes and fungus infection in our hospital from Jun 2002 to Jul 2007,and the result of bacterial cultures was analyzed.RESULTS The fungus infection took place more frequently in urinary tract(52.94%),then in the lungs and upper respiratory tract(27.05%).The frequently presented organism was the Candida albicans(42.35%),then C.glabrata(22.35%).CONCLUSIONS The age(≥60 years),sex,fasting plasma glucose concentration,2-hour postprandial blood glucose concentrations,the complications of chronic disease,and the long-term unreasonable use of antibiotic are the risk factors.

Nosocomial Systemic Fungus Infection: A Clinical Analysis of 496 Cases / 中华医院感染学杂志

OBJECTIVE To analyze the condition of nosocomical systemic fungus infection and make preventive and control measures against nosocomial systemic fungus infection.METHODS The 496 fungus-cultured positive cases with average age of 61.04 years old among the discharged patients from Jan 2003 to Dec 2005 were reviewed and analyzed.RESULTS The rate of nosocomical systemic fungus infection was 0.53%,from which the over 60 age senile patients accounted for 63.1%.Lower respiratory tract and urinary tract were the most frequent infection sites.The Candida albicans was accounted for 70.71%.The death rate of patients with nosocomial systemic fungus infection was 27.82%.The major correlated factors of nosocomial systemic fungus infection were the widespread use of broad-spectrum antibiotics and not be standardized and the iatrojenic injury of respiratory and urological tracts.CONCLUSIONS The causes of nosocomial systemic fungus infection are closely related to medical treatment;the death rate of patients with nosocomial systemic fungus infection is obvious higher than that without it;to prevent and control nosocomial systemic fungus infection is the key point of nosocomial treatment.

Clinical Analysis of 18 Neonates with Deep Fungus Infection under Mechanical Ventilation / 实用儿科临床杂志

Objective To explore the clinical and pathologic characteristic of deep fungus infection under mechanical ventilation in neonate. Method The clinical datas of 18 neonates under mechanical ventilation approved with deep fungus infection by autopsy from 1985 to 2003 in our department were collected and analyzed.Results In 18 infants who survived deep fungus infection,2 cases were premature and 16 cases were mature,the birth weight and the numbers of patients were:2500 g 2 cases;Time under mechanical ventilation was 8-86 days and the average time under mechanical ventilation was 13 days. The pathogen caused deep fungus infection was Aspergillus(8/18),Candida albicans(6/18) and Mucor(4/18),respectively. The infected organ were lung(12/18),brain(2/18),liver(4/18) and gastrointestinal tract(2/18),respectively.Two of them were found been infected in lung and liver at the same time.Conclusions We must attach importance to deep fungus infection in neonate under machine ventilation.Aspergillus and Candida albicans were the main pathogen bacteria and lung was the main infected organ of neonatal deep fungus infection.Early diagnosis may be the efficiency approach to increase livability.

Fungus infection of the cornea: a review of 43 cases

Forty-three proven cases of fungus infection of the cornea have been studied in the Philippine Eye Research Institute since 1968. Clinical features that suggested the nature of the infection included the (a) history of previous ocular trauma due to some vegetable matter, (b) severity of the pain on the affected eye, (c) non-response to prolonged anti-bacterial therapy, (d) preponderance of hard ulcers indicating minimal tissue necrosis, and the (e) hypopyon, when present, tended to be stringy and well-adherent to the back surface of the corneaEtiologic diagnosis requires demonstration of the organism in smears, cultures or preferably in the biopsy specimens. For this purpose, it is advised that the specimens should include portions of the advancing borders of the lesionsFusarium and Aspergillus which are plant pathogens were the most common fungi isolated from the cases. Others included Mycelia sterila, Hormodendrum, Curvularia, Phialophora verrucosa, Cephalosporium, Paecilomyces and Candida kruseiMedical therapy of the infection was not very encouraging. Part of the reason is that while the antifungal drugs are effective in-vitro against a wide variety of fungal cultures, they poorly penetrate the cornea. Surgical excision of the lesion removed a bulk of the infecting organisms and when used in conjunction with the antimycotic drugs, the procedure helped control the infection. (Summary)

Recombinant Human Granulocyte Colony-stimulating Factor in Treatment of Malignant Hematological Diseases with Fungus Infection and Its Clinical Significance / 中华医院感染学杂志

OBJECTIVE To investigate the effect of recombinant human granulocyte colony-stimulating factor(rhG-CSF) combined with antifungal drugs in the treatment of malignant hematologial diseases with fungus infection.METHODS Malignant hematologial patients with fungus infection were randomized to receive fluconazole with or without rhG-CSF.(RESULTS) The response rate in patients who received fluconazole combined with rhG-CSF was 89.1% and in(control) patients was 62.8%(P

High Risk Factors for Pulmonary Fungus Infection in Intensive Care Units of Neurosurgery / 中华医院感染学杂志

OBJECTIVE By analyzing the high risk factors for pulmonary fungus infection in intensive care units of neurosurgery,this paper may be regarded as a good reference for early diagnosis and treatment. METHODS According to the domestic diagnostic standard on pulmonary fungus infection,we analyzed the clinical data of 58 patients with pulmonary fungus infection in department of neursurgery. RESULTS Totally 117 strains of fungi were isolated from the 58 cases.Candidiasis was the most frequent type,accounting for 92.3%.Some factors,such as the severity of underlying diseases,long-time coma,long-term use of broad-spectrum antibiotic,abuse of glucocorticoid,the open airway and some traumatic intubations might be regarded as the high risk factors for pulmonary fungus infection.Fluconazole showed good clinical effects on the treatment of fungus infection. CONCLUSIONS It is important to eliminate the high risk factors for pulmonary fungus infection,to provide early diagnosis and to use prophylactic antifungal agent,which can reduce the incidence rate of pulmonary fungus infection.

Postoperational Fungus Infection: An Analysis / 中华医院感染学杂志

OBJECTIVE To investigate the distribution of fungus infection and risk factor of postoperation patients with tumors. METHODS We analyzed 1 256 postoperation patients in our hospital ICU from Aug 2000 to Aug 2004,and found that there were 88 fungus infection patients(7%),the pathogens were tested and analyzed. RESULTS The fungus infection,which dominated in respiratory tract and digestive tact,had an increasing tendency,the most prevalent fungus of infection was Candida albicans. CONCLUSIONS The risk factors of fungus infection are mechanical ventilation,the useness of antibiotics,radiotherapychemotherapy,and invasive treatment,it is very important to diagnose early and treat in time.