ABSTRACT
Organic dusts are complex bioaerosol mixtures comprised of dust and par ticulate matter of organic origin. These include components from bacteria, fungi, pollen, and viruses to fragments of animals and plants commonplace to several environmental/occupational settings encompassing agriculture/farming, grain processing, waste/recycling, textile, cotton, woodworking, bird breeding, and more. Organic dust exposures are linked to development of chronic bronchitis, chronic obstructive pulmonary disease, asthma, asthma-like syndrome, byssinosis, hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. Risk factors of disease development include cumulative dust exposure, smoking, atopy, timing/duration, and nutritional factors. The immunopathogenesis predominantly involves Toll-like receptor signaling cascade, T-helper 1/T-helper 17 lymphocyte responses, neutrophil influx, and potentiation of manifestations associated with allergy. The true prevalence of airway disease directly attributed to organic dust, especially in a workplace setting, remains challenging. Diagnostic confirmation can be difficult and complicated by hesitancy from workers to seek medical care, driven by fears of potential labor-related consequence. Clinical respiratory and systemic presentations coupled with allergy testing, lung function patterns of obstructive versus restrictive disease, and radiological characteristics are typically utilized to delineate these various organic dust-associated respiratory diseases. Prevention, risk reduction, and management primarily focus on reducing exposure to the offending dust, managing symptoms, and preventing disease progression.
Subject(s)
COVID-19 , Vocal Cord Dysfunction , Humans , SARS-CoV-2 , Vocal Cord Dysfunction/diagnosis , Diagnosis, Differential , Vocal CordsABSTRACT
PURPOSE OF REVIEW: Occupational rhinitis is an underdiagnosed disease with significant morbidity and implications in the workplace. Multiple factors associated with this disease continue to pose a challenge to investigators. This review aims to summarize recent literature in occupational rhinitis, including classifications, pathogenesis, diagnosis, and treatment, as well as the impact of occupational rhinitis on individuals. Additionally, it identifies areas in need of further research and investigation. RECENT FINDINGS: We highlight current research on the association between occupational rhinitis and occupational asthma and the role of immunotherapy in this disease. Discussion includes the impact of social trends on workers and the wider consequences of occupational rhinitis including decreased work productivity, absenteeism, and socioeconomic burden. Occupational rhinitis remains a challenging disease entity due to the numerous potential causative factors, reduced recognition, morbidity in asthma, and therapeutic limitations. Additional research is needed to better identify disease predictors and develop effective management strategies.
Subject(s)
Asthma, Occupational , Occupational Diseases , Occupational Exposure , Rhinitis , Humans , Rhinitis/diagnosis , Rhinitis/epidemiology , Rhinitis/therapy , Occupational Diseases/diagnosis , Occupational Exposure/adverse effects , WorkplaceABSTRACT
Introduction Patients that are presented with acute calculus cholecystitis (AC) and elevated liver enzymes markers (LEM), often require evaluation for concurrent choledocholithiasis (CDL). Currently, evaluation guidelines follow the American Society of Gastroenterology Endoscopy (ASGE) recommendations. Objectives The aim of the study was to externally validate both ASGE and the Chisholm predictors in a community hospital patient cohort. Methods We conducted a retrospective study of patients who presented to Ascension Saint John hospital with AC and elevated LEM over a period of two years. Sensitivity (SEN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were used to test the external validity of ASGE and Chisholm algorithms. Results A total of 132 patients' charts were reviewed, and 87 patients included. Chisholm predictors SEN, SP, PPV and NPV were 50%, 82%, 18%, and 95% respectively versus 100%, 19%, 8%, 100% for the ASGE predictors model. In the ASGE module, SP and PPV can be significantly improved to 60% and 13%, respectively, by changing a few risk categories including age and LEM range. Conclusions External validation of the Chisholm module in our patient cohort showed that it would lead to a low referral rate for unnecessary imaging and thus might be more cost-effective, especially when compared to current ASGE recommendations which would have a higher referral rate. On the other hand, current ASGE recommendations successively labeled all the patients with CDL, while the Chisholm module missed around 50 percent. We also observed that with the current ASGE module, the referral rate for further imaging and diagnostic tests can be possibly improved by adjusting a few of the predictors including the age and the abnormal liver transaminases range, but this observation is arbitrary and will need to be validated in a larger cohort study.
ABSTRACT
INTRODUCTION: The incidence of cardiac primary tumors is estimated to be 0.0017-0.28%, of which 25% are malignant, occupying mainly right cavities. CLINICAL CASE: Patient who present with neurological symptoms due to brain metastasis of primary cardiac tumor in the left atrium, infiltrating the mitral valve and pulmonary veins. Tumor resection was performed with mitral valve replacement and atrial re-modeling with the use of the left appendage. CONCLUSIONS: Imaging techniques are fundamental for the diagnosis of this pathology, since the majority of cardiac tumors are asymptomatic until late stages.
INTRODUCCIÓN: La incidencia de tumores primarios cardiacos se calcula en 0.0017 a 0.28%, de los cuales el 25% es maligno y ocupa principalmente cavidades derechas. CASO CLÍNICO: Paciente que inicia con síntomas neurológicos por metástasis cerebrales de tumor primario cardiaco en cavidades izquierdas, que infiltra válvula mitral y venas pulmonares. Se realiza resección tumoral con reemplazo valvular mitral y remodelamiento auricular con uso de orejuela izquierda. CONCLUSIONES: Las técnicas de imagen son fundamentales para el diagnóstico de esta afección, ya que la mayor parte de los tumores cardiacos se muestra asintomática hasta etapas tardías.
Subject(s)
Brain Neoplasms/secondary , Heart Atria/pathology , Heart Neoplasms/pathology , Mitral Valve/pathology , Pulmonary Veins/pathology , Sarcoma/pathology , Adult , Brain Neoplasms/diagnostic imaging , Heart Atria/surgery , Heart Neoplasms/surgery , Heart Valve Prosthesis Implantation , Humans , Male , Mitral Valve/surgery , Neoplasm Invasiveness/pathology , Sarcoma/diagnostic imaging , Sarcoma/secondary , Sarcoma/surgeryABSTRACT
BACKGROUND: The successful performance of ostomies for the treatment of different diseases has been described since 1706. We report herein the first case of successful ostomy utilizing a synthetic stoma created in a patient with peritoneal carcinomatosis. CLINICAL CASE: A 40-year-old woman presented with abdominal carcinomatosis due to psammomatous papillotubular adenocarcinoma consistent with primary ovarian carcinoma. The patient had negative estrogen and progesterone receptors and Ki-67 proliferative activity was 83%. She was initially treated with cytoreduction therapy, chemotherapy, and hyperthermic intraperitoneal chemotherapy. Because the patient presented with enteric perforations and the extensive tumor invasion and adhesions in all the intestinal segments made it impossible to create autologous decompression stomas, a synthetic stoma was constructed. CONCLUSIONS: Synthetic stomas can be a good treatment option when autologous stomas can not be created.
INTRODUCCIÓN: Desde el año 1706 se han descrito ostomías realizadas con éxito para el tratamiento de diferentes enfermedades; los autores describen el primer caso de éxito en una ostomía sintética en la carcinomatosis peritoneal. CASO CLÍNICO: Mujer de 40 años de edad con carcinomatosis abdominal por adenocarcinoma papilar tubulopapilar psamomatoso más consistente con cáncer primario de ovario, negativo a receptores de estrógenos y progesterona, con marcador Ki-67 al 83% de actividad. De modo inicial se trató con cirugía de citorreducción, quimioterapia, quimioterapia intraperitoneal hipertérmica y por último realización de estomas sintéticos debido a perforaciones entéricas e imposibilidad de realizar estomas descompresivos autólogos por la invasión tumoral extensa y adherencias de todas las asas intestinales. CONCLUSIONES: Los estomas sintéticos pueden ser una buena opción terapéutica cuando es imposible realizar estomas autólogos.
Subject(s)
Adenocarcinoma, Papillary/secondary , Drainage/instrumentation , Intestinal Neoplasms/secondary , Intestinal Perforation/surgery , Ovarian Neoplasms/surgery , Surgical Stomas , Adenocarcinoma, Papillary/drug therapy , Adenocarcinoma, Papillary/etiology , Adenocarcinoma, Papillary/surgery , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Argon Plasma Coagulation , Bevacizumab/administration & dosage , Carboplatin/administration & dosage , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Docetaxel/administration & dosage , Doxorubicin/administration & dosage , Doxorubicin/analogs & derivatives , Fatal Outcome , Female , Humans , Hyperthermia, Induced , Intestinal Neoplasms/drug therapy , Intestinal Neoplasms/etiology , Intestinal Neoplasms/surgery , Intestinal Perforation/etiology , Mitomycin/administration & dosage , Polyethylene Glycols/administration & dosageABSTRACT
BACKGROUND: Active surveillance is necessary for improving the management and outcomes of patients with candidemia. The aim of this study was to describe the epidemiologic and clinical features of candidemia in pediatric patients in Latin America. METHOD: Prospective, multicenter, surveillance study of candidemia in a pediatric population from 23 hospitals in 8 Latin America countries between November 2008 and October 2010. RESULTS: Three hundred and two cases of candidemia were reported with a median incidence of 0.81/1000 admissions. Eighty nine (29%) were neonates. The main risk factors were prematurity, intensive care unit (ICU) admission, parenteral nutrition, respiratory disease and mechanical ventilation in neonates and malignancy, neutropenia, neurological disease and previous use of corticosteroids in children. The main species isolated in neonates and children were Candida albicans (43.8% and 35.7%), Candida parapsilosis (27.0% and 26.3%) and Candida tropicalis (14.6% and 14.6%), respectively. The most frequent antifungal therapy used in neonates and children was deoxycholate-amphotericin-B (43.8% and 29.1%) and fluconazole (28.1% and 53.1%). Seventeen neonates (19.1%) and 20 children (9.4%) did not receive antifungal therapy. The 30-day survival rate was 60% in neonates and 72% in children (P = 0.02). Survival was significantly higher in treated than in nontreated neonates (72% vs. 24%; P < 0.001). A multivariate analysis showed that independent predictors for 30-day mortality in children were renal disease (odds ratio: 4.38, 95% confidence interval: 1.92-10.1, P < 0.001) and receipt of corticosteroids (odds ratio: 2.08, 95% confidence interval: 1.04-4.17, P = 0.04). CONCLUSIONS: To our knowledge, this is the first prospective, multicenter surveillance study of candidemia in children in Latin America. This epidemiologic information may provide us with methods to improve preventive, diagnostic and therapeutic strategies in our continent.
Subject(s)
Candidemia/epidemiology , Adolescent , Antifungal Agents/therapeutic use , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/drug therapy , Candidemia/microbiology , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Infant, Newborn , Intensive Care Units , Latin America/epidemiology , Male , Multivariate Analysis , Prospective Studies , Risk FactorsABSTRACT
La candidemia es una de las micosis oportunistas más frecuentes en todo el mundo. El escaso número de estudios epidemiológicos llevados a cabo en América Latina indica que las tasas de incidencia en esta región son mayores que las descritas en el hemisferio norte. A menudo el diagnóstico de la infección se establece tardíamente, lo que afecta al inicio del tratamiento antimicótico. Por esta razón, para el diagnóstico y el manejo de la candidemia está justificada una estrategia más científica, basada en parámetros específicos. Recomendaciones para el diagnóstico y manejo de la candidemia constituye una serie de artículos preparados por miembros del grupo Latin America Invasive Mycosis Network. Su objetivo es proporcionar las mejores evidencias disponibles para el diagnóstico y el manejo de la candidemia. El presente artículo, Recomendaciones para el diagnóstico de la candidemia en América Latina, ha sido redactado con el objetivo de brindar asesoramiento a los profesionales de la salud en lo referente al diagnóstico de la candidemia en pacientes que la padecen o están en riesgo de padecerla. Mediante la base de datos PubMed se emprendió una búsqueda informatizada de los estudios publicados. Los miembros del grupo revisaron y analizaron exhaustivamente los datos. El grupo también se reunió en 2 ocasiones para proponer preguntas, abordar los puntos de vista conflictivos y deliberar sobre las recomendaciones terapéuticas. Recomendaciones para el diagnóstico de la candidemia en América Latina incluye diversas recomendaciones sobre aspectos relacionados con los métodos diagnósticos para la detección de la candidemia, la identificación de las especies de Candida y las pruebas de sensibilidad antifúngica. Se expone también la disponibilidad de los métodos, sus costes y el marco en el que se aplican los tratamientos. Este manuscrito es el primero de los artículos de esta serie dedicada al diagnóstico y tratamiento de las candidiasis invasoras. Otras publicaciones de esta serie son Recomendaciones para el diagnóstico de la candidemia en adultos en América Latina, Recomendaciones para el manejo de la candidemia en niños en América Latina, y Recomendaciones para el manejo de la candidemia en neonatos en América Lat (AU)
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. Recommendations for the diagnosis and management of candidemia are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, Recommendations for the diagnosis of candidemia in Latin America, was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. Recommendations for the diagnosis of candidemia in Latin America includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: Recommendations for the management of candidemia in adults in Latin America, Recommendations for the management of candidemia in children in Latin America, and Recommendations for the management of candidemia in neonates in Latin America (AU)
Subject(s)
Humans , Male , Female , Candidemia/epidemiology , Mycoses/epidemiology , Mycoses/prevention & control , Antibodies, Fungal , Antifungal Agents/therapeutic use , Candidemia/diagnosis , Candidemia/microbiology , Latin America/epidemiology , Mycoses/microbiologyABSTRACT
La candidemia es una de las micosis oportunistas más frecuentes en todo el mundo. El escaso número de estudios epidemiológicos llevados a cabo en América Latina indica que las tasas de incidencia en esta región son mayores que las descritas en el hemisferio norte. A menudo el diagnóstico de la infección se establece tardíamente, lo que afecta el inicio del tratamiento antimicótico. Por esta razón, para el diagnóstico y el manejo de la candidemia está justificada una estrategia más científica, basada en parámetros específicos. Recomendaciones para el diagnóstico y manejo de la candidemia constituye una serie de artículos preparados por miembros del grupo Latin America Invasive Mycosis Network. Su objetivo es proporcionar las mejores evidencias disponibles para el diagnóstico y el manejo de la candidemia. El presente artículo, Recomendaciones para el manejo de la candidemia en neonatos en América Latina, ha sido redactado con el objetivo de orientar a los profesionales de la salud en el manejo de los neonatos que padecen, o pueden padecer, candidemia. Mediante la base de datos PubMed se emprendió una búsqueda informatizada de los estudios publicados. Los miembros del grupo revisaron y analizaron exhaustivamente los datos. El grupo también se reunió en dos ocasiones para proponer preguntas, abordar los puntos de vista conflictivos y deliberar sobre las recomendaciones terapéuticas. Recomendaciones para el manejo de la candidemia en neonatos en América Latina incluye aspectos sobre profilaxis, terapia empírica, tratamiento de la candidemia demostrada, evaluación y seguimiento del paciente después del diagnóstico de candidemia, manejo de los recién nacidos con infección por Candida del catéter venoso central y manejo de otras complicaciones. Este manuscrito es el cuarto de los artículos de esta serie dedicada al diagnóstico y tratamiento de las candidiasis invasoras. Otras publicaciones de esta serie son Recomendaciones para el diagnóstico de la candidemia en América Latina, Recomendaciones para el manejo de la candidemia en adultos en América Latina, y Recomendaciones para el manejo de la candidemia en niños en América Latina (AU)
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. Recommendations for the diagnosis and management of candidemia are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, Recommendations for the management of candidemia in neonates in Latin America, was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. Recommendations for the management of candidemia in neonates in Latin America includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: Recommendations for the diagnosis of candidemia in Latin America, Recommendations for the management of candidemia in adults in Latin America, and Recommendations for the management of candidemia in children in Latin America (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Candidemia/epidemiology , Candidemia/prevention & control , Mycoses/epidemiology , Mycoses/microbiology , Antibiotic Prophylaxis/methods , Candidemia/diagnosis , Candidemia/microbiology , Candidemia/therapy , Latin America/epidemiology , Gestational Age , Birth Weight , Birth Weight/physiology , Fluconazole/therapeutic useABSTRACT
La candidemia es una de las micosis oportunistas más frecuentes en todo el mundo. El escaso número de estudios epidemiológicos llevados a cabo en América Latina indica que las tasas de incidencia en esta región son mayores que las descritas en el hemisferio norte. A menudo el diagnóstico de la infección se establece tardíamente, lo que afecta al inicio del tratamiento antimicótico. Por esta razón, para el diagnóstico y el manejo de la candidemia está justificada una estrategia más científica, basada en parámetros específicos. Recomendaciones para el diagnóstico y manejo de la candidemia constituye una serie de artículos preparados por miembros del grupo Latin America Invasive Mycosis Network. Su objetivo es proporcionar las mejores evidencias disponibles para el diagnóstico y el manejo de la candidemia. El presente artículo, Recomendaciones para el manejo de la candidemia en adultos en América Latina, ha sido redactado con el objetivo de orientar a los profesionales de la salud en el manejo de los pacientes adultos que padecen, o pueden padecer, candidemia. Mediante la base de datos PubMed se emprendió una búsqueda informatizada de los estudios publicados. Los miembros del grupo revisaron y analizaron exhaustivamente los datos. El grupo también se reunió en dos ocasiones para proponer preguntas, abordar los puntos de vista conflictivos y deliberar sobre las recomendaciones terapéuticas. Recomendaciones para el manejo de la candidemia en adultos en América Latina está orientado al tratamiento de pacientes neutropénicos y no neutropénicos, e incluye aspectos sobre la profilaxis, el tratamiento empírico, el tratamiento de la candidemia confirmada, el seguimiento del paciente después del diagnóstico de la candidemia, la duración del tratamiento y el manejo del catéter venoso central. Esta publicación es la segunda de los artículos de esta serie dedicada al diagnóstico y tratamiento de las candidiasis invasoras. Otras publicaciones de esta serie son Recomendaciones para el diagnóstico de la candidemia en América Latina, Recomendaciones para el manejo de la candidemia en ninos en América Latina, y Recomendaciones para el manejo de la candidemia en neonatos en América Latina (AU)
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. Recommendations for the diagnosis and management of candidemia are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, Recommendations for the management of candidemia in children in Latin America, was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. Recommendations for the management of candidemia in children in Latin America includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: Recommendations for the diagnosis of candidemia in Latin America, Recommendations for the management of candidemia in adults in Latin America, and Recommendations for the management of candidemia in neonates in Latin America (AU)
Subject(s)
Humans , Male , Female , Child , Candidemia/epidemiology , Candidemia/microbiology , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/prevention & control , Neutropenia/epidemiology , Neutropenia/prevention & control , Antibiotic Prophylaxis/instrumentation , Antibiotic Prophylaxis/methods , Antibiotic Prophylaxis , Candidemia/prevention & control , Candidemia/physiopathology , Latin America/epidemiology , Fluconazole/therapeutic use , Antifungal Agents/therapeutic useABSTRACT
La candidemia es una de las micosis oportunistas más frecuentes en todo el mundo. El escaso número de estudios epidemiológicos llevados a cabo en América Latina indica que las tasas de incidencia en esta región son mayores que las descritas en el hemisferio norte. A menudo el diagnóstico de la infección se establece tardíamente, lo que afecta al inicio del tratamiento antimicótico. Por esta razón, para el diagnóstico y el manejo de la candidemia está justificada una estrategia más científica, basada en parámetros específicos. Recomendaciones para el diagnóstico y manejo de la candidemia constituye una serie de artículos preparados por miembros del grupo Latin America Invasive Mycosis Network. Su objetivo es proporcionar las mejores evidencias disponibles para el diagnóstico y el manejo de la candidemia. El presente artículo, Recomendaciones para el manejo de la candidemia en adultos en América Latina, ha sido redactado con el objetivo de orientar a los profesionales de la salud en el manejo de los pacientes adultos que padecen, o pueden padecer, candidemia. Mediante la base de datos PubMed se emprendió una búsqueda informatizada de los estudios publicados. Los miembros del grupo revisaron y analizaron exhaustivamente los datos. El grupo también se reunió en dos ocasiones para proponer preguntas, abordar los puntos de vista conflictivos y deliberar sobre las recomendaciones terapéuticas. Recomendaciones para el manejo de la candidemia en adultos en América Latina está orientado al tratamiento de pacientes neutropénicos y no neutropénicos, e incluye aspectos sobre la profilaxis, el tratamiento empírico, el tratamiento de la candidemia confirmada, el seguimiento del paciente después del diagnóstico de la candidemia, la duración del tratamiento y el manejo del catéter venoso central. Esta publicación es la segunda de los artículos de esta serie dedicada al diagnóstico y tratamiento de las candidiasis invasoras. Otras publicaciones de esta serie son Recomendaciones para el diagnóstico de la candidemia en América Latina, Recomendaciones para el manejo de la candidemia en ninos en América Latina, y Recomendaciones para el manejo de la candidemia en neonatos en América Latina (AU)
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. Recommendations for the diagnosis and management of candidemia are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, Recommendations for the management of candidemia in adults in Latin America, was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. Recommendations for the management of candidemia in adults in Latin America includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: Recommendations for the diagnosis of candidemia in Latin America, Recommendations for the management of candidemia in children in Latin America, and Recommendations for the management of candidemia in neonates in Latin America (AU)
Subject(s)
Humans , Male , Female , Candidemia/epidemiology , Candidemia/microbiology , Candidemia/prevention & control , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/prevention & control , Neutropenia/complications , Neutropenia/diagnosis , Azoles/therapeutic use , Latin America/epidemiology , Antibiotic Prophylaxis/instrumentation , Antibiotic Prophylaxis/methods , Antibiotic Prophylaxis , Neutropenia/microbiology , Neutropenia/physiopathology , Amphotericin B/therapeutic useABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Candidemia/drug therapy , Disease Management , Adult , Antifungal Agents/adverse effects , Antifungal Agents/therapeutic use , Candida/classification , Candida/drug effects , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/prevention & control , Candidiasis, Invasive/drug therapy , Candidiasis, Invasive/prevention & control , Catheter-Related Infections/drug therapy , Catheter-Related Infections/prevention & control , Clinical Trials as Topic , Cross Infection/drug therapy , Cross Infection/prevention & control , Disease Susceptibility , Early Diagnosis , Humans , Latin America , Neoplasms/complications , Neutropenia/complications , Postoperative Complications/drug therapy , Postoperative Complications/microbiology , Risk FactorsABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Candidemia/diagnosis , Antigens, Fungal/blood , Automation , Biopsy , Blood/microbiology , Candida/classification , Candida/drug effects , Candida/growth & development , Candida/isolation & purification , Candidemia/epidemiology , Chromogenic Compounds , Culture Media , Endocarditis/diagnostic imaging , Endocarditis/microbiology , Enzyme-Linked Immunosorbent Assay , Humans , In Situ Hybridization, Fluorescence/methods , Latin America/epidemiology , Microbial Sensitivity Tests/methods , Mycology/instrumentation , Mycology/methods , Polymerase Chain Reaction/methods , Radiography , Serologic Tests/methods , Species Specificity , Staining and Labeling/methods , UltrasonographyABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Candidemia/drug therapy , Disease Management , Algorithms , Antifungal Agents/administration & dosage , Antifungal Agents/adverse effects , Antifungal Agents/therapeutic use , Burns/complications , Burns/microbiology , Candida/classification , Candida/drug effects , Candida/isolation & purification , Candidemia/complications , Candidemia/prevention & control , Candidiasis, Invasive/drug therapy , Candidiasis, Invasive/prevention & control , Catheter-Related Infections/microbiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Child , Clinical Trials as Topic , Cross Infection/drug therapy , Cross Infection/prevention & control , Disease Susceptibility , Febrile Neutropenia/chemically induced , Febrile Neutropenia/complications , Humans , Immunocompromised Host , Latin America , Multicenter Studies as Topic , Neoplasms/complications , Postoperative Complications/drug therapy , Postoperative Complications/microbiology , Risk FactorsABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Antifungal Agents/therapeutic use , Candidemia/drug therapy , Adult , Antifungal Agents/administration & dosage , Antifungal Agents/pharmacology , Candida/drug effects , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/epidemiology , Candidemia/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/microbiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Device Removal , Early Diagnosis , Fluconazole/administration & dosage , Fluconazole/therapeutic use , Humans , Immunocompromised Host , Latin America/epidemiology , Meta-Analysis as Topic , Mycology/methods , Neoplasms/complications , Neoplasms/drug therapy , Neutropenia/complications , Randomized Controlled Trials as Topic , Risk Factors , Species SpecificityABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Candidemia/diagnosis , Biomarkers/blood , Biopsy , Candida/classification , Candida/drug effects , Candida/isolation & purification , Candidemia/blood , Candidemia/immunology , Candidemia/microbiology , Culture Media , Diagnostic Imaging , Drug Resistance, Fungal , Humans , Latin America , Microbial Sensitivity Tests , Microbiological Techniques , Mycological Typing Techniques/methods , Organ Specificity , Phenotype , Serologic Tests , Species SpecificityABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in neonates in Latin America', was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in neonates in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in children in Latin America'.
Subject(s)
Antifungal Agents/therapeutic use , Candidemia/drug therapy , Antifungal Agents/pharmacology , Candida/drug effects , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/epidemiology , Candidemia/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/microbiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Combined Modality Therapy , Device Removal , Diagnostic Imaging , Encephalitis/drug therapy , Encephalitis/microbiology , Endocarditis/diagnosis , Endocarditis/drug therapy , Endocarditis/microbiology , Endocarditis/surgery , Endophthalmitis/drug therapy , Endophthalmitis/microbiology , Fluconazole/administration & dosage , Fluconazole/therapeutic use , Gestational Age , Humans , Infant, Newborn , Infant, Premature, Diseases/drug therapy , Infant, Premature, Diseases/epidemiology , Infant, Premature, Diseases/microbiology , Latin America/epidemiology , Osteomyelitis/drug therapy , Osteomyelitis/microbiology , Osteomyelitis/surgery , Patient Selection , Randomized Controlled Trials as Topic , Risk Factors , Species SpecificityABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
Subject(s)
Antifungal Agents/therapeutic use , Candidemia/drug therapy , Antifungal Agents/pharmacology , Burns/complications , Candida/drug effects , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/epidemiology , Candidemia/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/microbiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Child , Clinical Trials as Topic , Device Removal , Diagnostic Imaging , Echinocandins/supply & distribution , Echinocandins/therapeutic use , Febrile Neutropenia/complications , Fluconazole/administration & dosage , Fluconazole/therapeutic use , Humans , Immunocompromised Host , Latin America/epidemiology , Risk Factors , Species SpecificityABSTRACT
Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in neonates in Latin America', was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in neonates in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in children in Latin America'.
