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Criptococose experimental e efeito de drogas antifúngicas.MEDEIROS, Caroline Sanuzi Quirino de 31 January 2009 (has links)
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Previous issue date: 2009 / Universidade Federal de Pernambuco / Cryptococcus neoformans é considerado o principal agente etiológico da Criptococose. A
infecção tem início geralmente nos pulmões, disseminando para outros órgãos. O sistema
nervoso central é o principal alvo em que a levedura sobrevive, prolifera e causa meningite e
meningoencefalite, podendo ser letal. O propósito desta pesquisa foi avaliar a eficácia
terapêutica da beta-lapachona e Anfotericina B na criptococose experimental. Camundongos
foram imunossuprimidos com 5mg de dexametasona via intraperitoneal e infectados com 106
UFC/mL de C. neoformans URM5811 uma semana após a imunossupressão pela veia caudal.
Após sete dias os camundongos foram tratados diariamente com beta-lapachona (10mg/Kg) ou
anfotericina B (0,5mg/Kg) via endovenosa. O grupo controle recebeu tampão fosfato seguindo o
mesmo tempo de tratamento. A Concentração Mínima Inibitória da beta-lapachona e
anfotericina B foram de 4μg/mL e 0,5μg/mL, respectivamente. A Concentração Mínima
Fungicida para a beta-Lapachona foi 64μg/mL. Os ensaios revelaram que a beta-lapachona na
concentração de 10mg/mL não apresentaram toxicidade para camundongos imunossuprimidos
após uma semana de exposição crônica. Camundongos imunossuprimidos infectados por C.
neoformans e tratados com 10mg/kg de beta-lapachona debelaram as leveduras do baço e fígado
e diminuíram a concentração de leveduras no pulmão e cérebro após 14 dias de infecção quando
comparado com o grupo tratado com tampão fosfato (P<0.05). Esses resultados foram similares
para o grupo tratado com anfotericina B. Os resultados indicam que a beta-lapachona é uma
droga promissora para o tratamento de criptococose disseminada, apresentando potente
atividade antifúngica in vitro e in vivo
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Ação da curcumina e morina em leveduras do Complexo Cryptococcus neoformans / Action of curcumin and morin in yeasts of the Cryptococcus neoformans ComplexFreitas, Vivianny Aparecida Queiroz 12 May 2017 (has links)
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Previous issue date: 2017-05-12 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Cryptococcosis is a fungal disease caused by yeasts belonging to the complex Cryptococus neoformans. The antifungal arsenal available for the treatment of this disease is still restricted and is related to the high toxicity and side effects of some drugs, causing great harm to the patients. In this context, it is necessary to discover new bioactives to quell the infections and reduce the adverse effects. The plants have rich source of secondary bioactive metabolites such as tannins, terpenoids, saponins, alkaloids, flavonoids and other compounds, registered with expressive antimicrobial properties. Therefore, the research of natural compounds and derivatives of natural products has been relevant in recent years, due to their relevance in the discovery of new drugs, in addition to which the association of drugs or compounds with different mechanisms of action has been used as an alternative in conventional therapy. We evaluated the mechanisms of action and antifungal effect of natural compounds, curcumin and morin, on Cryptococcus neoformans and Cryptococcus gattii isolates. The antifungal activity was determined across the minimum inhibitory concentration (MIC) and minimum fungicide (MFC). Polyphenols showed MICs ranging from 2 to 256 μg/mL. The compounds showed a synergistic interaction in 30% (6/20) and 15% (3/20) of the isolates when dealing with morin and curcumin, respectively, associated with fluconazole. In the interaction with amphotericin B morin presented synergism in 70% (14/20) of the isolates. Both compounds did not exhibit antagonism in any of the combinations. Changes in fungal cell morphology were observed, and in contact with red blood cells, presented low toxicity. The mechanisms of action revealed that both polyphenols act on the membrane of the fungal cell, inhibiting the synthesis of ergosterol and causing damage to it. These results demonstrate the potential of the compounds as natural bioactives, with great impact on the discovery of new drugs and their efficacy to be used in the treatment of fungal infections. / A Criptococose é uma doença fúngica causada por leveduras pertencentes ao complexo Cryptococus neoformans. O arsenal antifúngico disponível para o tratamento dessa doença ainda é restrito e está relacionado à elevada toxicidade e efeitos colaterais de alguns fármacos, causando grande prejuízo aos pacientes Neste contexto, se faz necessário descobrir novos bioativos para debelar as infecções e reduzir os efeitos adversos. As plantas apresentam rica fonte de metabólitos secundários bioativos como taninos, terpenóides, saponinas, alcalóides, flavonoides e outros compostos, registrados com expressiva propriedade antimicrobiana. Portanto, a pesquisa de compostos naturais e derivados de produtos naturais tem sido pertinente nos últimos anos, devido à sua relevância na descoberta de novos medicamentos, além do que, a associação de fármacos ou compostos, com diferentes mecanismos de ação tem sido utilizada como alternativa na terapia convencional. Nós avaliamos os mecanismos de ação e o efeito antifúngico dos compostos naturais, curcumina e morina, sobre isolados de Cryptococcus neoformans e Cryptococcus gattii. A atividade antifúngica foi averiguada através da determinação da concentração inibitória mínima (CIM) e fungicida mínima (CFM). Os polifenóis, apresentaram CIMs que variaram de 2 a 256 μg/mL. Os compostos apresentaram interação sinérgica em 30% (6/20) e 15%(3/20) dos isolados se tratando da morina e curcumina, respectivamente, associada ao fluconazol. Na interação com a anfotericina B a morina apresentou sinergismo em 70% (14/20) dos isolados. Ambos os compostos não apresentaram antagonismo em nenhuma das combinações. Alterações na morfologia da célula fúngica foram observadas, e em contato com as hemácias, apresentaram baixa toxicidade. Os ensaios de mecanismos de ação revelaram que ambos os polifenóis atuam na membrana da célula fúngica inibindo a síntese de ergosterol e causando danos a mesma. Estes resultados demonstram o potencial dos compostos como bioativos naturais, apresentando grande impacto na descoberta de novos fármacos e sua eficácia para serem utilizados no tratamento de infecções fúngicas.
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Caracterização ambiental do complexo de espécies Cryptococcus neoformans e C. gattii no interior do estado de São Paulo, Brasil /Janeck-Araujo, Matheus January 2020 (has links)
Orientador: Márcia Marinho / Resumo: A criptococose é uma doença sistêmica causada pela inalação de basidiosporos desidratados de espécies patogênicas do gênero Cryptococcus presentes no ambiente. Os complexos espécies mais associados à doença são os complexos de espécies Cryptococcus neoformans e C. gattii. O complexo de espécies C. neoformans está associado a casos de criptococose em pacientes imunossuprimidos, sendo comumente isolados do solo e de fezes de aves. O complexo de espécies de C. gattii, por sua vez, afeta principalmente indivíduos imunocompetentes e geralmente é isolado em espécies de árvores nativas ou exóticas em estado de biodegradação. Este estudo teve como objetivo realizar o mapeamento ambiental de espécies patogênicas do gênero Cryptococcus em amostras ambientais arbóreas em locais públicos da cidade de Birigui, São Paulo. Para a coleta das amostras, foram selecionadas regiões com maior trânsito neste município. Após processamento, foram realizados testes morfo-fisiológicos, bioquímicos, teste de assimilação de carbono e nitrogênio e PCR URA5 e RFLP com dupla digestão enzimática para caracterização do complexo de espécies/espécie de Cryptococcus. Entre fevereiro de 2018 e março de 2019, foram coletadas 100 amostras de diferentes árvores em locais arborizados públicos. A porcentagem de colonização das árvores por C. gattii VGII foi de 5%, por C. neoformans VNIV de 1% e foram encontrados 6% de C. laurentii e 3% de C. albidus. Estes resultados sugerem a existência de micro-focos e diversidade ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cryptococcosis is a systemic disease caused by the inhalation of dehydrated basidiospores of pathogenic species of Cryptococcus genus present in the environment. The two species complex associated with the disease are the Cryptococcus neoformans and C. gattii species complex. C. neoformans species complex are associated with cases of cryptococcosis in immunosuppressed patients, being commonly isolated from the soil and birds feces. C. gattii species complex affects mainly immunocompetent individuals and are often isolated in native or exotic tree species in some state of biodegradation. This study aimed to perform the environmental mapping of pathogenic species of the genus Cryptococcus in tree samples of public places of the city of Birigui, São Paulo. For collection, the samples were collected from regions with greater traffic in this city. After processing, morphophysiological, biochemical, carbon and nitrogen assimilation and URA5 PCR and RFLP with double enzymatic digestion tests were performed to characterize the Cryptococcus species/species complex. Between february 2018 and march 2019 was collected a total of 100 samples from different trees in public arborized locations. The percentage of tree colonization by the C. gattii VGII was 5%, for C. neoformans VNIV was 1% and was found 6% of C. laurentii and 3% of C. albidus species. These results obtained suggests that there are a micro-foci and diversity of pathogenic Cryptococcus species in some arboreal environment loca... (Complete abstract click electronic access below) / Mestre
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Reference Maps for Comparative Analysis of RNA by LC-MS and RNA SequencingPaulines, Mellie June January 2018 (has links)
No description available.
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Determining the Mode of Action of Ibomycin: A Novel Antifungal CompoundPatel, Dhruv 11 1900 (has links)
Unlike their bacterial counterparts, diseases caused by fungal pathogens are harder to treat due to a lack of discrete targets. Current antifungals are very broad spectrum and fall into three major classes: polyenes which target the cell membrane, azoles which target sterol biosynthesis and the echinocandins which target the cell wall. Recently a novel macrolide antibiotic produced by WAC 2288 was discovered in a co-culturing screen between various actinomycetes and pathogenic fungi. The active compound, a large type I polyketide compound called ibomycin, was specifically able to inhibit the growth of Cryptococcus neoformans but not Candida albicans. A combination of traditional and genetic approaches were used to identify the mode of action of ibomycin. Despite having characteristics associated with membrane perturbing agents such as fungicidal activity, causing hemolysis and even membrane localization in vivo, it does not seem that ibomycin disrupts the membrane in a sterol-dependent manner. We found evidence to suggest that ibomycin is not involved in disruption of cell wall biosynthesis based on localization in vivo and absence of viability rescue in presence of sorbitol. The results of haploinsufficiency and homozygous profiling of yeast deletion strains suggest that is no single protein target for ibomycin, but rather that membrane perturbation of ibomycin leads to downstream effects that impair vesicular trafficking and protein transport. Based on preliminary evidence, it is predicted that C. albicans is able to bind ibomycin but evades the induced toxic effects by barring access to its cell membrane. / Thesis / Master of Science (MSc)
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Genetic Analyses of Inter-Variety Hybridization in the Human Pathogenic Fungus Cryptococcus neoformansSun, Sheng 07 1900 (has links)
Cryptococcus neoformans is among the most common human pathogenic fungi and the leading cause of fungal meningitis. It consists of two divergent haploid serotypes A and D, as well as their hybrid serotypes AD. Hybridization between the two serotypes A and D is a widespread phenomenon in natural populations of this species. Studies have shown that serotype AD strains possess unique properties in several medically important traits: they are more virulent in animal models, more tolerant to antifungal drugs, more tolerant to UV radiation and other stresses than one or both parental serotypes. Despite the potential medical and evolutionary importance, relatively little is known about the phenotypic and genotypic consequences of the hybridization in C. neoformans. In my thesis, I present a series of studies that show: (1) recombination occurs at a very low frequency during hybridization between serotypes A and D; (2) serotypes A and D in C. neoformans have diverged from each other not only at the DNA sequence level, but also at the chromosomal structure level, both of which contributed to suppressed recombination and limited genetic introgression between the two serotypes; (3) though there is widespread hybridization, the hybrids seemed largely distinct and the genomes of the parental serotypes A and D populations are relatively unaffected by the hybrids in natural populations; and (4) the fixation of these serotype specific chromosomal rearrangements in the two serotypes, together with evidences of selective sweeps observed at both inversion junctions and genes located close to chromosomal inversions suggest that these rearranged regions (or genes surrounding these regions) were likely involved in the diversification between the two serotypes. My studies provide a genetic framework for future quantitative analyses of medically important traits of C. neoformans. / Thesis / Doctor of Philosophy (PhD)
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Developing a Genetic Linkage Map from an Intervarietal Cross of Serotypes A and D and the Analysis of the Costs and Benefits of Hybridization in Cryptococcus neoformans / Hybridation in Cryptococcus neoformansHan, Xiaoyu 08 1900 (has links)
N/A / Thesis / Master of Science (MS)
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Mating System and Mitochondrial Inheritance in a Basidiomycete Yeast, Cryptococcus neoformansYan, Zhun 03 1900 (has links)
In the majority of sexual eukaryotes, mitochondria are inherited predominantly from a single, usually the female, parent Like the majority of higher plants and animals, the pathogenic yeast Cryptococcus neoformans has two mating types (sexes), however, these two sexes are morphologically similar. In this study, I examined the distribution of the mating types and how mating types influence the inheritance of mitochondria in C. neoformans. My survey of mating type alleles in 358 isolates collected from four geographic areas in the US showed a biased distribution of mating type alleles with most isolates containing mating type a alleles. To characterize the role of mating type locus on mitochondrial inheritance, I constructed two pairs of congenic strains that differed only at the mitochondrial genome and mating type locus. Mating between these two pairs of strains demonstrated that uniparental inheritance in C. neoformans was controlled by the mating type locus and progeny predominantly inherited mitochondria from the mating type a parent. Specifically, we identified two genes within the mating type locus, SXIIa in mating type a strain and SXI2a in mating type a strain, that control mitochondrial inheritance. Disruption of these two genes resulted in biparental mitochondrial inheritance in sexual crosses. These two genes are the first ones identified capable of controlling uniparental mitochondrial inheritance in any organism. In addition, we determined that the deletion of the SXIIa gene enhanced the spread of mitochondrial introns in sexual crosses. This discovery is consistent with the hypothesis that uniparental lnheritance might have evolved to prevent the spread of selfish cytoplasmic elements. / Thesis / Doctor of Philosophy (PhD)
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Modelagem farmacocinética-farmacodinâmica de antifúngicos azólicos em animais infectados por Cryptococcus neoformans / Pharmacokinetic-pharmacodynamic modeling of azoles antifungals in Cryptococcus neoformans infected animalsAlves, Izabel Almeida January 2017 (has links)
O objetivo desta tese foi desenvolver um modelo farmacocinético-farmacodinâmico (PK-PD) aplicável a avaliação de esquemas posológicos de antifúngicos sistêmicos no tratamento de infecções cerebrais associadas ao Cryptococcus neorformans. Inicialmente um modelo de infecção cerebral em ratos Wistar machos imunocompetentes foi estabelecido. Os animais foram inoculados a partir da administração iv de 1.106 UFC/mL na veia lateral caudal, de uma cepa de Cryptococcus neoformans var neoformans (ATCC 28957). A presença da levedura em cérebro, pulmão, fígado, rins e coração foi avaliada após 7, 10 e 14 dias. Paralelamente foram investigados os parâmetros bioquímicos (contagem de leucócitos, TGO, TGP, uréia, creatinina, albumina e CK) e a permeabilidade vascular cerebral com azul de Evans. Após 10 dias de inoculação foi produzida uma infecção com características semelhantes a doença em humanos. C. neoformans esteve presente em todos os tecidos investigados pelas análises histológicas e microbiológicas e diferenças nos níveis de albumina, ureia, TGP e CK, alteração no número de leucócitos (monócitos e neutrófilos) e elevação da permeabilidade cerebral ao azul de Evans foram observadas nos animais infectados. Após estabelecida e caracterizada a infecção, foi avaliada a farmacocinética plasmática e tecidual cerebral através da técnica de microdiálise, do fluconazol (FLU) (20 mg/kg, i.v. bolus) e do voriconazol (VRC) (5 mg/kg, i.v. bolus) em ratos Wistar sadios (n = 13) e infectados (n = 13). De posse dos dados das concentrações plasmáticas e teciduais vs tempo dos grupos sadios e infectados construiu-se um modelo farmacocinético populacional (PopPK) para cada fármaco investigado. A penetração cerebral do VRC demonstrou-se elevada nos animais infectados (fTsadios = 0,85 vs fTinfectados = 1,86). O modelo PopPK de dois compartimentos e eliminação por Michaelis Menten descreveu o perfil de concentrações versus tempo de VRC em plasma e tecido, simultaneamente. A covariável infecção foi incluída em V2 e VM. Observou-se o grande potencial do VRC para tratar meningite associada a C. neoformans, pois os níveis alcançados em tecidos infectados foram superiores aos valores descritos para CIM de VRC contra C. neoformans (0,03 - 0,5 μg/mL). A farmacocinética do FLC foi descrita através de um modelo PopPK de dois compartimentos com eliminação linear incluindo dados de concentrações plasmáticas e livres cerebrais para ambos os grupos investigados. Nesse modelo a covariável infecção foi atribuída ao parâmetro k21 e covariável peso foi atribuída aos parâmetros V1 e V2. De posse desse modelo popPK, foram investigados os desfechos farmacodinâmicos considerando o nível de exposição cerebral nas doses de 125 e 250 mg/kg para ratos e 400-2000 mg para humanos observado em tecido sadio e infectado através da probabilidade de atingir o alvo terapêutico (PTA - fASC/CIM = 389) do FLC usando simulações de Monte Carlo. Essas simulações demonstraram um uso limitado de fluconazol em monoterapia para o tratamento de meningite por C. neoformans. Após a etapa farmacocinética procederam-se os estudos farmacodinâmicos através da metologia de curvas de morte em função do tempo do fluconazol e voriconazol frente a C. neoformans. Os dados da curva de morte foram modelados adequadamente com o modelo PK-PD de Emax modificado incluindo um termo de atraso de crescimento. A CIM foi determinada para ambos os fármacos por microdiluição e os valores foram de 0,03 μg/mL para voriconazol e 0,5 μg/mL para fluconazol, indicando que esta cepa ATCC 28957 é sensível a ambos os fármacos. Os valores de k, EC50 e kmax foram determinados para vários múltiplos das CIM de cada fármaco (0,03×, 0,06×, 0,25×, 0,5×, 1× 4×, 16×, 32× e 64×). O valor médio de k foi de 0,38 h-1, EC50 foi de 1,26 ± 0,18 μg/mL e 0,32 ± 0,06 μg/mL e kmax foi de 0,95 ± 0,21 h-1 e 0,64 ± 0,12 h-1 para FLC e VRC, respectivamente. Por fim, de posse dos parâmetros calculados através do modelo PK-PD foram realizadas simulações dos desfechos de tratamento para meningite criptocócica no cenário clínico para ambos os fármacos após administração das doses 200 e 400 mg de voriconazol e 800 e 2000 mg de fluconazol por dez semanas. Através das simulações conclui-se que para fluconazol há 25% de insucesso na dose de 800 mg e 10% na dose de 2000 mg com um tempo médio de 3 semanas para erradicação da levedura. Para o voriconazol, o EC50 teve pouco impacto sobre a erradicação do fungo e, em todos os cenários foi observada uma erradicação completa do fungo em curto espaço de tempo (1 - 2 semanas). Os resultados incentivam o uso de voriconazol nos pacientes com meningite criptocócica e uma reavaliação do uso de fluconazol. / The aim of this thesis was to develop a pharmacokinetic-pharmacodynamic (PK-PD) model for the evaluation of systemic antifungal dosing regimens for the treatment of brain infections associated with Cryptococcus neorformans. Firstly a model of brain infection in immunocompetent male Wistar rats was established. The animals were inoculated by intravenously administration of 1. 106 CFU/mL of Cryptococcus neoformans var neoformans (ATCC 28957) into the tail lateral vein. The presence of yeasts in the brain, lung, the liver, kidneys and the heart was evaluated after 7, 10 and 14 days. The biochemical parameters (leucocytes counting, GOT, GPT, urea, creatinine, albumin and CK) and cerebral vascular permeability with Evans blue were investigated. After 10 days post inoculation an infection with characteristics similar in humans was produced. C. neoformans was present in all tissues investigated by histological and microbiological analyzes and differences in albumin, urea, GPT and CK levels, alterations in the number of leukocytes (monocytes and neutrophils), and elevation of cerebral permeability to Evans blue were observed in infected animals. After establishing and characterizing the infection, the plasma and cerebral tissue pharmacokinetics were evaluated by microdialysis after administration of fluconazole (FLU) (20 mg/kg, iv bolus) and voriconazole (VRC) (5 mg/kg, iv bolus) in healthy (n = 13) and infected Wistar rats (n = 13). A population pharmacokinetic model (PopPK) was build for each drug, based on data from plasma and tissue concentrations vs. time of healthy and infected groups. The brain penetration of voriconazole was shown to be high in infected animals (fThealthy = 0.85 vs fTinfected = 1.86) than in healthy ones. The two-compartment model with Michaelis Menten elimination best described the concentration of VRC in plasma and tissue. The covariate infection was included in V2 and VM. The great potential of voriconazole to treat meningitis associated with C. neoformans was observed, as the levels reached in infected tissues were higher than the values described for MIC against C. neoformans (0.03 - 0.5 μg/mL). The pharmacokinetics of FLC was described using a two-compartment model with linear elimination including data from plasma and brain free concentrations for both groups investigated. In this model the covariate infection was attributed to parameter k21 and covariate weight was assigned to parameters V1 and V2. With this popPK model, the pharmacodynamic outcomes were investigated considering the level of brain exposure at doses of 125 and 250 mg/kg for rats and 400 - 2000 mg for humans observed in healthy and infected tissue through the probability of attaining the target (PTA - fAUC/MIC = 389) of fluconazole using Monte Carlo simulations. These simulations demonstrated limited use of fluconazole in monotherapy for the treatment of C. neoformans meningitis. After the pharmacokinetics modeling, the pharmacodynamic studies were carried out using the methodology of time-kill curves of fluconazole and voriconazole versus C. neoformans. The kill curves data were suitably modeled with the modified Emax PK-PD model including a growth delay term. MIC was determined for both drugs by microdilution and values were 0.03 μg.mL-1 for voriconazole and 0.5 μg.mL-1 for fluconazole, indicating that this ATCC 28957 strain is sensitive to both drugs. The values of k, EC50 and kmax were determined for several MIC multiples of each drug (0.03 ×, 0.06 ×, 0.25 ×, 0,5×, 1 × 4 ×, 16 ×, 32 × and 64 ×). The mean value of k was 0.38 h-1, EC50 was 1.26 ± 0.18 μg.mL-1 and 0.32 ± 0.06 μg.mL-1 and kmax was 0.95 ± 0.21 h -1 and 0.64 ± 0.12 h-1 for FLC and VRC, respectively. Finally, the parameters obtained using the PK-PD model were used to simulate treatment outcomes for cryptococcal meningitis in the clinical setting for both drugs after administration of 200 and 400 mg of voriconazole and 800 and 2000 mg of fluconazole for 10 weeks. By the simulations it is concluded that for fluconazole there is a 25% rate of failure at the dose of 800 mg and 10% at the dose of 2000 mg with an average time of 3 weeks for eradication of the yeast. For voriconazole, the EC50 had little impact on fungus eradication and, in all scenarios complete eradication of the fungus was observed in a short time (1 - 2 weeks). The results encourage the use of voriconazole in patients with cryptococcal meningitis and a reassessment of fluconazole use.
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Criptococose em pacientes submetidos a transplante de órgãos sólidos / Cryptococcosis in solid organ transplant recipientsSevero, Cecília Bittencourt January 2010 (has links)
No período de 1981-2010, foram estudados, retrospectivamente, 54 casos de criptococose em pacientes com transplante de órgão sólido, identificados no Laboratório de Micologia da Santa Casa Complexo Hospitalar, Porto Alegre, RS. A criptococose ocorreu em 31 transplantados de rim, 13 de fígado, 7 de pulmão, 2 de pâncreas e rim, e 1 de coração. A idade média foi de 47,91 ± 13,98 (12-76 anos). Um total de 38 pacientes do sexo masculino (70,4%). As manifestações clínicas mais frequentes (54 pacientes) foram febre, cefaléia, vômito, tosse e estado mental alterado. Os achados radiográficos mais comuns no tórax, em 27 pacientes, foram nódulo, consolidação, cavitação e derrame pleural, sendo 10 com comprometimento pulmonar comprovado. Trinta e quatro apresentavam acometimento do sistema nervoso central, 7 tinham envolvimento cutâneo, e 4 em outros locais. O liquor, sangue e urina, respectivamente, contribuíram para o diagnóstico microbiológico com maior frequência. A maioria das infecções, nesta série de pacientes com criptococose, foi causada por Cryptococcus neoformans (92,7%). Pela primeira vez na literatura, documentamos C. gattii em pacientes com transplante de pulmão. Finalmente, quanto ao regime imunossupressor primário utilizado, houve maior mortalidade entre os pacientes que usaram o regime terapêutico baseado em ciclosporina e menor naqueles que usaram tacrolimus. / In the period of 1981 to 2010, 54 cases of cryptococcosis in patients with solid organ transplantation indetified at Mycology Laboratory in Santa Casa Hospital Complex, Porto Alegre, RS, were retrospectively studied. Cryptococcois occured in 31 kidney, 13 liver, 7 lung, 2 kidney-pancreas, and 1 heart transplant. The mean age was 47.3 years old (range, 12-76; SD 13.98). A total of 38 patients were male (70.4%). The most frequent clinical manifestation (54 patients) was fever, headache, vomiting, cough and altered mental status. The most common chest radiographic fidings, in 27 patients, were nodules, masses, consolidation, cavitation, and pleural effusion, 10 with proved pulmonary involvement. Thirty four patients had central nervous system involvement, 7 with cutaneous involvement, and 4 at other sites. The cerebospinal fluid, blood, and urine had the highest yield for the microbiologic diagnosis, respectivelly. Nearly all infections in this series of patients with cryptococcosis involved Cryptococcus neoformans (92.7%). By the first time in the literature, we documented C. gattii in lung transplant patients. Finally, considering the type of primary immunosupressive agent used, there was a higher mortality rate on patients with cyclosporine based therapy, and lowest in those with tacrolimus.
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