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Frick MA, Ogunkeye J, Oladipo ED, Prado K, Bagshaw HP. Radiotherapy vs. Cystectomy for Treatment of Muscle Invasive Bladder Cancer in Very Elderly Patients. Int J Radiat Oncol Biol Phys 2023; 117:e383-e384. [PMID: 37785295 DOI: 10.1016/j.ijrobp.2023.06.2498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radical cystectomy (RC) has long remained the principal treatment of muscle invasive bladder cancer (MIBC). It is, however, associated with significant morbidity, long recovery, and reported worse overall and cancer specific survival, particularly for the very elderly (age > = 80). Bladder preservation with transurethral resection of bladder tumor (TURBT) followed by radiotherapy (RT) +/- concurrent chemotherapy (ChT) is regarded as a curative-intent alternative to RC in well-selected patients. The optimal treatment strategy remains unclear in very elderly patients. We hypothesize that outcomes following RT vs RC are clinically equivalent for treatment of MIBC in very elderly patients. MATERIALS/METHODS Patients > = 80 years old with T2-T4 N0-N1 bladder cancer treated definitively with RT versus RC were included. Exclusion criteria included history of pelvic RT, prior cystectomy, or palliative treatment intent. Clinicopathologic and treatment-related details, as well as clinical outcomes and toxicities were retrospectively abstracted. Kaplan-Meier analyses were performed. RESULTS At a median follow-up of 17 months (range 0.25-190), 47 patients received RT vs 83 patients who underwent RC with median age of 86 years (80-97) vs 83 years (range 80-91) (p<0.01), respectively. Median Charlson Comorbidity Index was similar between groups (p = 0.35) with median 7 for both cohorts, predicting 0% estimated 10y survival. Most patients had cT2 tumors (91% vs 99%, p = 0.06), cN0 nodal status (96% vs 100%, p = 0.06), and urothelial carcinoma histology (79% vs 90%, p = 0.22). Most RT patients received concurrent ChT (90%) and a minority of RC patients received neoadjuvant ChT (16%). 70% of RT pts had complete TURBTs prior to RT. Common RT regimens were 50-55 Gy in 20-25 fractions or 60-64.8 Gy in 30-36 fractions, using IMRT (89%) or 3D conformal (11%) technique. Overall survival for RT vs RC at 1- and 2- years was 79% vs 85% and 57% and 69%, respectively (p = 0.20). Locoregional control at 1- and 2-years was 73% vs 70% and 63% vs 66% (p = 0.59), respectively. Progression free survival at 1- and 2-years was 69% vs 66% and 52% vs 54% (p = 0.75), respectively. No RT patients went on to receive salvage cystectomy. Treatment complications are listed in Table 1; the Clavien Dindo classification system was used to describe acute surgical complications of RC and the Common Terminology Criteria for Adverse Events (CTCAE) Dictionary v5.0 was used for acute and late toxicity of RT. CONCLUSION In the very elderly, RT (with or without concurrent ChT) offers survival and locoregional control rates comparable to RC, with a favorable side effect profile. RT should be offered for definitive management of non-metastatic MIBC as an alternative to RC in selected, well- informed, and compliant very elderly patients.
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Affiliation(s)
- M A Frick
- Department of Radiation Oncology, Stanford University, Palo Alto, CA
| | - J Ogunkeye
- Department of Urology, Stanford University, Palo Alto, CA
| | - E D Oladipo
- Department of Radiation Oncology, Stanford University, Palo Alto, CA
| | - K Prado
- Department of Urology, Stanford University, Palo Alto, CA
| | - H P Bagshaw
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Burzynski HE, Ayala KE, Frick MA, Dufala HA, Woodruff JL, Macht VA, Eberl BR, Hollis F, McQuail JA, Grillo CA, Fadel JR, Reagan LP. Delayed cognitive impairments in a rat model of Gulf War Illness are stimulus-dependent. Brain Behav Immun 2023; 113:248-258. [PMID: 37437820 PMCID: PMC10530066 DOI: 10.1016/j.bbi.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/07/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
Gulf War Illness (GWI) collectively describes the multitude of central and peripheral disturbances affecting soldiers who served in the 1990-1991 Gulf War. While the mechanisms responsible for GWI remain elusive, the prophylactic use of the reversible acetylcholinesterase inhibitor, pyridostigmine bromide (PB), and war-related stress have been identified as chief factors in GWI pathology. Post-deployment stress is a common challenge faced by veterans, and aberrant cholinergic and/or immune responses to these psychological stressors may play an important role in GWI pathology, especially the cognitive impairments experienced by many GWI patients. Therefore, the current study investigated if an immobilization stress challenge would produce abnormal responses in PB-treated rats three months later. Results indicate that hippocampal cholinergic responses to an immobilization stress challenge are impaired three months after PB administration. We also assessed if an immune or stress challenge reveals deficits in PB-treated animals during hippocampal-dependent learning and memory tasks at this delayed timepoint. Novel object recognition (NOR) testing paired with either acute saline or lipopolysaccharide (LPS, 30 µg/kg, i.p.), as well as Morris water maze (MWM) testing was conducted approximately three months after PB administration and/or repeated restraint stress. Rats with a history of PB treatment exhibited 24-hour hippocampal-dependent memory deficits when challenged with LPS, but not saline, in the NOR task. Similarly, in the same cohort, PB-treated rats showed 24-hour memory deficits in the MWM task. Ultimately, these studies highlight the long-term effects of PB treatment on hippocampal function and provide insight into the progressive cognitive deficits observed in veterans with GWI.
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Affiliation(s)
- H E Burzynski
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States.
| | - K E Ayala
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - M A Frick
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - H A Dufala
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - J L Woodruff
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - V A Macht
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - B R Eberl
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States
| | - F Hollis
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States; Columbia VA Health Care System, Columbia, SC 29208, United States
| | - J A McQuail
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States; Columbia VA Health Care System, Columbia, SC 29208, United States
| | - C A Grillo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States; Columbia VA Health Care System, Columbia, SC 29208, United States
| | - J R Fadel
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States; Columbia VA Health Care System, Columbia, SC 29208, United States
| | - L P Reagan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC 29208, United States; Columbia VA Health Care System, Columbia, SC 29208, United States
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Olsson K, Engman J, Nowinski D, Ramklint M, Frick MA. Cognitive Development in Single-Suture Craniosynostosis - A Systematic Review. Dev Neuropsychol 2023:1-33. [PMID: 37341559 DOI: 10.1080/87565641.2023.2225662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
There is conflicting evidence whether single-suture craniosynostosis (SSC), is linked to adversities of cognitive development. To assess the evidence for a link between SSC and cognition, a systematic literature search was conducted and eligible studies assessed for inclusion by two independent readers. Forty-eight studies met inclusion criteria. Small to medium but persistent effects on both general and some specific cognitive functions across age bands were found in higher quality studies for SSC overall. There was limited evidence for effects related to surgical correction. Methodologies varied substantially and there was a lack of longitudinal studies using broad assessment batteries.
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Affiliation(s)
- K Olsson
- Rehabilitation Medicine, Uppsala University Hospital, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - J Engman
- Rehabilitation Medicine, Uppsala University Hospital, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - D Nowinski
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - M Ramklint
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - M A Frick
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
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López-Medina EM, Sainz T, de Ory SJ, Mellado-Peña MJ, González-Tomé MI, Gil EC, Cucurull TV, Neyra F, Frick MA, Martínez-Pérez J, Andrés AGA, Alonso MB, Laleona CG, Hernández MM, Hernández PC, Amador JTR, Gómez MLN, Santiago-García B. Tuberculosis in a Spanish cohort of children living with HIV: the CHOTIS study (Childhood HIV & TB study). Int J Tuberc Lung Dis 2021; 24:303-309. [PMID: 32228760 DOI: 10.5588/ijtld.19.0237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Tuberculosis (TB) is the leading opportunistic infection in children with human immunodeficiency virus (HIV), but is uncommon in low prevalence regions. We aim to describe the changing epidemiology and clinical presentation of TB-HIV co-infection in a cohort of HIV-infected children in Spain.METHODS: Children diagnosed with TB between 1995 and 2016 in the paediatric HIV cohort were identified. The incidence and clinical presentation were compared in three periods: 1995-1999 (P1, before initiation of combined antiretroviral therapy, cART), 2000-2009 (P2, increase in immigration), and 2010-2016 (P3, decrease in immigration).RESULTS: We included 29 TB cases among 1183 children aged <18 years (2.4%, 243/100 000 person-years). The proportion was stable in P1 and P2 (1.3%), but decreased in P3 (0.8%). The median age at TB diagnosis was 6.4 years (IQR 4-10.6); most children in P3 were aged >10 years (20% vs. 23.1% vs. 83.3%, P = 0.01). TB was diagnosed at HIV presentation in 11/29 children (37.9%). Foreign-born children accounted for respectively 0%, 8% and 67% of the total number of children in each period (P ≤ 0.0001). One third had extrapulmonary TB; four children died (13.8%).CONCLUSION: In our cohort, the incidence of TB-HIV co-infection decreased with decline in immigration. In regions with adequate cART coverage and low TB transmission, paediatric TB-HIV coinfection is uncommon, but associated with significant morbidity. Strategies for TB surveillance, diagnosis and treatment in this vulnerable population should be reinforced.
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Affiliation(s)
- E M López-Medina
- Department of Pediatric Infectious Diseases, University Hospital La Fe, Valencia
| | - T Sainz
- Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid
| | - S Jiménez de Ory
- University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), CoRISpe, Madrid
| | - M J Mellado-Peña
- Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid
| | - M I González-Tomé
- Pediatric Infectious Diseases and HIV Unit, University Hospital 12 de Octubre and Research Institute (I+12), Madrid
| | - E Colino Gil
- Pediatric Infectious Diseases Unit, Complejo Hospitalario Insular Materno Infantil Las Palmas, Las Palmas de Gran Canaria
| | - T Vallmanya Cucurull
- Pediatric Infectious Diseases Unit, University Hospital Arnau de Vilanova, Lleida
| | - Falcón Neyra
- Pediatric Infectious Diseases, Immunology and Rheumatology Unit, University Hospital Virgen del Rocío, and Instituto de Biomedicina de Sevilla (IBiS), Sevilla
| | - M A Frick
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona
| | | | - A G Andrés Andrés
- Pediatrics Department, Complejo Asistencial Universitario de León, León
| | - M Bustillo Alonso
- Pediatric Infectious Diseases Unit; Miguel Servet Pediatric Hospital, Zaragoza
| | - C Guerrero Laleona
- Pediatric Infectious Diseases Unit; Miguel Servet Pediatric Hospital, Zaragoza
| | - M Méndez Hernández
- Pediatric Infectious Diseases Unit, Hospital Germans Trias y Pujol, Universitat Autònoma de Barcelona, Badalona
| | - P Collado Hernández
- Pediatrics Department, Hospital Clínico Lozano Blesa, Universidad Zaragoza, Zaragoza
| | - J T Ramos Amador
- Pediatrics Department, Clínico San Carlos University Hospital and Research Institute (IDISSC), Universidad Complutense de Madrid, Madrid
| | - M L Navarro Gómez
- Department of Pediatric Infectious Diseases, Pediatrics Department, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | - B Santiago-García
- Department of Pediatric Infectious Diseases, Pediatrics Department, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
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Soriano-Arandes A, Rivero-Calle I, Nastouli E, Espiau M, Frick MA, Alarcon A, Martinón-Torres F. What we know and what we don't know about perinatal Zika virus infection: a systematic review. Expert Rev Anti Infect Ther 2018; 16:243-254. [PMID: 29415586 DOI: 10.1080/14787210.2018.1438265] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Zika virus (ZIKV) infection has caused the most challenging worldwide infectious epidemic outbreak in recent months. ZIKV causes microcephaly and other congenital malformations. There is a need to perform updated systematic reviews on ZIKV infection periodically because this epidemic is bringing up new evidence with extraordinary speed. Areas covered: Evidence related to ZIKV infection in the gestational, perinatal, and early infant periods covering epidemiology, virology, pathogenesis, risk factors, time of infection during pregnancy, newborn symptoms, treatment, and vaccines. To this end, a search was performed using terms ['Zika'] AND ['Perinatal Infection'] OR ['Congenital Infection'] in the PubMed® international electronic database. Out of a total of 1,538 articles published until 30 November 2017, we finally assessed 106 articles articles that were relevant to the research areas included in this study. Expert commentary: ZIKV is a new teratogenic/neurotropic virus affecting fetuses. Many challenges are still far from being solved regarding the epidemiology, case definition, clinical and laboratory diagnosis, and preventive measures. An approach using 'omics' and new biomarkers for diagnosis, and a ZIKV-vaccine for treatment, might finally give us the tools to solve these challenges.
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Affiliation(s)
- Antoni Soriano-Arandes
- a Pediatric Infectious Diseases and Immunodeficiencies Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Irene Rivero-Calle
- b Translational Pediatrics and Infectious Diseases, Department of Pediatrics , Complejo Hospitalario Universitario de Santiago de Compostela , Santiago de Compostela , Spain
| | - Eleni Nastouli
- c Department of Virology , University College of London Hospitals NHS Foundation Trust , London , UK
| | - Maria Espiau
- a Pediatric Infectious Diseases and Immunodeficiencies Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - M A Frick
- a Pediatric Infectious Diseases and Immunodeficiencies Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Ana Alarcon
- d Department of Neonatology , Hospital Universitari Sant Joan de Déu , Barcelona , Spain
| | - Federico Martinón-Torres
- b Translational Pediatrics and Infectious Diseases, Department of Pediatrics , Complejo Hospitalario Universitario de Santiago de Compostela , Santiago de Compostela , Spain
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Goycochea-Valdivia WA, Baquero-Artigao F, Del Rosal T, Frick MA, Rojo P, Echeverría MJ, Noguera-Julian A, Bringué X, Saavedra-Lozano J, Vives-Oñós I, Moliner E, Cilleruelo MJ, Cuadrado I, Colino E, Castells L, Tagarro A, Vilas J, Soler-Palacin P, Blázquez-Gamero D. Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up. Clin Infect Dis 2018; 64:1335-1342. [PMID: 28158709 DOI: 10.1093/cid/cix105] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/31/2017] [Indexed: 12/20/2022] Open
Abstract
Background DNA detection of human cytomegalovirus (hCMV) in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR) is a marker of central nervous system (CNS) involvement in congenital hCMV infection (cCMV), but its prognostic value is unknown. Methods A multicenter, retrospective study was performed using the Spanish Congenital Cytomegalovirus Infection Database (REDICCMV; http://www.cmvcongenito.es). Newborns with cCMV and a lumbar puncture performed were included and classified according to their hCMV-PCR in CSF result (positive/negative). Clinical characteristics, neuroimaging abnormalities, plasma viral load, and audiological and neurological outcomes of both groups were compared. Results A total of 136 neonates were included in the study: 21 (15.4%) with positive CSF hCMV-PCR and 115 (84.6%) with negative results. Seventeen patients (81%) in the positive group were symptomatic at birth compared with 52.2% of infants in the negative group (odds ratio [OR], 3.86; 95% confidence interval [CI], 1.28-14.1; P = .01). Only 4 asymptomatic newborns (6.8%) had a positive CSF hCMV-PCR. There were no differences between groups regarding the rate of microcephaly, neuroimaging abnormalities, neurological sequelae at 6 months of age, or plasma viral load. Sensorineural hearing loss (SNHL) at birth was associated with a positive CSF hCMV-PCR result (OR, 3.49; 95% CI, 1.08-11.27; P = .04), although no association was found at 6 months of age. Conclusions A positive hCMV-PCR result in CSF is associated with symptomatic cCMV and SNHL at birth. However, no differences in neuroimaging studies, plasma viral load, or outcomes at 6 months were found. These results suggest that hCMV-PCR in CSF may not be a useful prognostic marker in cCMV.
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Affiliation(s)
| | | | - Teresa Del Rosal
- Pediatric Infectious Diseases Unit, Hospital Universitario La Paz, Madrid
| | - Marie-Antoinette Frick
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d Hebrón, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona
| | - Pablo Rojo
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid
| | | | - Antoni Noguera-Julian
- Malalties infeccioses i resposta inflamatòria sistèmica en pediatria. Unitat d'Infeccions, Servei de Pediatria. Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona.,Departament de Pediatria, Universitat de Barcelona.,CIBER de Epidemiología y Salud Pública (Ciberesp, Spain) Barcelona
| | - Xavier Bringué
- Department of Pediatrics and Neonatal Unit, Hospital Universitario Arnau de Vilanova, Lleida
| | | | - Isabel Vives-Oñós
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d Hebrón, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona.,Department of Pediatrics, Hospital Quirónsalud Barcelona
| | - Elisenda Moliner
- Pediatric Infectious Diseases Unit, Hospital de la Santa Creu y Sant Pau, Barcelona
| | | | | | - Elena Colino
- Pediatric Infectious Diseases Unit, Hospital Las Palmas de Gran Canaria
| | - Laura Castells
- Department of Pediatrics and Neonatology Unit, Hospital Universitario General de Cataluña, Barcelona
| | - Alfredo Tagarro
- Department of Pediatrics, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid; and
| | - Javier Vilas
- Department of Pediatric Infectious Diseases, Complejo Hospitalario de Pontevedra, Spain
| | - Pere Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d Hebrón, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona
| | - Daniel Blázquez-Gamero
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid
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Figueras C, Díaz de Heredia C, García JJ, Navarro M, Ruiz-Contreras J, Rossich R, Rumbao J, Frick MA, Roselló EM. [The Spanish Society of Paediatric Infectious Diseases (SEIP) recommendations on the diagnosis and management of invasive candidiasis]. An Pediatr (Barc) 2011; 74:337.e1-337.e17. [PMID: 21396895 DOI: 10.1016/j.anpedi.2010.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 12/22/2010] [Accepted: 12/23/2010] [Indexed: 02/02/2023] Open
Abstract
Candida yeasts are ubiquitous commensals, which can cause opportunistic infection in any location of the body. The source of infection may be both endogenous and exogenous. Invasive candidiasis encompasses different entities ranging from invasive candidiasis to disseminated multiorgan infection. Invasive candidiasis is the third leading cause of nosocomial bloodstream infection and the fourth of all nosocomial infections. It is also the most common invasive fungal infection in non-neutropenic critically ill patients, with a remarkable increase in the last 20 years owing to the increased survival of these patients and to more complex diagnostic, therapeutic and surgical procedures. Its incidence in infants, according to recent reviews, stands at 38.8 cases/100,000 children younger than 1 year. Candida albicans remains the most frequent isolate in invasive infections, although infections caused by other species have risen in the last years, such as C. kruzsei, C. glabrata and C. parapsilosis; the latter causing invasive candidiasis mainly associated with central venous catheter management, especially in neonatal units. The overall mortality of invasive candidiasis is high, with 30-day mortality reaching 20-44% in some series involving paediatric patients. This report provides an update on incidence, epidemiology, clinical presentation, diagnosis, treatment and outcome of invasive infection by Candida spp. in the paediatric patient.
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Affiliation(s)
- C Figueras
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Vall d'Hebron, Barcelona, España. Coordinadora del Grupo de estudio de la IFI de la SEIP
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Hasler CM, Frick MA, Bennink MR, Trosko JE. TPA-induced inhibition of gap junctional intercellular communication is not mediated through free radicals. Toxicol Appl Pharmacol 1990; 103:389-98. [PMID: 2339413 DOI: 10.1016/0041-008x(90)90312-i] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present investigation was designed to determine whether the inhibition of gap junction-mediated intercellular communication (GJIC) induced by TPA (12-O-tetradecanoylphorbol-13-acetate) in rat liver epithelial (WB-F344) cells in vitro is mediated through free radical production. As assessed by fluorescence redistribution after photobleaching (FRAP) analysis, GJIC was significantly inhibited in cells treated for 1 hr with either 10 ng/ml TPA or 500 microM hydrogen peroxide (H2O2). Addition of 1000 U/ml catalase or 25 microM N',N'-diphenyl-p-phenylenediamine (DPPD) to TPA-treated cells did not alleviate the TPA-induced inhibition of GJIC. However, the concurrent addition of 1000 U/ml catalase to the culture medium prevented the H2O2 inhibition of GJIC. 2'-7'-dichlorofluorescein-mediated fluorescence, a measure of free radical production utilizing the Meridian ACAS 470 interactive laser cytometer, was not significantly increased in WB-F344 cells treated with 10 and 100 ng/ml TPA when compared to control cells. However, polymorphonuclear leukocytes (PMNs) treated for 10 min with 100 ng/ml TPA showed a substantial oxidative burst, as did WB-F344 cells treated for 1 hr with 500 microM H2O2. The concurrent addition of 1000 U/ml catalase to the culture medium attenuated H2O2-mediated free radical production in both PMNs and WB-F344 cells. Data from this study do not support a role for free radicals in the TPA-induced inhibition of GJIC in WB-F344 cells.
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Affiliation(s)
- C M Hasler
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing 48824
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Frick MA. Toxemia and the emergency department nurse. J Emerg Nurs 1978; 4:29-33. [PMID: 351252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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