Caspofungin Use in Daily Clinical Practice for Treatment of Invasive Aspergillosis: Results of a Prospective Observational Registry

<p>Abstract</p> <p>Background</p> <p>A prospective observational registry assessed real world experience with caspofungin monotherapy or combination therapy for the initial or salvage treatment of proven or probable invasive aspergillosis (IA).</p> <p>Methods</p> <p>Data were collected from April 2006 to September 2007 for patients treated with caspofungin for a single episode of IA. Clinical effectiveness was categorized as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT).</p> <p>Results</p> <p>Consecutive patients (n = 103) with proven or probable IA (per EORTC/MSG criteria) were identified from 11 countries. Malignancy (76.7%), neutropenia (64.1%), allogeneic hematopoietic stem cell transplantation (HSCT, 22.3%), solid organ transplantation (8.7%), autologous HSCT (4.9%), and HIV/AIDS (2.9%) were the most common underlying conditions. Most patients (84.5%) had pulmonary IA. <it>Aspergillus fumigatus </it>was the most frequently isolated species. The majority of patients received caspofungin monotherapy (82.5%) primarily as salvage therapy (82.4%). The main reason for switching to salvage therapy was clinical failure of the first-line therapy (69%). A favorable response at EOCT was seen in 56.4% (57/101) of patients overall, including 56.5% (48/85) and 56.3% (9/16) of patients receiving caspofungin monotherapy and combination therapy, respectively. Favorable response rates in clinically relevant subgroups were: malignancy, 51.9% (41/79); allogeneic HSCT, 56.5% (13/23); and neutropenia at time of hospitalization, 53.0% (35/66). There was a 72.3% (73/101) survival at 7 days after EOCT. Serious adverse events related to caspofungin were reported in 4 cases (3.9%); 3 patients (2.9%) discontinued treatment due to an adverse event related to caspofungin.</p> <p>Conclusions</p> <p>Caspofungin was both effective and well tolerated among high-risk patient groups such as those with neutropenia and active malignancies.</p

Prayers to Kāli: practicing radical numinosity

Prayers to Kāli is an invocation of the radical-sacred as a way into decolonization, liberation, and healing. The radical-sacred, as I conceive of it, is broadly to do with the work of retrieving our spiritual dimensions as an inextricable part of queer, and decolonial futurities. The construction and performance of decolonial, queer-feminist theory, and knowledge discourses as fundamentally located in communities of coalition, new modes of resistance and cosmologies, form the theoretical foil of this paper. The broader aim of the paper is to highlight the significance of spiritual, corporeal, and emotional knowledges in the work of decoloniality and dismantling systems of oppression. I locate this exploration within the narrative specifics of contemporary spirit- poetry from Tamil Nadu; a radical, border site where these connections and dimensions of decoloniality, gender, desire, and resistance play out

IDIM: Corona Virus कोरोना वायरस - पाई के रूप में आसान! *बच्चों के लिए* - हिंदी

इस वीडियो में, मेडिकल छात्र जूलियन वुरम कोरोना वायरस के बारे में सब कुछ बताते हैं, आप इसे कैसे अनुबंधित कर सकते हैं, हर कोई इसके बारे में क्यों बात कर रहा है और आप क्या कर सकते हैं। मजे से देखिए! डिसेम विडियो एर्क्लैर्ट यूच जूलियन वुरम, मेडिज़िनस्टुडेंटिन, डीएएस कोरोना-वायरस इगेंटेलिच आइसट, विए मैन सिच एस्टेक्ट, वारुम गेरेड एअर आरयूबर रेडेन डड डु ट्यून कन्नस्ट उम मित्ज़हेलफेन था। वेल स्पा V डैमिट! // In this video, the medical student Juliane Wurm explains everything about the corona virus, how you may contract it, why everyone is talking about it and what you can do to help. Have fun watching

Ertapenem versus ceftriaxone and metronidazole as treatment for complicated intra-abdominal infections

AbstractBackgroundPrompt surgical intervention supplemented by appropriate antimicrobial therapy is usually required for successful treatment of complicated intra-abdominal infections. The objective of this study was to further evaluate the efficacy and safety of ertapenem relative to ceftriaxone/metronidazole as treatment for complicated intra-abdominal infections.MethodsAdult patients with intra-abdominal infections requiring surgery were eligible for this open-label randomized trial comparing ertapenem 1g daily with ceftriaxone 2g daily plus metronidazole 30mg/kg/day. The primary efficacy outcome was the clinical response rate in clinically and microbiologically evaluable participants at the test-of-cure (TOC) visit 2 weeks after discontinuation of therapy. All treated patients were included in the safety analysis.ResultsParticipant demographics, disease characteristics, and duration of therapy in both treatment groups were generally similar. Escherichia coli was the most commonly isolated baseline pathogen, recovered in 52% of cases in each treatment group. Favorable clinical responses were achieved at TOC in 143 (96.6%) of 148 ertapenem recipients and in 146 (96.7%) of 151 ceftriaxone/metronidazole recipients. The frequencies of drug-related adverse events, most commonly nausea, diarrhea, vomiting, and elevated platelet count, were generally comparable in both treatment arms. Four ertapenem recipients (1.8%) and one ceftriaxone/metronidazole recipient (0.4%) experienced serious drug-related adverse events.ConclusionsIn this study, ertapenem and ceftriaxone/metronidazole were comparably effective treatments for adult patients with complicated intra-abdominal infections