RESUMO
OBJECTIVES: To evaluate the in vitro activity of anidulafungin combined with amphotericin B or voriconazole against Candida spp. biofilms. METHODS: Four Candida albicans, four Candida tropicalis, four Candida glabrata, two Candida parapsilosis and two Candida orthopsilosis blood isolates were tested by the microdilution chequerboard method combined with the XTT metabolic assay. Biofilm MIC was defined as the lowest concentration producing 50% metabolic inhibition with respect to control (BMIC50). Concentrations in the combinations ranged from 1/8â×âBMIC50 to 4â×âBMIC50 found for each antifungal tested alone. RESULTS: Anidulafungin plus amphotericin B acted synergistically against C. albicans and C. glabrata biofilms [fractional inhibitory concentration index (FICI): 0.082-0.387], but showed no interaction against C. tropicalis, C. parapsilosis and C. orthopsilosis (FICI: 0.516-2.099). The combination of these antifungals failed to completely remove biofilms of C. albicans and C. glabrata, decreasing the metabolic activity of the biofilms up to 80% and 95%, respectively, which did not occur when each antifungal was used alone. Anidulafungin plus voriconazole showed no interaction against all isolates. Using a less stringent criterion previously proposed to define synergism (FICIâ<â1) and antagonism (FICIâ>â1.25), antagonistic interactions were found against some isolates. CONCLUSIONS: Anidulafungin with amphotericin B results in a synergistic effect against C. albicans and C. glabrata biofilms at serum concentrations of the drugs, but showed no interaction against C. tropicalis and C. parapsilosis complex. Anidulafungin plus voriconazole showed no interaction against the five Candida species assayed. Biofilms of C. tropicalis were found to be the most resistant towards the combinations assayed. The results presented may be of potential interest in the clinical setting.
Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Candida/efeitos dos fármacos , Equinocandinas/farmacologia , Voriconazol/farmacologia , Anidulafungina , Candida/isolamento & purificação , Candida/fisiologia , Candidemia/microbiologia , Sinergismo Farmacológico , Humanos , Testes de Sensibilidade MicrobianaRESUMO
Keratoconus (KC) is the most common type of corneal ectasia. A corneal transplantation was the treatment of choice until the last decade. However, intra-corneal ring implantation has become more and more common, and it is commonly used to treat KC thus avoiding a corneal transplantation. This work proposes a new approach based on Machine Learning to predict the vision gain of KC patients after ring implantation. That vision gain is assessed by means of the corneal curvature and the astigmatism. Different models were proposed; the best results were achieved by an artificial neural network based on the Multilayer Perceptron. The error provided by the best model was 0.97D of corneal curvature and 0.93D of astigmatism.
Assuntos
Inteligência Artificial , Astigmatismo/diagnóstico , Transplante de Córnea/efeitos adversos , Sistemas de Apoio a Decisões Clínicas , Ceratocone/cirurgia , Próteses e Implantes/efeitos adversos , Ajuste de Prótese/métodos , Adulto , Idoso , Astigmatismo/etiologia , Astigmatismo/prevenção & controle , Topografia da Córnea/métodos , Transplante de Córnea/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Prognóstico , Resultado do Tratamento , Adulto JovemRESUMO
We report condylar resorption of the temporomandibular joint after difficult intubation, leading to progressive midline mandibular deviation, subsequently treated by prosthetic joint replacement.
Assuntos
Intubação Intratraqueal/efeitos adversos , Mandíbula/patologia , Transtornos da Articulação Temporomandibular/etiologia , Transtornos da Articulação Temporomandibular/patologia , Anastomose em-Y de Roux/métodos , Reabsorção Óssea/etiologia , Feminino , Humanos , Laparotomia , Imageamento por Ressonância Magnética , Côndilo Mandibular/lesões , Côndilo Mandibular/patologia , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/patologia , Reoperação , Tomografia Computadorizada por Raios XAssuntos
Continuidade da Assistência ao Paciente/organização & administração , Serviços de Saúde para Idosos/organização & administração , Pacientes Internados , Avaliação de Processos e Resultados em Cuidados de Saúde , Centros de Reabilitação/organização & administração , Atividades Cotidianas , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Amputados/reabilitação , Feminino , Avaliação Geriátrica , Mortalidade Hospitalar , Humanos , Tempo de Internação , Modelos Logísticos , Masculino , Alta do Paciente , Transferência de Pacientes , Estudos Prospectivos , Recuperação de Função Fisiológica , Medição de Risco , Acidente Vascular Cerebral/mortalidade , Reabilitação do Acidente Vascular Cerebral , Resultado do TratamentoRESUMO
Neurinomata developed from extracranial portion of hypoglossal nerve are very scarce. We report one case of neurinoma originated in the descending branch of hypoglossal nerve and not having found after careful perusal of the literature of this subject another case we consider the ours as the first portraying this type of pathology and its localization.
Assuntos
Neoplasias dos Nervos Cranianos/diagnóstico , Doenças do Nervo Hipoglosso/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , NeurilemomaRESUMO
Pilomatrixial carcinoma is the malignant variety of pilomatrixoma. It is a malignant lesion, locally aggressive that can reappear, specially if not completely removed. Scanty are the number of cases listed in the literature (2). Although metastases are uncommon one or twice references can be found in the writings (1). We report 2 cases of pilomatrixial carcinoma located in the middle canthal and malar zones, which were treated surgically: excision of the tumor and reconstruction by means of a local rotation flap.