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1.
Arch Bronconeumol ; 2020 May 20.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32446667

RESUMO

New evidence and knowledge about the clinical management of drug-resistant tuberculosis (TB) in the last 3 years, makes it necessary to update the recent guideline published by SEPAR in 2017, mainly in relation to new diagnostic methods, drug classification, and regimens of treatment recommended to treat patients with isoniazid-resistance TB, rifampicin resistance TB and multidrug-resistant TB. With respect to tuberculosis diagnosis, we recommend the use of rapid molecular assays that also help to detect mutations associated with resistance. In relation to the treatment of multidrug-resistant TB we prioritize effective all-oral shorter treatment regimens including bedaquiline, a fluoroquinolone (levofloxacin or moxifloxacin), bedaquiline and linezolid, instead of the previously recommended short-course treatment with aminoglycosides and other less effective and more toxic drugs. The design of these regimens (initial schedule and changes in the regimen if necessary) should be made in accordance with drug-resistant TB experts; the treatment should be the responsibility of personnel with experience in the treatment of TB and in TB units guaranteeing the follow-up of the treatment and the management of drugs adverse effects.

4.
Arch. bronconeumol. (Ed. impr.) ; 53(9): 501-509, sept. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-166280

RESUMO

En las últimas 2 décadas la tuberculosis con resistencia a fármacos se ha convertido en una amenaza y un reto para la salud pública mundial. El diagnóstico y el tratamiento de estas formas de tuberculosis es mucho más complejo, y el pronóstico empeora claramente a medida que se incrementa el patrón de las resistencias. Sin embargo, es necesario destacar cómo con el manejo clínico y programático adecuado de estos enfermos se puede conseguir la curación de una mayoría de ellos. En esta normativa se razonan las bases del diagnóstico y tratamiento de todos los pacientes afectos de tuberculosis, desde aquellos que tienen formas de la enfermedad con sensibilidad a todos los fármacos hasta aquellos que son portadores de los patrones más extensos de resistencia. Asimismo, se dan recomendaciones específicas para cada uno de estos supuestos. También se aborda el papel que ya están teniendo y pueden tener en un futuro inmediato los nuevos métodos moleculares de detección de resistencias, los esquemas acortados de tratamiento de la tuberculosis multi-farmacorresistente (TB-MDR) y los nuevos fármacos con actividad frente a Mycobacterium tuberculosis (AU)


In the last 2 decades, drug-resistant tuberculosis has become a threat and a challenge to worldwide public health. The diagnosis and treatment of these forms of tuberculosis are much more complex and prognosis clearly worsens as the resistance pattern intensifies. Nevertheless, it is important to remember that with the appropriatesystematic clinical management, most of these patients can be cured. These guidelines itemize the basis for the diagnosis and treatment of all tuberculosis patients, from those infected by strains that are sensitive to all drugs, to those who are extensively drug-resistant. Specific recommendations are given forall cases. The current and future role of new molecular methods for detecting resistance, shorter multi-drug-resistant tuberculosis regimens, and new drugs with activity against Mycobacterium tuberculosis are also addressed (AU)


Assuntos
Humanos , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Padrões de Prática Médica , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/patogenicidade , Fatores de Risco , Técnicas de Diagnóstico Molecular
5.
Arch Bronconeumol ; 53(9): 501-509, 2017 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28359606

RESUMO

In the last 2 decades, drug-resistant tuberculosis has become a threat and a challenge to worldwide public health. The diagnosis and treatment of these forms of tuberculosis are much more complex and prognosis clearly worsens as the resistance pattern intensifies. Nevertheless, it is important to remember that with the appropriatesystematic clinical management, most of these patients can be cured. These guidelines itemize the basis for the diagnosis and treatment of all tuberculosis patients, from those infected by strains that are sensitive to all drugs, to those who are extensively drug-resistant. Specific recommendations are given forall cases. The current and future role of new molecular methods for detecting resistance, shorter multi-drug-resistant tuberculosis regimens, and new drugs with activity against Mycobacterium tuberculosis are also addressed.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Antituberculosos/classificação , Antituberculosos/farmacologia , Busca de Comunicante , Gerenciamento Clínico , Quimioterapia Combinada , Tuberculose Extensivamente Resistente a Medicamentos/diagnóstico , Tuberculose Extensivamente Resistente a Medicamentos/tratamento farmacológico , Técnicas de Genotipagem , Humanos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Guias de Prática Clínica como Assunto , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
6.
Microb Ecol ; 73(2): 338-352, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27614749

RESUMO

Marine Actinobacteria are emerging as an unexplored source for natural product discovery. Eighty-seven deep-sea coral reef invertebrates were collected during an oceanographic expedition at the submarine Avilés Canyon (Asturias, Spain) in a range of 1500 to 4700 m depth. From these, 18 cultivable bioactive Actinobacteria were isolated, mainly from corals, phylum Cnidaria, and some specimens of phyla Echinodermata, Porifera, Annelida, Arthropoda, Mollusca and Sipuncula. As determined by 16S rRNA sequencing and phylogenetic analyses, all isolates belong to the phylum Actinobacteria, mainly to the Streptomyces genus and also to Micromonospora, Pseudonocardia and Myceligenerans. Production of bioactive compounds of pharmacological interest was investigated by high-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) techniques and subsequent database comparison. Results reveal that deep-sea isolated Actinobacteria display a wide repertoire of secondary metabolite production with a high chemical diversity. Most identified products (both diffusible and volatiles) are known by their contrasted antibiotic or antitumor activities. Bioassays with ethyl acetate extracts from isolates displayed strong antibiotic activities against a panel of important resistant clinical pathogens, including Gram-positive and Gram-negative bacteria, as well as fungi, all of them isolated at two main hospitals (HUCA and Cabueñes) from the same geographical region. The identity of the active extracts components of these producing Actinobacteria is currently being investigated, given its potential for the discovery of pharmaceuticals and other products of biotechnological interest.


Assuntos
Actinobacteria/química , Actinobacteria/classificação , Actinobacteria/isolamento & purificação , Antozoários/microbiologia , Produtos Biológicos/farmacologia , Filogenia , Actinobacteria/genética , Animais , Antibacterianos/farmacologia , Antineoplásicos/farmacologia , Bactérias/efeitos dos fármacos , Sequência de Bases , Biodiversidade , Produtos Biológicos/química , Produtos Biológicos/isolamento & purificação , Bioprospecção , Linhagem Celular Tumoral/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Classificação , Recifes de Corais , DNA Bacteriano , Ecossistema , Cromatografia Gasosa-Espectrometria de Massas , Genes Bacterianos , Invertebrados/microbiologia , Biologia Marinha , Extratos Vegetais , RNA Ribossômico 16S/genética , Água do Mar , Metabolismo Secundário , Espanha , Streptomyces/classificação , Streptomyces/isolamento & purificação
7.
Chemistry ; 21(2): 763-9, 2015 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-25430555

RESUMO

Herein we evaluate the influence of an electric field on the coupling of two delocalized electrons in the mixed-valence polyoxometalate (POM) [GeV14 O40 ](8-) (in short V14 ) by using both a t-J model Hamiltonian and DFT calculations. In absence of an electric field the compound is paramagnetic, because the two electrons are localized on different parts of the POM. When an electric field is applied, an abrupt change of the magnetic coupling between the two delocalized electrons can be induced. Indeed, the field forces the two electrons to localize on nearest-neighbors metal centers, leading to a very strong antiferromagnetic coupling. Both theoretical approaches have led to similar results, emphasizing that the sharp spin transition induced by the electric field in the V14 system is a robust phenomenon, intramolecular in nature, and barely influenced by small changes on the external structure.

9.
Antimicrob Agents Chemother ; 54(12): 5363-5, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20855731

RESUMO

Two new rifabutin analogs, RFA-1 and RFA-2, show high in vitro antimycobacterial activities against Mycobacterium tuberculosis. MIC values of RFA-1 and RFA-2 were ≤0.02 µg/ml against rifamycin-susceptible strains and 0.5 µg/ml against a wide selection of multidrug-resistant strains, compared to ≥50 µg/ml for rifampin and 10 µg/ml for rifabutin. Molecular dynamic studies indicate that the compounds may exert tighter binding to mutants of RNA polymerase that have adapted to the rifamycins.


Assuntos
Antibióticos Antituberculose/farmacologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Mycobacterium tuberculosis/efeitos dos fármacos , Rifabutina/farmacologia , Antibióticos Antituberculose/química , Testes de Sensibilidade Microbiana , Estrutura Molecular , Rifabutina/química
10.
ACS Nano ; 4(5): 2831-7, 2010 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-20405906

RESUMO

Many phenomena in condensed matter are thought to result from competition between different ordered phases. Palladium is a paramagnetic metal close to both ferromagnetism and superconductivity and is, therefore, a potentially interesting material to consider. Nanoscale structuring of matter can modify relevant physical energy scales, leading to effects such as locally modified magnetic interactions. We present transport measurements in electromigrated palladium break junction devices showing the emergence at low temperatures of anomalous sharp features in the differential conductance. These features appear symmetrically in applied bias and exhibit a temperature dependence of their characteristic voltages reminiscent of a mean-field phase transition. The systematic variation of these voltages with zero bias conductance, together with density functional theory calculations illustrating the relationship between the magnetization of Pd and atomic coordination, suggests that the features may result from the onset of spontaneous magnetization in the nanojunction electrodes. We propose that the characteristic conductance features are related to inelastic tunneling involving magnetic excitations.

11.
Bioorg Med Chem Lett ; 16(22): 5717-22, 2006 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-16987658

RESUMO

The synthesis, structure, and biological evaluation of a series of novel rifamycin derivatives, Rifastures (RFA) with potent anti-tuberculosis activity are presented. Some of these derivatives showed higher in vitro activity than rifabutin and rifampicin against not only Mycobacterium tuberculosis strains but also against MAC and Mycobacterium kansasii.


Assuntos
Antibióticos Antituberculose/farmacologia , Complexo Mycobacterium avium/efeitos dos fármacos , Mycobacterium kansasii/efeitos dos fármacos , Mycobacterium tuberculosis/efeitos dos fármacos , Rifabutina/farmacologia , Antibióticos Antituberculose/síntese química , Resistência Microbiana a Medicamentos , Testes de Sensibilidade Microbiana , Rifabutina/análogos & derivados , Rifabutina/síntese química , Rifampina/farmacologia
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