Pharmacokinetics and Pharmacodynamics of Cefepime in Adults with Hematological Malignancies and Febrile Neutropenia after Chemotherapy.

Patients with chemotherapy-induced febrile neutropenia (CIFN) may have changes in the pharmacokinetics (PK) compared to patients without malignancies or neutropenia. Those changes in antibiotic PK could lead to negative outcomes for patients if the therapy is not adequately adjusted to this. In this, open-label, non-randomized, prospective, observational, and descriptive study, a PK model of cefepime was developed for patients with hematological neoplasms and post-chemotherapy febrile neutropenia. This study was conducted at a cancer referral center, and study participants were receiving 2 g IV doses of cefepime every 8 h as 30-min infusions. Cefepime PK was well described by a two compartment model with a clearance dependent on a serum creatinine level. Using Monte Carlo simulations, it was shown that continuous infusions of 6g q24h could have a good achievement of PK/PD targets for MIC levels below the resistance cut-off point of Enterobacteriaceae. According to the simulations, it is unnecessary to increase the daily dose of cefepime (above 6 g daily) to increase the probability of target attainment (PTA). Cumulative fraction of response (CFR) using interment dosing was suboptimal for empirical therapy regimens against K. pneumoniae and P. aeruginosa, and continuous infusions could be used in this setting to maximize exposure. Patients with high serum creatinine levels were more likely to achieve predefined PK/PD targets than patients with low levels.

A new species in the troglomorphic scorpion genus Troglotayosicus from Colombia, representing the northernmost known record for the genus (Scorpiones, Troglotayosicidae).

We describe a new scorpion species in the troglomorphic genus Troglotayosicus Lourenço, 1981 from Colombia. Troglotayosicus meijdeni sp. nov. inhabits the forest leaf litter at Rivera municipality, on the western slope of the Eastern Andes. The male of the new species remains unknown; however, this species can be distinguished from other species in the genus by the female (and juvenile) morphology. The type locality of T. meijdeni sp. nov. represents the northernmost known record for a population of Troglotayosicus, further extending the known limits of distribution of this genus, and shedding more light on the distributional range of this group of scorpions in northwestern South America. With this description, the number of known species of Troglotayosicus is raised to four; three of them are endogean species living in forested areas in the Andean region of Colombia, whereas one is a hypogean species from a cave in Ecuadorian Amazonia.

Pharmacokinetics of piperacillin/tazobactam in cancer patients with hematological malignancies and febrile neutropenia after chemotherapy.

INTRODUCTION: Patients with febrile neutropenia (FN) exhibit changes in extracellular fluid that may alter the plasma concentrations of beta-lactams and result in therapeutic failure or toxicity. We evaluated the pharmacokinetics of piperacillin/tazobactam in patients with hematological malignancies and FN after receiving chemotherapy at a primary public cancer center. METHODS: This was an open, nonrandomized, observational, descriptive, and prospective study. Samples from 15 patients with hematological malignancies and FN were evaluated after the administration of chemotherapy. Five blood samples were taken from each patient when the antibiotic level was at steady-state 10, 60, 120, 180, and 350 min after each dose. Antibiotic concentrations were measured using gel diffusion with Bacillus subtilis. All study participants provided written informed consent. RESULTS: We investigated the pharmacokinetics of piperacillin in 14 patients between the ages of 18 years and 59 years and with a mean absolute neutrophil count of 208 cells per mm³ (standard deviation (SD) ± 603.2). The following pharmacokinetic measurements were obtained: maximum concentration, 94.1-1133 mg/L; minimum concentration, 0.47-37.65 mg/L; volume of distribution, 0.08-0.65 L/kg (mean, 0.34 L/kg); drug clearance (CL), 4.42-27.25 L/h (mean, 9.93 L/h); half-life (t(1/2)), 0.55-2.65 h (mean, 1.38 h); and area under the curve, 115.12-827.16 mg · h/L. CONCLUSION: Patients with FN after receiving chemotherapy exhibited significant variations in the pharmacokinetic parameters of piperacillin compared with healthy individuals; specifically, FN patients demonstrated an increase in t1(/2) and decreased CL.

Producción de fructooligosacaridos (FOS) por tecnología de enzimas. Parte I: Evaluación de aislados nativos de hongos para la producción de FOS / Production of fructooligosaccharides (FOS) by enzymatic technology. Part I: Evaluation of native isolates obtained from fungi for production of FOS

En este trabajo se estudió la influencia de la concentración de sacarosa, extracto de levadura y carbonato de calcio en la producción de FOS y la actividad fructosiltransferasa (FTF) en fermentaciones de 24, 36 y 48 horas usando Aspergillus niger AN166 como modelo biológico. La actividad FTF más alta de A. niger fue obtenida con 20 por ciento de sacarosa y 0.2 por ciento de extracto de levadura. El carbonato de calcio no tiene un efecto significativo en la producción de FOS. Adicionalmente, el medio de cultivo derivado del trabajo anterior fue usado para el aislamiento de hongos nativos de diferentes regiones de Cundinamarca (Colombia). Los aislados fueron evaluados con relación a la producción de FOS y actividad FTF. Solamente cinco aislados mostraron una mayor producción de FOS y actividad FTF que el A. niger AN166

La plaga olvidada / The forgotten plague

Paciente de 41 años, con cuadro de disnea súbita de tres semanas de evolución, cuya radiografía torácica evidencia imagen mediastinal sugestiva de masa dependiente de aorta, que rechaza y comprime la tráquea hacia la derecha en forma importante. Se realizó tomografía axial computadorizada contrastada que muestra dilatación de la aorta torácica inicial, y masa dependiente de cayado aórtico y de aorta descendente. Los antecedentes, la revisión por sistemas y el examen físico son normales. Se hospitaliza, y se realiza ecocardiograma y aortograma que confirman la existencia de dos aneurismas: uno en cayado aórtico y otro en aorta descendente. Se lleva el paciente a cirugía realizándose reemplazo de cayado aórtico sin complicaciones. El posoperatorio es satisfactorio, y el paciente es dado de alta. Se discuten las posibles etiologías en el interior del artículo.