Archive for March, 2012

TOXOPLASMOSIS OCULAR

Arch Soc Esp Oftalmol  Madrid oct. 2003  V.78  N.10

Propósito

Realizar una actualización sobre los aspectos más salientes de la toxoplasmosis ocular.

Métodos

En base a publicaciones recientes, reuniones científicas e interpretación de la literatura se intenta clarificar los conceptos sobre distintos aspectos de la toxoplasmosis ocular.

Resultados

Se pone un especial énfasis en la transmisión de la parasitosis y en la enfermedad ocular con sus presentaciones clínicas. Se mencionan además algunas actualizaciones en cuanto al diagnóstico y tratamiento de la enfermedad.

Conclusión

El conocimiento de la epidemiología permitirá limitar la enfermedad ocular y la correcta interpretación permitirá un mejor diagnóstico clínico. Con estos elementos se podrán aplicar las diferentes alternativas de tratamiento que poco han evolucionado en los últimos años.

FULL TEXT

http://scielo.isciii.es/scielo.php?pid=s0365-66912003001000004&script=sci_arttext

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March 31, 2012 at 11:55 am Leave a comment

Management of Toxoplasma gondii infection during pregnancy.

Clin Infect Dis. 2008 Aug 15 V.47 N.4 P.554-66.

Montoya JG, Remington JS.

Source

Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, USA.

Abstract

Acute infection with Toxoplasma gondii during pregnancy and its potentially tragic outcome for the fetus and newborn continue to occur in theUnited States, as well as worldwide, despite the fact that it can be prevented. The infection can be acquired through ingestion of infected, undercooked meat or contaminated food or water. Transmission to the fetus occurs almost solely in women who acquire their primary infection during gestation and can result in visual and hearing loss, mental and psychomotor retardation, seizures, hematological abnormalities, hepatosplenomegaly, or death. Systematic education and serological screening of pregnant women are the most reliable and currently available strategies for the prevention, diagnosis, and early treatment of the infection in the offspring; this is largely because toxoplasmosis in pregnant women most often goes unrecognized. Treatment of the infection in the fetus and infant during the first year of life has been demonstrated to significantly improve the clinical outcome.

PDF

http://cid.oxfordjournals.org/content/47/4/554.full.pdf+html

 

March 31, 2012 at 11:53 am Leave a comment

Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis.

J Infect Dis. 2002 Feb 15 V.185 Suppl 1:S73-82.

Montoya JG.

Source

Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, Palo Alto, California 94301, USA. gilberto@leland.stanford.edu

Abstract

For the past 40 years, the Toxoplasma Serology Laboratory at the Palo Alto Medical Foundation Research Institute (TSL-PAMFRI) has been dedicated to the laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. TSL-PAMFRI is the “brain child” of Jack S. Remington. Jack’s ceaseless devotion to objectivity and uncompromising excellence has made TSL-PAMFRI the Toxoplasma reference laboratory for the Centers for Disease Control and Prevention, the US Food and Drug Administration, and health care providers and clinical laboratories in theUnited Statesand other countries. Jack’s leadership and vision created, defined, and significantly contributed to the development of laboratory methods for the diagnosis of the infection and diseases caused by T. gondii. A summary of the laboratory tests currently available at TSL-PAMFRI for the diagnosis of infection and disease caused by the parasite is presented here.

PDF

http://jid.oxfordjournals.org/content/185/Supplement_1/S73.full.pdf+html

 

March 31, 2012 at 11:51 am Leave a comment

2009 – HIDATIDOSIS – Norma Técnica y Manual de Procedimientos para su control

Ministerio de Salud de la Nación – Rep. Argentina

INDICE

Introducción

Diagnóstico de Situación en Argentina

Objetivo General

Objetivos específicos

Base legal

Normas para Diagnóstico y Vigilancia

Normas de Control

Atención en el hombre

Referencias

Anexos

 

PDF

http://www.msal.gov.ar/images/stories/epidemiologia/pdf/NormasHidatidosis.pdf

March 31, 2012 at 11:49 am Leave a comment

Vancomycin Dosing in Critically Ill Patients: Robust Methods for Improved Continuous-Infusion Regimens

Antimicrobial Agents and Chemotherapy  June 2011 V.55 N.6 P.2704-2709

Jason A. Roberts1,*, Fabio Silvio Taccone2, Andrew A. Udy1, Jean-Louis Vincent2, Frédérique Jacobs3 and Jeffrey Lipman1

1Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia

2Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

3Department of Infectious Diseases, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

ABSTRACT

Despite the development of novel antibiotics active against Gram-positive bacteria, vancomycin generally remains the first treatment, although rapidly achieving concentrations associated with maximal efficacy provides an unresolved challenge. The objective of this study was to conduct a population pharmacokinetic analysis of vancomycin in a large population of critically ill patients. This was a retrospective data collection of 206 adult septic critically ill patients who were administered vancomycin as a loading dose followed by continuous infusion. The concentration-versus-time data for vancomycin in serum was analyzed by a nonlinear mixed-effects modeling approach using NONMEM.Monte Carlosimulations were performed using the final covariate model. We found that the best population pharmacokinetic model consisted of a one-compartment linear model with combined proportional and additive residual unknown variability. The volume of distribution of vancomycin (1.5 liters/kg) was described by total body weight and clearance (4.6 liters/h) by 24-hour urinary creatinine clearance (CrCl), normalized to body surface area. Simulation data showed that a 35-mg/kg loading dose was necessary to rapidly achieve vancomycin concentrations of 20 mg/liter. Daily vancomycin requirements were dependent on CrCl, such that a patient with a CrCl of 100 ml/min/1.73 m2 would require at least 35 mg/kg per day by continuous infusion to maintain target concentrations. In conclusion, we have found that higher-than-recommended loading and daily doses of vancomycin seem to be necessary to rapidly achieve therapeutic serum concentrations in these patients.

PDF

http://aac.asm.org/content/55/6/2704.full.pdf+html

 

March 24, 2012 at 9:26 pm Leave a comment

Optimization of Aminoglycoside Therapy

Antimicrobial Agents and Chemotherapy  June 2011 V.55 N.6 P.2528-2531

G. L. Drusano* and Arnold Louie

Ordway Research Institute, 150 New Scotland Avenue, Albany, New York 12208

ABSTRACT

Aminoglycosides are experiencing a resurgence in use because of the spread of multiresistant Gram-negative pathogens. Use of these agents is attended by the occurrence of nephrotoxicity. Aminoglycoside optimization of dose can be defined as the dose having the highest likelihood of a good outcome and the lowest likelihood of toxicity. We have defined the metric Δ as the difference between the likelihoods of good outcome and toxicity, with higher values being better. We developed a method for explicitly evaluating Δ for different daily doses of drug and different schedules of administration. In the empirical therapy setting, when aminoglycosides are administered every 12 h, treatment of infections caused by microbes with MIC values greater than 1 mg/liter cannot attain a high enough likelihood of a good outcome without engendering an unacceptable toxicity likelihood. Daily administration, by decrementing the likelihood of toxicity, allows higher doses to be employed with more acceptable probabilities of toxicity. Obtaining patient-specific information (concentration-time data) allows better identification of the patient’s specific pharmacokinetic parameters and dispersion. As these become better identified, optimal doses become rapidly identified so that optimal outcomes are attained. Optimization of therapy for aminoglycosides requires understanding the relationship between exposure and response as well as that between exposure and toxicity. Furthermore, daily administration is much preferred, and stopping therapy as quickly as possible (a week or less may be optimal) will contribute to the ability to optimize therapy.

PDF

http://aac.asm.org/content/55/6/2528.full.pdf+html

March 24, 2012 at 9:24 pm Leave a comment

Case Report of a Successful Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteremia and MRSA/Vancomycin-Resistant Enterococcus faecium Cholecystitis by Daptomycin▿

Antimicrobial Agents and Chemotherapy 1 May 2011 V.55 N.5 P.2458-2459

Carlo Tascini1,†, Antonello Di Paolo2,†,*, Marialuisa Polillo2, Mauro Ferrari3, Paola Lambelet4, Romano Danesi2 and Francesco Menichetti1

1Infectious Diseases Unit, Santa Chiara University Hospital, Pisa, Italy

2Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa, Italy

3Division of Vascular Surgery, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy

4Division of Medicine, Versilia Hospital, Camaiore, Italy

ABSTRACT

A 72-year-old man, receiving 8 mg daptomycin/kg body weight/day for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, was diagnosed with MRSA/vancomycin-resistant Enterococcus faecium (VRE) cholecystitis (daptomycin MIC values, 1 and 2 mg/liter, respectively). After the fifth drug dose, the bile concentration of daptomycin was 66 mg/liter 5 min after drug administration, with the biliary concentration/MIC values higher than 30 for both bacterial strains. Therefore, daptomycin achieved therapeutic levels in bile, hence suggesting a role for the drug in the treatment of MRSA/VRE cholecystitis.

PDF

http://aac.asm.org/content/55/5/2458.full.pdf+html

March 20, 2012 at 9:56 pm Leave a comment

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