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Vigilance Needed in Treating a Child with Disseminated TB: A Case Report. 治疗儿童播散性肺结核需要警惕:病例报告。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-19 DOI: 10.2174/0118715265287146240405075930
Hemasri Velmurugan, Krishnapriya Neelambaran, M. Gurunthalingam, Dushyant Chouhan, P. Thangaraju, Bikram Keshari Kar, N. R. Gaikwad
BACKGROUNDTuberculosis is still one of the biggest causes of infection-related death around the world. Disseminated tuberculosis is a potentially fatal disease caused by the haematogenous spread of Mycobacterium tuberculosis. First-line anti-tuberculosis drugs in-clude isoniazid, rifampicin, pyrazinamide, and ethambutol. The first three drugs are known to cause hepatotoxicity.CASE PRESENTATIONWe have, herein, reported a case of Drug-induced Liver Injury (DILI) due to anti-tuberculosis therapy in a one-year-old male child with disseminated tuberculosis. He was started on a fixed-dose combination of Anti-tuberculosis Therapy (ATT; isoniazid 50 mg, rifampicin 75 mg, and pyrazinamide 150 mg) and pyridoxine 10 mg orally. Initially, liver pa-rameters were normal, but later on with the course of the treatment, there was a rapid rise in liver enzymes, suggesting liver injury.DISCUSSIONThe association between liver injury and anti-tuberculosis therapy has been con-firmed by applying various causality association scales. It is obvious that proper treatment of disseminated tuberculosis can avoid the development of drug-resistant strains that can be harm-ful, worsening the prognosis as there are fewer therapeutic alternatives available. At the same time, there is a need to monitor the patient with ATT-induced DILI.CONCLUSIONThe diagnosis of tuberculosis in children is difficult because of the mild, nonspe-cific clinical presentation, which usually reflects the implicated underlying organ. In addition to prompt diagnosis and treatment of disseminated TB, careful monitoring is equally important.
背景肺结核仍然是全世界与感染相关死亡的最大原因之一。播散性结核病是由结核分枝杆菌经血液传播引起的一种潜在致命疾病。一线抗结核药物包括异烟肼、利福平、吡嗪酰胺和乙胺丁醇。我们在此报告了一例因抗结核治疗导致药物性肝损伤(DILI)的病例,患者是一名患有播散性结核病的一岁男童。他开始口服固定剂量的抗结核疗法(ATT;异烟肼 50 毫克、利福平 75 毫克和吡嗪酰胺 150 毫克)和吡哆醇 10 毫克。最初,肝脏指标正常,但后来随着治疗的进行,肝酶迅速上升,提示肝损伤。显而易见,对播散性结核病的适当治疗可以避免耐药菌株的产生,而耐药菌株可能会对人体造成伤害,并由于可供选择的治疗方法较少而使预后恶化。同时,有必要对 ATT 引起的 DILI 患者进行监测。结论:由于临床表现轻微、无特异性,儿童结核病的诊断非常困难,这通常反映了受影响的潜在器官。除了及时诊断和治疗播散性肺结核外,仔细监测也同样重要。
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引用次数: 0
Vitamin D and Mitochondrial Activity Preservation in COVID-19. COVID-19中的维生素D和线粒体活性保存。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-19 DOI: 10.2174/0118715265304580240405064250
Julien Giacomoni, Jean-Marc Sabatier
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引用次数: 0
Recombinant ACE2 - Opportunities and Challenges in COVID-19 Treatment. 重组 ACE2 - COVID-19 治疗的机遇与挑战。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-18 DOI: 10.2174/0118715265298816240321045741
Rahul Sandhu, Mandeep Kaur, Akriti Aggarwal
It was in 2019 that the world experienced the devastation caused by SARS-COV-2, contributing to a large number of deaths. This contagious virus not only challenged the health care system but has also hit the economy very badly. There has been a lot of research on effective vaccine development, and there has been some success in the same, but no effective antiviral drugs are available in the market. No doubt vaccination can prevent the disease, but it doesn't have the potential to cure an infected person, for which there is a dire need to develop some effective drug. Angiotensin convertase enzyme 2 (ACE2) played a substantial role in SARS-COV2 pathogenesis and thus has gained much attention during the pandemic. Moreover, it has opened up new avenues for the cure of COVID-19.
就在 2019 年,全世界经历了 SARS-COV-2 带来的灾难,造成大量人员死亡。这种传染性病毒不仅挑战了医疗保健系统,也对经济造成了严重打击。人们对有效疫苗的开发进行了大量研究,并取得了一些成功,但市场上还没有有效的抗病毒药物。毫无疑问,接种疫苗可以预防疾病,但却无法治愈感染者,因此迫切需要开发一些有效的药物。血管紧张素转换酶 2(ACE2)在 SARS-COV2 发病过程中发挥了重要作用,因此在这次大流行中备受关注。此外,它还为治疗 COVID-19 开辟了新的途径。
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引用次数: 0
A Day Saved is a Life Saved: Direct Antimicrobial Susceptibility Testing from Positively Flagged Blood Culture Bottles and their Concordance with the Routine Method. 救人一命胜造七级浮屠:从阳性标记血培养瓶直接进行抗菌药物敏感性检测及其与常规方法的一致性。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-17 DOI: 10.2174/0118715265280460240302165218
Alisha Aggarwal, Kumar S Abhishek, Vibhor Tak, Sukanya Mehrotra, Venkat Goutham Nag, Vidhi Jain
BACKGROUNDSepsis is a major health problem worldwide and is associated with high morbidity and mortality with every hour delay in initiation of therapy. A conventional method of blood culture and Antimicrobial Susceptibility Testing (AST) takes around 48-72 hours. Empirical antibiotics need to be administered until the sensitivity report is made available. It has been estimated that 20-50% of the empirical antibiotics are inappropriate, resulting in prolonged hospital stays, adverse effects, and emergence of drug resistance. Additionally, this also puts an extra financial burden on both the patients and healthcare settings. Performing direct Antimicrobial Sensitivity Testing (dAST) is an important tool to reduce turn-around time (TAT) by at least 18-24 hours, thus reducing morbidity and mortality among critically ill patients.METHODSDirect AST (dAST) was performed from the positively flagged blood culture bottles received between December, 2021 to May, 2022 from Intensive Care Units (ICUs) on MuellerHinton Agar (MHA) using four drops of withdrawn blood. dAST was performed for six drugs: Ceftriaxone-30 µg (CTR), Piperacillin/Tazobactam-100/10 µg (PIT), Meropenem-10 µg (MRP), Ciprofloxacin-5 µg (CIP), Aztreonam-30 µg (AT), and Colistin (CL). The zone of inhibition was interpreted as per CLSI M100 ed32, 2022 guidelines. A parallel conventional method was also performed to examine for categorical agreement and disagreement. Identification was carried out using MALDI-TOF MS from the colonies that appeared on the dAST plate on the subsequent day.RESULTSA total of 162 positively flagged blood culture bottles were included in the study. The majority of the Gram-negative organisms were from Enterobacterales (n=109), followed by Acinetobacter spp. (n=28) and Pseudomonas aeruginosa (n=25). Out of the 972 isolate-antimicrobial combinations, overall Categorical Agreement (CA) was seen in 936 (96.3%), whereas disagreement was observed in 36 with minor error (mE) in 21 (2.2%), major error (ME) in 7 (0.7%), and very major error (VME) in 8 (0.8%) when compared to the routine method. Categorical agreement (CA) of > 99% was seen in ceftriaxone (CTR) and ciprofloxacin (CIP). In comparison, the lowest CA was observed with meropenem (MRP) at 92%. Colistin dAST was performed using the E-strip method, and the result obtained was highly convincing, with an overall disagreement of only 1.2%.CONCLUSIONRapid dAST from positively flagged blood culture bottles proved to significantly reduce the TAT from the time of sample collection to the first availability of antimicrobial susceptibility report with excellent categorical agreement of > 95% using the conventional disc diffusion method. Results obtained were within the acceptance criteria set by U. S. Food and Drug Administration (FDA) guidelines of > 90% categorical agreement for a new method. We were able to obtain excellent concordance for colistin using the E-strip method. Performing dAST not only saves a "da
背景败血症是世界范围内的一个主要健康问题,每延迟一小时开始治疗,就会导致很高的发病率和死亡率。血液培养和抗菌药敏感性检测(AST)的传统方法大约需要 48-72 小时。在获得药敏报告之前,需要使用经验性抗生素。据估计,20%-50% 的经验性抗生素使用不当,导致住院时间延长、不良反应和耐药性的出现。此外,这也给患者和医疗机构带来了额外的经济负担。直接进行抗菌药物敏感性测试(dAST)是将周转时间(TAT)缩短至少 18-24 小时的重要工具,从而降低了重症患者的发病率和死亡率。方法对 2021 年 12 月至 2022 年 5 月期间从重症监护病房(ICU)收到的阳性标记血培养瓶进行了直接抗菌药物敏感性测试(dAST),使用抽取的四滴血液在穆勒欣顿琼脂(MHA)上进行测试:头孢曲松-30 µg (CTR)、哌拉西林/他唑巴坦-100/10 µg (PIT)、美罗培南-10 µg (MRP)、环丙沙星-5 µg (CIP)、氨曲南-30 µg (AT) 和秋水仙碱 (CL)。抑制区按照 CLSI M100 ed32, 2022 指南进行解释。还采用了平行常规方法来检查分类一致和不一致的情况。使用 MALDI-TOF MS 对第二天出现在 dAST 平板上的菌落进行鉴定。大多数革兰氏阴性菌来自肠杆菌科(109 个),其次是醋杆菌属(28 个)和铜绿假单胞菌(25 个)。在 972 个分离物-抗菌药物组合中,与常规方法相比,936 个组合(96.3%)总体分类一致(CA),36 个组合不一致,其中 21 个组合(2.2%)存在轻微误差(mE),7 个组合(0.7%)存在重大误差(ME),8 个组合(0.8%)存在极重大误差(VME)。头孢曲松(CTR)和环丙沙星(CIP)的分类一致性(CA)大于 99%。相比之下,美罗培南(MRP)的分类一致性最低,仅为 92%。结论事实证明,从采集样本到首次获得抗菌药物药敏报告的时间大大缩短,而且使用传统的盘式扩散法,分类一致率大于 95%。获得的结果符合美国食品和药物管理局(FDA)制定的新方法分类一致性大于 90% 的接受标准。我们使用 E-条带法检测可乐定的一致性非常好。使用 dAST 不仅能挽救 "一天",正确使用 dAST 还能挽救 "生命"。
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引用次数: 0
Outbreak and Management Strategies of Nipah Virus: A Scenario from the Southern Part of India. 尼帕病毒的爆发和管理策略:印度南部地区的情况。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-17 DOI: 10.2174/0118715265299783240402063101
Muskan Gupta, Tuhin Mukherjee, Satyajit Mohanty
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引用次数: 0
Patient-Centric Approaches: Revolutionizing Rare Disease Drug Research. 以患者为中心的方法:罕见病药物研究的革命。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-16 DOI: 10.2174/0118715265296986240329060452
Abhishek Verma, Ankit Awasthi
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引用次数: 0
Guardians of Health: Navigating Nipah Virus Challenges in India. 健康卫士:在印度应对尼帕病毒的挑战。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-04-08 DOI: 10.2174/0118715265292757240320081250
Komal, Diksha, N. S. Patil, Amandeep Singh
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引用次数: 0
Emergence of Monkeypox (MPX): A Close Relative of Small Pox During COVID-19 Era. 猴痘(MPX)的出现:COVID-19 时代小痘痘的近亲。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.2174/1871526523666230823105945
Ivneet Kour, Lipika Singhal, Sonia Mehta, Varsha Gupta

After the eradication of smallpox (SPX), a new zoonotic threat that can trigger outbreaks has emerged. It may be fatal during the COVID19 outbreak. Humanity continues to be threatened due to re-emergence of the outbreaks. In most cases, new emerging viral agents originate from nonhuman hosts with zoonotic origins. Recent outbreaks of zoonotic infectious diseases with the potential to cause epidemics and pandemics continue to pose a major threat to the health security of entire regions, continents, and the world at large. Around five decades backthat Monkeypox (MPX) was reported for the first time in the Democratic Republic of the Congo (DRC) and was then confined to Central Africa only. Over the time, it has spread to other regions of Africa as well as outside Africa. As of August 2022, 40398 infections have been confirmed in almost 68 countries that have never reported MPX before. The majority of infections have been reported in Europe and Southeast Asia. On 23rd August 2022, MPX was declared a public health emergency of international concern, a step below declaring any disease as a pandemic. The article discusses the recent history of MPX outbreaks, as well as the evolving clinical manifestations of the disease, and the possible causes of the increase in cases, including the cessation of SPX vaccinations.

在消灭天花(SPX)之后,又出现了一种可引发疫情爆发的新的人畜共患病威胁。在 COVID19 爆发期间,它可能会致命。由于疫情再次爆发,人类继续受到威胁。在大多数情况下,新出现的病毒病原体来源于人畜共患病的非人类宿主。最近爆发的人畜共患传染病有可能导致流行病和大流行,继续对整个地区、大陆和全世界的健康安全构成重大威胁。大约五十年前,猴痘(MPX)首次在刚果民主共和国(DRC)被报道,当时仅局限于中非。随着时间的推移,它已蔓延到非洲其他地区以及非洲以外地区。截至 2022 年 8 月,近 68 个从未报告过 MPX 的国家已确诊 40398 例感染。大多数感染病例发生在欧洲和东南亚。2022 年 8 月 23 日,MPX 被宣布为国际关注的突发公共卫生事件,比宣布任何疾病为大流行更进一步。文章讨论了近期 MPX 爆发的历史、该疾病不断演变的临床表现以及病例增加的可能原因,包括停止 SPX 疫苗接种。
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引用次数: 0
Review on Mucormycosis: Pathogenesis, Epidemiology, Microbiology and Diagnosis. 粘菌病综述:发病机制、流行病学、微生物学和诊断。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.2174/1871526523666230822154407
Aditya Sharma, Md Aftab Alam, Shivang Dhoundiyal, Pramod Kumar Sharma

Mucormycosis is a serious and invasive fungal infection caused by Mucorales fungi. This review article provides a concise overview of the pathogenesis, epidemiology, microbiology, and diagnosis of mucormycosis. The introduction section highlights the key microbiological properties of the pathogen and delves into the underlying mechanisms of mucormycosis pathogenesis, including the invasion and proliferation of the fungus within the host. The description of the disease section focuses on the epidemiology of mucormycosis, including its incidence, risk factors, and geographical distribution. It also explores the specific context of mucormycosis infection about COVID-19 and diabetes mellitus, highlighting the increased susceptibility observed in individuals with these conditions. A case study illustrates the clinical manifestations and challenges associated with mucormycosis, emphasizing the importance of early detection. Additionally, the review discusses the diagnosis of mucormycosis, emphasizing the significance of clinical assessment, radiological imaging, and microbiological tests for accurate and timely detection of the infection. Regarding treatment, the article covers the various therapeutic approaches, including antifungal therapy, surgical interventions, and management of underlying predisposing conditions. The limitations and challenges associated with treatment options are also addressed. This review aims to provide a comprehensive understanding of mucormycosis, equipping healthcare professionals with valuable insights into its pathogenesis, epidemiology, microbiology, and diagnostic strategies. By enhancing knowledge and awareness of this fungal infection, this review can improve patient outcomes through early diagnosis and appropriate management.

粘孢子菌病是由粘孢子菌引起的一种严重的侵袭性真菌感染。这篇综述文章简要概述了粘孢子菌病的发病机制、流行病学、微生物学和诊断。引言部分重点介绍了病原体的主要微生物特性,并深入探讨了粘孢子菌病发病的基本机制,包括真菌在宿主体内的入侵和增殖。疾病描述部分重点介绍了粘孢子菌病的流行病学,包括发病率、风险因素和地理分布。它还探讨了粘孢子菌感染 COVID-19 和糖尿病的具体情况,强调了患有这些疾病的人更容易感染粘孢子菌。病例研究说明了粘孢子菌病的临床表现和相关挑战,强调了早期检测的重要性。此外,综述还讨论了粘孢子菌病的诊断,强调了临床评估、放射成像和微生物检测对准确及时发现感染的重要性。在治疗方面,文章介绍了各种治疗方法,包括抗真菌治疗、外科干预和潜在易感疾病的管理。文章还讨论了与治疗方案相关的局限性和挑战。本综述旨在提供对粘孢子菌病的全面了解,使医疗保健专业人员对其发病机制、流行病学、微生物学和诊断策略有宝贵的见解。通过加强对这种真菌感染的了解和认识,本综述可通过早期诊断和适当治疗改善患者的预后。
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引用次数: 0
Characteristics and Applications of Peptide Nucleic Acid in the Treatment of Infectious Diseases and the Effect of Antimicrobial Photodynamic Therapy on Treatment Effectiveness. 多肽核酸在治疗传染病中的特点和应用以及抗菌光动力疗法对治疗效果的影响。
Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.2174/1871526523666230724120957
Zahra Javanmard, Maryam Pourhajibagher, Abbas Bahador

Antibiotic resistance is a growing global problem, so there is an urgent need for new antimicrobial agents and strategies. Peptide nucleic acid (PNA) oligomers could be designed and utilized as gene-specific oligonucleotides to target any infectious agents. Selectivity and high-affinity binding are the main properties of PNA. However, in therapeutic applications, intracellular delivery of peptide nucleic acids is still a challenge. In photodynamic therapy (PDT), which could be a useful adjunct to mechanical and antibiotics in removing pathogenic agents, low-power lasers are used in appropriate wavelength for killing the microorganisms that have been treated with a photosensitizer drug. Antimicrobial photodynamic therapy (aPDT) in combination with lipid-charged nanoparticles of PNA is a promising alternative therapy proposed to control infectious diseases. This review summarizes progress in the uptake of peptide nucleic acids at intracellular targets. In addition, we focus on recent nanoparticle- based strategies to efficiently deliver conventional and chemically modified peptide nucleic acids. The likely impact of using two treatment methods simultaneously, i.e., PNP and PDT, has already been discussed.

抗生素耐药性是一个日益严重的全球性问题,因此迫切需要新的抗菌剂和策略。多肽核酸(PNA)寡聚体可被设计和用作基因特异性寡核苷酸,以靶向任何感染性病原体。选择性和高亲和性是 PNA 的主要特性。然而,在治疗应用中,多肽核酸的细胞内递送仍是一项挑战。在光动力疗法(PDT)中,使用适当波长的低功率激光来杀死经过光敏剂药物处理的微生物,可以作为机械和抗生素清除病原体的有效辅助手段。抗菌光动力疗法(aPDT)与带脂质的 PNA 纳米粒子相结合,是一种很有前景的控制传染病的替代疗法。本综述总结了肽核酸在细胞内靶点吸收方面的进展。此外,我们还重点介绍了最近基于纳米粒子的高效递送传统和化学修饰肽核酸的策略。我们已经讨论了同时使用两种治疗方法(即 PNP 和 PDT)可能产生的影响。
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引用次数: 0
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Infectious disorders drug targets
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