scholarly journals Issues beyond resistance: inadequate antibiotic therapy and bacterial hypervirulence

FEMS Microbes ◽  
2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Lee W Goneau ◽  
Johannes Delport ◽  
Luana Langlois ◽  
Susan M Poutanen ◽  
Hassan Razvi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Significance ◽  
Clinical Course ◽  
Disease Course ◽  
Course Of Disease ◽  
Inadequate Antibiotic Therapy ◽  
Microbe Interactions ◽  
Persistence Factors ◽  
Selection Of

ABSTRACT The administration of antibiotics while critical for treatment, can be accompanied by potentially severe complications. These include toxicities associated with the drugs themselves, the selection of resistant organisms and depletion of endogenous host microbiota. In addition, antibiotics may be associated with less well-recognized complications arising through changes in the pathogens themselves. Growing evidence suggests that organisms exposed to antibiotics can respond by altering the expression of toxins, invasins and adhesins, as well as biofilm, resistance and persistence factors. The clinical significance of these changes continues to be explored; however, it is possible that treatment with antibiotics may inadvertently precipitate a worsening of the clinical course of disease. Efforts are needed to adjust or augment antibiotic therapy to prevent the transition of pathogens to hypervirulent states. Better understanding the role of antibiotic-microbe interactions and how these can influence disease course is critical given the implications on prescription guidelines and antimicrobial stewardship policies.

scholarly journals Effects of Potent Neutralizing Antibodies from Convalescent Plasma in Patients Hospitalized for Severe SARS-CoV-2 Infection.

2020 ◽  
Author(s):  
Arvind Gharbharan ◽  
Carlijn Jordans ◽  
Corine GeurtsvanKessel ◽  
Jan den Hollander ◽  
Faiz Karim ◽  
...  
Keyword(s):  
Plasma Treatment ◽  
Neutralizing Antibodies ◽  
Clinical Course ◽  
Humoral Response ◽  
Disease Course ◽  
Course Of Disease ◽  
Future Studies ◽  
Immunological Responses ◽  
Translational Approach

Abstract Convalescent plasma could be an inexpensive and widely available treatment for COVID-19 patients but reports on effectiveness are inconclusive. We collected convalescent plasma from donors with high titers of neutralizing anti-SARS-CoV-2 antibodies effectively blocking SARS-CoV-2 infection in vitro. In a randomized clinical trial of 86 COVID-19 patients, no overall clinical benefit of 300 mL convalescent plasma was found in patients hospitalized for COVID-19 in the Netherlands. Using a comprehensive translational approach, we unraveled the virological and immunological responses following plasma treatment which helps to understand which COVID-19 patients may benefit from this therapy and should be the focus of future studies. Convalescent plasma treatment in this patient group did not improve survival, had no effect on the clinical course of disease, nor did plasma enhance viral clearance in the respiratory tract, influence anti-SARS-CoV-2 antibody development or serum proinflammatory cytokines levels. The vast majority of patients already had potent neutralizing anti-SARS-CoV-2 antibodies at hospital admission and at comparable titers as the carefully selected plasma donors. Together, these data indicate that the variable effectivity observed in trials on convalescent plasma for COVID-19 may be explained by the timing of treatment and varying levels of preexisting anti-SARS-CoV-2 immunity in patients. It also substantiates that convalescent plasma should be studied as early as possible in the disease course or at least preceding the start of an autologous humoral response. Trial registration: Clinicaltrials.gov: NCT04342182

The Place of Antiarrhythmic Drugs and Rhythm Control in the Treatment of Atrial Fibrillation

2009 ◽  
Vol 5 (1) ◽  
pp. 36
Author(s):  
Philippe Chevalier ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Antiarrhythmic Drugs ◽  
Structural Heart Disease ◽  
Rhythm Control ◽  
Disease Course ◽  
Drug Trials ◽  
Cardiac Safety ◽  
Selection Of

Atrial fibrillation (AF) is the most common arrhythmia, with incidence increasing with age and a ranging severity of symptoms. The arrhythmia, perpetuated from electrical, functional and structural remodelling by AF itself, can ultimately lead to increased morbidity and mortality. Emerging evidence appears to support the initiation of rhythm control, particularly early on in the disease course. Antiarrhythmic drugs have proved useful in inducing and maintaining cardioversion, but treatment varies depending on the degree of structural heart disease. Drug trials and selection of therapy have historically focused largely on cardiac safety. Class Ic drugs have demonstrated safety and efficacy in patients with little to no structural heart disease, yet their use continues to be superseded by the use of other drugs, especially amiodarone, which carries significant risks of extracardiac effects and end-organ toxicities. This article discusses the role of sinus rhythm control and antiarrhythmic drugs in AF, with an emphasis on patients exhibiting no or minimal structural heart disease and the importance of selecting an appropriate antiarrhythmic drug, taking into account arrhythmia burden, presence of concurrent cardiovascular disease and severity and, most importantly, the safety of the drug therapy.

Faculty selection of textbooks: Key variables and the role of teaching experience

2010 ◽  
Author(s):  
Aja Taitano ◽  
Bradley Smith ◽  
Cade Hulbert ◽  
Kristin Batten ◽  
Lalania Woodstrom ◽  
...  
Keyword(s):  
Teaching Experience ◽  
Key Variables ◽  
Faculty Selection ◽  
Selection Of

Posttransplant CMV infection and the role of immunosuppression (Sponsor: Novartis Pharma GmbH, Nürnberg)

2016 ◽  
Vol 04 (01) ◽  
pp. 4-10
Keyword(s):  
Lower Incidence ◽  
Paradigm Shift ◽  
Mtor Inhibitor ◽  
De Novo ◽  
Expert Panel ◽  
Risk Of Infection ◽  
Cmv Infection ◽  
Expert Meeting ◽  
Selection Of

AbstractImmunosuppression permits graft survival after transplantation and consequently a longer and better life. On the other hand, it increases the risk of infection, for instance with cytomegalovirus (CMV). However, the various available immunosuppressive therapies differ in this regard. One of the first clinical trials using de novo everolimus after kidney transplantation [1] already revealed a considerably lower incidence of CMV infection in the everolimus arms than in the mycophenolate mofetil (MMF) arm. This result was repeatedly confirmed in later studies [2–4]. Everolimus is now considered a substance with antiviral properties. This article is based on the expert meeting “Posttransplant CMV infection and the role of immunosuppression”. The expert panel called for a paradigm shift: In a CMV prevention strategy the targeted selection of the immunosuppressive therapy is also a key element. For patients with elevated risk of CMV, mTOR inhibitor-based immunosuppression is advantageous as it is associated with a significantly lower incidence of CMV events.

Multi-dimensional Visualisation of Laboratory Findings and Functional Test Results for Analysing the Clinical Course of Disease in Medicine

1995 ◽  
Vol 34 (03) ◽  
pp. 302-308 ◽  
Author(s):  
C. J. Luz ◽  
W. Giere ◽  
R. Lüdecke ◽  
D. Jonas ◽  
A. J. W. Goldschmidt
Keyword(s):  
Clinical Course ◽  
Test Results ◽  
Geometrical Figure ◽  
Laboratory Findings ◽  
Course Of Disease ◽  
Quantitative Examination ◽  
Ward Rounds ◽  
Patient’S History ◽  
Graphical Primitive ◽  
Computerized Medical Record

Abstract:The illustration of a patient’s history by a graphical primitive is discussed. Illustration technology is presented which simultaneously represents quantitative examination findings (e. g., laboratory values) and qualitative findings (e. g., from function diagnostics) by a single geometrical figure. Depending on the medical results, this figure takes on characteristic forms which can be identified as patterns typical for a specific disease. The procedure developed is integrated in a user interface which is implemented in the form of a computerized medical record for use on a pentop computer. This portable computer assists the physician during ward rounds, supplies additional, intelligence-based information, serves quality control, and streamlines working procedures making them more efficient.

Energy Efficiency Analysis in ERA using NFL-BA Algorithm

2020 ◽  
pp. 340-348
Author(s):  
Palky Mehta ◽  
H. L. Sharma
Keyword(s):  
Cluster Head ◽  
Vital Role ◽  
Wireless Sensor ◽  
Energy Usage ◽  
Cluster Heads ◽  
Comparison Results ◽  
Current Scenario ◽  
Energy Efficiency Analysis ◽  
Selection Of

In the current scenario of Wireless Sensor Network (WSN), power consumption is the major issue associated with nodes in WSN. LEACH technique plays a vital role of clustering in WSN and reduces the energy usage effectively. But LEACH has its own limitation in order to search cluster head nodes which are randomly distributed over the network. In this paper, ERA-NFL- BA algorithm is being proposed for selects the cluster heads in WSN. This algorithm help in selection of cluster heads can freely transform from global search to local search. At the end, a comparison has been done with earlier researcher using protocol ERA-NFL, which clearly shown that proposed Algorithm is best suited and from comparison results that ERA-NFL-BA has given better performance.

Tauchnitz for Translators. The Circulation of English-language Literature in Finland

2019 ◽  
Vol 16 (2-3) ◽  
pp. 161-179
Author(s):  
Outi Paloposki
Keyword(s):  
Foreign Language ◽  
English Language ◽  
Book History ◽  
Language Skills ◽  
Point Of View ◽  
Book Production ◽  
German Publisher ◽  
Language Literature ◽  
Selection Of

The article looks at book production and circulation from the point of view of translators, who, as purchasers and readers of foreign-language books, are an important mediating force in the selection of literature for translation. Taking the German publisher Tauchnitz's series ‘Collection of British Authors’ and its circulation in Finland in the nineteenth and early twentieth century as a case in point, the article argues that the increased availability of English-language books facilitated the acquiring and honing of translators' language skills and gradually diminished the need for indirect translating. Book history and translation studies meet here in an examination of the role of the Collection in Finnish translators' work.

The Adult as Foe or Friend?: Childism in Guus Kuijer's Criticism and Fiction

2013 ◽  
Vol 6 (2) ◽  
pp. 205-217 ◽  
Author(s):  
Vanessa Joosen
Keyword(s):  
Children's Literature ◽  
Children’S Literature ◽  
Age Groups ◽  
Children's Books ◽  
Children’S Books ◽  
Memorial Award ◽  
Adult Reader ◽  
Shed Light ◽  
Selection Of

Compared to the attention that children's literature scholars have paid to the construction of childhood in children's literature and the role of adults as authors, mediators and readers of children's books, few researchers have made a systematic study of adults as characters in children's books. This article analyses the construction of adulthood in a selection of texts by the Dutch author and Astrid Lindgren Memorial Award winner Guus Kuijer and connects them with Elisabeth Young-Bruehl's recent concept of ‘childism’ – a form of prejudice targeted against children. Whereas Kuijer published a severe critique of adulthood in Het geminachte kind [The despised child] (1980), in his literary works he explores a variety of positions that adults can take towards children, with varying degrees of childist features. Such a systematic and comparative analysis of the way grown-ups are characterised in children's texts helps to shed light on a didactic potential that materialises in different adult subject positions. After all, not only literary and artistic aspects of children's literature may be aimed at the adult reader (as well as the child), but also the didactic aspect of children's books can cross over between different age groups.

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