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Il y a 3 mois
Intérêt du suivi thérapeutique pharmacologique dans le cadre des infections pulmonaires

Publication date: Available online 18 May 2017
Source:Revue des Maladies Respiratoires
Author(s): C. Padoin
Les infections pulmonaires sont dues à des virus, des bactéries, des parasites ou encore à des champignons. Elles correspondent aux infections respiratoires basses avec les pneumonies aiguës communautaires et nosocomiales, les bronchites, les pneumopathies, les abcès du poumon, des infections fongiques ou encore la tuberculose. La prise en charge de ces infections va être guidée par les recommandations prenant en compte les micro-organismes les plus souvent impliqués dans le cadre de traitements empiriques, ou par l’identification de celui-ci pour les traitements ciblés. Le statut immunitaire du patient, les modifications physiologiques à l’origine de modifications pharmacocinétiques et les caractéristiques des médicaments utilisés peuvent aboutir à un échec microbiologique et/ou clinique lors de l’utilisation de posologies standard. L’objectif du suivi thérapeutique pharmacologique est d’aboutir à une individualisation de la posologie administrée au regard de la mesure d’une ou plusieurs concentrations et d’objectifs pharmacocinétiques/pharmacodynamiques définis. Il permet d’optimiser la réponse et de prévenir la survenue d’une résistance ou d’une toxicité. Il est indispensable de définir les médicaments et les patients pour lesquels le bénéfice attendu est optimal. Cette démarche doit s’inscrire dans une démarche globale de prise en charge des patients.Pulmonary infections are common and caused by a wide range of viruses, bacteria, parasites and fungi. They consist of lower respiratory tract infections with community and hospital acqui[...]

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Numéro 6/2017. Réponses
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Il y a 4 heures
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Publication date: Available online 21 August 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): E. Delay


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Il y a 4 heures
ScienceDirect

Publication date: Available online 21 August 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): D. Guillier, V. Moris, A.A. Al Hindi, K. Rem, H. Chatel, L.-A. See, M. Revol, S. Mazouz Dorval
BackgroundSurgical approaches in neck dissection: comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André’s approach.MethodsThis single-center retrospective study compares a new transverse incision for cervicotomy to the classical approach described by Paul André in neck dissections. The evaluation criteria were: number of lymph nodes analyzed, operative time, complications, patient satisfaction and aesthetic aspects of the scar.ResultsA total of 34 patients were included in this study, from September 2009 until January 2015. The number of lymph nodes analyzed is not affected by this new approach compared to the classical one (P=0.9). The scar has a significantly more discreet appearance in the transverse cervicotomy group (P=0.023) likewise; patient satisfaction is higher in this group (P=0.006).ConclusionsAesthetic and functional impairment can be reduced using this new transverse cervical approach hidden in the natural creases of the neck described by Langer.

Presse médicale
Il y a 4 heures
ScienceDirect

Publication date: Available online 21 August 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): D. Guillier, V. Moris, A.A. Al Hindi, K. Rem, H. Chatel, L.-A. See, M. Revol, S. Mazouz Dorval
BackgroundSurgical approaches in neck dissection: comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André’s approach.MethodsThis single-center retrospective study compares a new transverse incision for cervicotomy to the classical approach described by Paul André in neck dissections. The evaluation criteria were: number of lymph nodes analyzed, operative time, complications, patient satisfaction and aesthetic aspects of the scar.ResultsA total of 34 patients were included in this study, from September 2009 until January 2015. The number of lymph nodes analyzed is not affected by this new approach compared to the classical one (P=0.9). The scar has a significantly more discreet appearance in the transverse cervicotomy group (P=0.023) likewise; patient satisfaction is higher in this group (P=0.006).ConclusionsAesthetic and functional impairment can be reduced using this new transverse cervical approach hidden in the natural creases of the neck described by Langer.

Actualité
Il y a 4 heures
sante-medecine-RFI

1 milliard de femmes souffrent d’infections gynécologiques dans le monde. Mycose vaginale, cystite, herpès génital sont autant de troubles qui peuvent revenir de manière cyclique chez une femme, et qui sont souvent accompagnés de symptômes douloureux. Comment prévenir les infections ? Quels sont les gestes à adopter et ceux, au [...]

Actualité
Il y a 4 heures
sante-medecine-RFI

1 milliard de femmes souffrent d’infections gynécologiques dans le monde. Mycose vaginale, cystite, herpès génital sont autant de troubles qui peuvent revenir de manière cyclique chez une femme, et qui sont souvent accompagnés de symptômes douloureux. Comment prévenir les infections ? Quels sont les gestes à adopter et ceux, au [...]

Presse médicale
Il y a 5 heures
ScienceDirect

Publication date: Available online 21 August 2017
Source:Journal de Mycologie Médicale / Journal of Medical Mycology
Author(s): P. Sony, M. Kalyani, D. Jeyakumari, I. Kannan, R.G. Sukumar
BackgroundCandida species is the fourth common cause of blood stream infections all over the world which is life threatening. Invasive candidiasis leads to increased mortality and morbidity especially in immunosuppressed. The antifungal resistance pattern in high-risk patients is major concern.PurposeThe present study was to access the anticandidal activity of leaves, bark and seeds of Cassia fistula against fluconazole resistant Candida species, C.albicans, C.glabrata, C.krusei, C.tropicalis, C. kefyr and C.parapsilosis isolated from HIV patients. The predominant phytochemical component responsible for fungicidal activity was to be accessed.Material and methodsEthanol, chloroform, petroleum ether and aqueous extracts of leaves, bark and seeds of C.fistula linn. was evaluated against Microbial type culture collection (MTCC) Candida strains and 21 fluconazole resistant clinical isolates. Antifungal activity was evaluated by agar diffusion and broth dilution techniques. The active phytochemical component present in the ethanol extract of seeds was accessed by high performance thin layer chromatography. The docking study was done with lanosterol 14-alpha demethylase, the azole drug target with the predominant phytochemical from the extract having antifungal activity.ResultsAll the extracts of C.fistula showed excellent anticandidal activity. Ethanol extract of C.fistula seed exhibited the most inhibitory activity. C.krusei and C.parapsilosis were the most inhibited and C.kefyr was the least inhibited species. The predominant phytochemical active component of the ethanol extract of seed was gallic acid. Gallic acid showed excellent binding with lanosterol 14-alpha demethylase.ConclusionThe present study reports the antifungal activity of various extracts of Cassia fistula for the first time against fluconazole resistant Candida isolates. We can conclude that the polyphenolic compound gallic acid is a potent natu[...]