New and emerging treatments for fungal infections

Although several new antifungal drugs have been licensed in the last 5 years, some patients remain difficult to treat. The main reasons for this include intrinsic or acquired antifungal resistance, organ dysfunction preventing the use of some agents and drug interactions. In addition, some drugs pene-trate poorly into sanctuary sites including eye and urine, and others are associated with considerable adverse events. Here, we review the preclinical and clinical development progress with four new anti-fungal agents: isavuconazole, ravuconazole, albaconazole and aminocandin. Isavuconazole and ravu-conazole are extremely similar, with a broad spectrum of activity, a very long half-life and large volume of distribution and good in vivo data supporting their efficacy in invasive aspergillosis and candidosis. Both compounds are in early Phase 3 development. Albaconazole has also shown very potent activity against species of Candida, Cryptococcus and Aspergillus. It was well tolerated and effective in women with vaginal candidosis. Aminocandin is an intravenous-only echinocandin with in vivo activity against Candida spp. and Aspergillus spp. Its extended half-life probably permits dosing less fre-quently than once a day. Overall these new antifungal agents in development offer extended half-lives, possibly reduced drug interaction profiles and good tolerance. Their antifungal spectrum is narrower than posaconazole and probably similar to voriconazole (isavuconazole and ravuconazole) and caspo-fungin (aminocandin). Licensure and determination of their place in clinical practice requires random-ized clinical studies, which are or will be underway

Comparison of two fluorescent whiteners, Calcofluor and Blankophor, for the detection of fungal elements in clinical specimens in the diagnostic laboratory

ABSTRACTFluorescent whiteners, such as Blankophor and Calcofluor white, bind to chitin and cellulose, and fluoresce when exposed to UV light. Detection of fungal elements from skin and nail samples was faster and more accurate using Blankophor compared with potassium hydroxide preparations and Calcofluor (sensitivity and specificity 100% and 86% vs. 83–90% and 84–88%, or 80% and 84%, respectively). Visibility was improved, and the procedures were simple, inexpensive and rapid, all of which are important considerations in a busy diagnostic laboratory

The burden of serious fungal infections in Portugal

Using published data, we were able to estimate the incidence or prevalence of the above referred fungal infections and ~194 293 (1.8%) people in Portugal suffer from those fungal infections each year

IPO Underpricing Firm Quality, and Subsequent Reissuance Activity

A signaling argument has recently been developed whereby IPO underpricing is a signal of future firm value. Only higher quality firms can be expected to recover the cost of this signal through subsequent offerings of seasoned equities. This study uses three proxies for firm quality and finds evidence of a positive relationship between these measures of firm quality and reissuance activity. Greater IPO underpricing is also found to be associated with greater levels of future equity selling and higher levels of earnings per share

A case of spotted fever group rickettsiosis imported into the United Kingdom and treated with ciprofloxacin: a case report

<p>Abstract</p> <p>Introduction</p> <p>Spotted fever group rickettsioses are an interesting group of infections, which are increasing in incidence worldwide.</p> <p>Case presentation</p> <p>Here we describe an imported case to the United Kingdom occurring in a patient who had recently visited Kruger National Park in South Africa – a highly endemic area for <it>Rickettsia </it>infections. Initial treatment with doxycycline failed but the patient made a prompt recovery after commencement of ciprofloxacin.</p> <p>Conclusion</p> <p>This finding raises the possibility that there are resistant strains of <it>Rickettsia </it>present.</p

Observations of neutral depletion and plasma acceleration in a flowing high-power argon helicon plasma

Neutral depletion effects are observed in a steady-state flowing argon helicon plasma with a magnetic nozzle for high rf input powers (up to 3 kW). Noninvasive diagnostics including 105 GHz microwave interferometry and optical spectroscopy with collisional-radiative modeling are used to measure the electron density (ne), electron temperature (Te), and neutral density (nn). A region of weak neutral depletion is observed upstream of the antenna where increasing rf power leads to increased electron density (up to ne = 1.6×1013 cm-3) while Te remains essentially constant and low (1.7–2.0 eV). The downstream region exhibits profound neutral depletion (maximum 92% line-averaged ionization), where Te rises linearly with increasing rf power (up to 4.9 eV) and ne remains constrained (below 6.5×1012 cm-3). Flux considerations indicate accelerated plasma flow (Mach 0.24) through the antenna region due to an axial pressure gradient with reduced collisional drag from neutral depletion

Serious fungal infections in Portugal

There is a lack of knowledge on the epidemiology of fungal infections worldwide because there are no reporting obligations. The aim of this study was to estimate the burden of fungal disease in Portugal as part of a global fungal burden project. Most published epidemiology papers reporting fungal infection rates from Portugal were identified. Where no data existed, specific populations at risk and fungal infection frequencies in those populations were used in order to estimate national incidence or prevalence, depending on the condition. An estimated 1,510,391 persons develop a skin or nail fungal infection each year. The second most common fungal infection in Portugal is recurrent vulvovaginal candidiasis, with an estimated 150,700 women (15-50 years of age) suffering from it every year. In human immunodeficiency virus (HIV)-infected people, oral or oesophageal candidiasis rates were estimated to be 19.5 and 16.8/100,000, respectively. Candidaemia affects 2.19/100,000 patients, in a total of 231 cases nationally. Invasive aspergillosis is less common than in other countries as chronic obstructive pulmonary disease (COPD) is uncommon in Portugal, a total of 240 cases annually. The estimated prevalence of chronic pulmonary aspergillosis after tuberculosis (TB) is 194 cases, whereas its prevalence for all underlying pulmonary conditions was 776 patients. Asthma is common (10% in adults) and we estimate 16,614 and 12,600 people with severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis, respectively. Sixty-five patients develop Pneumocystis pneumonia in acquired immune deficiency syndrome (AIDS) and 13 develop cryptococcosis. Overall, we estimate a total number of 1,695,514 fungal infections starting each year in Portugal.info:eu-repo/semantics/publishedVersio