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Susceptibility of 64 clinical isolates from vaginal mycoses to a new propiconazole derivative Mares, Mihai1; Doroftei, Bogdan2; Stefanache, Alina3; Valica, Vasile4; Popovici, Iuliana5 1 Mycomedica Medical Center, Codrescu 7B, B4, B, 9, Iasi, Romania; 2University of Medicine and Pharmacy, 2nd Clinic of Obstetrics-Gynecology, Iasi, Romania; 3University of Medicine and Pharmacy, Inorganic Chemistry, Iasi, Romania; 4National Institute of Pharmacy, Chisinau, Moldova, Republic of; 5University of Medicine and Pharmacy, Pharmaceutical Technology, Iasi, Romania Background: Vaginal candidosis represents a significant health problem to women of childbearing age worldwide. Inflammation of the vulva and or vagina is caused by yeasts of the genus Candida, primarily by the species Candida albicans and Candida glabrata. Infections with other species are very rare. Nowadays, the resistance to usual antifungals, especially to azoles, is increasing. Objectives: To evaluate the antifungal activity of a new propiconazole derivative against 64 strains of yeast species isolated from vulvovaginitis under in vitro conditions resembling the vaginal microenvironment. Method: We performed the susceptibility testing in a vagina-simulative medium using the NCCLS M27-A2 standard guidelines. The range of tested concentrations was based on a 2 fold dilution series and it varied between 0.0625-16 mg L. Interpretation of results was performed after 48 hours of incubation at 35C. The minimal inhibitory concentration MIC ; was considered the lowest concentration of the drug which corresponds to 80% reduction in turbidity compared with that of the drug-free growth control. Results: The MIC90 was 0.5 mg L and the MIC50 was 0.0625 mg L respectively. The tests exhibited low MICs for all strains which may be useful in using of this new azole compound for treatment of mycotic vaginitis. Since the interpretative breakpoints are yet unknown the clinical relevance of testing remains uncertain. Conclusions: The results encourage the future researches in order to determine the interpretative breakpoints, to evaluate the in vitro - in vivo correlations, and to evaluate the appropriate doses in order to start clinical trials and soma.
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| The problems with diagnosis and treatment of transient ischaemic attacks TIAs ; . For many years, a TIA has been defined as a "neurologic deficit lasting less than 24 hours that is attributed to focal cerebral or retinal ischaemia". However, in the vast majority of TIA cases, the symptoms and signs last less than one hour, which makes diagnosis by the physician, who is unlikely to have witnessed the event, difficult and dependent largely on the patient's or relative's description. Moreover studies evaluating the short-term prognosis of patients with a diagnosed TIA have shown a 10% risk of stroke within the first 90 days, of which 50% occur within the first 2 days. Risk factors for the development of stroke include age, diabetes, longer duration of TIA symptoms, weakness or speech impairment during the episode, as well as predisposing disease such as carotid artery disease or atrial fibrillation. The authors state that the aim of management should be to reduce as much as possible the likelihood of developing a stroke, which is associated with considerable mortality and morbidity. Therefore they recommend that patients with TIAs be treated as a medical emergency to identify predisposing factors for developing a stroke. In addition, although formal studies have not evaluated its benefit, most guidelines recommend that aspirin 50-325mg day be given to TIA patients, with the initiation of anticoagulant treatment in those with atrial fibrillation. NEJM 2002; 347 21 1642-3; 1687-92; 1713-1716 and valium.
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1. 2. PPA spending data 2001 Data based on - National Institute of Clinical Excellence, Guidance in the use of proton pump inhibitors in the treatment of dyspepsia 2000 Kahrilas PJ, Falk GW, Johnson DA, Schmitt C, Collins DW, Whipple J, D'Amico D, Hamelin B, Joelsson B. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomised controlled trial. The Esomeprazole Study Investigators. Alimentary Pharmacology and Therapeutics 2000; 14: 1249-58 Richter JE, Kahrilas PJ, Johanson J, Maton P, Breiter JR, Hwang C, Marino V, Hamelin B, Levine JG. Esomeprazole Study Investigators. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomised controlled trial. The American journal of Gastroenterology 2001; 96: 656-65 Castell DO, Kahrilas PJ, Richter JE, Vakil NB, Johnson DA, Zukerman S, Skammer W, Levine JG. Esomeprazole 40mg ; compared with lansoprazole 30mg ; in the 6. treatment of erosive esophagitis. American Journal of Gastroenterology2002; 97: 575-83 Howden CW, Ballard II ED, Robieson W. Evidence for therapeutic equivalence of Lansoprazole and Esomeprazole 40mg in the treatment of erosive oesophagitis. Clinical Drug Investigation 2002; 22: 99109 Talley NJ, Lauritsen K, Tunturi-Hihnala H, Lind T, Moum B, Bang C, Schulz T, Omlands TM, Delle M, Junhhard O. Esomeprazole 20mg maintains symptom control in endoscopy-negative gastro-oesophageal reflux disease: a controlled trial of "on-demand" therapy for 6 months. Ailmentary Pharmacology and Therapeutics 2001; 15: 347-354 Wahlqvist P, Junghard O, Hihhins A, Green J. Cost effectiveness of proton pump inhibitors in gastrooesophageal reflux disease without oesophagitis. Comparison of on-demand esomeprazole with conventional omeprazole strategies. Pharmacoeconomics 2002; 20: 267-277 Nesium Summary of Product Characteristics, AstraZenica and viagra and nexium.
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