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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fungal osteomyelitis is a rare and possibly life-threatening condition. Factors that increase the risk of bone infection include the use of indwelling catheters, immunosuppressive agents (cyclosporine) in organ transplantation, aggressive anticancer chemotherapy, total parenteral nutrition, and broad spectrum antibiotics; immunocompromised hosts (human immunodeficiency virus) and individuals who have suffered burns, have diabetes mellitus or have undergone abdominal surgery. Treatment involves the use of intravenously administered antifungal agents, such as micafungin (MFG), initially, followed by long term oral suppressive therapy. The purpose of this study was to assess the impact of MFG at low (0.128 microg/mL), medium (64 microg/mL) and high (125 microg/mL) concentrations on MG-63 osteoblast-like cells (MOCs) on cell growth and viability. Apoptosis, glutathione and malondialdehyde assays, hematoxylin and eosin stains, and the proliferation rate were used to characterize MOCs (1 x 104 cells/well) for growth and viability after exposure to low, medium and high concentrations of MFG at 24, 48 and 72 hours in tissue culture. Micafungin at 0.128 and 64 microg/mL had a stimulatory effect on bone cell proliferation as early as 24 hours and was maintained for the duration of the study. Micafungin at high concentration showed suppressive effects on cell number after 72 hours and markedly decreased glutathione levels at 24 hours. Cell membrane damage was less than that observed in controlled untreated cells. Cell morphology and apoptosis evaluation of cells treated with MFG at high concentration showed a greater potential towards cell damage. Micafungin, at low and medium concentrations, minimally affected the integrity of MOCs relative to the control at 24, 48 and 72 hours in tissue culture medium.
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PMID:The impact of micafungin on the cellular integrity of mg63 osteoblastlike cells in vitro a preliminary study. 1914 57

We report an uncommon but emerging fungal pathogen, Candida kefyr, as a causative agent of infective endocarditis in a patient with a known history of hypertrophic obstructive cardiomyopathy. A 74-year-old woman with diabetes type II, hypertrophic obstructive cardiomyopathy, presented with gross hematuria and abdominal pain. Computed tomography scan revealed a hemorrhagic mass in the superior pole of the right kidney, with a thrombus extending from the ureter to the bladder. She underwent cryotherapy of the renal mass, together with retrograde ureteral stent placement, developed hypotension and respiratory distress, spiked high-grade fever, and had a new pansystolic murmur over the mitral and aortic areas. Urine and blood culture grew C. kefyr. Transthoracic echocardiogram revealed large mitral valve vegetation with moderate regurgitation. Micafungin was started, patient responded, and fungemia cleared. Repeat echocardiogram showed small vegetation, preserved leaflet mobility and mild regurgitation. Patient received 10 days of micafungin, followed by 6 weeks of fluconazole.
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PMID:Candida kefyr endocarditis in a patient with hypertrophic obstructive cardiomyopathy. 2008 70

A 73-year-old man was admitted with high fever and right chest pain. Chest X-ray showed a rapidly growing mass shadow in the right lower lung field. The patient had been in remission for malignant lymphoma and had developed interstitial pneumonia and diabetes mellitus following 1 year of corticosteroid therapy. His illness was diagnosed as invasive aspergillosis because of a high level of beta-D-glucan and cultured Aspergillus fumigatus in the sputum. He was treated with a combination of micafungin and itraconazole. However, because these agents did not improve his clinical condition, transbronchial lung biopsy was performed. Histologically, Mucor hyphae were detected in these specimens. Micafungin and itraconazole were stopped and infusion of liposomal amphotericin B was initiated. Because his condition worsened, a right lower lobectomy was performed. Rhizopus Oryzae was detected in the lung tissue. We report a case of pulmonary mucormycosis in which mixed infection with A. fumigatus was suspected. Pulmonary mucormycosis is a life-threatening infection in which it is rare that an antemortem diagnosis is established and organisms are isolated. We believe diagnostic tests should be performed aggressively, even when pulmonary aspergillosis is suspected.
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PMID:[A case of resected pulmonary mucormycosis that was suspected of mixed infection with Aspergillus fumigatus, diagnosed by transbronchial lung biopsy]. 2080 83