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Sandín-López E, Fernández-López A, Fernández-Torres B. Usefulness of the spectral density matrix in the dosing of halogenated hypnotics. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00055-6. [PMID: 38437988 DOI: 10.1016/j.redare.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- E Sandín-López
- Departmento de Anestesiología, Hospital Virgen Macarena, Sevilla, Spain.
| | - A Fernández-López
- Departmento de Anestesiología, Hospital Virgen Macarena, Sevilla, Spain
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Fernández-Torres B, Fernández-López A, Congregado M. Scimitar syndrome: Anaesthetic management for pulmonary resection of the unaffected lung. ACTA ACUST UNITED AC 2017; 64:594-599. [PMID: 28554711 DOI: 10.1016/j.redar.2017.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/21/2017] [Accepted: 03/27/2017] [Indexed: 11/25/2022]
Abstract
Scimitar syndrome is a rare congenital anomaly characterized by anomalous drainage of the right pulmonary veins in the inferior vena cava, frequently associated with right lung and pulmonary artery hypoplasia, dextrocardia and abnormal systemic arterial supply to the lower lobe. Pulmonary resection surgery on healthy lung is exceptional, and there are no published records of it, as far as we know. A man with scimitar syndrome diagnosed with a lung nodule with malignant features in the contralateral lung. This situation implies huge anaesthetic complexity, mainly for intraoperative ventilation. Although spirometry and stress test did not contraindicate the planned lobectomy, scintigraphy showed a hypoplastic right lung with an uptake of 15%. From an anaesthetic point of view we discarded selective ventilation of the right lung, since the shunt made it functionally non-existent. In consequence we proposed four anaesthetic possibilities. After the placement of an epidural catheter and left selective intubation, thoracoscopy with intermittent apnoeas was our first choice, and we could complete the extirpation and avoid excessive complexity.
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Affiliation(s)
- B Fernández-Torres
- Hospital Universitario, Virgen Macarena, Sevilla, España; Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
| | | | - M Congregado
- Hospital Universitario, Virgen Macarena, Sevilla, España; Facultad de Medicina, Universidad de Sevilla, Sevilla, España
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Carrillo-Muñoz AJ, Fernández-Torres B, Cárdenes DC, Guarro J. In vitro Activity of Sertaconazole against Dermatophyte Isolates with Reduced Fluconazole Susceptibility. Chemotherapy 2003; 49:248-51. [PMID: 14504436 DOI: 10.1159/000072449] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2002] [Accepted: 03/14/2003] [Indexed: 11/19/2022]
Abstract
We have studied the in vitro antifungal activity of sertaconazole against 114 dermatophytes with low susceptibility to fluconazole following the National Committee for Clinical Laboratory Standards for filamentous fungi (M38-P). However, several important factors such as the temperature (28 vs. 35 degrees C) and time of incubation (4-10 days vs. 21-74 h), have been found to affect dermatophytes. Isolates were recently recovered from human samples. Sertaconazole was active against 114 isolates of 12 fungal dermatophyte species, showing an overall geometric mean of 0.41 microg/ml with a minimum inhibitory concentration (MIC) range of 0.01-2 microg/ml against these isolates with reduced fluconazole susceptibility. Differences between both antifungals were significant (p < 0.05). MIC(50) and MIC(90) of sertaconazole were of 0.5 and 1 microg/ml, respectively, while the MIC of fluconazole was >/=16 microg/ml. None of the isolates was resistant to sertaconazole during the study while for four isolates the MIC of fluconazole was >/=64 microg/ml. No evidence of cross-resistance between both antifungals was found.
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Fernández-Torres B, Carrillo-Muñoz A, Ortoneda M, Pujol I, Pastor FJ, Guarro J. Interlaboratory evaluation of the Etest for antifungal susceptibility testing of dermatophytes. Med Mycol 2003; 41:125-30. [PMID: 12964844 DOI: 10.1080/mmy.41.2.125.130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A three-site interlaboratory reproducibility evaluation of the Etest concentration gradient strip method for testing antifungal susceptibilities was conducted using 30 strains of dermatophytes exposed to strips loaded with ketoconazole (KTZ), itraconazole (ITZ), amphotericin B (AMB) and fluconazole (FCZ). Etest minimal inhibitory concentrations were compared with those obtained using a broth microdilution method. All isolates produced clearly detectable growth at 28 degrees C within 72-96 h for reading with the Etest method. The highest interlaboratory agreement between Etest and the microdilution method was shown with FCZ (94%), and the lowest was seen with KTZ (60%). Overall, agreement between the Etest and microdilution method was variable. It was excellent for AMB (97%), good for ITZ (80%) and KTZ (77%), and low for fluconazole (27%).
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Affiliation(s)
- B Fernández-Torres
- Unitat de Microbiologia, Facultat de Medicine, Institut d'Estudis Avançats, Universitat Rovira i Virgili, 43201 Reus, Tarragona, Spain
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Fernández-Torres B, Carrillo-Muñoz A, Ortoneda M, Pujolz I, Pastor FJ, Guarro J. Interlaboratory evaluation of the Etest® for antifungal susceptibility testing of dermatophytes. Med Mycol 2003. [DOI: 10.1080/714043907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Pujol I, Capilla J, Fernández-Torres B, Ortoneda M, Guarro J. Use of the sensititre colorimetric microdilution panel for antifungal susceptibility testing of dermatophytes. J Clin Microbiol 2002; 40:2618-21. [PMID: 12089289 PMCID: PMC120574 DOI: 10.1128/jcm.40.7.2618-2621.2002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Sensititre YeastOne antifungal panel was used to test 49 dermatophytes belonging to the species Epidermophyton floccosum, Microsporum gypseum, Microsporum canis, Trichophyton tonsurans, Trichophyton rubrum, and Trichophyton mentagrophytes. The MICs of four antifungals obtained with the Sensititre YeastOne antifungal panel were compared with those obtained by the reference NCCLS microdilution method. The levels of agreement between the two methods (<or=2 dilutions) were 81.6% with amphotericin B, 87.7% with itraconazole, 67.3% with fluconazole, and 69.4% with ketoconazole.
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Affiliation(s)
- I Pujol
- Laboratori de Microbiologia, Hospital Universitari de Sant Joan de Reus. Unitat de Microbiologia, Facultat de Medicina. Institut d'Estudis Avançats, Universitat Rovira i Virgili, Reus, Tarragona, Spain
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Abstract
We report a case of subcutaneous infection caused by the dermatophyte Microsporum gypseum in an immunocompetent host. The patient acquired the infection in the knee through a traumatic inoculation of a splinter. To our knowledge this is the first case of subcutaneous infection caused by this fungus.
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Affiliation(s)
- B Fernández-Torres
- Unitat de Microbiologia, Facultat de Medicina, Institut d'Estudis Avançats, Universitat Rovira i Virgili, Carrer Sant Llorenç, 21, 43201, Reus, Spain
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Fernández-Torres B, Pereiro M, Guarro J. Comparison of two methods for antifungal susceptibility testing of Trichophyton rubrum. Eur J Clin Microbiol Infect Dis 2002; 21:70-1. [PMID: 11913509 DOI: 10.1007/s10096-001-0661-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- B Fernández-Torres
- Unitat de Microbiologia, Facultat de Medicina, Institut d'Estudis Avançats, Universitat Rovira i Virgili, Reus, Spain
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Fernández-Torres B, Carrillo AJ, Martín E, Del Palacio A, Moore MK, Valverde A, Serrano M, Guarro J. In vitro activities of 10 antifungal drugs against 508 dermatophyte strains. Antimicrob Agents Chemother 2001; 45:2524-8. [PMID: 11502524 PMCID: PMC90687 DOI: 10.1128/aac.45.9.2524-2528.2001] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2000] [Accepted: 06/18/2001] [Indexed: 11/20/2022] Open
Abstract
We have tested 508 strains belonging to 24 species of dermatophytes against 10 antifungal drugs following mainly the NCCLS (M38-P) standard for filamentous fungi. However, several important factors, such as the temperature (28 versus 35 degrees C) and time of incubation (4 to 10 days versus 21 to 74 h), have been modified. The antifungals used were itraconazole, ketoconazole, miconazole, clotrimazole, voriconazole, terbinafine, amphotericin B, fluconazole, UR-9825, and G-1. In general, with the exception of fluconazole and G-1, all antifungals were shown to be highly effective.
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Affiliation(s)
- B Fernández-Torres
- Unitat de Microbiología, Facultat de Medicina and Institut d'Estudis Avançats, Universitat Rovira i Virgili, Reus, Spain
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Fernández-Torres B, Márquez-Espinós C, de Las Mulas-Béjar M. [Controversies surrounding pain and inhalation anesthesia in nineteenth century Spain]. Rev Esp Anestesiol Reanim 2001; 48:235-43. [PMID: 11412734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The introduction of inhaled anesthetics to Spain in 1847 brought appearances by enthusiastic promotors, prudent and reserved admirers and stubborn adversaries - sparking controversy over the use of the new gases. In some cases debate involved the discussion of various concepts of pain, as is shown by heated exchanges among Eusebio Castelo Serra, Manuel Santos Guerra and Zacarías Benito González in the pages of the journal Boletín de Medicina, Cirugía y Farmacia, in three articles appearing between 1850 and 1851 on the concept of pain: Sobre el dolor de las enfermedades y principalmente en las operaciones quirúrgicas, Modificación de dos instrumentos and Estudios sobre el dolor. Investigation into the authors' biographies and an analysis of the content of the articles has permitted us to reconstruct some aspects of the concept of pain in Spain in the middle of the nineteenth century.
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Affiliation(s)
- B Fernández-Torres
- Servicios de Anestesiología y Reanimación.Hospital del SAS Punta de Europa. Algeciras. Cádiz
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Fernández-Torres B, Vázquez-Veiga H, Llovo X, Pereiro M, Guarro J. In vitro susceptibility to itraconazole, clotrimazole, ketoconazole and terbinafine of 100 isolates of Trichophyton rubrum. Chemotherapy 2000; 46:390-4. [PMID: 11053904 DOI: 10.1159/000007319] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND A reference method for dermatophyte in vitro susceptibility testing is lacking. With the advent of new antimycotics, susceptibility testing has received increasing attention as an important laboratory tool for aiding the selection of appropriate drug therapy. METHODS One hundred strains of Trichophyton rubrum were tested against four antifungal agents, itraconazole, clotrimazole, ketoconazole and terbinafine, by using a modification of the proposed standard M38-P of the National Committee for Clinical Laboratory Standards and two types of standardized inocula, 1.4 x 10(4) and 5 x 10(3) CFU/ml. RESULTS Terbinafine was revealed to be the most effective antifungal drug. Of the three azole derivatives tested, clotrimazole showed the highest antifungal activity, while the minimum inhibitory concentrations (MICs) of itraconazole and ketoconazole were similar. Inoculum size did not affect the MIC of any of the antifungal agents tested. CONCLUSION Our preliminary data provide promising results for the development of a reference method for dermatophyte susceptibility testing based on the microdilution technique, although more dermatophytes should be tested and the method evaluated in different laboratories.
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Affiliation(s)
- B Fernández-Torres
- Unitat de Microbiologia, Facultat de Medicina i Institut d'Estudis Avançats, Universitat Rovira i Virgili, Reus, España
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Fernández-Torres B, Pereiro M, Llovo J, Otero XL, Toribio J. [Influence of incubation time in the in vitro antifungal activity of terbinafine against Trichophyton rubrum.]. Rev Iberoam Micol 1998; 15:290-293. [PMID: 18473520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Antifungal susceptibility tests are influenced by a number of technical variables, including inoculum size, temperature, medium formulation and duration of incubation. In this study, we have compared the in vitro susceptibility of 20 strains de Trichophyton rubrum against clotrimazole and terbinafine, and studied the influence of incubation time on MICs of both drugs. The assay was performed by agar dilution, the medium used was Saboraud glucose agar without an antibiotic. The MIC was evaluated at 15, 30 and 45 days' incubation. The MICs ranges of terbinafine were 0.002 to 0.0975 microg/ml, 0.0975 to 0.39 microg/ml and 0.195 to 0.39 microg/ml at 15, 30 and 45 days' incubation, respectively. The MICs ranges of clotrimazole at 15, 30 and 45 days' incubation were 3.125 to 50 microg/ml. T. rubrum was markedly more susceptible to terbinafine than to clotrimazole (p<0.001). In addition, we observed that an increase of incubation time causing an increase in the MIC value of terbinafine (p<0.001), but MIC values for clotrimazole remained constant with time (p=0.464). In conclusion, the MIC is dependent on reading time and the antifungal compound.
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Affiliation(s)
- B Fernández-Torres
- Servicio de Microbiología, Hospital de Conxo, Complexo Hospitalario Universitario de Santiago de Compostela, Spain.
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Aldana-Díaz EM, Fernández-Torres B, Herrera-Saval JC, Toro-Ibáñez D, de las Mulas-Béjar M. [Unilateral post-bilobectomy pulmonary edema originating from thrombosis of the pulmonary vein]. Rev Esp Anestesiol Reanim 1996; 43:375-8. [PMID: 9019791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Foucart (1875) and Ortner (1899) were the first to describe unilateral pulmonary edema as a complication of drainage of hydrothorax. Although various causes have been reported for this entity, it continues to be rare. We report a case of right unilateral pulmonary edema due to thrombosis of the superior pulmonary vein that was detected while a patient was in the recovery room after bilateral lobectomy for pulmonary tumors. The possible pathophysiological mechanisms contributing to pulmonary edema are discussed.
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Affiliation(s)
- E M Aldana-Díaz
- Departamento de Anestesiología. Hospital Universitario Virgen de la Macarena, Sevilla
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