Tratamiento con equinocandinas en un paciente crítico sometido a técnica continua de reemplazo renal

BackgroundCritically ill patients with invasive candidiasis (IC) often suffer renal failure, which sometimes requires continuous renal replacement techniques (CRRT). Echinocandins are the first line treatment for IC in critically ill patients with mild or severe illness. Their elimination during CRRT should be negligible due to their pharmacokinetic and pharmacodynamic (PK/PD) profile, and dose adjustment are not needed, as suggested by the few reported clinical studies.Clinical caseThis is the case of a 66 year old male who underwent surgery due to peritonitis secondary to intestinal suture dehiscence. The patient was admitted to ICU with septic shock symptoms and multiple organ dysfunction syndrome (MODS), and CRRT was started. Anidulafungin was prescribed at the usual dosage due to the IC risk factors present, and the observation of yeasts in the peritoneal fluid. Anidulafungin was selected due to the hepatic failure suffered by the patient. An isolate of Candida albicans susceptible to fluconazole was cultured from peritoneal fluid and rectal exudates. However, anidulafungin was maintained due to the MODS and observing the clearance of fluconazole during CRRT. The patient's condition improved favourably, being moved to the surgical ward 20 days after the surgery.ConclusionsEchinocandins, due to their PK/PD profile, could be safely given at usual doses to critically ill patients undergoing CRRT. However, new studies are required to strengthen this recommendation. Its extrahepatic metabolism makes anidulafungin a more attractive option among echinocandins and other antifungals when used in patients with different degrees of hepatic failure     

Apomorphine as an emetic for insectivorous songbirds: effectiveness and post‐release effects on survival and mass change

Emetics can be used to obtain food samples from birds, but they can harm birds during or after treatment. Studies to date suggest that apomorphine is a safe emetic for songbirds, but information is needed about possible post‐release deleterious effects. From March to July 2012, we collected food samples from insectivorous songbirds using apomorphine. We treated 67 Moustached Warblers (Acrocephalus melanopogon), 56 Reed Warblers (Acrocephalus scirpaceus), 15 Great Reed Warblers (Acrocephalus arundinaceus), and 12 Savi's Warblers (Locustella luscinoides). Effectiveness in inducing regurgitation was high (76.7%) and varied among species, being significantly more effective with Reed Warblers (91.1%). No birds died during treatment. To check for possible post‐release negative effects, we considered 53 treated Moustached Warblers and 37 treated Reed Warblers and selected an equal number of untreated individuals (simply captured, banded, and measured). We found no support for differences in survival or recapture probabilities between treated and untreated birds of either species within 21 d after administering apomorphine. We calculated body mass changes of all Moustached Warblers subsequently recaptured (within 21 d) and found no difference between treated (N = 8) and untreated (N = 22) birds, suggesting normal foraging activity after release. Our results suggest that apomorphine is a safe emetic, with no negative effect on survival at least in the short term. The effectiveness of apomorphine with insectivorous songbirds in our study contrasts with the results of some previous studies and confirms the differences in effectiveness among different taxa of songbirds. As with differences in effectiveness among species in our study, this variability in sensitivity to the emetic could be caused by morphological and physiological differences among different taxa.     

Global distribution of IRC7 alleles in Saccharomyces cerevisiae populations: a genomic and phenotypic survey within the wine clade

The adaptation to the different biotic and abiotic factors of wine fermentation has led to the accumulation of numerous genomic hallmarks in Saccharomyces cerevisiae wine strains. IRC7, a gene encoding a cysteine-S-β-lyase enzyme related volatile thiols production in wines, has two alleles: a full-length allele (IRC7^F) and a mutated one (IRC7^S), harbouring a 38 bp-deletion. Interestingly, IRC7^S-encoding a less active enzyme – appears widespread amongst wine populations. Studying the global distribution of the IRC7^S allele in different yeast lineages, we confirmed its high prevalence in the Wine clade and demonstrated a minority presence in other domesticated clades (Wine-PDM, Beer and Bread) while it is completely missing in wild clades. Here, we show that IRC7^S-homozygous (HS) strains exhibited both fitness and competitive advantages compared with IRC7^F-homozygous (HF) strains. There are some pieces of evidence of the direct contribution of the IRC7^S allele to the outstanding behaviour of HS strains (i.e., improved response to oxidative stress conditions and higher tolerance to high copper levels); however, we also identified a set of sequence variants with significant co-occurrence patterns with the IRC7^S allele, which can be co-contributing to the fitness and competitive advantages of HS strains in wine fermentations.