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10.4274/tjh.2018.0007 http://scihub22266oqcxt.onion/10.4274/tjh.2018.0007 C5843768!5843768 !29391334     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29391334 &cmd=llinks): Failed to open stream: HTTP request failed! 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Hematolojik Kanserleri Olan ?nvaziv Mantar Enfeksiyonlu Hastalar: Dirençli Patojenlerin Ortaya Ç?k??? ve Yeni Antifungal Tedaviler |pdf=|usr=}}{{29391334 }} gab.com Text Hematolojik Kanserleri Olan nvaziv Mantar Enfeksiyonlu Hastalar: Dirençli Patojenlerin Ortaya Ç k ve Yeni Antifungal Tedaviler JO: Turk J Haematol http://www.kidney.de/pget.php?&tw=1&pmid=29391334 #FOAvip Invasive fungal infections caused by drug-resistant organisms are an emerging threat to heavily immunosuppressed patients with hematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis and empirical and preemptive therapy, result in long-term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the nonlinear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors. The widespread use of agricultural and industrial fungicides with similar chemical structures and mechanisms of action has resulted in the development of environmental reservoirs for some drug-resistant fungi, especially azole-resistant Aspergillus species, which have been reported from four continents. The majority of resistant strains have the mutation TR34/L98H, a finding suggesting that the source of resistance is the environment. The global emergence of new fungal pathogens with inherent resistance, such as Candida auris, is a new public health threat. The most common mechanism of antifungal drug resistance is the induction of efflux pumps, which decrease intracellular drug concentrations. Overexpression, depletion, and alteration of the drug target are other mechanisms of resistance. Mutations in the ERG11 gene alter the protein structure of C-demethylase, reducing the efficacy of antifungal triazoles. Candida species become echinocandin-resistant by mutations in FKS genes. A shift in the epidemiology of Candida towards resistant non-albicans Candida spp. has emerged among patients with hematological malignancies. There is no definite association between antifungal resistance, as defined by elevated minimum inhibitory concentrations, and clinical outcomes in this population. Detection of genes or mutations conferring resistance with the use of molecular methods may offer better predictive values in certain cases. Treatment options for resistant fungal infections are limited and new drugs with novel mechanisms of actions are needed. Prevention of resistance through antifungal stewardship programs is of paramount importance. Twit Text FOAVip Hematolojik Kanserleri Olan nvaziv Mantar Enfeksiyonlu Hastalar: Dirençli Patojenlerin Ortaya Ç k ve Yeni Antifungal Tedaviler ????Turk J Haematol http://www.kidney.de/pget.php?&tw=1&pmid=29391334 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29391334 #FOAvip English Wikipedia <ref>{{Cite pmid|29391334 }}</ref> Hematolojik Kanserleri Olan ?nvaziv Mantar Enfeksiyonlu Hastalar: Dirençli Patojenlerin Ortaya Ç?k??? ve Yeni Antifungal Tedaviler #MMPMID29391334 Gamaletsou MN ; Walsh TJ ; Sipsas NV Turk J Haematol 2018[Mar]; 35 (1 ): 1-11 PMID29391334 show ga Invasive fungal infections caused by drug-resistant organisms are an emerging threat to heavily immunosuppressed patients with hematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis and empirical and preemptive therapy, result in long-term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the nonlinear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors. The widespread use of agricultural and industrial fungicides with similar chemical structures and mechanisms of action has resulted in the development of environmental reservoirs for some drug-resistant fungi, especially azole-resistant Aspergillus species, which have been reported from four continents. The majority of resistant strains have the mutation TR34/L98H, a finding suggesting that the source of resistance is the environment. The global emergence of new fungal pathogens with inherent resistance, such as Candida auris, is a new public health threat. The most common mechanism of antifungal drug resistance is the induction of efflux pumps, which decrease intracellular drug concentrations. Overexpression, depletion, and alteration of the drug target are other mechanisms of resistance. Mutations in the ERG11 gene alter the protein structure of C-demethylase, reducing the efficacy of antifungal triazoles. Candida species become echinocandin-resistant by mutations in FKS genes. A shift in the epidemiology of Candida towards resistant non-albicans Candida spp. has emerged among patients with hematological malignancies. There is no definite association between antifungal resistance, as defined by elevated minimum inhibitory concentrations, and clinical outcomes in this population. Detection of genes or mutations conferring resistance with the use of molecular methods may offer better predictive values in certain cases. Treatment options for resistant fungal infections are limited and new drugs with novel mechanisms of actions are needed. Prevention of resistance through antifungal stewardship programs is of paramount importance. |Antifungal Agents/pharmacology/*therapeutic use [MESH] |Drug Discovery [MESH] |Drug Resistance, Fungal [MESH] |Hematologic Neoplasms/*complications/therapy [MESH] |Humans [MESH] |Invasive Fungal Infections/diagnosis/*drug therapy/epidemiology/*etiology [MESH] |Outcome Assessment, Health Care [MESH] |Prevalence [MESH]Hematolojik Kanserleri Olan ?nvaziv Mantar Enfeksiyonlu Hastalar: Dire(epmc).pdf DeepDyve Pubget Overpricing