Articles: adult.
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Expert Rev Respir Med · Aug 2012
CommentWhat is the current place of azoles in allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization.
Evaluation of: Chishimba L, Niven RM, Cooley J, Denning DW. Voriconazole and posaconazole improve asthma severity in allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. J. ⋯ Severe asthma with fungal sensitization, a disorder closely related to ABPA, is a specific phenotype of asthma characterized by severe asthma and evidence of fungal sensitization after exclusion of ABPA. Again, oral itraconazole has been found to improve the quality of life in these steroid-dependent asthma patients. The current retrospective study evaluated the use of newer azoles (voriconazole and posaconazole) in adult asthmatic patients with either ABPA or severe asthma with fungal sensitization, and found the newer azoles to improve asthma control and reduce the severity of ABPA.
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Many chemotherapeutic regimens produce neutropenia, which predisposes to microbial infection. However, not all neutropenic individuals develop infections, so the ability to predict this outcome would be a powerful clinical tool. ⋯ The authors demonstrate that when the neutrophil concentration approaches the critical concentration, bacterial populations in contact with them exhibit bistability. Their experimental findings raise the intriguing possibility of greater variability in bactericidal activity of neutrophils from healthy adults than heretofore recognized; their model predicts that this could have life-and-death consequences.