Publications by authors named "Daniel Chastain"

Fidaxomicin may exhibit cross-reactivity in patients with known macrolide allergies. In this analysis, compared to patients without macrolide allergies, the odds of fidaxomicin allergy were 2.31, 8.

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Anthropogenic climate change, primarily driven by greenhouse gas emissions, is reshaping ecosystems and creating conditions that affect 58% of all known human infectious diseases, including fungal infections. Specifically, increasing temperatures, changing precipitation patterns, and extreme weather events are influencing fungal growth, distribution, and virulence. These factors may expand the geographic range of pathogenic fungi, exposing populations to novel, potentially more virulent, or drug-resistant strains.

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Objective: This study aimed to explore the challenges pharmacy students face when learning to detect medication-related problems (MRPs) in electronic health records (EHRs) during simulated patient work-ups and offer implications for instructional design in pharmacy education.

Methods: A qualitative research design was employed to analyze responses from 120 third-year pharmacy students enrolled in a required course. The students completed open-ended surveys at the end of the semester, describing the difficulties they encountered while working on patient cases in a simulated EHR.

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Understanding the impact of different Candida species on patient outcomes is crucial for effective management and treatment strategies. This study aims to comprehensively analyze the association between Candida species and mortality in documented candidemia. We queried TriNetX, a global research network database, to identify patients diagnosed with candidemia through polymerase chain reaction from 2020 to 2023.

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Article Synopsis
  • - The review highlights the efficacy and safety of pivmecillinam in treating uncomplicated acute cystitis, based on data from six randomized controlled trials showing effectiveness at doses of 200 to 400 mg taken three times daily for 3 to 7 days.
  • - Higher doses (400 mg) and longer treatment durations resulted in better clinical and bacteriologic outcomes, while pivmecillinam is particularly beneficial for populations not commonly approved by the FDA, like men or pregnant women.
  • - As antibiotic resistance increases, pivmecillinam offers a new, potentially effective outpatient treatment option for uncomplicated acute cystitis in the U.S., with a focus on cost and its low resistance profile in managing uropathogens. *
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Objectives: This large database analysis aims to describe the incidence, timeline, and risk factors for viral and fungal infections after chimeric antigen receptor (CAR) T-cell therapy.

Methods: We queried a global research network database, TriNetX, for patients who received CAR T-cell therapy, who were identified and followed for the development of viral and fungal infections. Baseline demographic, oncologic history, laboratory data and medication histories were collected.

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Background: Prior reports have suggested a possible increase in the frequency of invasive fungal infections (IFIs) with use of a Bruton tyrosine kinase inhibitor (BTKi) for treatment of chronic lymphoid malignancies such as chronic lymphocytic leukemia (CLL), but precise estimates are lacking. We aim to characterize the prevalence of IFIs among patients with CLL, for whom a BTKi is now the first-line recommended therapy.

Methods: We queried TriNetX, a global research network database, to identify adult patients with CLL using the code (C91.

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Article Synopsis
  • There are limited treatment options for people with HIV-1 who have already tried many medicines and have drug-resistant HIV-1.
  • Since 2018, three new medications have been approved to help these patients: ibalizumab, fostemsavir, and lenacapavir.
  • Experts created guidelines to help doctors use these new medicines better and suggested more areas to study for future research.
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Human strongyloidiasis is a potentially life-threatening parasitic disease among immunocompromised hosts. We aim to determine the factors and mortality associated with disseminated strongyloidiasis. We conducted a U.

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Background: Limited data on females with mpox restricts understanding of potential sex-based disparities in treatment and outcomes. This study aims to investigate these differences using administrative claims and clinical data repositories.

Methods: We retrospectively analyzed adults diagnosed with mpox using TriNetX, stratifying cohorts by sex.

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Daptomycin use for gram-positive infections has increased. This cost minimization analysis aimed to determine cost and/or time savings of daptomycin over vancomycin. The estimated hospital cost savings was US$166.

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People with human immunodeficiency virus (HIV) have a 50% excess risk for intensive care unit (ICU) admission, often for non-HIV-related conditions. Despite this, clear guidance for managing antiretroviral therapy (ART) in this setting is lacking. Selecting appropriate ART in the ICU is complex due to drug interactions, absorption issues, and dosing adjustments.

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Background: Emerging risk factors highlight the need for an updated understanding of cryptococcosis in the United States.

Objective: Describe the epidemiological trends and clinical outcomes of cryptococcosis in three patient groups: people with HIV (PWH), non-HIV-infected and non-transplant (NHNT) patients, and patients with a history of solid organ transplantation.

Methods: We utilized data from the Merative Medicaid Database to identify individuals aged 18 and above with cryptococcosis based on the International Classification of Diseases, Tenth Revision diagnosis codes from January 2017 to December 2019.

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Background: Despite accounting for more than half of new Human Immunodeficiency Virus diagnoses in the United States, the South has fewer than 30% of all pre-exposure prophylaxis users. Pre-exposure prophylaxis access geospatial analyses have focused on drive time but analyses along public transit routes have not been evaluated. Given the proximity to pharmacists and pharmacies, involvement in pre-exposure prophylaxis services may increase access and uptake of this preventative health need.

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Background: Cryptococcal meningitis (CM), an opportunistic fungal infection affecting immunocompromised hosts, leads to high mortality. The role of previous exposure to glucocorticoids as a risk factor and as an outcome modulator has been observed, but systematic studies are lacking.

Objective: The primary aim of this study is to evaluate the impact of glucocorticoid use on the clinical outcomes, specifically mortality, of non-HIV and non-transplant (NHNT) patients diagnosed with CM.

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Toxoplasma gondii is a prevalent parasitic disease with significant morbidity and mortality in immunocompromised populations. We lack long-term outcomes for latent infections. We aimed to elucidate the relationship between latent T.

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Cryptococcus neoformans, an opportunistic fungal pathogen, primarily infects immunodeficient patients frequently causing cryptococcal meningoencephalitis (CM). Increased intracranial pressure (ICP) is a serious complication responsible for increased morbidity and mortality in CM patients. Non-invasive pharmacological agents that mitigate ICP could be beneficial in treating CM patients.

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Article Synopsis
  • * A study comparing HIV-negative, non-transplant patients found that those with DM2 had a higher likelihood of cognitive dysfunction when afflicted with cryptococcosis, but similar rates of mortality and other severe outcomes compared to those without DM2.
  • * It’s rare for DM2 to be the only risk factor for cryptococcosis, and other factors like kidney disease and immune dysfunction also play a role in increasing the risk among patients with DM2.
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Despite advancements in diagnosing and treating invasive pulmonary aspergillosis (IPA), there is limited knowledge of real-world treatment pathways and medication switches. We queried the TrinetX global research network database and identified 5,410 patients diagnosed with IPA. The most common initial treatments were voriconazole (49%), fluconazole (11%), and posaconazole (7%).

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Glucocorticoids are widespread anti-inflammatory medications used in medical practice. The immunosuppressive effects of systemic glucocorticoids and increased susceptibility to infections are widely appreciated. However, the dose-dependent model frequently used may not accurately predict the risk of infection in all patients treated with long-term glucocorticoids.

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  • Monkeypox (Mpox) is a viral disease with over 87,000 cases reported globally as of May 2023, but predictive hospitalization factors are not well understood.
  • The study aimed to compare the clinical characteristics and outcomes of hospitalized versus nonhospitalized Mpox patients using a retrospective case-control cohort.
  • Key findings indicate that hospitalization for Mpox was more prevalent among Black individuals, those with HIV, and patients experiencing severe proctitis, highlighting the need to identify risk factors for severe outcomes in Mpox infections.
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