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Related Concept Videos

Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Defining Psychology01:24

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Psychology is the scientific discipline dedicated to understanding both observable behavior and the internal mental processes underlying such behavior. It aims to comprehend human nature and apply this understanding to solve practical problems, enhance well-being, and improve societal outcomes. An example of psychology's application is the study of prosocial behavior, such as why and under what conditions individuals might help strangers in need. This process involves describing observed...
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Social psychology investigates how the presence and actions of others influence individual behavior, cognition, and emotion. Examining the social environment's impact provides a scientific framework for understanding how individuals perceive others and are, in turn, influenced by them. This field seeks to uncover the underlying principles guiding social interactions, exploring phenomena such as conformity, obedience, and prosocial behavior.Core Themes in Social PsychologyOne central focus of...
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Related Experiment Video

Updated: Feb 2, 2026

Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
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Defining clinical failure for salvage studies.

Georg Maschmeyer1, Antje Haas1

  • 1Department of Hematology and Oncology, Klinikum Ernst von Bergmann, Charlottenstrasse 72, D-14467, Potsdam, Germany.

Medical Mycology
|November 10, 2018
PubMed
Summary

Accurate assessment of invasive aspergillosis treatment failure is crucial. Redefining criteria and standardizing clinical trial designs are essential for evaluating salvage antifungal therapies in invasive aspergillosis (IA).

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Assessing treatment failure in invasive aspergillosis (IA) is complex, with clinical and radiological changes often misinterpreted.
  • Factors like neutrophil recovery and infarcted tissue can mimic treatment failure, complicating efficacy assessment.
  • Current diagnostic markers, such as serum galactomannan, can be affected by other medications or clinical conditions, leading to potential misinterpretation.

Purpose of the Study:

  • To highlight the challenges in defining and assessing treatment failure in invasive aspergillosis (IA).
  • To propose re-evaluation of criteria for 'clinical refractoriness,' 'resistance,' 'non-response,' and 'failure' in IA.
  • To suggest improvements for clinical trial designs evaluating salvage antifungal therapies for IA.

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Main Methods:

  • Review of clinical scenarios and diagnostic challenges in invasive aspergillosis management.
  • Analysis of factors influencing treatment response assessment, including imaging, host factors, and biomarkers.
  • Proposal for revised definitions of treatment failure and recommendations for future clinical trial methodologies.

Main Results:

  • Stable disease or radiological progression during neutropenia recovery may not indicate antifungal failure.
  • Serum galactomannan levels can be falsely elevated by certain antibiotics or persist after lipid formulation AmB treatment.
  • Current criteria for IA treatment failure are inadequate and require redefinition.

Conclusions:

  • A composite score including clinical, radiological, and mycological criteria is proposed for a more valid definition of IA treatment failure.
  • Assessment of treatment response should ideally occur after seven days of full-dose antifungal therapy.
  • Future clinical trials for salvage IA therapy should be randomized, blinded, stratified by failure reason and host criteria, and ideally employ a three-arm design.