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Therapeutics and Clinical Risk Management

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https://www.readbyqxmd.com/read/28932121/treatment-of-pretibial-myxedema-with-intralesional-immunomodulating-therapy
#1
Ziwei Ren, Min He, Fang Deng, Yan Chen, Liyin Chai, Bing Chen, Wuquan Deng
OBJECTIVE: Local immune regulation therapy has been one of the therapeutic methods used for the treatment of autoimmune thyroid disease in patients with pretibial myxedema (PTM). However, the poor response rate and high recurrence rate are still major problems. Whether a premixed corticosteroid, compound betamethasone, could enhance remission rate and decrease recurrence rate in patients with PTM was investigated in the present study. SUBJECTS AND METHODS: We have performed a clinical utility observation of compound betamethasone with intralesional injections based on basic thyroid disease treatment in 32 PTM patients between January 2008 and August 2016...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28924350/pharmacovigilance-and-adverse-drug-reaction-reporting-a-perspective-of-community-pharmacists-and-pharmacy-technicians-in-sana-a-yemen
#2
Yaser Mohammed Al-Worafi, Yaman Walid Kassab, Wafa Mohammed Alseragi, Masaad Saeed Almutairi, Ali Ahmed, Long Chiau Ming, Ali Saleh Alkhoshaiban, Muhammad Abdul Hadi
OBJECTIVE: The aim of this study was to compare the knowledge, attitude and barriers of pharmacy technicians and pharmacists toward pharmacovigilance, adverse drug reactions (ADRs) and ADR reporting in community pharmacies in Yemen. METHODS: This cross-sectional survey was conducted among community pharmacists and pharmacy technicians in the capital of Yemen, Sana'a. A total of 289 community pharmacies were randomly selected. The validated and pilot-tested questionnaire consisted of six sections: demographic data, knowledge about pharmacovigilance, experience with ADR reporting, attitudes toward ADR reporting, and the facilitators to improve ADR reporting...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28919771/the-challenge-of-perioperative-pain-management-in-opioid-tolerant-patients
#3
REVIEW
Flaminia Coluzzi, Francesca Bifulco, Arturo Cuomo, Mario Dauri, Claudio Leonardi, Rita Maria Melotti, Silvia Natoli, Patrizia Romualdi, Gennaro Savoia, Antonio Corcione
The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28919770/swollen-lymph-nodes-may-not-be-clinical-manifestations-of-chronic-myeloid-leukemia-case-report-and-revision-of-literature
#4
Zhihe Liu, Siyun Li, Ou Bai
We present here the case of a 33-year-old Chinese female patient with synchronous double primary malignant tumors (chronic myeloid leukemia [CML] and classic Hodgkin lymphoma). This patient was admitted to our hospital because of bilateral cervical lymph node enlargement and recurrent fever for 2 weeks. The complete blood cell count revealed white blood cell counts of 18.2×10(9)/L, hemoglobin of 9.6 g/dL, and platelet counts of 1,547×10(9)/L. Chromosome karyotype analysis demonstrated that t(9;22)(q34;q11) was positive in all 20 cells examined...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28919769/evaluating-the-antiemetic-administration-consistency-to-prevent-chemotherapy-induced-nausea-and-vomiting-with-the-standard-guidelines-a-prospective-observational-study
#5
Afsaneh Vazin, Davood Eslami, Ebrahim Sahebi
Nausea and vomiting (NV) are the most prevalent adverse effects of chemotherapy (CT). This study was conducted to evaluate adherence of the health care team to standard guidelines for antiemetics usage to prevent acute chemotherapy-induced nausea and vomiting (CINV) in a large CT center. A prospective study was performed during an 11-month period on patients receiving CT. A form was designed to collect patients' demographic information and their chemotherapeutic and antiemetic regimen data. The Likert scale was used to measure the effectiveness of the antiemetics in patients...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894376/operative-and-nonoperative-management-for-renal-trauma-comparison-of-outcomes-a-systematic-review-and-meta-analysis
#6
REVIEW
Andrea Mingoli, Marco La Torre, Emanuele Migliori, Bruno Cirillo, Martina Zambon, Paolo Sapienza, Gioia Brachini
INTRODUCTION: Preservation of kidney and renal function is the goal of nonoperative management (NOM) of renal trauma (RT). The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM) with respect to mortality, morbidity, and length of hospital stay (LOS). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894375/impact-of-t1-slope-on-surgical-and-adjacent-segment-degeneration-after-bryan-cervical-disc-arthroplasty
#7
Peng Yang, Yongqian Li, Jia Li, Yong Shen
BACKGROUND: This retrospective study investigated an association between preoperative T1 slope and surgical and adjacent segment degeneration (SASD) after Bryan cervical disc arthroplasty (BCDA) in patients with cervical degenerative disc disease. METHODS: Based on preoperative standing lateral radiographs, 90 patients were classified according to T1 slope that was higher or lower than the 50th percentile (high T1 or low T1, 28 and 62 patients, respectively). Patients were also classified as SASD or non-SASD (38 and 52 patients, respectively) determined by radiographs at final follow-up...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894374/predicting-and-managing-sepsis-in-burn-patients-current-perspectives
#8
Omar Nunez Lopez, Janos Cambiaso-Daniel, Ludwik K Branski, William B Norbury, David N Herndon
Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894373/curcumin-inhibits-apoptosis-by-modulating-bax-bcl-2-expression-and-alleviates-oxidative-stress-in-testes-of-streptozotocin-induced-diabetic-rats
#9
Lingling Zhao, Qianru Gu, Lanting Xiang, Xidan Dong, Huimin Li, Jinyao Ni, Li Wan, Guoping Cai, Guorong Chen
SCOPE: The present study was designed to examine the damage caused by high-fat diet and streptozotocin-induced diabetes on the testis of rats and the effects of curcumin against oxidative stress and apoptosis from high-fat diet and diabetes. METHODS: Diabetes was induced by intraperitoneal injection of streptozotocin (30 mg/kg in 0.1 M sodium citrate buffer, pH 4.5) in obese rats. The rats in the obese and diabetic groups were treated with a daily dose of curcumin by intragastric intubation (100 mg/kg body weight) for 8 weeks...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894372/frequent-respiratory-events-in-postoperative-patients-aged-60-years-and-above
#10
Suzanne Jl Broens, Xuan He, Rachel Evley, Erik Olofsen, Marieke Niesters, Ravi P Mahajan, Albert Dahan, Monique van Velzen
There is limited information on the occurrence of respiratory events in postoperative patients after discharge from the postanesthesia care unit. We studied the respiratory rate (RR) of 68 patients aged 60 years and above during the first 6 hours following elective surgery under general anesthesia to assess the frequency of respiratory events in the care unit and on the ward. RR was derived from the continuous RR counter RespiR8, measuring RR by quantifying the humidity of exhaled air. One-minute-averaged RRs were collected and analyzed to assess the frequency of postoperative bradypnea (RR 1-6 breaths/minute) and apnea (cessation of inspiratory flow ≥60 seconds)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28894371/radiologic-findings-of-thoracic-trauma
#11
Cihan Akgul Ozmen, Serdar Onat, Delal Aycicek
INTRODUCTION: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. METHODS: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28883736/omentum-flap-as-a-salvage-procedure-in-deep-sternal-wound-infection
#12
Nick Spindler, Christian D Etz, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Stefan Langer
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28883735/hollow-viscus-injuries-predictors-of-outcome-and-role-of-diagnostic-delay
#13
Andrea Mingoli, Marco La Torre, Gioia Brachini, Gianluca Costa, Genoveffa Balducci, Barbara Frezza, Giovanna Sgarzini, Bruno Cirillo
INTRODUCTION: Hollow viscus injuries (HVIs) are uncommon but potentially catastrophic conditions with high mortality and morbidity rates. The aim of this study was to analyze our 16-year experience with patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome. METHODS: From our multicenter trauma registry, we selected 169 consecutive patients with an HVI, enrolled from 2000 to 2016...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28883734/prognostic-impact-of-blood-pressure-and-heart-rate-at-admission-on-in-hospital-mortality-after-primary-percutaneous-intervention-for-acute-myocardial-infarction-with-st-segment-elevation-in-western-romania
#14
Diana Aurora Bordejevic, Florina Caruntu, Cristian Mornos, Ioan Olariu, Lucian Petrescu, Mirela Cleopatra Tomescu, Ioana Citu, Adelina Mavrea, Sorin Pescariu
BACKGROUND: The purpose of this retrospective study was to evaluate the prognostic impact of systolic blood pressure (SBP) and heart rate (HR) on in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) patients, after primary percutaneous intervention (PCI). PATIENTS AND METHODS: The study included 294 patients admitted for STEMI. They were divided into five groups according to the SBP at admission: group I, <105 mmHg; group II, 105-125 mmHg; group III, 126-140 mmHg; group IV, 141-158 mmHg; and group V, ≥159 mmHg...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860789/new-developments-in-the-treatment-of-primary-biliary-cholangitis-role-of-obeticholic-acid
#15
REVIEW
Manan A Jhaveri, Kris V Kowdley
Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that predominantly affects women in early to middle age. It is typically associated with autoantibodies to mitochondrial antigens and results in immune-mediated destruction of small and medium-sized intrahepatic bile ducts leading to cholestasis, hepatic fibrosis and may progress to cirrhosis or hepatic failure and, in some cases, hepatocellular carcinoma. The clinical presentation and the natural history of PBC have improved over the years due to recognition of earlier widespread use of ursodeoxycholic acid (UDCA); about one-third of patients show suboptimal biochemical response to UDCA with poor prognosis...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860788/impact-of-immunosuppressant-therapy-on-new-onset-diabetes-in-liver-transplant-recipients
#16
Fu-Chao Liu, Huan-Tang Lin, Jr-Rung Lin, Huang-Ping Yu
This nationwide, population-based study aimed to clarify the effects of immunosuppressive regimens on new-onset diabetes after liver transplantation (NODALT). The National Health Insurance database of Taiwan was explored for patients who received liver transplantation without pre-transplant diabetes from 1998 to 2012. Information regarding clinical conditions and immunosuppressant utilization among these patients was analyzed statistically. Of the 2,140 patients included in our study, 189 (8.8%) developed NODALT...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860787/prevalence-and-predictors-of-sleep-apnea-in-patients-with-stable-coronary-artery-disease-a-cross-sectional-study
#17
Audrius Alonderis, Giedrius Varoneckas, Nijole Raskauskiene, Julija Brozaitiene
BACKGROUND: Sleep apnea (SA) is increasingly recognized as being important in the prognosis of patients with coronary artery disease (CAD); however, symptoms of SA are not easily identified, and as many as 80% of sufferers remain undiagnosed. AIM: This cross-sectional study investigated the prevalence and predictors of SA that may help to increase the awareness and diagnosis of SA in stable CAD patients. MATERIALS AND METHODS: Polysomnography was performed in 772 medically stable CAD patients with untreated SA recruited from the Clinic of Cardiovascular Rehabilitation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860786/risk-factors-and-early-outcomes-of-acute-renal-injury-after-thoracic-aortic-endograft-repair-for-type-b-aortic-dissection
#18
Songyuan Luo, Huanyu Ding, Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become an emerging treatment modality for acute type B aortic dissection (TBAD) patients in recent years. The risk factors and impacts of acute kidney injury (AKI) after percutaneous TEVAR, however, have not been widely established. METHODS: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860785/the-value-of-time-averaged-serum-high-sensitivity-c-reactive-protein-in-prediction-of-mortality-and-dropout-in-peritoneal-dialysis-patients
#19
Shou-Hsuan Liu, Chao-Yu Chen, Yi-Jung Li, Hsin-Hsu Wu, Chan-Yu Lin, Yung-Chang Chen, Ming-Yang Chang, Hsiang-Hao Hsu, Cheng-Lung Ku, Ya-Chung Tian
PURPOSE: C-reactive protein (CRP) is a useful biomarker for prediction of long-term outcomes in patients undergoing chronic dialysis. This observational cohort study evaluated whether the time-averaged serum high-sensitivity CRP (HS-CRP) level was a better predictor of clinical outcomes than a single HS-CRP level in patients undergoing peritoneal dialysis (PD). PATIENTS AND METHODS: We classified 335 patients into three tertiles according to the time-averaged serum HS-CRP level and followed up regularly from January 2010 to December 2014...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28860784/effect-of-additive-calcium-administration-on-fgf23-levels-in-patients-with-mild-chronic-kidney-disease-treated-with-calcitriol-a-randomized-open-labeled-clinical-trial
#20
Nayoung Han, Su Hyun Hong, Yon Su Kim, Dong Ki Kim, In-Wha Kim, Eunhee Ji, Jung Mi Oh
BACKGROUND: The purpose of the present study was to determine the effect of additional calcium carbonate treatment on fibroblast growth factor 23 (FGF23) levels in patients treated with calcitriol. METHODS: In this randomized, open-labeled, and parallel-group study, a total of 30 patients with early chronic kidney disease (CKD) and vitamin D deficiency were randomly assigned to two groups and received interventions for 8 weeks: 1) a combination of calcium carbonate and calcitriol group; and 2) calcitriol only group...
2017: Therapeutics and Clinical Risk Management
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