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Therapeutics and Clinical Risk Management

Yuda Sutherasan, Pongdhep Theerawit, Alongkot Suporn, Arkom Nongnuch, Pariya Phanachet, Chomsri Kositchaiwat
Purpose: The aim of this study was to evaluate the impact of a hospital protocol in response to patient deterioration in general wards, stratified using the national early warning score (NEWS), on primary patient outcomes of in-hospital mortality and percentage of patients transferred to the intensive care unit (ICU). Patients and methods: We conducted a prospective observational cohort study among adult medical patients admitted to a university hospital in Bangkok...
2018: Therapeutics and Clinical Risk Management
Renling Yang, Anxin Wang, Li Ma, Zhaoping Su, Shuohua Chen, Yilong Wang, Shouling Wu, Chen Wang
Background and purpose: Whether higher hematocrit levels could increase the incidence of stroke has always been full of controversy. This study aimed to explore the association between hematocrit and the incidence of stroke in the Chinese population. Subjects and methods: The Kailuan study is a prospective longitudinal cohort study on risk factors and events of chronic diseases. Using a multivariable Cox proportional hazards analysis, we examined the association between baseline hematocrit values and the incidence of stroke in the Kailuan cohort (93,299 participants)...
2018: Therapeutics and Clinical Risk Management
Diego Jose Maselli, Linda Rogers, Jay I Peters
There are now multiple monoclonal antibodies targeting different inflammatory pathways of severe asthma. Benralizumab is a recently approved monoclonal antibody indicated for the treatment of severe eosinophilic asthma by targeting a subunit of the IL-5 receptor. Treatment with benralizumab results in significant reductions of blood and tissue eosinophils. Early studies report that this therapy has an adequate safety profile, and this was confirmed in later trials. Phase III studies have shown that benralizumab is effective in reducing the rate of exacerbations and improving asthma symptoms and quality of life in patients with severe eosinophilic asthma...
2018: Therapeutics and Clinical Risk Management
(no author information available yet)
[This corrects the article on p. 1863 in vol. 14, PMID: 30323608.].
2018: Therapeutics and Clinical Risk Management
Mehmet Ali Erdogan, Muhsin Murat Harputluoglu
Purpose: Almost all of the publications regarding the treatment of biliary complications after liver transplantation are related to biliary complications after right lobe living donor liver transplantation (LDLT) and cadaveric liver transplantation (LT). The number of publications regarding endoscopic treatment of biliary complications after left lobe LDLT is negligible. In this study, we aimed to present the results of endoscopic treatments applied in the management of biliary complications developed in left-lobe duct-to-duct LDLT patients...
2018: Therapeutics and Clinical Risk Management
Angela Kornberger, Iris Burck, Hazem El Beyrouti, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
Background: False-positive diagnosis of acute Stanford type A aortic dissection (AAD) on computed tomography angiography (CTA) is still an issue and may lead to substantial consequences. Given that electrocardiography (ECG)-gated CTA provides greater diagnostic safety, it may be assumed that interhospital referrals with a diagnosis of AAD based on non-ECG-gated pre-referral CTA carry an elevated risk of false-positive diagnosis. Patients and methods: We reviewed a series of patients in whom a diagnosis of AAD based on non-ECG-gated pre-referral CTA was subsequently proven false by ECG-gated CTA...
2018: Therapeutics and Clinical Risk Management
Nobuaki Ochi, Tokio Wakabayashi, Atsushi Urakami, Tomoki Yamatsuji, Naoto Ikemoto, Yasunari Nagasaki, Nozomu Nakagawa, Yoshihiro Honda, Hidekazu Nakanishi, Hiromichi Yamane, Yasumasa Monobe, Takeshi Akisada, Hiroshi Katayama, Yoshio Naomoto, Nagio Takigawa
A 26-year-old man with right lower mandibular and chest pain, fever, and respiratory distress was urgently transported to our hospital. CT images revealed gas collection and an abscess from the neck to the mediastinum with bilateral pleural effusion. Descending necrotizing mediastinitis (DNM) induced by an odontogenic infection of a right mandibular molar abscess was diagnosed. The cervical and mediastinal areas were drained, extensive debridement was performed, necrotic tissue was excised, and broad-spectrum antibiotics were administered immediately...
2018: Therapeutics and Clinical Risk Management
Seung Hyun Kim, Do-Hyeong Kim, Eungjin Kim, Hyun Jung Kim, Yong Seon Choi
Purpose: Perioperative dextrose-containing fluid administration has been used as a non-pharmacologic preventive measure against postoperative nausea and vomiting (PONV), a common and distressing complication of anesthesia. However, its efficacy remains unclear as previous studies reported inconsistent results. Our objective was to compare dextrose-containing fluid with non-dextrose-containing fluid in terms of PONV for 24 hours after surgery under general anesthesia. The effects of dextrose according to different types of surgery and the fluid volume were also examined...
2018: Therapeutics and Clinical Risk Management
Jia Jiang, Da-Xu Ma, Bo Li, An-Shi Wu, Fu-Shan Xue
Background: Awake intubation with videolaryngoscopy (VL) is a novel method that is drawing more and more attention as an alternative to awake intubation with fiberoptic bronchoscope (FOB). This meta-analysis is designed to determine the performance of VL compared to the FOB for awake intubation. Methods: The Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of science were searched from database inception until October 30, 2017. Randomized controlled trials comparing VL and FOB for awake intubation were selected...
2018: Therapeutics and Clinical Risk Management
Binshan Zha, Geliang Xu, Huagang Zhu, Wentao Xie, Zhigong Zhang, Yongsheng Li, Peng Qiu
Purpose: The aim of this study was to present our experience and assess the morphologic changes of the descending aorta after the restrictive bare stent (RBS) technique in the treatment of type B aortic dissection (TBAD). Patients and methods: A retrospective study was conducted of 22 consecutive patients with TBAD who underwent RBS treatment between February 2012 and June 2016. Indications for the RBS procedure included radiological evidence of true lumen (TL) compression or collapse and/or tortuosity index (TI) of the descending aorta >1...
2018: Therapeutics and Clinical Risk Management
Jin Liu, Chengyong Dong, Haibo Wang, Deguang Sun, Rui Liang, Zhenming Gao, Liming Wang
A horseshoe appendix is a subtype of duplex appendix, in which the appendix is shaped like a circle that may lead to an internal hernia and result in intestinal necrosis. This subtype is extremely rare, with only 13 cases reported worldwide to date, and easily triggers a series of medico-legal consequences due to the neglect of another infection base of the appendix. We describe a 22-year-old man who presented with a 3-day history of fever and was diagnosed with pneumonia. After receiving antibiotics for 3 days in the Department of Pneumology, he was found to have a periappendiceal abscess...
2018: Therapeutics and Clinical Risk Management
Ding-Yun Feng, Yu-Qi Zhou, Yan-Fang Xing, Chuang-Feng Li, Qing Lv, Jie Dong, Jie Qin, Yue-Fei Guo, Nan Jiang, Chencui Huang, Hai-Tao Hu, Xing-Hua Guo, Jie Chen, Liang-Hong Yin, Tian-Tuo Zhang, Xing Li
Purpose: The effect of glucocorticoid(s) on connective tissue disease (CTD)-related interstitial lung disease (ILD) is controversial. This multicenter study aimed to identify glucocorticoid-sensitive patients using a radiomics approach. Methods: A total of 416 CTD-ILD patients who began glucocorticoid treatment at the discretion of the attending physician, with or without cyclophosphamide, were included in this study. High doses were defined as pulsed intravenous methylprednisolone, an initial dose of 1 mg/kg/day of prednisolone or 0...
2018: Therapeutics and Clinical Risk Management
Marija Stevic, Dusica Simic, Nina Ristic, Ivana Budic, Vesna Marjanovic, Marija Jovanovski-Srceva, Nikola Repac, Milica Rankovic-Janevski, Goran Tasic
Purpose: Preterm newborns, due to many factors, are at increased risk for poor neural development, intraventricular hemorrhages, infections, and higher rate of mortality. The aim of this study was to evaluate the risk factors associated with poor outcome in preterm neonates with late-onset neonatal sepsis (LONS) who had posthemorrhagic hydrocephalus and underwent neurosurgical procedures for treatment of the hydrocephalus. Patients and methods: Preterm neonates who had undergone insertion of ventriculoperitoneal shunt or Ommaya reservoir, during the 10-year period at University Children's Hospital, were retrospectively analyzed...
2018: Therapeutics and Clinical Risk Management
Hitoki Saito, Momoko Ebashi, Masaru Kushimoto, Jin Ikeda, Fujiko Egashira, Suguru Yamaguchi, Kentaro Watanabe, Katsuhiko Ogawa, Yutaka Suzuki, Hisamitsu Ishihara, Midori Fujishiro
Patients with diabetes mellitus (DM) are at increased risk of infections, with the urinary tract being the most frequent infection site. Incomplete bladder emptying, frequent urination and abdominal distension are typical symptoms of urinary tract infections (UTIs). A 68-year-old female with a long history of poorly controlled type 2 DM (T2DM) visited our hospital complaining of urinary retention, which was initially diagnosed as cystitis by another doctor. The urologist at our hospital identified a skin rash extending from the left hip to her genital area...
2018: Therapeutics and Clinical Risk Management
Saeed Akhlaghi, Maryam Sahebari, Mahmoud Mahmoodi, Mehdi Yaseri, Mohammad Ali Mansournia, Houshang Rafatpanah, Hojjat Zeraati
Purpose: One of the most important long-term side effects of therapy for rheumatoid arthritis (RA) is the elevation of liver function tests, with earlier studies reporting an elevation of more than 1× the upper limit of normal (>1 × ULN). The current study expands the literature by comparing the trends of transaminase changes caused by conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Patients and methods: The drug categories examined were methotrexate (MTX) and all other nonbiologic DMARDs...
2018: Therapeutics and Clinical Risk Management
Anastasia I Ryzhkova, Margarita A Sazonova, Vasily V Sinyov, Elena V Galitsyna, Mariya M Chicheva, Alexandra A Melnichenko, Andrey V Grechko, Anton Yu Postnov, Alexander N Orekhov, Tatiana P Shkurat
There are several types of mitochondrial cytopathies, which cause a set of disorders, arise as a result of mitochondria's failure. Mitochondria's functional disruption leads to development of physical, growing and cognitive disabilities and includes multiple organ pathologies, essentially disturbing the nervous and muscular systems. The origins of mitochondrial cytopathies are mutations in genes of nuclear DNA encoding mitochondrial proteins or in mitochondrial DNA. Nowadays, numerous mtDNA mutations significant to the appearance and progress of pathologies in humans are detected...
2018: Therapeutics and Clinical Risk Management
Jiunn-Song Jiang, Chew-Teng Kor, David Dar Kuo, Ching-Hsiung Lin, Chia-Chu Chang, Gau-Yang Chen, Cheng-Deng Kuo
Purpose: It has been shown that the power spectral density (PSD) of heart rate variability (HRV) can be decomposed into a power-law function and a residual PSD (rPSD) with a more prominent high-frequency component than that in traditional PSD. This study investigated whether the residual HRV (rHRV) measures can better discriminate patients with acute myocardial infarction (AMI) from patients with patent coronary artery (PCA) than traditional HRV measures. Materials and methods: The rHRV and HRV measures of 48 patients with AMI and 69 patients with PCA were compared...
2018: Therapeutics and Clinical Risk Management
Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń
The most frequent causes of leg ulcers are chronic venous disease (CVD) related mainly to venous hypertension and peripheral arterial disease (PAD) related to disseminated atheromatous lesions in lower limb arteries. In 15%-21% of patients, ulcers of mixed venous-arterial etiology occur, which are usually more resistant for conservative therapy (compression therapy, pharmacotherapy, wearing elastic stockings, leg elevation and massage, change of lifestyle, and regular physical exercises). The contemporary model of complex therapy of leg ulcers in the course of chronic venous and arterial insufficiency more often also comprises numerous physical therapy procedures as associated therapy...
2018: Therapeutics and Clinical Risk Management
Francesca Guerriero, Valentina Orlando, Valeria Marina Monetti, Francesca Maria Colaccio, Maurizio Sessa, Cristina Scavone, Annalisa Capuano, Enrica Menditto
Aim: The aim of this study was to assess the predictive role of age, gender, and number and type of co-treatments for new oral anticoagulant (NOAC) vs warfarin prescription in elderly patients naïve for the aforementioned drugs. Materials and methods: Data collected in the period from January 1, 2014, to December 31, 2014, in Caserta Local Health Unit administrative databases (Campania Region, Italy) were screened to identify new users of oral anticoagulants (OACs) who were 75 years or older and whose OAC prescriptions amounted to >90 days of treatment...
2018: Therapeutics and Clinical Risk Management
Xiang Fang, Hongyuan Liu, Yan Xiong, Wenli Zhang, Yi Luo, Fan Wu, Yong Zhou, Liuhong Song, Zeping Yu, Chongqi Tu, Hong Duan
Purpose: Arthrodesis is one of the most widely accepted surgical recommended methods for tumors of the talus, but it may be associated with poor limb functions. The aim of this study was to present a novel reconstruction with ankle function preserved after en bloc talus tumor resection. Patient and method: A 43-year-old female with mesenchymal sarcoma of the talus was admitted in West China Hospital. Total talar replacement with three-dimensional (3D) printed modular prosthesis was prepared for reconstruction...
2018: Therapeutics and Clinical Risk Management
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