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Therapeutics and Clinical Risk Management

Nian Chen, Qin Qin, Ke-Dai Sun, Dan Luo, Qiong-Hui Cheng
Introduction: Primary cutaneous nocardiosis is a rare suppurative or granulomatous inflammation disease caused by Nocardia infection. Because of nonspecific clinical findings, it is always misdiagnosed as common pyogenic infection. Sulfonamides have been the standard treatment for nocardiosis, but the outcome is always poor due to the high rates of misdiagnosis and refractoriness of the disease. Cases presentations: The presented cases are patients of acute suppurative cutaneous infection without involvement of other organs...
2018: Therapeutics and Clinical Risk Management
Haneen Alrawashdeh, Lama Madi, Arwa Hassan Ahmed Elhada, Afif Ahmed, Dhiaddin Serheed
We describe the case of a 49-year-old male who presented to the emergency department with right-sided weakness and inability to speak. He was diagnosed with stroke and was admitted to Qatar Rehabilitation Institute after he was treated for the acute phase at Hamad General Hospital. As part of his management, he was started on oxybutynin 5 mg orally twice daily for the treatment of overactive bladder. Within a week, his liver enzymes started to increase. After a thorough medication review, oxybutynin was suspended as it was the only suspected medication to be responsible of this elevation in liver enzymes...
2018: Therapeutics and Clinical Risk Management
Carmen Fucile, Francesca Mattioli, Valeria Marini, Massimo Gregori, Aurelio Sonzogni, Antonietta Martelli, Natalia Maximova
To date, in pediatric field, various hematological malignancies are increasingly treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Iron overload and systemic siderosis often occur in this particular cohort of patients and are associated with poor prognosis. We describe herein the case of two allo-HSCT patients, on treatment with deferasirox; they showed histopathological elements compatible with venoocclusive disease or vanishing bile duct syndrome in ductopenic evolution before deferasirox started...
2018: Therapeutics and Clinical Risk Management
Jesper Park-Hansen, Anders M Greve, Johan Clausen, Susanne J Holme, Christian L Carranza, Akhmadjon Irmukhamedov, Lubna Sabah, Qing Lin, Anne Sofie Madsen, Helena Domínguez
Background: Incident atrial fibrillation (AF) is reported in 10%-65% of patients without previous AF diagnosis after open heart surgery. The risk of late AF recurrence after a postoperative AF onset is unclear, and it is controversial whether AF limited to the postoperative period should elicit oral anticoagulation (OAC) therapy. The primary objective of this study was to evaluate the long-term recurrence of AF in patients developing new-onset peri-procedural AF. Patients and methods: Patients (n=189) with available baseline and follow-up data included in Left Atrial Appendage Closure with Surgery trial were coded for known AF at baseline and for postoperative first-time AF diagnosis...
2018: Therapeutics and Clinical Risk Management
Giuseppe Derosa, Pamela Maffioli
Recently, a new class of anti-diabetic drugs has found its way into the market: sodium-glucose cotransporters (SGLT) inhibitors. Two major SGLT isoforms have been identified: SGLT-2, mainly expressed in proximal renal tubules, and SGLT-1, mainly expressed in the small intestine, the proximal renal tubule, and the myocardium. SGLT-2 inhibitors increase urinary glucose excretion, lowering glycemia without inducing excessive insulin secretion. Marketed SGLT-2 inhibitors actually include dapagliflozin, canagliflozin, and empagliflozin; a new SGLT-2 inhibitor is being studied: ertugliflozin...
2018: Therapeutics and Clinical Risk Management
Xiao-Ling Zou, Zhuang-Gui Chen, Tian-Tuo Zhang, Ding-Yun Feng, Hong-Tao Li, Hai-Ling Yang
Background: Th17 and regulatory T cell (Treg) play crucial roles in the pathogenesis of asthma. However, the association between Th17/Treg homeostasis and asthma exacerbation remains unclear. Patients and methods: To investigate the role of Th17/Treg bias in asthma exacerbation, 49 asthma patients were enrolled in the current study, of whom 31 had acute asthma exacerbation (exacerbation group) and 18 did not (non-exacerbation group). Meanwhile, 17 healthy subjects were recruited as normal controls (control group)...
2018: Therapeutics and Clinical Risk Management
Qinglin Cheng, Gang Zhao, Li Xie, Xuchu Wang
Objective: The objective of our study was to conduct a series of analyses that examined the impacts of age and gender at the risk of underlying medical conditions (UMCs) and death in patients with influenza A (H7N9). Methods: We began by searching for potentially relevant articles in English or Chinese before February 28, 2018. Additionally, we reviewed our own files and reference lists of articles identified by this search. Results: The association between death and UMCs was significant in H7N9 patients, with an OR of 1...
2018: Therapeutics and Clinical Risk Management
Seung Hyun Kim, Minsu Park, Jinae Lee, Eungjin Kim, Yong Seon Choi
Background: The use of capnography monitoring devices has been shown to lower the rates of hypoxemia via early detection of respiratory depression, and facilitate more accurate titration of sedatives during procedures. The aim of the current meta-analysis was to compare the incidence of hypoxemia associated with standard monitoring alone during gastrointestinal endoscopy to that associated with standard monitoring with the addition of capnography. Methods: The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials scientific databases were searched to identify relevant studies...
2018: Therapeutics and Clinical Risk Management
Saki Oyama, Keiko Hosohata, Ayaka Inada, Iku Niinomi, Yasuhiro Mori, Yuki Yamaguchi, Mayako Uchida, Kazunori Iwanaga
Introduction: Tubulointerstitial nephritis (TIN) is a problem in clinical settings because drug therapy is the cause in most cases. Patients often present with nonspecific symptoms, which can lead to delays in the diagnosis and treatment of the disease. The purpose of this study was to clarify the rank-order of the association of TIN with the causative drugs using a spontaneous reporting system database. Materials and methods: Data were extracted from the Japanese Adverse Drug Event Report database of the Pharmaceuticals and Medical Devices Agency (Japan)...
2018: Therapeutics and Clinical Risk Management
Rizky Abdulah, Widya N Insani, Dika P Destiani, Nurul Rohmaniasari, Nithya D Mohenathas, Melisa I Barliana
Background: The geriatric population is particularly vulnerable to being prescribed potentially inappropriate medication (PIM); however, the prevalence of this occurrence remains poorly investigated in Indonesia. Thus in this research, we focused on investigating the prevalence and predictors of PIM among the Indonesian geriatric population in a primary health care setting. Methods: A retrospective observational study was conducted in 25 primary health care facilities in Karawang District, Indonesia...
2018: Therapeutics and Clinical Risk Management
Mansour Alizadeh, Ali Nasebakht, Rohollah Valizadeh, Mohammadreza Mohammadi Fallah, Ali Taghizadeh Afshari, Mohsen Mohammad Rahimi, Chimen Daneshyar
Introduction: Varicocele is a common problem with a high prevalence in population with primary and secondary infertilities. The adverse effects of varicocele on spermatogenesis and fertility are known, but the association between clinical varicocele and testosterone is not clear. Hence, we decided to evaluate the serum levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in patients with varicocele after varicocelectomy. Methods: In this study, 100 patients with varicocele were divided into two groups: hypogonadal patients with testosterone level <280 ng/dL and eugonadal patients with testosterone level >280 ng/dL...
2018: Therapeutics and Clinical Risk Management
Matthew H Forsberg, Amritava Das, Krishanu Saha, Christian M Capitini
Recent advancements in immunooncology have resulted in the generation of novel therapies such as chimeric antigen receptor (CAR) T cells, which have revolutionized the treatment of pediatric patients with relapsed or refractory B-cell acute lymphoblastic leukemia. The journey of tisagenlecleucel (formerly CTL019) from early preclinical success to the US Food and Drug Administration approval is summarized in this review. Strategies that are currently being investigated to improve the efficacy and safety profile of CAR T-cells are also explored, as well as the factors contributing to the present state of patient access to CAR T therapy...
2018: Therapeutics and Clinical Risk Management
Yoojin Noh, Sukhyang Lee, Sooyoung Shin
Background: As newly available antidiabetic drugs (ADs) are used more commonly as initial hypoglycemic choice for early stage diabetes patients, there is an urgent need to investigate how these agents may differ in treatment durability relative to metformin. This study aimed to investigate the incidence and risk of treatment adjustment among newly treated type 2 diabetes mellitus (T2DM) patients receiving an oral AD as initial monotherapy. Methods: T2DM patients registered in the National Health Insurance Program who were newly prescribed an oral AD were identified...
2018: Therapeutics and Clinical Risk Management
Guanhua Li, Wen Jiang, Yu Zhang, Xiaohua Zhang, Jimei Chen, Jian Zhuang, Chengbin Zhou
Purpose: To investigate the influence and possible pathophysiological mechanism of pulsatile cardiopulmonary bypass (CPB) in various frequencies in pediatric patients undergoing congenital cardiac surgery. Patients and methods: Clinical data and hemodynamic parameters were collected in 80 patients who underwent congenital cardiac surgeries and were perfused in different settings: pulsatile perfusion (PP) in frequencies of 30 beats/min, PP 60 beats/min, PP 100 beats/min and non-pulsatile perfusion (NP)...
2018: Therapeutics and Clinical Risk Management
Cecilia Lazea, Carmen Asavoaie, Camelia Al-Khzouz, Lenuta Popa
Neurofibromatosis 1 (NF1) is an autosomal-dominant disorder with various clinical expressivity and complications. Arterial hypertension may be present in patients with NF1 and is secondary to vasculopathy or pheochromocytoma. We herein describe two children (17 and 4 years old) diagnosed late with NF1 after severe arterial hypertension had been discovered due to pheochromocytoma and middle aortic syndrome. Routine measurement of arterial pressure is mandatory in children with NF1, in order to diagnose the complications of this disease...
2018: Therapeutics and Clinical Risk Management
Xue-Lian Zhang, Ming-Xia Yuan, Gang Wan, Guang-Ran Yang, Dong-Mei Li, Han-Jing Fu, Liang-Xiang Zhu, Rong-Rong Xie, Jian-Dong Zhang, Yu-Jie Lv, Yu-Ling Li, Xue-Ping Du, Zi-Ming Wang, Xue-Li Cui, De-Yuan Liu, Ying Gao, Shu-Yan Cheng, Qian Wang, Yu Ji, Guang-Wei Li, Shen-Yuan Yuan
Objective: It is well known that diabetic kidney disease is a risk factor for cardiovascular diseases (CVD) in patients with type 2 diabetes mellitus (T2DM). In this study, the effects of urine albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR) on CVD outcomes were analyzed in a population of T2DM. Methods: The study was carried out using recorded information of a cohort study. A total of 1,914 patients with T2DM with no prevalent CVD were enrolled in an 8 years prospective study and received multifactorial intervention...
2018: Therapeutics and Clinical Risk Management
Jianhua Fang, Yi Shao, Jiezhi Su, Ying Wan, Lingyun Bao, Wei Wang, Fanlei Kong
Introduction: This study explored the value of measuring programmed death 1 (PD-1) in peripheral blood, combined with breast ultrasound using the Breast Imaging Reporting and Data System (BI-RADS) classification, for differentiation between benign and malignant breast tumors. Materials and methods: We enrolled 113 patients with breast cancer and 66 patients with benign breast tumors who were admitted to Hangzhou First People's Hospital from September 2014 to August 2017...
2018: Therapeutics and Clinical Risk Management
Izabela Rozmilowska, Damian Czyzewski, Bogdan Mazur, Monika Adamczyk-Sowa
Objective: Myasthenia gravis (MG) is a disease with autoimmune etiology. The main pathomechanism is related to the production of antibodies against nicotinic acetylcholine receptor. The present study is aimed to compare the serum level of adipokines in patients with MG with that in controls, as well as to study the relation of these levels with disease severity. Patients and methods: Fifty patients with MG and 30 healthy individuals were enrolled in our study. Serum concentrations of select adipokines, namely adiponectin, leptin, omentin, visfatin, and resistin were measured...
2018: Therapeutics and Clinical Risk Management
Qintai Yang, Hui Li, Weijun Wu, Xuekun Huang, Bo Tu, Yukun Ma, Huiyi Deng, Meijiao Li, Hongfeng He, Can Li, Yongqi Yang
Background: The effect of continuous positive airway pressure (CPAP) on nasal symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) remains controversial. In addition, possible mechanism(s) remains unclear. Objective: To examine whether CPAP contributes to the onset and exacerbation of allergic rhinitis (AR) in OSAHS patients based on patient-reported changes in nasal symptoms with and without CPAP therapy and the detection of house dust mites (HDMs) in CPAP filters and household environments...
2018: Therapeutics and Clinical Risk Management
Xiangbin Meng, Wenyao Wang, Kuo Zhang, Yu Qi, Shimin An, Siyuan Wang, Jilin Zheng, Joyce Kong, Henghui Liu, Jing Wu, Yong Zhou, Chuanyu Gao, Yi-Da Tang
Background: Epicardial adipose tissue (EAT) is considered an important source of bioactive molecules that can influence coronary arteries directly and is related to the concurrent presence of both obstructive coronary stenosis and myocardial ischemia independently. Non-alcoholic fatty liver disease (NAFLD) has become an emergent health problem worldwide. Aim: This cross-sectional study aimed to address the relationship between the volume of EAT and NAFLD and other cardiovascular risk factors in the general population...
2018: Therapeutics and Clinical Risk Management
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