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rhabdomyolysis guidelines

Seungho Kang, Jeongmi Moon, Byeongjo Chun
OBJECTIVE: This study aims to help set domestic guidelines for administration of antivenom to envenomated patients after snakebites. METHODS: This retrospective observational case series comprised 128 patients with snake envenomation. The patients were divided into two groups according to the need for additional antivenom after the initial treatment based on the traditional snakebite severity grading scale. One group successfully recovered after the initial treatment and did not need any additional antivenom (n=85) and the other needed an additional administration of antivenom (n=43)...
March 2016: Clin Exp Emerg Med
Behrooz Hashemi, Saeed Safari, Mostafa Hosseini, Mahmoud Yousefifard, Elham Erfani, Alireza Baratloo, Farhad Rahmati, Maryam Motamedi, Mohammad Mehdi Forouzanfar, Iraj Najafi
CONTEXT: Crush syndrome and its potentially life-threatening complications, such as acute kidney injury (AKI), are one of the most important medical problems of disaster victims. However, today, many unanswered questions abound about the potential risk factors of crush syndrome, predictive factors of AKI, proper amount of prophylactic hydration therapy, type of fluid, time of continuing fluid, intravenous versus oral hydration, etc. Therefore, this study was designed to review the findings on Iranian nephrologist experiences in diagnosis and management of traumatic rhabdomyolysis following the last two strong earthquakes of Bam (2003) and Manjil-Rudbar (1990)...
June 2016: Archives of Trauma Research
Lane B Benes, Nikhil S Bassi, Michael H Davidson
The 2013 American College of Cardiology/American Heart Association guidelines on cholesterol management have placed greater emphasis on high-intensity statin dosing for those with known cardiovascular disease or diabetes mellitus. Differences in risk of hepatotoxicity, new onset diabetes and rhabdomyolysis specifically between the high-intensity statins and the most common moderate-intensity statin, simvastatin, were not found to a significant degree in this review. Rather, baseline characteristics and drug-drug interactions (DDIs) appear to be more important regarding the risk of these adverse effects...
September 2016: Progress in Cardiovascular Diseases
Christopher Stomberg, Margaret Albaugh, Saul Shiffman, Neeraj Sood
OBJECTIVES: To estimate the costs and benefits of over-the-counter (OTC) statins under the 2013 American College of Cardiology/American Heart Association guidelines. STUDY DESIGN: A 10-year cost-effectiveness model using a health system perspective was developed to analyze the impact of making an OTC statin drug available. METHODS: We calibrated the model by using nationally representative survey data on statin use and cardiovascular risk, data from clinical studies on the safety and efficacy of statins, and data from a study on consumer decisions to use an OTC statin...
2016: American Journal of Managed Care
Saeed Safari, Mahmoud Yousefifard, Behrooz Hashemi, Alireza Baratloo, Mohammad Mehdi Forouzanfar, Farhad Rahmati, Maryam Motamedi, Iraj Najafi
INTRODUCTION: During the past decade, using serum biomarkers and clinical decision rules for early prediction of rhabdomyolysis-induced acute kidney injury (AKI) has received much attention from researchers. This study aimed to broadly review the value of scoring systems and urine dipstick in prediction of rhabdomyolysis-induced AKI. MATERIALS AND METHODS: The study was designed based on the guidelines of the Meta-analysis of Observational Studies in Epidemiology statement...
May 2016: Iranian Journal of Kidney Diseases
Kevin Schleich, Tyler Slayman, Douglas West, Kyle Smoot
OBJECTIVE: To outline a 4-phase progressive program that safely and successfully enabled athletes to return to sport without recurrence of exertional rhabdomyolysis symptoms. BACKGROUND: In January 2011, a large cluster of National Collegiate Athletic Association Division I football athletes were evaluated and treated for exertional rhabdomyolysis. After the athletes were treated, the athletic trainers and sports medicine providers were challenged to develop a safe return-to-play program because of the lack of specific reports in the medical literature to direct such activities...
May 2016: Journal of Athletic Training
Kevin Hummel, Andrew Gregory, Neerav Desai, Alex Diamond
Rhabdomyolysis is a syndrome characterized by muscle pain, weakness and myoglobinuria and ranges in severity from asymptomatic to life threatening with acute kidney failure. While a common condition in adult populations, it is understudied in pediatrics and the majority of adolescent cases are likely exercise-induced, caused by strenuous exercise in athletes. Recently, in our pediatric sports medicine practice, we have seen numerous cases of late adolescent high school athletes who present with severe muscle pain and were found to have elevated creatine kinase levels...
2016: Physician and Sportsmedicine
Anna Hüsing, Iyad Kabar, Hartmut H Schmidt
Hyperlipidemia is very common after liver transplantation and can be observed in up to 71% of patients. The etiology of lipid disorders in these patients is multifactorial, with different lipid profiles observed depending on the immunosuppressive agents administered and the presence of additional risk factors, such as obesity, diabetes mellitus and nutrition. Due to recent improvements in survival of liver transplant recipients, the prevention of cardiovascular events has become more important, especially as approximately 64% of liver transplant recipients present with an increased risk of cardiovascular events...
March 28, 2016: World Journal of Gastroenterology: WJG
Scott N Drum, Bryanne Bellovary, Randall Jensen, Maggie Moore, Lars Donath
BACKGROUND: CrossFit® is considered an intense and extreme conditioning program (ECP) that can cause overtraining and injury. Exertional Rhabdomyolysis (ER) - breakdown of muscle tissue - after ECP has been reported in CrossFit® and might be linked to comparatively high rates of subjectively perceived exertion levels. Therefore, the present study aimed at (a) recording symptoms of post-exercise physical dysfunction (e.g., excessive muscle soreness, shortness of breath) following CrossFit® and (b) ratings of perceived exertion (RPE) during CrossFit® compared with training according to the American College of Sports Medicine (ACSM) guidelines...
February 12, 2016: Journal of Sports Medicine and Physical Fitness
Vera Krane, Kay-Renke Schmidt, Lena J Gutjahr-Lengsfeld, Johannes F E Mann, Winfried März, Florian Swoboda, Christoph Wanner
The 4D (Die Deutsche Diabetes Dialyse) Study was a randomized, double-blind trial comparing 4 years of treatment with atorvastatin to placebo in 1255 hemodialysis patients with type 2 diabetes. The primary end point of cardiovascular events (cardiac death, myocardial infarction, and stroke) was non-significantly reduced by 8%. However, long-term effects remained uncertain. Therefore, surviving patients were invited to a follow-up survey done by questionnaire. Post-trial statin therapy was at nephrologist discretion, and outcomes were centrally adjudicated and analyzed by intention to treat and time to first event in the original treatment groups...
June 2016: Kidney International
Daejin Kim, Eun-Jung Ko, HyeJeong Cho, Su Hyung Park, Sang Hwan Lee, Nam-Gil Cho, So-Young Lee, Hye Yun Jeong, Dong Ho Yang
Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time...
December 2015: Electrolyte & Blood Pressure: E & BP
Joel Elterman, David Zonies, Ian Stewart, Raymond Fang, Martin Schreiber
BACKGROUND: Rhabdomyolysis is a recognized complication of traumatic injury. The correlation of an elevated creatine kinase (CK) level and the development of acute kidney injury (AKI) has been studied in the civilian population. We sought to review the prevalence of rhabdomyolysis in injured war fighters and determine if peak CK levels correlate with AKI. METHODS: This is a retrospective cohort study of patients admitted at a US military treatment facility from January to November 2010...
October 2015: Journal of Trauma and Acute Care Surgery
F Mochel
INTRODUCTION: Inborn errors of metabolism (IEM) are traditionally defined by enzymatic deficiencies or defects in proteins involved in cellular metabolism. Historically discovered and characterized in children, a growing number of IEM are described in adults, and especially in the field of neurology. In daily practice, it is important to recognize emergency situations as well as neurodegenerative diseases for which a metabolic disease is likely, especially when therapeutic interventions are available...
June 2015: Revue Neurologique
Janet Furman
Exertional rhabdomyolysis is a clinical condition caused by intense, repetitive exercise or a sudden increase in exercise in an untrained person, although rhabdomyolysis can occur in trained athletes. In many cases, the presentation of early, uncomplicated rhabdomyolysis is subtle, but serious complications such as renal failure, compartment syndrome, and dysrhythmias may arise if severe exertional rhabdomyolysis is undiagnosed or untreated. Management is further complicated by the lack of concrete management guidelines for treating rhabdomyolysis and returning patients to activity...
April 2015: JAAPA: Official Journal of the American Academy of Physician Assistants
Marc-Andre Cornier, Robert H Eckel
In this manuscript, three manifestations of statin intolerance will be covered. The first, myopathy, is mostly subjective with variable complaints of myalgias often worsened by exercise, muscle cramping or weakness, and at times associated with a biomarker, elevations in creatine kinase (CK). A rare but serious manifestation can be rhabdomyolysis. The second, liver toxicity, is associated with reversible biochemical increases in transaminases and rarely other liver function tests. Finally, statin-related central nervous system (CNS) toxicity typically defined as cognitive impairment is quite rare and appears to be idiosyncratic...
2015: Current Atherosclerosis Reports
Iveta Šimić, Željko Reiner
Statins reduce cardiovascular mortality and morbidity as well as cardiovascular events in patients with a very high risk of cardiovascular disease (CVD) and also in subjects with high or moderate risk by reducing the levels of low-density lipoprotein cholesterol (LDL-C). Although they are considered to be drugs with a very good safety profile, because of their wide use there are many concerns that their adverse effects might compromise their proven beneficial effects. Therefore this article reviews all the data and provides an evidence- based insight what are the proven adverse effects of statins and what are the "myths" about them...
2015: Current Pharmaceutical Design
Andrew W Nichols
Exertional heat-related illness (EHRI) is comprised of several states that afflict physically active persons when exercising during conditions of high environmental heat stress. Certain forms of EHRI may become life threatening if not treated. Exertional heat stroke (EHS), characterized by a core body temperature of >40 ° C and mental status changes, is the most severe form of EHRI. EHS must be treated immediately with rapid body cooling to reduce morbidity and mortality. Many EHRI cases are preventable by following heat acclimatization guidelines, modifying sports and exercise sessions during conditions of high environmental heat stress, maintaining adequate hydration, avoiding exertion in the heat when ill, and by educating sports medicine personnel, coaches, parents, and athletes on the early recognition and prevention of EHRI...
December 2014: Current Reviews in Musculoskeletal Medicine
Chintan S Desai, Seth S Martin, Roger S Blumenthal
Statins form the pharmacologic cornerstone of the primary and secondary prevention of atherosclerotic cardiovascular disease. In addition to beneficial cardiovascular effects, statins seem to have multiple non-cardiovascular effects. Although early concerns about statin induced hepatotoxicity and cancer have subsided owing to reassuring evidence, two of the most common concerns that clinicians have are myopathy and diabetes. Randomized controlled trials suggest that statins are associated with a modest increase in the risk of myositis but not the risk of myalgia...
2014: BMJ: British Medical Journal
Viktor Voros, Peter Osvath, Sandor Fekete, Tamas Tenyi
Introduction. Elevated serum CK levels often occur in psychiatric in-patient practice. Although the majority of cases are benign and temporary, it is important to recognize and treat these conditions. Aims. To discuss the etiology, the clinical significance and the management of elevated creatine kinase levels in psychiatric in-patient practice, focusing on antipsychotic-induced rhabdomyolysis. To compare the pathogenesis and the clinical features of rhabdomyolysis and neuroleptic malignant syndrome. Methods...
2008: International Journal of Psychiatry in Clinical Practice
R Tompkins, A Schwartzbard, E Gianos, E Fisher, H Weintraub
Statins are the first-line pharmacotherapy for cholesterol reduction. Use of these drugs in large randomized clinical trials has consistently shown significant reductions in major vascular events, including death, myocardial infarction, stroke, and coronary revascularization. The updated guidelines for the treatment of high blood cholesterol from the American College of Cardiology/American Heart Association (ACC/AHA), will lead to an increase in the number of patients taking statins. Hence, the number of cases of statin intolerance may subsequently increase, emphasizing the need to understand and treat this important problem...
July 2014: Clinical Pharmacology and Therapeutics
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