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https://www.readbyqxmd.com/read/28203342/optimizing-current-and-emerging-therapies-in-multiple-myeloma-a-guide-for-the-hematologist
#1
REVIEW
Shahzad Raza, Rachael A Safyan, Evan Rosenbaum, Alex S Bowman, Suzanne Lentzsch
Multiple myeloma (MM) is the second most common hematologic malignancy. The diagnosis of MM requires ⩾10% clonal plasma cells in the bone marrow or biopsy-proven plasmacytoma, plus evidence of end-organ damage (hypercalcemia, renal failure, anemia, and lytic bone lesions). The definition of MM has recently been expanded to include a ⩾60% clonal plasma cell burden in the bone marrow, serum involved/uninvolved light chain ratio of ⩾100, or more than one focal lesion on magnetic resonance imaging ⩾5 mm in the absence of end-organ damage...
February 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/28143591/a-case-report-of-intravenous-posaconazole-in-hepatic-and-renal-impairment-patient-with-invasive-aspergillus-terreus-infection-safety-and-role-of-therapeutic-drug-monitoring
#2
Pitchaya Dilokpattanamongkol, Panadda Panusitthikorn, Rasda Boonprasert, Methee Chayakulkeeree, Porpon Rotjanapan
BACKGROUND: Invasive aspergillosis (IA) is a fatal infectious complication among immunocompromised patients. Aspergillus terreus, the fourth common species can be difficult to treat due to a unique resistance pattern. To date, there has been no report on safety and dose adjustment when intravenous posaconazole is selected in hepatic and renal impairment patient. We present a rare case of intravenous posaconazole use in a hepatic and renal impairment patient with invasive A. terreus pulmonary infection...
January 31, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28129817/-dalbavancin-pharmacokinetic-and-pharmacodynamic-parameters
#3
José Ramón Azanza, Belén Sádaba, Joana Reis
Dalbavancin is a new lipoglycopeptide antibiotic whose structure influences its pharmacokinetic profile. It is not absorbed after oral administration and is therefore administered intravenously. It is distributed through intracellular fluid, reaching adequate concentrations in the skin, bone, blister fluid and synovial fluid. Plasma protein binding is very high. Concentrations in brain tissue and cerebrospinal fluid (CSF) are inadequate. Excretion is through non-microsomal metabolism with inactive metabolites and through the kidneys by glomerular filtration...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28107415/serum-uric-acid-and-progression-of-kidney-disease-a-longitudinal-analysis-and-mini-review
#4
Ching-Wei Tsai, Shih-Yi Lin, Chin-Chi Kuo, Chiu-Ching Huang
BACKGROUND: Increasing evidence supports the association between hyperuricemia and incident chronic kidney disease (CKD); however, there are conflicting data regarding the role of hyperuricemia in the progression of CKD. This study retrospectively assessed the longitudinal association between uric acid (UA) level and CKD progression in a Chinese population lived in Taiwan. METHODS: Patients with physician diagnosis of hyperuricemia or receiving urate-lowering therapy between 2003 and 2005 were identified in the electronic medical records (EMR) of a tertiary medical center and were followed up until December 31, 2011...
2017: PloS One
https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#5
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28039098/efficacy-and-tolerability-of-interferon-free-antiviral-therapy-in-kidney-transplant-recipients-with-chronic-hepatitis-c
#6
Inmaculada Fernández, Raquel Muñoz-Gómez, Juan M Pascasio, Carme Baliellas, Natalia Polanco, Nuria Esforzado, Ana Arias, Martín Prieto, Lluis Castells, Valentín Cuervas-Mons, Olga Hernández, Javier Crespo, José L Calleja, Xavier Forns, María-Carlota Londoño
BACKGROUND & AIMS: The development of direct-acting antiviral agents (DAAs) is a major step forward in the treatment of hepatitis C (HCV). The aims of the study were to evaluate the efficacy and tolerability of DAAs in kidney transplant (KT) recipients. METHODS: Hepa-C is a Spanish registry of patients treated with DAAs in which clinical, virological and analytical data were prospectively included. We report on the data from 103 KT recipients who received DAAs. RESULTS: The most commonly used DAAs combinations were sofosbuvir/ledipasvir (n=59, 57%) and sofosbuvir+daclatasvir (n=18, 17%)...
December 28, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27941283/efficacy-of-pomalidomide-in-a-multiple-myeloma-patient-requiring-hemodialysis
#7
Michiko Kida, Masako Hirao, Hiromitsu Iizuka, Akira Hangaishi, Kensuke Usuki
A 67-year-old male patient developed multiple myeloma with acute renal failure caused by myeloma kidney. Although a very good partial response was achieved with bortezomib with dexamethasone (BD) therapy under temporary dialysis, relapse occurred 3 years later. Thalidomide was added to the BD therapy but was discontinued because of drug-induced eczema. Subsequently, bone lesions and chromosomal abnormalities appeared. Because renal failure progressed with increased serum free light chain levels, maintenance hemodialysis was introduced...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27938247/estimating-diesel-fuel-exposure-for-a-plumber-repairing-an-underground-pipe
#8
Mary Finn, Mark Stenzel, Gurumurthy Ramachandran
We estimated the diesel fuel exposure of a plumber repairing an underground water line leak at a truck stop. The repair work was performed over three days during which the plumber spent most of his time in a pit filled with a mixture of water and diesel fuel. Thus, the plumber was exposed via both the inhalation and dermal routes. While previously asymptomatic, he was diagnosed with acute renal failure 35 days after working at this site. No measurements were available for estimating either inhalation or dermal exposures or the cumulative dose and, therefore, two different approaches were used that were based on simple models of the exposure scenario...
December 12, 2016: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/27816115/implications-of-serum-chloride-homeostasis-in-acute-heart-failure-from-rose-ahf
#9
Justin L Grodin, Jie-Lena Sun, Kevin J Anstrom, Horng H Chen, Randall C Starling, Jeffrey M Testani, W H Wilson Tang
Lower serum chloride (Cl) levels are strongly associated with increased long-term mortality after admission for acute heart failure (AHF). However, the therapeutic implications of serum Cl levels during AHF are unknown. We sought to determine the short-term clinical response and postdischarge outcomes associated with serum Cl levels in AHF. Serum Cl was measured at randomization (n = 358) and during hospitalization from patients with AHF in the Renal Optimization Strategies Evaluation in Acute Heart Failure trial...
January 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27799609/supratherapeutic-inr-resulting-from-the-initiation-of-warfarin-in-a-patient-receiving-axitinib
#10
Brian Primeaux, Bradley Burton, Stephanie Shuey
Axitinib is a vascular endothelial growth factor receptor inhibitor indicated for advanced renal cell cancer after failure of one prior systemic therapy. We report a case where a patient receiving axitinib experienced a supratherapeutic INR soon after initiation of an age-appropriate warfarin dose. We propose two possible mechanisms for this interaction, including competitive protein binding and decreased metabolism. Close INR monitoring and dose adjustments of warfarin may be necessary in patients receiving concomitant axitinib and warfarin in order to decrease the risks associated with this interaction...
October 31, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27743903/allogeneic-mesenchymal-precursor-cells-mpc-in-diabetic-nephropathy-a-randomized-placebo-controlled-dose-escalation-study
#11
RANDOMIZED CONTROLLED TRIAL
David K Packham, Ian R Fraser, Peter G Kerr, Karen R Segal
BACKGROUND: Diabetic nephropathy is the most common cause of end stage renal failure. We assessed the safety, tolerability, and explored therapeutic effects of adult allogeneic bone-marrow derived mesenchymal precursor cells (MPC) in patients with moderate to severe diabetic nephropathy. METHODS: Multicenter, randomized, double-blind, dose-escalating, sequential, placebo-controlled trial assessing a single intravenous (IV) infusion of allogeneic MPC (United States adopted name: rexlemestrocel-L) 150×10(6) (n=10), 300×10(6) (n=10) or placebo (n=10) in adults with diabetic nephropathy with an estimated glomerular filtration rate (eGFR) 20-50ml/min/1...
October 2016: EBioMedicine
https://www.readbyqxmd.com/read/27703360/delirium-as-a-complication-of-the-surgical-intensive-care
#12
Rostislav Horacek, Barbora Krnacova, Jan Prasko, Klara Latalova
BACKGROUND: The aim of this study was to examine the impact of somatic illnesses, electrolyte imbalance, red blood cell count, hypotension, and antipsychotic and opioid treatment on the duration of delirium in Central Intensive Care Unit for Surgery. PATIENTS AND METHODS: Patients who were admitted to the Department of Central Intensive Care Unit for Surgery in the University Hospital Olomouc from February 2004 to November 2008 were evaluated using Riker sedation-agitation scale...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27661398/population-pharmacokinetics-of-everolimus-in-relation-to-clinical-outcomes-in-patients-with-advanced-renal-cell-carcinoma
#13
Atsuko Tanaka, Ikuko Yano, Keiko Shinsako, Eriko Sato, Masahide Fukudo, Satohiro Masuda, Toshinari Yamasaki, Tomomi Kamba, Osamu Ogawa, Kazuo Matsubara
BACKGROUND: Everolimus has been used for the treatment of unresectable or metastatic renal cell carcinoma (RCC). Here, we measured blood concentrations of everolimus to obtain the population pharmacokinetic parameters and to examine the relationship between blood concentration and clinical outcomes. METHODS: Twenty-two Japanese patients were enrolled. Blood samples were collected before and 2, 4, 8, and 24 hours after drug administration on days 1 and 8 of everolimus therapy (5 or 10 mg) from inpatients; occasional samples were collected from outpatients...
December 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27637303/direct-oral-anticoagulants-monitoring-anticoagulant-effect
#14
REVIEW
Barbara A Konkle
In some clinical settings laboratory measurement of direct oral anticoagulants effect is helpful in guiding medical care, such as life-threatening bleeding, need for emergency surgery, renal impairment, severe hepatic failure, extremes of body weight, or in patients with bleeding or thrombosis on therapy. This article reviews approaches to laboratory testing to assess the anticoagulant effect of these drugs. Because of the wide variation in levels measured in patients on therapy and minimal clinical data from dose adjustment, dose adjustment based on levels is not currently advised...
October 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27594177/severity-of-renal-impairment-in-patients-with-heart-failure-and-atrial-fibrillation-implications-for-non-vitamin-k-antagonist-oral-anticoagulant-dose-adjustment
#15
Nathaniel M Hawkins, Pardeep S Jhund, Andrea Pozzi, Eileen O'Meara, Scott D Solomon, Christopher B Granger, Salim Yusuf, Marc A Pfeffer, Karl Swedberg, Mark C Petrie, Sean Virani, John J V McMurray
AIMS: The non-vitamin K antagonist oral anticoagulants (NOACs) have varying degrees of renal elimination which may be challenging in patients with heart failure (HF) and atrial fibrillation (AF). We examined the severity and variation in renal impairment, and the proportion of patients requiring NOAC cessation or dose reduction. METHODS AND RESULTS: A retrospective analysis of patients with HF and AF in the Candesartan in Heart failure Assessment of Reduction in Mortality and Morbidity programme was carried out...
September 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27568454/treatment-with-optimal-dose-angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-has-a-positive-effect-on-long-term-survival-in-older-individuals-aged-70%C3%A2-years-and-octogenarians-with-systolic-heart-failure
#16
Luis Sargento, Andre Vicente Simões, Susana Longo, Nuno Lousada, Roberto Palma Dos Reis
BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) is a disease of older people, but the target doses of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are unknown. OBJECTIVE: To evaluate the association of ACEI/ARB dose level with long-term survival in stable older patients (aged >70 years) and octogenarian outpatients with HFrEF. POPULATION AND METHODS: A total of 138 outpatients aged >70 years (35...
September 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27555569/primary-and-key-secondary-results-from-the-rocket-af-trial-and-their-implications-on-clinical-practice
#17
REVIEW
Rohan Shah, Manesh R Patel
BACKGROUND: The safety and efficacy of the oral anticoagulant rivaroxaban were studied in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF trial). A number of subanalyses of the ROCKET AF trial have subsequently analyzed the use of rivaroxaban in special patient populations. METHODS: The outcomes of the ROCKET AF trial were reviewed. The use of rivaroxaban in higher risk populations, as determined by the presence of co-morbidities included in the CHADS2 criteria, was analyzed...
August 23, 2016: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/27536671/lupus-nephritis-a-different-disease-in-european-patients
#18
REVIEW
Vladimir Tesar, Zdenka Hruskova
BACKGROUND: Lupus nephritis (LN) is still associated with significant mortality and substantial risk of progression to end-stage renal failure. Its outcome is related to the class and severity of LN and response to treatment, and it is poorer in patients with renal relapses. Ethnicity has a relatively well-defined impact on the outcome of the patients and their response to treatment and must always be taken into consideration in treatment decisions. SUMMARY: In this article, we provide a review of the impact of ethnicity on the prevalence of systemic lupus erythematosus (SLE), the proportion of patients with SLE developing LN, outcomes of SLE and LN and response of LN to treatment...
September 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27509826/staphylococcus-aureus-osteo-articular-infection-usefulness-of-the-determination-of-daptomycin-serum-concentration-to-explain-a-treatment-failure
#19
Sylvain Barreau, Sihem Benaboud, Solen Kernéis, Laurence Moachon, Philippe Blanche, Matthieu Groh, Laurent Massias, Jean-Marc Treluyer, Claire Poyart, Josette Raymond
We report two cases of treatment failure in patients with osteoarticular infection associated with <i>Staphylococcus aureus</i> bacteremia and receiving daptomycin. Using a published population-pharmacokinetic model and daptomycin blood level in these patients, area under the curve (AUC) was calculated and compared to the pharmacological target. For the first patient, treated with 6 mg/kg every 48 hours due to acute renal failure and then every 24 hours, the AUC was 820 mg×h×L<sup>-1</sup>, with a minimal concentration of 23...
November 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27500271/a-proposal-for-early-dosing-regimens-in-heart-transplant-patients-receiving-thymoglobulin-and-calcineurin-inhibition
#20
REVIEW
Markus J Barten, Uwe Schulz, Andres Beiras-Fernandez, Michael Berchtold-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Martin Schweiger, Markus Wilhelm, Andreas Zuckermann
There is currently no consensus regarding the dose or duration of rabbit antithymocyte globulin (rATG) induction in different types of heart transplant patients, or the timing and intensity of initial calcineurin inhibitor (CNI) therapy in rATG-treated individuals. Based on limited data and personal experience, the authors propose an approach to rATG dosing and initial CNI administration. Usually rATG is initiated immediately after exclusion of primary graft failure, although intraoperative initiation may be appropriate in specific cases...
June 2016: Transplantation Direct
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