Pharmacogenomics and Clinical Assessment of Drug-Induced Hepatotoxicity toward Improving Clinical Outcomes

2014 ◽  
pp. 1331-1372
Keyword(s):  
Clinical Outcomes ◽  
Clinical Assessment ◽  
Drug Induced

Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty

2021 ◽  
pp. 107110072110613
Author(s):  
Vinay V. Balesar ◽  
Lennard A. Koster ◽  
Bart L. Kaptein ◽  
Stefan B. Keizer
Keyword(s):  
Prospective Study ◽  
Clinical Outcomes ◽  
Condition Number ◽  
Clinical Assessment ◽  
Functional Outcomes ◽  
Metatarsal Bone ◽  
Migration Patterns ◽  
Patient Questionnaires

Background: Mixed results for functional outcomes and long-term fixation have been reported for first metatarsophalangeal arthroplasty. This prospective study was designed to evaluate the migration of the BioPro metatarsophalangeal-1 (MTP-1) joint hemiprosthesis with Roentgen stereophotogrammetric analysis (RSA). Migration patterns of the prosthesis, prosthesis-induced erosion of the metatarsal bone, and clinical outcomes were evaluated sequentially to 5 years postoperation (PO). Methods: Eleven female patients received the BioPro-1 hemiprosthesis. Prosthesis translation and metatarsal erosion were measured with RSA at immediately PO, 6 weeks, and 3, 6, 12, 36, and 60 months postoperatively. Clinical assessment was done by patient questionnaires. Results: RSA data of 9 patients were available for analysis. Median (range) number of markers used in RSA analysis, condition number, and mean error of markers around the prosthesis were 4 (3-7), 320 (208-862), and 0.13 (0.02-0.28), respectively. Progressive subsidence was seen up to 3 years PO (mean 2.1 mm, SE 0.32). Progressive metatarsal erosion was found from 1 year PO (mean 0.49 mm, SE 0.15). Pain, function, and quality scores improved after surgery and did not deteriorate at later follow-up moments. Conclusion: Model-based RSA of the BioPro-1 prosthesis shows nonstabilizing medial and distal translation and metatarsal erosion. Despite the measured migration and erosion, clinical outcomes improved and remained similar up to 5 years postoperation.

scholarly journals Clinical Assessment and Management of Portal Hypertension

2018 ◽  
Vol 35 (03) ◽  
pp. 153-159 ◽  
Author(s):  
Jacob Kibrit ◽  
Ruben Khan ◽  
Barbara Jung ◽  
Sean Koppe
Keyword(s):  
Portal Hypertension ◽  
Clinical Outcomes ◽  
Clinical Assessment ◽  
Poor Prognosis ◽  
Delay Progression

AbstractThe development of portal hypertension in a patient with cirrhosis portends a poor prognosis. Untreated or progressive portal hypertension has serious clinical outcomes, which are often fatal. It is important to recognize portal hypertension early to delay progression and to treat complications of portal hypertension as they arise. This review will focus on the clinical assessment and management of portal hypertension.

scholarly journals Drug-Induced Metabolic Acidosis

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1460 ◽  
Author(s):  
Amy Quynh Trang Pham ◽  
Li Hao Richie Xu ◽  
Orson W. Moe
Keyword(s):  
Metabolic Acidosis ◽  
Clinical Outcomes ◽  
Comorbid Conditions ◽  
Acid Base ◽  
Drug Induced ◽  
Pathophysiological Mechanisms ◽  
Pathogenic Mechanisms ◽  
Base Equilibrium ◽  
Acid Base Equilibrium

Metabolic acidosis could emerge from diseases disrupting acid-base equilibrium or from drugs that induce similar derangements. Occurrences are usually accompanied by comorbid conditions of drug-induced metabolic acidosis, and clinical outcomes may range from mild to fatal. It is imperative that clinicians not only are fully aware of the list of drugs that may lead to metabolic acidosis but also understand the underlying pathogenic mechanisms. In this review, we categorized drug-induced metabolic acidosis in terms of pathophysiological mechanisms, as well as individual drugs’ characteristics.

scholarly journals The risk of adverse clinical outcomes following treatment of Plasmodium vivax malaria with and without primaquine in Papua, Indonesia

2020 ◽  
Vol 14 (11) ◽  
pp. e0008838
Author(s):  
Kamala Thriemer ◽  
Jeanne-Rini Poespoprodjo ◽  
Enny Kenangalem ◽  
Nicholas M. Douglas ◽  
Paulus Sugiarto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
G6pd Deficiency ◽  
Cox Regression ◽  
Artemisinin Combination Therapy ◽  
Morbidity And Mortality ◽  
Radical Cure ◽  
Drug Induced ◽  
Routine Administration ◽  
Plasmodium Vivax Malaria ◽  
Glucose 6 Phosphate Dehydrogenase

The widespread use of primaquine (PQ) radical cure for P. vivax, is constrained by concerns over its safety. We used routinely collected patient data to compare the overall morbidity and mortality in patients treated with and without PQ without prior testing of Glucose-6-Phosphate-Dehydrogenase (G6PD) deficiency in Papua, Indonesia, where there is a low prevalence of G6PD deficiency. Records were collated from patients older than 1 year, with P. vivax infection, who were treated with an artemisinin combination therapy (ACT). The risks of re-presentation, hospitalization, major fall in haemoglobin and death within 30 days were quantified and compared between patients treated with and without PQ using a Cox regression model. In total 26,216 patients with P. vivax malaria presented to the hospital with malaria during the study period. Overall 27.56% (95% Confidence Interval (95%CI): 26.96–28.16) of 21,344 patients treated with PQ re-presented with any illness within 30 days and 1.69% (1.51–1.88) required admission to hospital. The corresponding risks were higher in the 4,872 patients not treated with PQ; Adjusted Hazard Ratio (AHR) = 0.84 (0.79–0.91; p<0.001) and 0.54 (0.41–0.70; p<0.001) respectively. By day 30, 14.15% (12.45–16.05) of patients who had received PQ had a fall in haemoglobin (Hb) below 7g/dl compared to 20.43% (16.67–24.89) of patients treated without PQ; AHR = 0.66 (0.45–0.97; p = 0.033). A total of 75 (0.3%) patients died within 30 days of treatment with a mortality risk of 0.27% (0.21–0.35) in patients treated with PQ, compared to 0.38% (0.24–0.60) without PQ; AHR = 0.79 (0.43–1.45; p = 0.448). In Papua, Indonesia routine administration of PQ radical cure without prior G6PD testing, was associated with lower risk of all cause hospitalization and other serious adverse clinical outcomes. In areas where G6PD testing is not available or cannot be delivered reliably, the risks of drug induced haemolysis should be balanced against the potential benefits of reducing recurrent P. vivax malaria and its associated morbidity and mortality.

Histologic pattern is better correlated with clinical outcomes than biochemical classification in patients with drug-induced liver injury

2019 ◽  
Vol 32 (12) ◽  
pp. 1795-1805 ◽  
Author(s):  
Qiu-ju Tian ◽  
Xin-yan Zhao ◽  
Yan Wang ◽  
Aileen Wee ◽  
Gwyneth Shook Ting Soon ◽  
...  
Keyword(s):  
Liver Injury ◽  
Clinical Outcomes ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Histologic Pattern

An Overview and Awareness of Acute Coronary Syndrome Based on Risk Factors, Early Clinical Assessment Tools, and Improving Clinical Outcomes

2019 ◽  
Vol 12 (1) ◽  
pp. 125-131
Author(s):  
Eulalia D'souza
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Clinical Outcomes ◽  
Cause Of Death ◽  
Clinical Assessment ◽  
The United States ◽  
Assessment Tools ◽  
Cardiac Biomarkers ◽  
Timely Manner ◽  
Coronary Syndrome

BackgroundCardiovascular disease is the leading cause of death worldwide accounting for 17.3 million deaths per year, a number that is estimated to grow to more than 23.6 million by 2030. Coronary artery disease (CAD) is the most common form of cardiovascular diseases and remains the number one cause of death in the United States, killing more than 375,000 Americans every year. Acute coronary syndrome (ACS) is a manifestation of CAD, which is life threatening and an emergency situation.ObjectiveTo provide an overview and an awareness of ACS based on risk factors, early clinical assessment tools, and to improving clinical outcomes.MethodsFor registered nurses (RNs) in any clinical setting, this overview will educate and inform nurses how they can approach patient care in an urgent and timely manner.ResultsAdvances in diagnostic cardiac biomarkers, risk assessment tools, medical management, and invasive strategies have allowed for earlier and more accurate diagnosis and treatment of ACS, thereby improving clinical outcomes.ConclusionsCompetence in early recognition of the major differences in clinical presentation of ACS will enable prompt diagnosis and initiation of proven therapies.Implications for Nursing PracticeAs the prevalence for ACS continues to rise, RNs in all clinical settings should make a concerted effort to identify and mitigate risk factors early as well as to recognize, diagnose, and respond to ACS events in a timely manner.

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