Role of diuretics, hormonal derangements, and clinical setting of hyponatremia in medical patients

AbstractPathogenesis of endometriosis is still unclear and a role of both innate and adaptive immune system has been postulated. Some recent findings have revealed an increased risk to have concomitant autoimmune disease in women with endometriosis, but no study so far has investigated whether this association could affect endometriosis severity and stage. We retrospectively reviewed medical patients’ notes of women with a confirmed diagnosis of endometriosis who referred to our endometriosis outpatient clinic between January 2015 and December 2019. Cases (endometriosis and an autoimmune disease) were matched in a 1:3 ratio by age and study period with controls (endometriosis without history of autoimmunity). At univariate logistic analysis, concomitant autoimmunity (OR 2.63, 95% CI 1.64–4.21, p < 0.001) and the number of laparoscopic procedures performed (OR 2.81, 95% CI 1.45–5.43, p = 0.002) emerged as factors significantly associated with the likelihood of stage IV endometriosis. In the multivariate logistic regression model, concomitant autoimmunity remained a significant predictor of stage IV endometriosis (OR 2.54, 95% CI 1.57–4.10, p = 0.004), whereas the association between the number of laparoscopic procedures performed and stage IV endometriosis was found to be of borderline-significance (OR 2.70, 95% 1.37–5.30, p = 0.050). Our findings suggest that endometriosis is more severe in patients who are also affected by autoimmune disturbances after controlling for relevant confounders.

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Crisis and Informed Consent: Analysis of a Law-Medicine Malocclusion

American Journal of Law & Medicine ◽

10.1017/s0098858800007413 ◽

1987 ◽

Vol 12 (1) ◽

pp. 55-97 ◽

Cited By ~ 1

Author(s):

Fran Carnerie

Keyword(s):

Informed Consent ◽

Medical Treatment ◽

Clinical Setting ◽

Patient Relationship ◽

Physician Patient Relationship ◽

Catastrophic Illness ◽

Physician Patient ◽

Emotional Impairment

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.

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Cetirizine versus diphenhydramine in the prevention of chemotherapy-related hypersensitivity reactions

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218811505 ◽

2018 ◽

Vol 25 (6) ◽

pp. 1396-1401 ◽

Cited By ~ 2

Author(s):

Charis G Durham ◽

Deepthi Thotakura ◽

Lauren Sager ◽

Jennifer Foster ◽

Jon D Herrington

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Retrospective Study ◽

Prospective Studies ◽

Clinical Setting ◽

Hypersensitivity Reactions ◽

Efficacy And Safety ◽

Infusion Reactions

Objective This study evaluated the role of cetirizine compared to diphenhydramine as premedications for patients receiving paclitaxel, cetuximab, and rituximab infusions. Historically, diphenhydramine has been linked with more sedation in comparison to cetirizine; however, it is unknown if cetirizine can replace diphenhydramine in the prevention of hypersensitivity reactions in patients receiving chemotherapy. Methods This is a retrospective study designed to assess infusion reactions occurring in patients receiving diphenhydramine or cetirizine premedication for rituximab, paclitaxel, or cetuximab therapies. Infusion reactions were defined as various symptoms such as flushing, itching, alterations in heart rate and blood pressure, and dyspnea plus the clinical setting of a concurrent or very recent infusion. Results A total of 207 patients were evaluated in this study with 83 patients receiving cetirizine and 124 diphenhydramine patients. Overall, the percentage of patients with at least one chemotherapy-related infusion event in the cetirizine group was 19.3% (95% CI 11.4–29.4) compared to diphenhydramine group 24.2% (95% CI 17.0–32.7), P = 0.40. Of the patients who received cetirizine and then experienced an event in the first cycle, 41.7% (95% CI 13.7–74.3) of the events were due to paclitaxel, 50.0% (95% CI 19.4–80.6) were due to rituximab, and 8.3% (95% CI 0.1–43.6) were due to cetuximab. Of the patients who received diphenhydramine and then experienced an event in the first cycle, 26.1% (95% CI 5.7–51.4) were due to paclitaxel, 73.9% (95% CI 48.6–94.3) were due to rituximab and none due to cetuximab. Conclusion Cetirizine appears to be a viable substitute for diphenhydramine for the prevention of infusions reactions with cetuximab, paclitaxel, and rituximab infusions in adults. Prospective studies are needed to determine the efficacy and safety of cetirizine compared with diphenhydramine in the prevention of chemotherapy-related infusion reactions.

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Granulocyte Transfusions

PEDIATRICS ◽

10.1542/peds.81.6.915a ◽

1988 ◽

Vol 81 (6) ◽

pp. 915-915

Author(s):

MITCHELL S. CAIRO

Keyword(s):

Supportive Care ◽

Preterm Infants ◽

Clinical Setting ◽

Neonatal Sepsis ◽

Statistical Significance ◽

Buffy Coat ◽

Granulocyte Transfusion

In Reply.— The comments raised by Baley et al are well taken and bring up one of the most important variables in the role of granulocyte transfusion in neonatal sepsis. Most of the studies to date have involved small numbers of patients in single institutions. This has prevented us from accumulating a large enough population of patients to adequately assess the role of either buffy coat transfusions or leukapheresed transfusions in this clinical setting. My comments in the commentary suggested that, with only eight patients in a group of preterm infants with presumed sepsis and only five patients with presumed sepsis with birth weights greater than 1,500 g, the numbers are essentially too small to determine any statistical significance between the role of buffy coat transfusions or supportive care.

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The role of the assistant practitioner in the clinical setting: a focus group study. Part 1

British Journal of Healthcare Assistants ◽

10.12968/bjha.2019.13.2.94 ◽

2019 ◽

Vol 13 (2) ◽

pp. 94-99 ◽

Cited By ~ 1

Author(s):

Catherine Henshall ◽

Andrea Doherty ◽

Helen Green ◽

Liz Westcott ◽

Helen Aveyard

Keyword(s):

Focus Group ◽

Clinical Setting ◽

Focus Group Study ◽

Assistant Practitioner

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Medical patients’ affective well-being after emergency department admission: The role of personal and social resources and health-related variables

PLoS ONE ◽

10.1371/journal.pone.0212900 ◽

2019 ◽

Vol 14 (3) ◽

pp. e0212900 ◽

Cited By ~ 1

Author(s):

Lukas Faessler ◽

Jeannette Brodbeck ◽

Philipp Schuetz ◽

Sebastian Haubitz ◽

Beat Mueller ◽

...

Keyword(s):

Emergency Department ◽

Well Being ◽

Social Resources ◽

Medical Patients ◽

Emergency Department Admission ◽

Health Related

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Demographics of Prehospital Helicopter EMS Responses in Rural Florida

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00039637 ◽

1992 ◽

Vol 7 (3) ◽

pp. 279-281 ◽

Cited By ~ 1

Author(s):

Eric Savitsky ◽

Howard Rodenberg

Keyword(s):

Medical Patient ◽

Helicopter Emergency Medical Service ◽

Medical Illness ◽

Medical Patients ◽

North Central ◽

Central Florida ◽

Rural Settings ◽

Trauma Victims ◽

Rural Florida

AbstractIntroduction:Helicopter emergency medical service (HEMS) systems typically are described in terms of their role in the care and transport of trauma victims, while their function(s) in the care of patients with medical illness goes unrecognized.Methods:Review of 575 prehospital HEMS missions by a flight program located in rural, north-central Florida over a five-year period, was performed to define demographics regarding the nature of the call.Results:Scene responses for trauma victims comprised 63% of these missions, while patients with medical illnesses comprised 37%. The incidence of medical scene responses is significantly higher in this review than has been noted in previous reports.Conclusion:1) In rural settings, patients with medical illnesses comprise a major share of prehospital HEMS responses; 2) HEMS flight crews should be competent in treatment of prehospital medical patients, and their protocols reflect the needs of these patients; and 3) EMS providers must be aware of the role of HEMS in the transport of the medical patient.

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