44. Differences in language functioning in Hurler syndrome before and after HCT: A qualitative comparison of treatments and risk factors

Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT.

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Spironolactone-Induced Agranulocytosis

Annals of Pharmacotherapy ◽

10.1177/106002809703100511 ◽

1997 ◽

Vol 31 (5) ◽

pp. 582-585 ◽

Cited By ~ 11

Author(s):

Anna M Whitling ◽

Pablo E Pérgola ◽

John Lee Sang ◽

Robert L Talbert

Keyword(s):

Risk Factors ◽

Adverse Effect ◽

Bone Marrow ◽

Leukocyte Count ◽

Laboratory Data ◽

University Hospital ◽

Drug Induced ◽

Bone Marrow Biopsies ◽

Case Summary ◽

Before And After

OBJECTIVE: TO report a case of agranulocytosis secondary to spironolactone in a patient with cryptogenic liver disease. CASE SUMMARY: A 58-year-old Hispanic woman with cryptogenic cirrhosis was admitted to University Hospital on October 31, 1995. Laboratory data revealed a leukocyte count of 1.0 × 103/mm3 and an absolute neutrophil count (ANC) of 10 cells/mm3. Prior to treatment with spironolactone, the leukocyte count was 10.2 × 103/mm3 and ANC 8400 cells/mm3. Agranulocytosis resolved 5 days following the discontinuation of spironolactone. Results from the bone marrow biopsies before and after treatment with spironolactone suggested that agranulocytosis was caused by the drug's toxic effect on the bone marrow. DISCUSSION: Drug-induced agranulocytosis is a serious adverse effect, occurring at a rate of approximately 6.2 cases per million persons each year. In addition to the case reported here, three other reports of agranulocytosis secondary to spironolactone have been published in the literature. Several factors have been identified that may increase a patient's risk for developing agranulocytosis, including increased age, hepatic or renal impairment, drag dosage and duration, and concurrent medications. CONCLUSIONS: Agranulocytosis secondary to spironolactone is a serious potential adverse effect. Patients with risk factors for developing this adverse effect should be closely monitored since early detection and discontinuation of spironolactone can improve prognosis.

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Risk factors of postthrombotic syndrome before and after deep venous thrombosis treatment

Phlebology The Journal of Venous Disease ◽

10.1177/0268355516652010 ◽

2016 ◽

Vol 32 (6) ◽

pp. 384-389 ◽

Cited By ~ 4

Author(s):

Rob HW Strijkers ◽

Mark AF de Wolf ◽

Cees HA Wittens

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Treatment Options ◽

Postthrombotic Syndrome ◽

Factor X ◽

Catheter Directed Thrombolysis ◽

Before And After ◽

Patient Selection Criteria ◽

The Moment

Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.

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Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

Innovation in Aging ◽

10.1093/geroni/igaa057.716 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 222-222

Author(s):

Noriko Suzuki ◽

Masahiko Hashizume ◽

Hideyuki Shiotani

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Older Adults ◽

Older People ◽

Future Research ◽

Baseline Body Mass Index ◽

Term Care ◽

Postprandial Hypotension ◽

Before And After ◽

Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p <0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

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Study on oxidative stress and antioxidant level in patients of acute myocardial infarction before and after regular treatment

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v40i2.25226 ◽

2015 ◽

Vol 40 (2) ◽

pp. 79-84 ◽

Cited By ~ 10

Author(s):

T Bashar ◽

N Akhter

Keyword(s):

Oxidative Stress ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Vitamin E ◽

Plasma Vitamin ◽

Regular Treatment ◽

Before And After ◽

The Difference ◽

Plasma Vitamin E

In acute myocardial infarction (AMI), lack of oxygen delivery to myocardium leads to generation of reactive oxygen species (ROS) which play an important role in the pathogenesis of AMI. Endogenous anti-oxidants protect the myocardial tissues from the deleterious effect of free radical mediate injury. The study evaluates the extent of oxidative stress and antioxidant status against ROS in AMI patients and amelioration of oxidative stress after regular treatment and also assesses the association between oxidative stress and risk factors for atherosclerosis like dyslipidemia and diabetes mellitus (DM).The study was conducted on 72 AMI patients and age and sex matched 18 healthy controls. Patients were assigned to four groups, AMI without dyslipidemia or DM, with dyslipidemia, with DM and with both dyslipidemia and DM. Plasma malondialdehyde (MDA) and GSH content and vitamin E levels were determined on admission into hospital and on the 5th day of treatment. Plasma MDA level increased significantly (p<0.001) and erythrocyte GSH and plasma vitamin E levels were decreased (p<0.001) in all the groups of patients as compared to control. On the 5th day of regular treatment MDA level reduced (p<0.001) and GSH and vitamin E levels increased (p<0.001) in patients. The plasma MDA level was significantly higher (p<0.001) in patients with both dyslipidemia and DM or with only DM in comparison to patients without dyslipidemia and DM. The difference in the GSH level between patients with risk factors and without risk factors was not significant. It may be conclude that an imbalance exists between oxidant and antioxidant molecules in AMI patients which shift towards oxidative side and regular treatment restores this balance. There may be some association between oxidative stress in AMI and risk factors like dyslipidemia and diabetes mellitus.Bangladesh Med Res Counc Bull 2014; 40 (2): 79-84

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