scholarly journals Concerns About the Special Article on Hydroxychloroquine and Azithromycin in High Risk Outpatients with COVID-19 by Dr. Harvey Risch

2020 ◽  
Author(s):  
Matthew P Fox ◽  
Lucy D'Agostino McGowan ◽  
Bryan D James ◽  
Justin Lessler ◽  
Shruti H Mehta ◽  
...  
Keyword(s):  
High Risk ◽  
Effective Treatment ◽  
Scientific Evidence ◽  
Scale Up ◽  
New Information ◽  
Open Debate ◽  
The Face ◽  
Risk Patients ◽  
The Many

Abstract In May, this journal published an opinion piece by one of the members of the Editorial Board, Dr. Harvey Risch, that reviewed several papers and argued that using hydroxychloroquine (HCQ) + azithromycin (AZ) early to treat symptomatic COVID-19 cases in high-risk patients should be broadly applied. As members of the journal's editorial board, we are strongly supportive of open debate in science, which is essential even on highly contentious issues. However, we must also be thorough in our examination of the facts and open to changing our minds when new information arises. In this commentary, we document several important errors in the manuscript by Dr. Risch, review the literature he presented and demonstrate why it is not of sufficient quality to support scale up of HCQ+AZ, and then discuss the literature that has been generated since his publication, which also does not support use of this therapy. Unfortunately, the current scientific evidence does not support HCQ+AZ as an effective treatment for COVID-19, if it ever did; and even suggests many risks. Continuing to push the view that it is an essential treatment in the face of this evidence is irresponsible and harmful to the many people already suffering from infection.

scholarly journals Catheter-Directed Pulmonary Thrombolysis: A Safe and Effective Treatment Even in High-Risk Patients

2016 ◽  
Vol 63 (2) ◽  
pp. 564
Author(s):  
Kristen Lee ◽  
Andrew Cha ◽  
Mark H. Kumar ◽  
Clifford M. Sales
Keyword(s):  
High Risk ◽  
Effective Treatment ◽  
High Risk Patients ◽  
Risk Patients

Diagnostic use of contrast medium and the kidney: A challenge or a ghost?

2018 ◽  
Vol 2 (1) ◽  
pp. 6-15
Author(s):  
Marina Foramitti ◽  
Bruno Perrucci ◽  
Stefano Panni ◽  
Fabio Malberti
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Renal Damage ◽  
Preventive Measures ◽  
Scientific Evidence ◽  
Function Evaluation ◽  
Contrast Induced Nephropathy ◽  
Diagnostic Use ◽  
Contrast Enhanced ◽  
Risk Patients

The global growing number of contrast-enhanced procedures highlights the risk of contrast media–induced renal damage. This review is an effort to define contrast-induced nephropathy and its pathogenesis, weigh its principal risk factors, give some clarifications about kidney function evaluation tools, acquire some clinical relevance prognostic concerns, and bring into focus preventive measures, with special regard to cancer patients. Our final purpose is focused on the request of diagnostic safety in high-risk patients, which may be achieved without unfair differences in this subgroup, too. A second reading of the scientific evidence may offer a chance to tear down the kidney damage ghost, replacing it with the consciousness of a still existing challenge that engages more than one specialty.

The incidence of non-melanoma skin cancer after a single field treatment with aminolevulinic acid and blue light photodynamic therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e14646-e14646
Author(s):  
O. N. Kozyreva ◽  
N. Konnikov
Keyword(s):  
Photodynamic Therapy ◽  
High Risk ◽  
Skin Cancer ◽  
Aminolevulinic Acid ◽  
Non Melanoma Skin Cancer ◽  
Before And After ◽  
The Face ◽  
Risk Patients ◽  
History Of ◽  
Melanoma Skin

e14646 Background: Non-melanoma skin cancer (NMSC) is the most common form of human cancer. Aminolevulinic acid photodynamic therapy (ALA PDT) is a safe and effective treatment for NMSC precursors. It is unknown if ALA PDT treatment will affect incidence of NMSC in high risk patients (pts). Methods: A retrospective study was undertaken using a Veteran Affairs Boston Health Care System Medical Record Database. Study population included immunocompetent pts with history of NMSC, multiple actinic keratosis (AKs), and moderate to severe dermatoheliosis (DH). Study pts received a single application of 20 % ALA to the face or scalp following by exposure to blue light at 10 J/cm2. Differences in incidence of NMSC two years prior and two years after ALA PDT were tested using the Wilcoxon rank sum test. Data were analyzed by the median and interquartile range (IQR). Results: 43 Caucasian males (range 59- 87 yrs), 37 (87%) had history of NMSC on the face or scalp, 32 (78%) had basal cell carcinoma (BCC), 11 (22%) squamous cell carcinoma (SCC), 100% of patients had multiple (>4) AKs prior to treatment and 23 (75% ) had moderate to severe DH determined by Griffiths scale. Prior to ALA-PDT 74 NMSC's were documented: 40 (54%) BCC and 34 (46%) SCC. 46 NMSC's were documented following ALA-PDT: 22 (48%) BCC and 24 (52%) SCC. Prior to ALA-PDT, the frequency of BCC averaged 2 [IQR 1 to 3, max=4], and the frequency of SCC averaged 1 [IQR 1 to 1, max=3]. Following ALA-PDT, the occurrence of BCC averaged 1 [IQR 0 to 1, max=5], and that of SCC averaged 1 [IQR 0 to 2, max= 4]. The difference between BCC frequency before and after ALA-PDT treatment shown a significant reduction in BCC incidence (P = 0.0018). No such differences were observed between the frequency of SCC before and after ALA-PDT (P=0.6230) Conclusions: A single ALA-PDT treatment to the face or scalp in high risk patients significantly reduces the incidence of BCC, the incidence of SCC was not reduced. The potential role of ALA PDT as a NMSC chemopreventive modality warrants further investigation in larger samples with an alternative treatment protocols. No significant financial relationships to disclose.

scholarly journals Sudden Cardiac Death in Chagas Disease

2016 ◽  
Vol 7 ◽  
Author(s):  
Dario Di Toro ◽  
Adrian Baranchuk
Keyword(s):  
High Risk ◽  
Sudden Cardiac Death ◽  
Effective Treatment ◽  
Chagas Disease ◽  
Cardiac Death ◽  
Implantable Cardioverter Defibrillators ◽  
Endemic Region ◽  
Arrhythmic Death ◽  
Risk Patients ◽  
Cardioverter Defibrillators

<p>Chagas’ disease remains a major epidemiologic problem in endemic countries. The most dramatic course of the disease is represented by sudden cardiac death. Some of these deaths could be preventable, if efforts are directed towards identifying high-risk patients. Implantable cardioverter-defibrillators are an effective treatment for the prevention of sudden cardiac arrhythmic death, however; its costs are the major limitation for their widespread use in the endemic region.</p><p>This review will cover some of the most relevant aspects of sudden cardiac death in Chagas’ disease. </p>

scholarly journals The Management of Co-Morbidities in Patients with Heart Failure – Potassium Balance

2017 ◽  
Vol 10 ◽  
Author(s):  
Ewa Jankowska
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Ventricular Arrhythmias ◽  
Potassium Balance ◽  
Patients With Heart Failure ◽  
Risk Patients ◽  
The Many ◽  
To Receive ◽  
Effective Medication

Both hypokalaemia and hyperkalaemia are common in HF patients. They are each associated both with HF and with the many drugs used for HF. They are important as they both can aggravate ventricular arrhythmias, both can cause symptoms in HF patients and in the case of hyperkalaemia in particular, are a common reason not to prescribe or reduce the dose of or even cease use of effective medication with life- prolonging benefits in HFrEF, including ACEI’s and MRA’s. Treatment optiosn for bioth hypokalaemia and hyperkalaemia are discussed including the emerging evidence that agents such as patiromer may be safe and effective agents to be used long-term in high-risk patients with HF to allow them to take doses of RAAS inhibitors in particular which they otherwise may not be able to take. This might allow them to continue to receive the mortality morbidity benefits these treatments confer.

Combination of norfloxacin and cisapride in prevention of SBP in high risk patients: A new approach

2001 ◽  
Vol 120 (5) ◽  
pp. A376-A376
Author(s):  
B JEETSANDHU ◽  
R JAIN ◽  
J SINGH ◽  
M JAIN ◽  
J SHARMA ◽  
...  
Keyword(s):  
High Risk ◽  
New Approach ◽  
High Risk Patients ◽  
Risk Patients
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