Adherence to recommended UK sampling protocols for detecting mast cell mediator release in perioperative anaphylaxis

2016 ◽  
Vol 70 (1) ◽  
pp. 85-88 ◽  
Author(s):  
William Egner
Keyword(s):  
Adverse Reactions ◽  
Reference Range ◽  
Clinical Information ◽  
Three Samples ◽  
Sampling Protocols ◽  
If Current ◽  
Pro Forma ◽  
Mast Cell Mediator Release ◽  
True Peak

BackgroundSheffield National Adverse Reactions Consultancy Service (NARCOS) investigates and triages suspected perioperative anaesthetic reactions to allergy clinics, using serial tryptase samples, urinary methylhistamine and clinical information on a pro forma request.ObjectiveTo determine if current UK guidelines on serial tryptase samples are achieved and describe the patterns of tryptase release.MethodA retrospective review of 3455 NARCOS cases. Tryptase and clinical details were analysed. 1746 had sufficient clinical information to grade the reactions according to the Ring and Messmer scale.Results98% provided two or more acute samples, but only 60% supplied clinical information. 308 patients never dropped within the reference range over three samples.ConclusionsGood compliance with UK guidelines for tryptase measurements is achievable in this long-term cohort, but obtaining clinical details at referral remains a challenge. Sample sequence labelling and apparent timing may be misleading. Baseline tryptase may frequently need to be rechecked in allergy clinics to estimate true peak-to-trough changes.

scholarly journals Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fereidoun Azizi ◽  
Hengameh Abdi ◽  
Atieh Amouzegar
Keyword(s):  
Low Dose ◽  
Reference Range ◽  
Antithyroid Drug ◽  
Therapeutic Modality ◽  
Thyroid Status ◽  
Antithyroid Drug Therapy ◽  
Daily Dose ◽  
Prevention Of Relapse

Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143.

scholarly journals Large papillary fibroelastoma of right atrium, an unusual case of respiratory distress in a young man

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Le Ho ◽  
Pui Fong Ng ◽  
Sotheenathan Krishinan ◽  
Basheer Ahamed Abdul Kareem
Keyword(s):  
Right Atrium ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Interatrial Septum ◽  
Papillary Fibroelastoma ◽  
Case Presentation ◽  
Intracardiac Masses ◽  
The Right ◽  
Embolic Risk

Abstract Background Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. Case presentation We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. Conclusion Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.

Diet composition of Steller sea lions (Eumetopias jubatus) in Frederick Sound, southeast Alaska: a comparison of quantification methods using scats to describe temporal and spatial variabilities

2015 ◽  
Vol 93 (5) ◽  
pp. 361-376 ◽  
Author(s):  
D.J. Tollit ◽  
M.A. Wong ◽  
A.W. Trites
Keyword(s):  
Pacific Salmon ◽  
Biomass Energy ◽  
Eumetopias Jubatus ◽  
Steller Sea Lions ◽  
Southeast Alaska ◽  
Merluccius Productus ◽  
Sea Lions ◽  
Sampling Protocols ◽  
Dietary Indices

We compared eight dietary indices used to describe the diet of Steller sea lions (Eumetopias jubatus (Schreber, 1776)) from 2001 to 2004 in Frederick Sound, southeast Alaska. Remains (n = 9666 items) from 59+ species categories were identified from 1684 fecal samples (scats) from 14 collection periods. The most frequently occurring prey were walleye pollock (Theragra chalcogramma (Pallas, 1814) = Gadus chalcogrammus Pallas, 1814; 95%), Pacific herring (Clupea pallasii Valenciennes in Cuvier and Valenciennes, 1847; 30%), Pacific hake (Merluccius productus (Ayres, 1855); 29%), and arrowtooth flounder (Atheresthes stomias (Jordan and Gilbert, 1880) = Reinhardtius stomias (Jordan and Gilbert, 1880); 21%). These species, along with Pacific salmon (genus Oncorhynchus Suckley, 1861) and skate (genus Raja L., 1758), accounted for 80%–90% of the reconstructed biomass and energy contribution, with pollock contributing 37%–60%. Overall, 80% of fish were 14–42 cm long and mainly pelagic, though 40% of scats contained benthic-associated prey. Steller sea lions switched from adult pollock to strong cohorts of juvenile pollock, and took advantage of spawning concentrations of salmon in autumn and herring in late spring and summer, as well as a climate-driven increase in hake availability. Observed temporal and site differences in diet confirm the need for robust long-term scat sampling protocols. All major indices similarly tracked key temporal changes, despite differences in occurrence and biomass-energy-based diet estimates linked to prey size and energy-density effects and the application of correction factors.

scholarly journals Enterovirus and parechovirus meningitis in infants younger than 90 days old in the UK and Republic of Ireland: a British Paediatric Surveillance Unit study

2018 ◽  
Vol 104 (6) ◽  
pp. 552-557 ◽  
Author(s):  
Seilesh Kadambari ◽  
Serena Braccio ◽  
Sonia Ribeiro ◽  
David J Allen ◽  
Richard Pebody ◽  
...  
Keyword(s):  
White Cell Count ◽  
Clinical Information ◽  
Neurological Complications ◽  
Surveillance Period ◽  
Live Births ◽  
Young Infants ◽  
Hearing Test ◽  
Surveillance Unit ◽  
The Uk

ObjectivesThis study aimed to prospectively collect detailed clinical information for all enterovirus (EV) and human parechovirus (HPeV) meningitis cases in infants aged <90 days in the UK and Ireland.Participants, design and settingProspective, active national surveillance during July 2014 to July 2015 through the British Paediatric Surveillance Unit. Reporting paediatricians completed questionnaires requesting information on clinical presentation, investigations, management and outcomes at hospital discharge and after 12 months.Main outcome measuresTo describe the clinical burden of EV and HPeV meningitis in infants aged <90 days.ResultsDuring the 13-month surveillance period, 703 cases (668 EV, incidence0.79/1,000 live- births; 35 HPeV, 0.04/1,000 live-births) were identified. The most common clinical presentations were fever (EV: 570/668(85%); HPeV: 28/35(80%)), irritability (EV: 441/668(66%); HPeV: 23/35(66%)) and reduced feeding (EV: 363/668(54%); HPeV 23/35(66%)). Features of circulatory shock were present in 27% (182/668) of EV and 43% (15/35) of HPeV cases. Overall, 11% (76/668) of EV and 23% (8/35) of HPeV cases required intensive care support. Nearly all cases (678/703, 96%) were confirmed by cerebrospinal fluid (CSF) PCR, with 52% (309/600) having normal CSF white cell count for age. Two infants with EV meningitis died (2/668, 0.3%) and four survivors (4/666, 0.6%) had long-term complications at 12 months’ follow-up. Infants with HPeV meningitis survived without sequelae. Overall 189 infants had a formal hearing test and none had sensorineural hearing loss.ConclusionThe incidence of laboratory-confirmed EV/HPeV meningitis in young infants is more than twice that for bacterial meningitis. Less than 1% will develop severe neurological complications or die of their infection. Further studies are required to formally assess long-term neurodevelopmental sequelae.

A Case of Gastric Cancer in Which Long-Term Administration of 5′-Deoxy-5-Fluorouridine Proved Effective

1989 ◽  
Vol 17 (2) ◽  
pp. 179-184
Author(s):  
T. Koda ◽  
T. Kurahori ◽  
N. Iwao ◽  
S. Sumi ◽  
T. Sonoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Reactions ◽  
Substantial Improvement ◽  
Term Treatment ◽  
Borrmann Type ◽  
Long Term Treatment ◽  
Term Administration ◽  
Stopping Treatment ◽  
Lesser Curvature

A patient diagnosed with Borrmann type 4 gastric cancer (mucinous adenocarcinoma), who had refused surgery, was treated by oral administration of 1200 mg/day 5′-deoxy-5-fluorouridine for about 23 weeks. This resulted in substantial improvement of her condition, i.e. the tumour almost completely disappeared, distensibility improved between the central region of the corpus ventriculi and the angulus, and only small protrusions remained on the anterior and posterior walls and the pars pylorica of the lesser curvature. Mild anorexia and diarrhoea were noted as adverse reactions although these symptoms subsided by reducing the dose or temporarily stopping treatment, thereby allowing long-term treatment. Long-term use of 5′-deoxy-5-fluorouridine proved temporarily effective in this patient. The patient died about 3 years and 7 months after starting therapy. Examination showed that the cancer had been mainly in the stomach and that it had metastasized to the colon and pancreas. The liver was free of metastasis.

ADVERSE REACTIONS TO TETRACYCLINE, PENICILLIN AND AN OLEANDOMYCIN-PENICILLIN MIXTURE USED IN THE LONG-TERM THERAPY OF CHRONIC PULMONARY DISEASE

1962 ◽  
Vol 243 (3) ◽  
pp. 341-353 ◽  
Author(s):  
Solomon Sobel ◽  
Edward A. Lichter ◽  
J Calvin Davis ◽  
Harry F. Dowling ◽  
Mark H. Lepper ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Adverse Reactions ◽  
Term Therapy ◽  
Chronic Pulmonary Disease ◽  
Long Term Therapy

Methenamine Hippurate (‘Hiprex’)† in the Treatment of Chronic Urinary Tract Infections: A Trial in a Geriatric Hospital

1976 ◽  
Vol 4 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Salme Parvio
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Adverse Reactions ◽  
Bacterial Resistance ◽  
Term Treatment ◽  
Chronic Urinary Tract Infection ◽  
Long Term Treatment ◽  
Geriatric Hospital ◽  
Tract Infections

Fifty-two patients, all of whom were more than 66 years-old and who were hospitalized for periods in excess of two years were treated for chronic urinary tract infection. All patients received a course of antibiotic treatment for seven to ten days and were then put onto treatment with methenamine hippurate 1 g twice daily for six months. Of the original fifty-two patients, twelve did not complete the six month course. During the six month period with ‘Hiprex’ there were far fewer re-infections than in the previous six months during which time they had received intermittent antibiotic therapy and other long-term treatment. There were no adverse reactions and bacterial resistance did not occur.

scholarly journals The effect of the main active substances of antihypertensive eye drops on condition of the eyes of glaucoma patients

2020 ◽  
pp. 5-10
Author(s):  
O. N. Onufriichuk ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Quality Of Life ◽  
Adverse Reactions ◽  
Hypotensive Effect ◽  
Eye Drops ◽  
Common Cause ◽  
Treatment Regimens ◽  
Active Substances ◽  
Lifetime Treatment

Today, glaucoma is considered to be the most common cause of irreversible blindness. The treatment of this disease is aimed at reducing intraocular tension in order to slow down the deterioration of visual functions and to maintain accept‑ able quality of life. Most ophthalmologists prefer local medicamentous therapy. Despite a significant expansion of the range of antihypertensive medicines, a significant increase in the hypotensive effect is not always achieved in each certain case, at the same time, at long-term (sometimes lifetime) treatment local and systemic adverse reactions arise and intensify. The findings of recent clinical trials presented in this overview demonstrate an adverse effect of active compounds, preservatives and ad‑ ditives of ophthalmic medicines not only on the eye surface but also on the structure of anterior and posterior eye segments. Taking into account possible side effects of each component of medicines used in glaucoma therapy, ophthalmologists will be able to reasonably approach the choice of optimal treatment regimens with the lowest risk for patients.

scholarly journals Antibiotic Therapy Associated Cardiotoxicity

2021 ◽  
Vol 4 (10) ◽  
pp. RV18-RV21
Author(s):  
Manisha Jha ◽  
Akram Khan
Keyword(s):  
Antibiotic Therapy ◽  
Health Risks ◽  
Adverse Reactions ◽  
Therapeutic Agents ◽  
Qt Prolongation ◽  
Aortic Aneurysms ◽  
Drug Reactions ◽  
Frequent Use ◽  
High Concern

The improper and frequent use of antibiotics has been on a rise. Empirical use for unapproved indications leads to development of resistant pathogens. Many other adverse drug reactions are associated with the use of antibiotics. These may be due to the direct effect of these drugs or due to their interactions with other therapeutic agents. Cardiac toxicities like QT prolongation, aortic aneurysms and dissections are of high concern and may result in long-term health risks. To prevent these adverse reactions, antibiotics should be used as per the manufacturer’s and physician’s instructions. The use of interacting drugs should be avoided wherever possible. Polypharmacy practice should be done after considering all the patient’s health aspects. This review summarizes the cardiac toxicities of commonly prescribed antibiotics and their interactions with other drugs.

scholarly journals Lipid profile in school children: study from a District of Uttar Pradesh, India

2017 ◽  
Vol 4 (3) ◽  
pp. 719
Author(s):  
Utkarsh Bansal ◽  
Ekansh Rathoria ◽  
Abhishek Gupta ◽  
Nyay Bhai Gupta ◽  
Shwinka Agarwal ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Age Groups ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Lipid Levels ◽  
Cross Sectional ◽  
Number Of Children ◽  
Prevention Of Atherosclerosis ◽  
Pro Forma

Background:Lipid imbalance when diagnosed in childhood, can forecast the development of atherosclerosis in adulthood and its complications. Therefore, early detection of dyslipidemia should begin in childhood and it should lead to long-term prevention of atherosclerosis by controlling the risk factors. The Objectives of the study were to study lipid profile of children in the age group of 10-19 years and the prevalence of dyslipidemia among them.Methods: This is a cross-sectional study, which was conducted in 300 children aged 10 to 19 years, of either sex, from schools of Barabanki. After getting consent from school authorities, children and their parents, a detailed history was taken with a pre-designed pro forma and fasting blood samples were analyzed for lipid profile.Results:Mean total cholesterol (TC) for boys and girls were 161.06±33.14 mg/dl and 164.68±33.53 mg/dl, LDL-C 99.35±27.41 mg/dl and 101.71±26.44 mg/dl, HDL-C 42.76±5.78 mg/dl and 43.93±5.68 mg/dl, VLDL-C 18.94±4.47 mg/dl and 19.04±4.97 mg/dl and triglycerides (TG) 94.69±22.34 mg/dl and 95.20±24.83 mg/dl respectively. Serum TC, TG, LDL-C, VLDL-C and HDL-C levels were higher in girls than in boys for all age groups. 26.55% boys and 25.20% girls had TC levels above 190 mg/dl. The overall results revealed that 26.0% of children had hypercholesterolemia.Conclusions:The study presents age- and sex-related findings about the dynamics of changes in serum lipid levels in children. Significant number of children had hypercholesterolemia.

Sign in / Sign up

Export Citation Format

Share Document