Aspects of Orthodox Medicines (Therapeutic Drugs) Poisoning in Urban Zimbabwe

1992 ◽  
Vol 11 (5) ◽  
pp. 329-333 ◽  
Author(s):  
C.F.B. Nhachi ◽  
T. Habane ◽  
P. Satumba ◽  
O.M.J. Kasilo
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Total Population ◽  
Supportive Therapy ◽  
The Other ◽  
Therapeutic Drug ◽  
Traditional Medicines ◽  
Insect Venom ◽  
Therapeutic Drugs ◽  
Household Chemicals

1 A retrospective study (extending over 10 years, 1980 to 1989 inclusively) of hospital admission cases, due to therapeutic drug poisoning was carried out at the six main hospitals of Zimbabwe's four cities. 2 The four cities have a total population of approximately 4 million. 3 A total of 1061 cases were recorded and analysed. This constituted 16.7% of all poisoning admission cases (i.e. the fourth biggest cause of poisoning after traditional medicines, household chemicals and snake/insect venom). 4 Of the 1061 cases, 31 % were aged 21-30 years, 21.9% were aged 11-20 years, 14.9% were aged under 5 years and 12.8% were aged 31-40 years. Those aged over 80 years accounted for only 0.6% of the cases. 5 The major groups of drugs implicated were: the analgesics, 22% of the total; sedatives and hypnotics, 13.2%; antipsychotics, 11.6%; antimalarials, 9.3%; antidepressants, 9.0%; antimicrobials, 7.5%; and alcohol, 7.1 %. The other drugs each accounted for the less than 7%; the least used group were the gastrointestinal drugs which formed only 0.6% of the total. Poisoning due to drug abuse was cited at 1.3%. Overdose, either accidental or in the course of treatment, accounted for 63.5% of the cases. 6 The mortality rate was 3.9% and most of the deaths were suicides. 7 Treatment consisted mainly of the administration of ipecacuanha in those under 5 years old age and supportive therapy in adults. A few cases were given an antidote if it was specifically indicated.

A Multicenter Evaluation of a Nongel Mechanical Separator Plasma Blood Collection Tube for Testing of Selected Therapeutic Drugs

2020 ◽  
Vol 5 (4) ◽  
pp. 671-685
Author(s):  
Svetlana Morosyuk ◽  
Julie Berube ◽  
Robert Christenson ◽  
Alan H B Wu ◽  
Denise Uettwiller-Geiger ◽  
...  
Keyword(s):  
The Other ◽  
Initial Time ◽  
Therapeutic Drug ◽  
Blood Collection ◽  
Test Results ◽  
Sample Storage ◽  
Therapeutic Drugs ◽  
Collection Tube ◽  
And Storage ◽  
Blood Collection Tube

Abstract Background Some therapeutic drugs are unstable during sample storage in gel tubes. BD Vacutainer® Barricor™ Plasma Blood Collection Tube with nongel separator was compared with plasma gel tubes, BD Vacutainer PST™, PST II, and BD Vacutainer Serum Tube for acetaminophen, salicylate, digoxin, carbamazepine, phenytoin, valproic acid, and vancomycin during sample storage for up to 7 days. Methods Seven hospital sites enrolled 705 participants who were taking at least one selected drug. The study tubes were collected and tested at initial time (0 h), after 48 h of storage at room temperature and on day 7 (after additional 5 days of refrigerated storage). The performance of BD Barricor tube was evaluated for each drug by comparing BD Barricor samples with samples from the other tubes at 0 h from the same participant; stability was evaluated by comparing test results from the same tube at 0 h, 48 h, and 7 days. Results At 0 h, BD Barricor showed clinically equivalent results for selected therapeutic drugs compared with the other tubes, except phenytoin in BD PST. Phenytoin samples ≥20 µg/mL in BD PST had 10–12% lower values than samples in BD Barricor. During sample storage, all selected drugs remained stable for 7 days in BD Barricor and in serum aliquots. In BD PST, all drugs remained stable except phenytoin and carbamazepine and in BD PST II except for phenytoin. Conclusion The BD Barricor Tube is effective for the collection and storage of plasma blood samples for therapeutic drug monitoring without sample aliquoting.

scholarly journals First-Level Systematic Echocardiographic Evaluation in a COVID-19 Lombardy Hospital

2021 ◽  
Vol 4 (3) ◽  
pp. 01-04
Author(s):  
Giuseppe Ciconte
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Clinical Course ◽  
Fatal Outcome ◽  
The Other ◽  
Systematic Data ◽  
Global Pandemic ◽  
Echocardiographic Evaluation ◽  
Level Systematic

Coronavirus Disease 2019 (COVID-19) is a global pandemic. Although cardiovascular (CV) morbidity has been associated to the clinical course of the disease, systematic data regarding CV implications during COVID19 are still lacking. The aim of this study is to report the echocardiographic features of COVID19 patients undergoing first-level echocardiographic screening in a COVID Hospital in Lombardy. In this retrospective study, 70 consecutive patients admitted to our Hospital with confirmed COVID-19 diagnosis, underwent a first-level echocardiographic screening. Of the 70 patients, 8 (11.4%) patients died; survivors had lower sPAP levels as compared to deceased subjects (25.4±9.4 vs 34.8±5.9 mmHg, p=0.008) and splitting the patients in four quartiles based on sPAP, mortality rate was significantly higher among patients with more elevated sPAP compared to the other groups (Q4 29.4% vs Q3 12.5% vs Q2 6.25% vs Q1 0%, p=0.026). A first-level echocardiographic screening might be helpful in the management of Covid-19 patients by identifying those at higher risk of fatal outcome.

scholarly journals Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

2017 ◽  
Vol 05 (05) ◽  
pp. E389-E394 ◽  
Author(s):  
Sherine Khater ◽  
Gabriel Rahmi ◽  
Guillaume Perrod ◽  
Elia Samaha ◽  
Hedi Benosman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Ureteral Obstruction ◽  
Mortality Rates ◽  
The Other ◽  
Significant Difference ◽  
Before And After ◽  
Over The Scope Clip ◽  
Time Periods ◽  
Second Period

Abstract Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.

scholarly journals Therapeutic drug monitoring of thiopurines: Effect of reduced 6-thioguanine nucleotide target levels in IBD patients

2021 ◽  
Author(s):  
Monique Boekema ◽  
Carmen Horjus ◽  
Britt Roosenboom ◽  
Lian Roovers ◽  
Matthijs van Luin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Retrospective Study ◽  
Total Population ◽  
Target Range ◽  
Therapeutic Drug ◽  
Local Hospital ◽  
Thiopurine Therapy ◽  
Target Values ◽  
Thioguanine Nucleotide ◽  
Inflammatory Bowel

Aim: The effect of the Dutch nationwide adjustment of reduced 6-TGN target values (from 600-1200 pmol/8x108 RBC to 320-630 pmol/8x108 RBC) on toxicity and clinical outcome of thiopurine treatment in patients with inflammatory bowel disease (IBD) has not yet been established. Therefore the authors determined the incidence of toxicity-induced discontinuations and efficacy at both target concentrations. Methods: This retrospective study was performed in IBD patients treated with azathioprine or mercaptopurine. Two groups were defined: the former target (FT) group with target concentrations of 600-1200 pmol/8x10^8 RBC and the adjusted target (AT) group with target concentrations of 320-630 pmol/8x10^8 RBC. Patients were followed for maximum 52 weeks or until discontinuation of thiopurine therapy. Data were collected from the local hospital electronic health software of Rijnstate Hospital. Results: 151 patients were included, 76 in the FT group and 75 in the AT group. At week 52, 100 out of 150 patients (66%) of the total population discontinued thiopurine therapy. Forty-eight of this discontinuations were due toxicity (48%). The estimated cumulative incidence of toxicity was higher in the FT group compared to the AT group (47% and 35% respectively, p=0.25). No loss of efficacy was seen in the AT group. Conclusion: Reduction of the target range may lead to less toxicity induced discontinuations. In addition, this study did not find any indication that the reduction of the target range diminished efficacy.

Clinicogenetic Profile, Treatment Modalities, and Mortality Predictors of Gaucher Disease: A 15-Year Retrospective Study

2021 ◽  
pp. 1-10
Author(s):  
Anitha M. Barney ◽  
Sumita Danda ◽  
Aby Abraham ◽  
N.A. Fouzia ◽  
Aruna Gowdra ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Gaucher Disease ◽  
Supportive Therapy ◽  
Premature Mortality ◽  
Haematopoietic Stem Cell ◽  
Definitive Treatment ◽  
Kaplan Meier ◽  
Mortality Predictors ◽  
Definite Treatment

<b><i>Introduction:</i></b> Gaucher disease (GD) is a rare autosomal recessive lysosomal storage disorder, in which biallelic pathogenic variants in the Glucosidase beta acid (<i>GBA</i>) gene result in defective functioning of glucosylceramidase that causes deposition of glucocerebroside in cells. GD has 3 major types namely, non-neuronopathic (type I), acute neuronopathic (type II), and chronic neuronopathic (type III). Definite treatment options are limited and expensive. They succumb early to the disease, if untreated. There is paucity of studies from the Indian subcontinent, which elicit the factors resulting in their premature mortality. <b><i>Materials and Methods:</i></b> A retrospective study was carried out in a tertiary care setting of South India to assess the clinical profile, mutation spectrum, and various management strategies (only supportive therapy, enzyme replacement therapy [ERT], substrate reduction therapy [SRT] haematopoietic stem cell transplant [HSCT]), and mortality predictors of patients with GD from 2004 to 2019. A Kaplan-Meier survival curve was plotted. In silico predictions were performed for novel variants. <b><i>Results:</i></b> There were 60 patients with all types of GD seen over the study period of 15 years. Their median age at diagnosis was 2 years. The median follow-up was for 5 years (interquartile range [IQR] = 2–8). The overall mortality rate was 35%; however, it was only 10% in those receiving definite treatment. Mortality was higher (47.5%) by more than 4 folds in those only on supportive therapy. The median survival from the time of diagnosis was 6.3 years (IQR = 3.5–10.8) in the definite treatment group and 3.5 years (IQR = 1–5) in those on supportive therapy. The Kaplan-Meier survival analysis showed significant (<i>p</i> value 0.001) mortality difference between these groups. The multiple logistic regression analysis found the neuronopathic type (OR = 5) and only supportive therapy (OR = 6.3) to be the independent risk factors for premature mortality. <b><i>Conclusion:</i></b> GD is a rare disease with a high mortality rate, if left untreated. ERT and SRT are the definitive treatments which increase the survival. In resource-limited settings like India, with higher prevalence of the neuronopathic type, HSCT may be a more suitable definitive treatment option, due to its one-time intervention and cost, assuming similar efficacy to ERT. However, the efficacy and safety of HSCT in GD needs to be established further by substantial patient numbers undergoing it.

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

2020 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Operative Time ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

scholarly journals Use tumor suppressor genes as biomarkers for diagnosis of non-small cell lung cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chuantao Zhang ◽  
Man Jiang ◽  
Na Zhou ◽  
Helei Hou ◽  
Tianjun Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mortality Rate ◽  
Tumor Suppressor ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Network Effects ◽  
Small Cell ◽  
The Other ◽  
Small Cell Lung ◽  
High Efficient

AbstractLung cancer is the leading cause of death worldwide. Especially, non-small cell lung cancer (NSCLC) has higher mortality rate than the other cancers. The high mortality rate is partially due to lack of efficient biomarkers for detection, diagnosis and prognosis. To find high efficient biomarkers for clinical diagnosis of NSCLC patients, we used gene differential expression and gene ontology (GO) to define a set of 26 tumor suppressor (TS) genes. The 26 TS genes were down-expressed in tumor samples in cohorts GSE18842, GSE40419, and GSE21933 and at stages 2 and 3 in GSE19804, and 15 TS genes were significantly down-expressed in tumor samples of stage 1. We used S-scores and N-scores defined in correlation networks to evaluate positive and negative influences of these 26 TS genes on expression of other functional genes in the four independent cohorts and found that SASH1, STARD13, CBFA2T3 and RECK were strong TS genes that have strong accordant/discordant effects and network effects globally impacting the other genes in expression and hence can be used as specific biomarkers for diagnosis of NSCLC cancer. Weak TS genes EXT1, PTCH1, KLK10 and APC that are associated with a few genes in function or work in a special pathway were not detected to be differentially expressed and had very small S-scores and N-scores in all collected datasets and can be used as sensitive biomarkers for diagnosis of early cancer. Our findings are well consistent with functions of these TS genes. GSEA analysis found that these 26 TS genes as a gene set had high enrichment scores at stages 1, 2, 3 and all stages.

Beta-Blocker Attenuates Cardiotoxicity Related Anthracycline Usage

2021 ◽  
Vol 104 (8) ◽  
pp. 1389-1392
Keyword(s):  
Side Effects ◽  
Cancer Therapy ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Beta Blocker ◽  
The Other ◽  
Large Numbers ◽  
Therapy Effectiveness ◽  
Chemotherapy Agents

To summarize the recent trials and studies of the role of beta-blocker on the treatment for cancer patients treated with anthracycline to decrease morbidity and mortality rate. Good management of cancer will result in large numbers of cancer survivors. On the other hand, cancer therapy also has side effects, one of which is cardiotoxicity. Cardiotoxicity could reduce therapy effectiveness, hence, increase disease progression and mortality rate. Anthracyclines is one of the chemotherapy agents with cardiotoxicity as a side effect. Beta-blocker has the ability to reduce cardiotoxicity due to anthracyclines usage. Keywords: Beta-blocker; Cardiotoxicity; Anthracyclines

scholarly journals Bridge-therapy with enoxaparin in the preoperative period of endarterectomy

2010 ◽  
Vol 68 (5) ◽  
pp. 775-777
Author(s):  
Jair Leopoldo Raso ◽  
Rogério Zenóbio Darwich ◽  
Francisco de Lucca Jr ◽  
Romeu Valle Santana ◽  
Marco Túlio Tanure ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Mortality Rate ◽  
Prospective Study ◽  
Low Molecular Weight Heparin ◽  
The Other ◽  
Low Molecular Weight ◽  
Preoperative Period ◽  
Safe Strategy ◽  
A Prospective Study ◽  
Bridge Therapy

Cervical clot is one of the complications of endarterectomy. This risk may be higher in patients using aspirin or clopidogrel. On the other hand, stroke may occur if the medication is interrupted before surgery. We carried out a prospective study of 124 endarterectomies in 119 patients in which aspirin or clopidogrel was stopped and a bridge-therapy with enoxaparin was administered preoperatively. There was no case of stroke during the period of the bridge-therapy. One patient developed cervical clot (0.8%) in the fifth postoperative day. Mortality rate in this series was 0.8%. There was no complication directly related to the use of enoxaparin. Bridge-therapy with low molecular weight heparin is a safe strategy for patients elected for endarterectomy

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