scholarly journals Adherence to Monitoring Guidelines of Amiodarone Adverse Reactions

2019 ◽  
Vol 6 ◽  
pp. 233339281984463 ◽  
Author(s):  
Ophir Lavon ◽  
Ron Goldman
Keyword(s):  
Clinical Guidelines ◽  
Chart Review ◽  
Adverse Reactions ◽  
Retrospective Chart Review ◽  
X Ray ◽  
Liver Functions ◽  
Function Test ◽  
Improve Compliance ◽  
Amiodarone Treatment ◽  
Chest X Ray

Background: Amiodarone treatment frequently causes adverse reactions. Clinical guidelines warrant a comprehensive assessment prior to chronic treatment with amiodarone and repeated monitoring for the appearance of adverse reactions. Objective: To evaluate adherence to these guidelines. Methods: A retrospective chart review of electronic medical records of adult patients treated with oral amiodarone for at least 12 months. Results: One hundred patient records were analyzed; 97% of patients were evaluated for thyroid and liver functions prior to treatment. Liver functions were properly monitored every 6 months in 96% of patients and thyroid function in only 59%. Most (84%) patients completed a chest X-ray before treatment; only 2% completed a respiratory function test. None have performed a chest X-ray annually. Sixty-four percent of the patients were examined by an ophthalmologist prior to treatment; periodic ophthalmic surveillance was not consistent. Neurological and dermatological evaluations were not recorded for any of the patients, unless symptoms appeared. Only 50% were adherent to annual cardiac reassessment. Conclusions: Adherence to recommended clinical guidelines for monitoring amiodarone adverse reactions is poor. Interventions to improve compliance with these guidelines are needed.

scholarly journals Absence of major fibrotic adverse events in hyperprolactinemic patients treated with cabergoline

2010 ◽  
Vol 162 (4) ◽  
pp. 667-675 ◽  
Author(s):  
M Lafeber ◽  
A M E Stades ◽  
G D Valk ◽  
M J Cramer ◽  
F Teding van Berkhout ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Adverse Reactions ◽  
Valvular Regurgitation ◽  
X Ray ◽  
Increased Risk ◽  
Function Test ◽  
Additional Imaging ◽  
Chest X Ray

BackgroundCabergoline, a dopamine agonist used to treat hyperprolactinemia, is associated with an increased risk of fibrotic adverse reactions, e.g. cardiac valvular fibrosis, pleuropulmonary, and retroperitoneal fibrosis.ObjectiveThis study evaluated the prevalence and risk of fibrotic adverse reactions during cabergoline therapy in hyperprolactinemic and acromegalic patients.DesignA cross-sectional study was conducted in a University Hospital.PatientsA total of 119 patients with hyperprolactinemia and acromegaly who were on cabergoline therapy participated in the study.MethodsAll patients were requested to undergo a cardiac assessment, pulmonary function test, chest X-ray, and blood tests as recommended by the European Medicine Agency. Matched controls were recruited to compare the prevalence of valvular regurgitation. Cardiac valvular fibrosis was evaluated by assessing valvular regurgitation and the mitral valve tenting area (MVTa). The risk of pleuropulmonary fibrosis was assessed by a pulmonary function test, a chest X-ray, and if indicated, by additional imaging studies.ResultsThe prevalence of clinically relevant valvular regurgitation was not significantly different between cases (11.3%) and controls (6.1%; P=0.16). The mean MVTa was 1.27±0.17 and 1.24±0.21 cm2 respectively (P=0.54). Both valvular regurgitation and the MVTa were not related to the cumulative dose of cabergoline. A significantly decreased pulmonary function required additional imaging in seven patients. In one patient, possible early interstitial fibrotic changes were seen. Lung function impairment was not related to the cumulative cabergoline dose.ConclusionCabergoline, typically dosed for the long-term treatment of hyperprolactinemia or acromegaly, appears not to be associated with an increased risk of fibrotic adverse events.

AB0796 THE EVALUATION OF LUNG DIAGNOSTIC PROCEDURE AT THE ONSET OF INFLAMMATORY RHEUMATIC DISEASES WITH INTERSTITIAL LUNG DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1422.3-1423
Author(s):  
T. Hoffmann ◽  
P. Oelzner ◽  
F. Marcus ◽  
M. Förster ◽  
J. Böttcher ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Interstitial Lung Disease ◽  
Lung Function ◽  
Lung Disease ◽  
Sensitivity And Specificity ◽  
Lung Function Test ◽  
Inflammatory Rheumatic Diseases ◽  
X Ray ◽  
Function Test ◽  
Chest X Ray

Background:Interstitial lung disease (ILD) in inflammatory rheumatic diseases (IRD) is associated with increased mortality. Moreover, the lung is one of the most effected organs on IRD. Consequently, screening methods were required to the detect ILD in IRD.Objectives:The objective of the following study is to evaluate the diagnostic value of lung function test, chest x-ray and HR-CT of the lung in the detection of ILD at the onset of IRD.Methods:The study is designed as a case-control study and includes 126 patients with a newly diagnosed IRD. It was matched by gender, age and the performance of lung function test and chest x-ray. The sensitivity and specificity were verified by crosstabs and receiver operating characteristic (ROC) curve analysis. The study cohort was divided in two groups (ILD group: n = 63 and control group: n = 63). If possible, all patients received a lung function test and optional a chest x-ray. Patients with pathological findings in the screening tests (chest x-ray or reduced diffusing capacity for carbon monoxide (DLCO) < 80 %) maintained a high-resolution computer tomography (HR-CT) of the lung. Additionally, an immunological bronchioalveolar lavage was performed in the ILD group as gold standard for the detection of ILD.Results:The DLCO (< 80 %) revealed a sensitivity of 83.6 % and specificity of 45.8 % for the detection of ILD. Other examined parameter of lung function test showed no sufficient sensitivity as screening test (FVC = Forced Vital Capacity, FEV1 = Forced Expiratory Volume in 1 second, TLC = Total Lung Capacity, TLCO = Transfer factor of the Lung for carbon monoxide). Also, a combination of different parameter did not increase the sensitivity. The sensitivity and specificity of chest x-ray for the verification of ILD was 64.2 % versus 73.6 %. The combination of DLCO (< 80 %) and chest x-ray showed a sensitivity with 95.2 % and specificity with 38.7 %. The highest sensitivity (95.2 %) and specificity (77.4 %) was observed for the combination of DLCO (< 80 %) and HR-CT of the lung.Conclusion:The study highlighted that a reduced DLCO in lung function test is associated with a lung involvement in IRD. DLCO represented a potential screening parameter for lung manifestation in IRD. Especially patients with suspected vasculitis should receive an additional chest x-ray. Based on the high sensitivity of DLCO in combination with chest x-ray or HR-CT for the detection of ILD in IRD, all patients with a reduced DLCO (< 80%) should obtained an imaging of the lung.Disclosure of Interests:None declared

scholarly journals Poster 2021: The incidence of adverse reactions induced by subcutaneous immunotherapy in an allergy center in Monterrey, México: a retrospective chart review

2014 ◽  
Vol 7 ◽  
pp. P27
Author(s):  
Sandra Nora Gonzalez-Diaz ◽  
Alfredo Arias ◽  
Lorena Rangel ◽  
Rafael Perez-Vanzzini ◽  
Samuel Palma-Gomez
Keyword(s):  
Chart Review ◽  
Adverse Reactions ◽  
Retrospective Chart Review ◽  
Subcutaneous Immunotherapy

scholarly journals Continuous Positive Airway Pressure Adherence for Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa L. Somers ◽  
Ed Peterson ◽  
Saurabh Sharma ◽  
Kathleen Yaremchuk
Keyword(s):  
Chart Review ◽  
High School Graduates ◽  
Patient Adherence ◽  
Retrospective Chart Review ◽  
Initial Visit ◽  
Obstructive Sleep ◽  
Improve Compliance ◽  
Male Patients ◽  
One Year ◽  
To Receive

Objective. To determine predictors of patient adherence to CPAP. Design. A retrospective chart review identified patients with AHI values greater than 15 who were recommended to receive CPAP. Compliance was measured at a 1-to 4-month interval and at 1 year. Results. There were 106 of 368 (29%) patients who received CPAP therapy that were compliant with CPAP use at 1 to 4 months. Forty-six patients (12%) were using CPAP at one year. For the male group at one year, the model demonstrated the AHI value (P  value=.026) as a predictor of compliance if greater than 27.3 and a significant two-way interaction between age and AHI (P=.023). Increased length of time from the initial visit and receiving the CPAP machine was associated with poorer compliance (P=.002). Those living in areas with higher incomes and with a higher percentage of non-high-school graduates were more likely to be compliant (P=.01 and P=.044). Conclusion. Older male patients with higher AHI values were noted to be more adherent to CPAP. Efforts should be made to try to minimize the length of time between the initial visit and the time to receive CPAP to improve compliance.

scholarly journals Amiodarone and its Pulmonal Toxicity

2014 ◽  
pp. 113-25
Author(s):  
Kemalasari Nas Darisan ◽  
Jamal Zaini ◽  
Yoga Yuniadi
Keyword(s):  
Pulmonary Toxicity ◽  
Ventricular Arrhythmias ◽  
Treatment Guidelines ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
Risk Patients ◽  
Life Threatening ◽  
Amiodarone Treatment ◽  
Chest X Ray ◽  
Modest Reduction

Amiodarone is an antiarrhythmic agent commonly used to treat supraventricular and ventricular arrhythmias. The drug prevents the recurrence of life-threatening ventricular arrhythmias and produces a modest reduction of sudden deaths in high-risk patients. This drug is an iodine-containing compound that tends to accumulate in several organs, including the lungs. It has been associated with a variety of adverse events. Of these events, the most serious is amiodarone pulmonary toxicity. Although the incidence of this complication has decreased with the use of lower doses of amiodarone, it can occur with any dose. Because amiodarone is widely used, all clinicians should be vigilant of this possibility. Pulmonary toxicity usually manifests as an acute or subacute pneumonitis, typically with diffuse infiltrates on chest x-ray and high-resolution computed tomography. Other, more localized, forms of pulmonary toxicity may occur, including pleural disease, migratory infiltrates, and single or multiple nodules. With early detection, the prognosis is good. Most patients diagnosed promptly respond well to the withdrawal of amiodarone and the administration of corticosteroids, which are usually given for four to 12 months. It is important that physicians be familiar with amiodarone treatment guidelines and follow published recommendations for the monitoring of pulmonary as well as extrapulmonary adverse effects.

scholarly journals Effect of Injinoryung-san Administration on the Elevated Hepatic Function Test Level: Retrospective Chart Review

2019 ◽  
Vol 40 (3) ◽  
pp. 478-490
Author(s):  
Hongmin Chu ◽  
Hyeryung Shin ◽  
Yeon-ju Moon ◽  
Cheol-hyun Kim ◽  
Kwang-ho Kim ◽  
...  
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Hepatic Function ◽  
Function Test ◽  
Test Level

scholarly journals Low QRS Voltage in Limb Leads Indicates Accompanying Precordial Voltage Attenuation Resulting in Underestimation of Left Ventricular Hypertrophy

2021 ◽  
Vol 18 (24) ◽  
pp. 12867
Author(s):  
Hye-Bin Gwag ◽  
Su-Hyun Lee ◽  
Hyeon-Jun Kim ◽  
June-Soo Kim ◽  
Young-Keun On ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Healthy Population ◽  
Primary Analysis ◽  
X Ray ◽  
Function Test ◽  
Chest X Ray ◽  
Voltage Attenuation

Low QRS voltage (LQRSV) in electrocardiography (ECG) often occurs in limb leads without apparent cause. However, its clinical significance is obscure in healthy populations. We reviewed patients aged over 60 who were scheduled for non-cardiac surgery in two hospitals. Patients underwent pre-operative ECG, echocardiography, pulmonary function test, and chest X-ray. Patients with LQRSV isolated to limb leads and patients without LQRSV were selected from separate hospitals. Among the 9832 patients screened in one hospital, 292 (3.0%) showed LQRSV in limb leads. One-hundred and ninety-four without LQRSV were selected as the control from the 216 patients screened at the other hospital. For primary analysis, patients with structural heart disease or classic etiologies of LQRSV were excluded. Patients with LQRSV had a higher proportion of male and a greater body mass index. Precordial QRS voltages were smaller, whereas left ventricular mass index and the prevalence of echocardiographic left ventricular hypertrophy (LVH) was higher in patients with LQRSV than in those without. Consequentially, diagnostic performance of precordial voltage criteria for LVH was particularly poor in patients with LQRSV in limb leads. LQRSV in limb leads frequently occurs without apparent etiologies. ECG voltage criteria may underestimate LVH in a relatively healthy population with LQRSV in limb leads.

Routine Chest X-ray after Percutaneous Tracheostomy is Unnecessary

2005 ◽  
Vol 71 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Francesca Hoehne ◽  
Maria Ozaeta ◽  
Ray Chung
Keyword(s):  
Medical Center ◽  
Percutaneous Tracheostomy ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Trauma Patients ◽  
Common Procedure ◽  
X Ray ◽  
Chest X Ray ◽  
Tube Malposition ◽  
Routine Chest

Percutaneous tracheostomy (PT) is an increasingly common procedure in the management of critically ill patients. Current practice for both open and percutaneous tracheostomies is a post-procedure chest X-ray to rule out potentially life-threatening complications such as a pneumothorax or tube malposition. Our study evaluated the utility of chest X-ray after PT. A retrospective chart review was conducted for patients undergoing PT at Kern Medical Center between January 1999 and December 2003. Charts were reviewed for age, sex, and clinical outcome as well as the radiologist's interpretation of the postprocedure chest X-ray. A total of 73 procedures were completed in 47 men and 26 women. The majority of the tracheostomies were in trauma patients who needed prolonged ventilatory support. There were no complications identified on postprocedure chest X-ray. A single patient was converted to an open procedure secondary to bleeding. We conclude that routine chest X-ray after PT is unnecessary.

scholarly journals A tüdő nekrotizáló sarcoid granulomatosisa

2021 ◽  
Vol 162 (38) ◽  
pp. 1541-1547
Author(s):  
Noémi Zombori-Tóth ◽  
Katalin Ugocsai ◽  
Árpád Vincze ◽  
József Furák ◽  
László Tiszlavicz ◽  
...  
Keyword(s):  
Standard Form ◽  
Spontaneous Remission ◽  
Rare Entity ◽  
Soft Tissue Density ◽  
Thoracoscopic Resection ◽  
Granulomatous Angiitis ◽  
X Ray ◽  
Bilateral Hilar Lymphadenopathy ◽  
Function Test ◽  
Chest X Ray

Összefoglaló. A nekrotizáló sarcoid granulomatosis a granulomatosus pulmonalis angitisek közé tartozó, ritka kórkép. Egyesek a sarcoidosis variánsának, mások primer pulmonalis vasculitisnek tartják. A kórkép klinikai és patológiai jellegzetességeit két eset bemutatásával ismertetjük. A 20 éves nőbeteg sürgősséggel került pulmonológiai osztályra száraz köhögés, jobb oldali, mély belégzéssel összefüggő mellkasi fájdalom és láz miatt, a 63 éves férfi beteget pedig pneumoniát követő kontroll-mellkasröntgenfelvételen látott elváltozás kivizsgálása során észlelték. Az autoimmun panel vizsgálata, a mikrobiológiai tesztek mindkét betegnél negatívnak bizonyultak, a légzésfunkciós vizsgálat és a bronchoszkópos vizsgálat nem talált eltérést. A mellkas-CT-felvételen lágyrész-denzitású nodulusok látszottak egyoldali dominanciával, a folyamatot nem kísérte a hilusi nyirokcsomók szimmetrikus megnagyobbodása. A nodulusok szövettani vizsgálata vált indokolttá, melyet videoasszisztált torakoszkópos tüdőreszekciós mintavétellel biztosítottak. Mikroszkóposan a tüdőparenchymában gócos nekrózisokat, a környezetükben el nem sajtosodó epitheloid sejtes granulomatosus gócokat, az átfutó artériákban pedig granulomatosus arteritist láttak; a klinikai adatok figyelembevételével a tüdő nekrotizáló sarcoid granulomatosisa diagnózisát állították fel. A tüdőbetegség mindkét betegnél egy év alatt spontán regrediált. Az irodalom adatait és az eseteket összegezve, a tüdő nekrotizáló sarcoid granulomatosisában mikrobiológiai vizsgálatokkal nem igazolható tüdőfertőzés, és az immunológiai kivizsgálás sem tár fel szisztémás autoimmun betegséget; a diagnózis a klinikai kép és a képalkotó vizsgálatok alapján indikált szövettani vizsgálattal állítható fel. A betegség szteroidkezelésre jól reagál, de előfordul spontán regresszió is, az utóbbira láttunk példát. Bár az entitás átmenetet képez a nekrotizáló vasculitisek és a sarcoidosis között, egyre több érv szól amellett, hogy a sarcoidosis spektrumába tartozik. Orv Hetil. 2021; 162(38): 1541–1547. Summary. Necrotizing sarcoid granulomatosis is a rare entity currently classified as a subtype of granulomatous pulmonary angiitis. It is considered to be either a variant of sarcoidosis or a primary pulmonary angiitis. Two cases are demonstrated to present its clinical and pathological features. A 20-year-old female patient was admitted to the department of pulmonology with dry cough, right-sided chest pain during hyperventilation and fever. A 63-year-old male patient was observed with a right-sided lesion on chest X-ray after pneumonia. In both cases, autoimmune panel examination, microbiology tests, spirometry function test and bronchoscopy were unremarkable. Chest CT scans have revealed nodules with soft-tissue density without bilateral hilar lymphadenopathy. In order to clarify the diagnosis, video-assisted thoracoscopic resection (biopsy) was performed. Microscopically, parenchymal focal necrosis with adjacent to non-caseating granulomas and granulomatous angiitis were detected. In both cases, spontaneous remission occurred within a year. Histological examination – integrated with clinical data and radiological tests’ results – is the gold standard form of evaluation to confirm necrotizing sarcoid granulomatosis; furthermore, exclusion of pneumonia and autoimmune diseases are also required. The disease responds well to corticosteroids; moreover, spontaneous remission is often reported, as it happened in both cases. Necrotizing sarcoid granulomatosis is a transition between necrotizing vasculitides and sarcoidosis; although more and more evidence appears supporting the fact that necrotizing sarcoid granulomatosis may belong to the spectrum of sarcoidosis. Orv Hetil. 2021; 162(38): 1541–1547.

Multicenter real-world experience with epinephrine 0.5 mg dosing for anaphylaxis with allergen immunotherapy

Immunotherapy ◽  
2021 ◽  
Author(s):  
Natasha Correa ◽  
Ariba Quidwai ◽  
Samira Jeimy ◽  
Natalie Rondilla ◽  
Fred White ◽  
...  
Keyword(s):  
Emergency Department ◽  
Real World ◽  
Chart Review ◽  
Adverse Reactions ◽  
Allergen Immunotherapy ◽  
Retrospective Chart Review ◽  
Safety And Efficacy ◽  
Allergy And Immunology

Aim: To determine the safety and efficacy of 0.5 mg intramuscular (IM) epinephrine for the treatment of subcutaneous allergen immunotherapy induced anaphylaxis. Patients & methods: Retrospective chart review of patients who received 0.5 mg of IM epinephrine for treatment of anaphylaxis from subcutaneous allergen immunotherapy at two outpatient allergy and immunology practices. Results: Thirty-eight patients received 0.5 mg IM epinephrine. Eleven patients (29%) required a second dose, and two patients (5%) required a third dose of IM epinephrine. Sixteen patients (42%) were transferred to the emergency department with ongoing symptoms. All had eventual resolution of anaphylaxis. There were no adverse reactions or fatalities. Conclusion: IM epinephrine at a dose of 0.5 mg is safe and effective for treatment of anaphylaxis from subcutaneous allergen immunotherapy.

Sign in / Sign up

Export Citation Format

Share Document