Clinical characteristics and risk factors for cefaclor-induced immediate hypersensitivity: a retrospective observation at two university hospitals in Korea

Abstract Background Cefaclor, a second-generation oral cephalosporin, is widely prescribed to treat infectious diseases. Immediate hypersensitivity (HS) reactions to cefaclor have continuously been reported and are expected to increase with its greater use. This study aimed to investigate the clinical characteristics and risk factors of immediate HS to cefaclor over the most recent 5 years. Methods This retrospective study investigated 521 adverse drug reactions (ADRs) to cefaclor at pharmacovigilance centers at two tertiary hospitals from January 2014 to December 2018. In total, 459 patients with immediate HS to cefaclor were reviewed. Results A total of 459 cases of cefaclor immediate HS were included among 521 cefaclor ADRs, and anaphylaxis was recorded in 61.2%. Female sex (odds ratio 2.917, 95% confidence interval 2.397–3.550, P < 0.001), age under 65 years (4.225, 3.017–5.916, P < 0.001), hypertension (2.520, 1.875–3.388, P < 0.001), liver diseases (2.189, 1.208–3.967, P = 0.010), asthma (8.075, 5.301–12.302, P < 0.001), and concomitant use of nonsteroidal anti-inflammatory drugs (1.888, 1.554–2.294, P < 0.001) were significantly associated with cefaclor immediate HS. Conclusions Cefaclor was found to elicit high proportions of immediate HS and anaphylaxis. Physicians ought to be cautious with prescribing cefaclor to females, individuals with hypertension, liver diseases, or asthma, and patients taking nonsteroidal anti-inflammatory drugs. Trial registration This study was retrospectively registered.

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Subclinical atherosclerosis in children and adolescents with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951120004448 ◽

2020 ◽

pp. 1-8

Author(s):

Silvia M. Cardoso ◽

Michele Honicky ◽

Yara M. F. Moreno ◽

Luiz R. A. de Lima ◽

Matheus A. Pacheco ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Clinical Characteristics ◽

Congenital Heart ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

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Adverse reactions with the use of non-steroidal anti-inflammatory drugs

Vrač skoroj pomoŝi (Emergency Doctor) ◽

10.33920/med-02-2008-02 ◽

2020 ◽

pp. 35-50

Author(s):

M. L. Maksimov ◽

N. M. Kiseleva ◽

D. G. Semenikhin ◽

B. K. Romanov

Keyword(s):

Risk Factors ◽

Adverse Reactions ◽

Effective Prevention ◽

Chemical Structures ◽

Wide Range ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Prevention Method ◽

Effective Medication ◽

Upper Gastrointestinal

Non-steroidal anti-inflammatory drugs (NSAIDs) are included in a pharmacological group of drugs with different chemical structures providing anti-inflammatory, analgesic and antipyretic actions, as well as antiplatelet action to a certain degree. Unfortunately, NSAIDs can cause a wide range of adverse reactions (AR) posing a serious risk to the health and life of patients. Therefore, the rational use of NSAIDs should include methods for effective prevention of drug complications. Many NSAIDs have a pronounced therapeutic effect, simultaneously causing many undesirable effects, so the drug shall be chosen considering the development of predicted side effects and modern algorithms. According to clinical recommendations, risk factors and administration of safer NSAIDs shall be considered as the main prevention method. Besides, it is possible to protect the patient from the upper gastrointestinal tract complications using proton pump inhibitors. It should be noted that there are no effective medication methods for kidney and liver protection to reduce the risk of NSAID-associated complications.

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Rheumatoid arthritis: influence of inflammation and anti-inflammatory therapy on cardiovascular risk factors

Medical Council ◽

10.21518/2079-701x-2020-11-32-44 ◽

2020 ◽

pp. 32-44

Author(s):

D. I. Trukhan ◽

D. S. Ivanova ◽

K. D. Belus

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factors ◽

Chronic Inflammation ◽

Pharmacological Intervention ◽

Increased Risk ◽

Inflammatory Drugs ◽

Anti Inflammatory

Rheumatoid arthritis is a frequent and one of the most severe immuno-inflammatory diseases in humans, which determines the great medical and socio-economic importance of this pathology. One of the priority problems of modern cardiac rheumatology is an increased risk of cardiovascular complications in rheumatoid arthritis. In patients with rheumatoid arthritis, traditional cardiovascular risk factors for cardiovascular diseases (metabolic syndrome, obesity, dyslipidemia, arterial hypertension, insulin resistance, diabetes mellitus, smoking and hypodynamia) and a genetic predisposition are expressed. Their specific features also have a certain effect: the “lipid paradox” and the “obesity paradox”. However, chronic inflammation as a key factor in the development of progression of atherosclerosis and endothelial dysfunction plays a leading role in morbidity and mortality from cardiovascular diseases in rheumatoid arthritis. This review discusses the effect of chronic inflammation and its mediators on traditional cardiovascular risk factors and its independent significance in the development of CVD. Drug therapy (non-steroidal anti-inflammatory drugs, glucocorticosteroids, basic anti-inflammatory drugs, genetically engineered biological drugs) of the underlying disease also has a definite effect on cardiovascular risk factors in patients with rheumatoid arthritis. A review of studies on this problem suggests a positive effect of pharmacological intervention in rheumatoid arthritis on cardiovascular risk factors, their reduction to a level comparable to the populations of patients not suffering from rheumatoid arthritis. The interaction of rheumatologists, cardiologists and first-contact doctors (therapist and general practitioner) in studying the mechanisms of the development of atherosclerosis in patients with rheumatoid arthritis will allow in real clinical practice to develop adequate methods for the timely diagnosis and prevention of cardiovascular diseases in patients with rheumatoid arthritis.

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Administration of Antithrombotic Treatment Was a Risk Factor for Intraperitoneal Hemorrhage in Patients Undergoing Percutaneous Interventions for Liver Diseases.

10.21203/rs.3.rs-150259/v1 ◽

2021 ◽

Author(s):

Akira Asai ◽

Keisuke Yokohama ◽

Hideko Ohama ◽

Yusuke Tsuchimoto ◽

Shinya Fukunishi ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Liver Diseases ◽

Retrospective Cohort ◽

Clinical Characteristics ◽

Ultrasound Guided ◽

Antithrombotic Treatment ◽

Percutaneous Interventions ◽

Intraperitoneal Hemorrhage ◽

Number Of Patients

Abstract Percutaneous interventions for liver diseases are currently essential for diagnosis and treatment. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases and administered antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage after percutaneous interventions for liver diseases. This study recruited 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. Intraperitoneal hemorrhage after percutaneous interventions was detected by abdominal computed tomography. Intraperitoneal hemorrhage occurred in 9 patients (0.88%), and these adverse events weren’t severe. We compared clinical characteristics between the patients with intraperitoneal hemorrhage and without. There were differences regarding patients who underwent percutaneous treatments of liver tumor (p = 0.1271), administration of antithrombotics (p = 0.1961), and prothrombin time (p = 0.1683). Thereafter, to evaluate the influence of antithrombotics on hemorrhage, we compared the patients with antithrombotics and without. After propensity score matching, hemorrhage in patients treated with antithrombotics was significantly increased than in those without (p = 0.0407). The administration of antithrombotics was a risk factor for intraperitoneal hemorrhage in patients undergoing percutaneous interventions for liver diseases.

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The Incidence of Non-Tuberculous Mycobacteria in Infants in Kenya

Journal of Tropical Medicine ◽

10.1155/2019/1273235 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Grace Kaguthi ◽

Videlis Nduba ◽

Wilfred Murithi ◽

Suzanne Verver

Keyword(s):

Risk Factors ◽

Lung Disease ◽

Hiv Testing ◽

Chest Radiography ◽

Odds Ratio ◽

Clinical Characteristics ◽

Skin Testing ◽

American Thoracic Society ◽

Tuberculin Skin Testing ◽

Western Kenya

There is inadequate understanding of the epidemiology of Non-Tuberculous Mycobacteria (NTM) among infants in high tuberculosis burden countries. The objective of this study was to document the incidence and diversity of NTM disease or colonisation in sputum specimens from infants with presumptive TB, the risk factors, and clinical characteristics, in a high TB and HIV burden setting in Western Kenya. A cohort of 2900 newborns was followed for 1–2 years to assess TB incidence. TB investigations included collection of induced sputa and gastric aspirates for culture and speciation by HAIN®, Tuberculin Skin Testing (TST), HIV testing, and chest radiography. The American Thoracic Society Criteria (ATS) were applied to identify NTM disease. Among 927 (32% of 2900) with presumptive TB, 742 (80%) were investigated. NTM were isolated from 19/742 (2.6%) infants. M. fortuitum was most frequently speciated (32%). Total person-time was 3330 years. NTM incidence was 5.7/1,000 person-years, 95% CI (3.5, 8.7). Infants diagnosed with TB were more likely to have NTM isolation (odds ratio 11.5; 95% CI 3.25, 41.0). None of the infants with NTM isolated met the criteria for NTM disease. The incidence of NTM isolation was comparable to similar studies in Africa. NTM isolation did not meet ATS criteria for disease and could represent colonisation. TB disease appears to be structural lung disease predisposing to NTM colonisation.

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AB0332 CLINICAL FEATURES AND RISK FACTORS OF CHRONIC HEART FAILURE IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS PRIOR TO THERAPY WITH BASIC ANTI-INFLAMMATORY DRUGS

10.1136/annrheumdis-2019-eular.5934 ◽

2019 ◽

Author(s):

Irina Kirillova ◽

Diana Novikova ◽

Tatiana Popkova ◽

Eugenia Markelova ◽

Helen Udachkina ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Features ◽

Early Rheumatoid Arthritis ◽

Inflammatory Drugs ◽

Anti Inflammatory

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Diaphragm disease in emergency surgery

British Journal of Hospital Medicine ◽

10.12968/hmed.2019.0409 ◽

2020 ◽

Vol 81 (3) ◽

pp. 1-6

Author(s):

Diwakar R Sarma ◽

Pratik Bhattacharya

Keyword(s):

Risk Factors ◽

Small Intestine ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Emergency Laparotomy ◽

Diaphragm Disease ◽

Inflammatory Drugs ◽

Acute Small Bowel Obstruction ◽

Anti Inflammatory

Background/Aims Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form of non-steroidal anti-inflammatory drug-induced enteropathy, often presenting as acute small bowel obstruction. A systematic review was performed to identify risk factors and patient outcomes in histologically-proven diaphragm disease of the small intestine in patients undergoing emergency operation for small bowel obstruction. Methods A comprehensive search was performed between January 1975 and March 2019 using relevant MeSH terms. Studies were chosen based on predefined inclusion criteria. Diaphragm disease of the small intestine was defined as macroscopically detected thin diaphragm-like mucosal folding inside the lumen of the bowel. The parameters assessed included patient characteristics, duration of use of non-steroidal anti-inflammatory drugs, type of emergency surgery performed, complications, recurrence, presentation and diagnosis of diaphragm disease. Results A total of 21 studies were analysed which included 17 case reports, one case series, and three retrospective comparative studies. Overall 29 patients with diaphragm disease of the small bowel were reported following emergency laparotomy for small bowel obstruction. Use of non-steroidal anti-inflammatory drugs was noted in all cases with an average duration of 3–5 years. All patients presented acutely with features of small bowel obstruction and had emergency laparotomy, except one who underwent laparoscopic resection. In the comparative studies patients were more likely to be female and to have been taking non-steroidal anti-inflammatory drugs for more than 7 years. Conclusions This is a rare disease, difficult to diagnose and often confirmed by the intra-operative macroscopic appearance of circumferential stenosis of the bowel. Risk factors for developing small bowel diaphragm disease include long-term use of non-steroidal anti-inflammatory drugs, and female gender. Patients with this disease are at increased risk of developing acute small bowel obstruction, so early identification is important.

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Nonsteroidal anti-inflammatory drug use is a risk factor for early Type II endoleak after endovascular abdominal aortic repair

Vascular ◽

10.1177/1708538119866603 ◽

2019 ◽

Vol 28 (1) ◽

pp. 53-58

Author(s):

Yutaka Matsubara ◽

Kentaro Inoue ◽

Kazuki Mori ◽

Masato Morita ◽

Satoshi Takebayashi ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Risk Factor ◽

Drug Use ◽

Type Ii ◽

Type Ii Endoleak ◽

Inflammatory Drug ◽

Postoperative Risk ◽

Inflammatory Drugs ◽

Anti Inflammatory

Objectives Type II endoleak is a problem after endovascular abdominal aneurysm repair. Preoperative risk factors for Type II endoleak include anatomical factors in the lumbar artery and inferior mesenteric artery; however, preventable postoperative risk factors are unknown. Postimplantation syndrome is associated with lower incidence of Type II endoleak. Therefore, we focused on inflammation, and our aim was to investigate nonsteroidal anti-inflammatory drugs as a postoperative risk factor for Type II endoleak. Methods This was a retrospective study of patients with aortic aneurysm who underwent endovascular aneurism repair at the Department of Cardiovascular Surgery, Beppu Medical Center, Oita, Japan, from January 2011 to August 2018. Clinical characteristics were retrieved from patients’ medical records and included age, sex, body mass index, smoking history, comorbidities, treatment devices, medications, and perioperative information, including postimplantation syndrome. Postimplantation syndrome was defined as body temperature >38.5°C with 12,000/dL white blood cells or >10.0 mg/dL C-reactive protein. The primary outcome was the presence or absence of Type II endoleak assessed on the first postoperative enhanced computed tomography scan. Risk factors for Type II endoleak were assessed. Results and conclusions: Of the eligible 84 patients, 20 (24%) had Type II endoleak identified in the first enhanced computed tomographic scans after endovascular aneurism repair. Nonsteroidal anti-inflammatory drug use (odds ratio (OR): 21.2; 95% confidence interval (95% CI): 1.5–308.4; P = 0.026), cerebrovascular disease (OR: 7.27; 95% CI: 1.06–49.99; P = 0.044), and body mass index <22 kg/m2 (OR: 17.3; 95% CI: 2.1–141.8; P = 0.008) were independent risk factors for Type II endoleak after endovascular aneurism repair. Comparing the rate of Type II endoleak among patients who did not receive nonsteroidal anti-inflammatory drugs within 24 h after endovascular aneurism repair, patients who first used nonsteroidal anti-inflammatory drugs 12–24 h after endovascular aneurism repair, and those who received nonsteroidal anti-inflammatory drugs within 12 h after endovascular aneurism repair, we found a significant difference among the groups (4%, 18%, 45%, respectively; P = 0.001). Nonsteroidal anti-inflammatory drug use within 24 h after endovascular aneurism repair is a risk factor for Type II endoleak. We should know nonsteroidal anti-inflammatory drugs within 24 h after endovascular aneurism repair can be a risk of Type II endoleak.

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Nonsteroidal Anti-Inflammatory Drugs and Risk of Melanoma

Journal of Skin Cancer ◽

10.1155/2011/598571 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 11

Author(s):

Joanne M. Jeter ◽

Joseph D. Bonner ◽

Timothy M. Johnson ◽

Stephen B. Gruber

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Structured Interview ◽

Melanoma Risk ◽

Unadjusted Odds Ratio ◽

Epidemiologic Evidence ◽

Inflammatory Drugs ◽

Chemopreventive Effect ◽

Anti Inflammatory

Because nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit tumor growthin vitro, we investigated the association between NSAIDs and melanoma to determine if there was epidemiologic evidence of a chemopreventive effect from these medications. Three hundred twenty-seven subjects with incident melanoma and 119 melanoma-free controls completed a structured interview assessing melanoma risk factors. The unadjusted odds ratio (OR) for use of nonaspirin NSAIDs was 0.58 (95% CI 0.31–1.11), in a comparison of subjects with melanoma to controls. After adjustment for melanoma risk factors, the OR was 0.71 (95% CI 0.23–2.02). Aspirin users had an unadjusted OR of 0.85 (95% CI 0.45–1.69) and an adjusted OR of 1.45 (95% CI 0.44–4.74). In this pilot study, we found no evidence of a significant association between analgesic use and melanoma risk when potential confounders are assessed. Based on conflicting reports in the literature, meta-analysis may be appropriate.

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