scholarly journals Is high dose intravenous acetaminophen affect liver function in premature neonates with patent ductus arteriosus?

2020 ◽  
Author(s):  
Reza Bahrami ◽  
Aida Ezzatabadi ◽  
Nima Mehdizadegan ◽  
Hamid Mohammadi ◽  
Hamid Amoozgar ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Liver Enzymes ◽  
Therapeutic Option ◽  
Ductus Arteriosus ◽  
P Value ◽  
High Dose ◽  
Efficacy And Safety ◽  
Adverse Side Effects ◽  
Significant Difference ◽  
Intravenous Acetaminophen

Abstract Objectives The aim of this study was to collect consistent data on the efficacy and safety and evaluation hepatotoxicity of intravenous acetaminophen for the treatment of PDA in preterm infants. Methods This is an observational longitudinal prospective study on 46 preterm infants with PDA who treated with high dose of acetaminophen and evaluated with echocardiography and serum liver enzymes at Hafez and Zeinabiyeh hospitals from January 2016 to December 2019. Result Forty-six preterm infants with PDA treated with intravenous acetaminophen. Rate of closure of PDA was 82.6. There was no significant difference after treatment regarding AST, ALT, Albumin, total and direct bilirubin (P value > 0.05) and no adverse side effects were observed in association with intravenous acetaminophen. Conclusion High dose of acetaminophen is an effective and safe therapeutic option without hepatotoxic side effect for PDA closure.

scholarly journals Does high dose intravenous acetaminophen affect liver function for PDA closure in premature neonate?

2020 ◽  
Author(s):  
Reza Bahrami ◽  
Aida Ezzatabadi ◽  
Nima Mehdizadegan ◽  
Hamid Mohammadi ◽  
Hamid Amoozgar ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Liver Enzymes ◽  
Therapeutic Option ◽  
Premature Neonate ◽  
P Value ◽  
High Dose ◽  
Efficacy And Safety ◽  
Adverse Side Effects ◽  
Significant Difference ◽  
Intravenous Acetaminophen

Abstract Objectives: The aim of this study was to collect consistent data on the efficacy and safety and evaluation hepatotoxicity of intravenous acetaminophen for the treatment of PDA in preterm infants.Methods: This is an observational longitudinal prospective study on 46 preterm infants with PDA who treated with high dose of acetaminophen and evaluated with echocardiography and serum liver enzymes at Hafez and Zeinabiyeh hospitals from January 2016 to December 2019.Result: Forty-six preterm infants with PDA treated with intravenous acetaminophen. Rate of closure of PDA was 82.6. There was no significant difference after treatment regarding AST, ALT, Albumin, total and direct bilirubin (P value >0.05) and no adverse side effects were observed in association with intravenous acetaminophen. Conclusion: High dose of acetaminophen is an effective and safe therapeutic option without hepatotoxic side effect for PDA closure.

scholarly journals Does high dose intravenous acetaminophen affect liver function for PDA closure in premature neonate?

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Reza Bahrami ◽  
Aida Ezzatabadi ◽  
Nima Mehdizadegan ◽  
Hamid Mohammadi ◽  
Hamid Amoozgar ◽  
...  
Keyword(s):  
Side Effects ◽  
Liver Function ◽  
Preterm Infants ◽  
Liver Enzymes ◽  
Premature Neonate ◽  
High Dose ◽  
Efficacy And Safety ◽  
Adverse Side Effects ◽  
Significant Difference ◽  
Intravenous Acetaminophen

Abstract Objectives The aim of this study was to collect consistent data on the efficacy and safety and evaluation hepatotoxicity of intravenous acetaminophen for the treatment of PDA in preterm infants. Methods This is an observational longitudinal prospective study on 46 preterm infants with PDA who treated with high dose of acetaminophen and evaluated with echocardiography and serum liver enzymes at Hafez and Zeinabiyeh hospitals from January 2016 to December 2019. Result Forty-six preterm infants with PDA treated with intravenous acetaminophen. Rate of closure of PDA was 82.6. There was no significant difference after treatment regarding AST, ALT, Albumin, total and direct bilirubin (P value > 0.05) and no adverse side effects were observed in association with intravenous acetaminophen. Conclusion High dose of acetaminophen is not more effective than that with standard doses although without hepatotoxic side effect for PDA closure.

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

The Efficacy and Safety of Coenzyme Q10 in Preventing the Progression of Early Parkinson’s Disease: A Meta-Analysis

2017 ◽  
Vol 51 (2) ◽  
Author(s):  
Ranhel C. De Roxas ◽  
Roland Dominic G. Jamora
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Coenzyme Q10 ◽  
Meta Analysis ◽  
P Value ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Early Parkinson’S Disease

Introduction. Coenzyme Q10, also known as Ubiquinone, is a substance now being used as a dietary supplement in many countries including the Philippines. It has also been the focus of several researches as treatment for several diseases including Parkinson’s Disease. Several studies have shown that Coenzyme Q10 inhibits mitochondrial dysfunction in Parkinson’s Disease, hence delaying its progression. Objectives. The objective of this study is to assess and summarize the available evidence on the efficacy and safety of Coenzyme Q10 administration in the prevention of the progression of early Parkinson’s Disease. Methods. This is meta-analysis of randomized controlled trials on the use of Coenzyme Q10 in Parkinson’s Disease. A literature search in several databases was conducted for relevant studies. Three randomized controlled trials met the inclusion criteria. The efficacy of Coenzyme Q10 were measured using the total and the component scores of the Unified Parkinson Disease Rating Scale on follow-up. On the other hand, safety were measured using the withdrawal rate and the associated adverse reactions during the therapy of CoQ10. The Review Manager Software was utilized for the meta-analysis. Results. Compared to Placebo, treatment of CoQ10 did not show any significant difference in the mean scores of the UPDRS mental and ADL scores. Interestingly, the UPDRS motor score showed a significant difference between Coenzyme Q10 and placebo, but no significant difference when a subgroup analysis between high-dose (-4.03 [-15.07-7.01], p-value 0.47, I2 67%, P for heterogeneity 0.08) and low-dose Coenzyme Q10 (0.53 [-0.891.94], p-value 0.47, I2 34%, P for heterogeneity 0.22) was done. Overall, there was no significant difference in the total UPDRS score (0.68 [-0.61-1.97], p-value 0.30, I2 0%, P for heterogeneity 0.70). The most common side effects of the use of Coenzyme Q10 are anxiety, back pain, headache, sore throat, nausea, dizziness and constipation. Conclusion. Contrary to some animal and human studies, this meta-analysis showed that the use of CoQ10 results to nonsignificant improvement in all components of the UPDRS scores as opposed to placebo. However, the use of CoQ10 is tolerated and seems to be safe but further studies are needed to validate this finding.

High Dose Indomethacin for Patent Ductus Arteriosus Closure Increases Neonatal Morbidity

2019 ◽  
Author(s):  
Salome Waldvogel ◽  
Andrew Atkinson ◽  
Mélanie Wilbeaux ◽  
Mathias Nelle ◽  
Markus R. Berger ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Standard Dose ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Univariate Analysis ◽  
High Dose ◽  
Closure Rate ◽  
Patent Ductus

Abstract Objective Symptomatic patent ductus arteriosus (sPDA) is the most common heart abnormality in preterm infants. Optimal duration and dose of medical treatment is still unclear. We assessed undesired effects and closure rate of high-dose indomethacin (HDI) for pharmacological closure of sPDA. Study Design Retrospective single center analysis of 248 preterm infants born between January 2006 and December 2015 with a birth weight <2,000 g and sPDA which was treated with indomethacin. Patients were treated with either standard dose indomethacin (SDI; n = 196) or HDI (n = 52). Undesired effects and PDA closure were compared between patients treated with SDI and HDI. Results In univariate analysis, patients receiving HDI had a significant increase in gastrointestinal hemorrhage (32.7 vs.11.7%, p = 0.001), bronchopulmonary dysplasia (BPD) (77.8 vs. 55.1%, p = 0.003), and retinopathy of prematurity (13.5 vs. 2.6%, p = 0.004). Moreover, HDI patients needed longer mechanical ventilation (2.5 vs. 1.0 days, p = 0.01). Multivariate analyses indicated that necrotizing enterocolitis (17 vs. 7%, p = 0.01) and BPD (79 vs. 55%, p = 0.02) were more frequent in HDI patients. PDA closure rate was 79.0% with HDI versus 65.3% with SDI. Conclusion HDI used for PDA closure is associated with an increase in necrotizing enterocolitis and BPD. Risks of HDI should be balanced against other treatment options.

scholarly journals Efficacy of low or high-dose rituximab treatment in membranous nephropathy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Naresh Kharbuja ◽  
Min Wu ◽  
Yu-Chen Han ◽  
Dan Liu ◽  
Bin Wang ◽  
...  
Keyword(s):  
Membranous Nephropathy ◽  
Low Dose ◽  
Control Strategies ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Biological Indicators ◽  
High Dose ◽  
Serious Adverse Events ◽  
Protein Levels ◽  
Significant Difference

Abstract Background: Rituximab (RTX) has emerged as a promising therapeutic option in patients with primary membranous nephropathy (MN). But the optimal dosing of RTX protocol has not been established. Recently, favorable outcomes even with low-dose of RTX has been described in MN patients. Thus, the aim of this meta-analysis is to compare the efficacy and safety between high-dose and low-dose RTX in patients with MN.Methods: After literature search, eligible studies were further classified into high-dose and low-dose groups according to the dosage of one cycle RTX therapy. A meta-analysis was performed to evaluate remission rates and changes in biological indicators in two groups. Results: Eight studies involving 588 patients were included in this meta-analysis. In comparison to the control groups (including cyclosporin, cyclophosphamide, chlorambucil, prednisone, non-immunosuppressive anti-proteinuria treatment), RTX significantly improved the complete remission (CR) rate. Furthermore, there is no significant difference between high-dose and low-dose RTX in inducing total remission (TR) and CR. Also, high-dose RTX did not significantly improve serum albumin, creatine and urinary protein levels when compared with the low-dose RTX group. However, high-dose RTX did reduce the serum PLA2R antibody titers in patients. Even the difference was not significant, there was a tendency for low-dose RTX to have less serious adverse events (SAEs) than high-dose RTX groups. Conclusion: RTX administration indicated a better efficacy than the control strategies for the treatment of primary MN. And a low-dose regimen of RTX was non-inferior to high-dose usage in inducing long-term TR up to 24 months and holds the superior tendency in preventing SAEs in MN patients.

scholarly journals Vascular Rehabilitation Benefits of Tribulus Terrestris (TT), Taurine and High Dose Alpha Lipoic Acid (ALA) Supplementation with Interval Walking Training Program after Surgical Vascular Bypass Treatment (Pilot Study)

2019 ◽  
Vol 7 (3) ◽  
pp. 22
Author(s):  
Sid Solakovic Solakovic ◽  
Ratko Pavlovic ◽  
Mensur Vrcic ◽  
Emir Solakovic
Keyword(s):  
Physical Activity ◽  
Training Program ◽  
P Value ◽  
High Dose ◽  
Tribulus Terrestris ◽  
Graft Occlusion ◽  
Amputation Level ◽  
Below The Knee ◽  
Significant Difference ◽  
Vein Bypass

Background: Some of main raisons for the elderly graft occlusion after successful aortal-iliac, aortal Femoral and Femoral Distal Vein Bypass, progression of main disease, continuing bad life Habits and uncontrolled risk factors such are mostly: poor nutrition traditional or fast food, Smocking and Lacks of Walking and Physical Activity Habits. Objective: The primary objective of the study was to estimate influence of Interval Walking Training Program combine with Tribulus Terrestris, 3-5 gram of Taurine and high dose of 1800mg supplementation of ALA on primary potency and vascular treatment. Secondary goals of this study is determinate by establishing better understanding connection between ordinary vascular walking therapy 30-45 min and interval walking program combine with Tribulus Terrestris, Taurine and high dose of and ALA as secondary supplementation after surgical and endovascular treatment. Methodology: The study included 112 patients, at the Clinic of cardiovascular surgery, Clinical Center University of Sarajevo, age between 50 and 75 (50 patients surgical treated with aortic-iliac, aortic-femoral and femoral distal vein bypass with and without Linton-patch/Taylor patch-first group) and (62 endovascular Iliac treated patients (indication TASC II A and B) with and without support Tribulus Terrestris, high dose of ALA and Taurine - second group). Results: Final analysis has reveal the rehabilitation outcome in 83% patients with bypass above the knee was fully rehabilitated compared to 46,6% patients with bypass below the knee was statistically considered significant by using p value less than (p<0,05) In anamnestic history in 83% patient with amputation above the knee was documented the presence of hypertension, hyperlipidemia, nicotinismus and diabetes compared to 66,7% of patients with amputation level below the knee but there was no statistically significant difference (p>0,05). Conclusion: Interval Walking Training Program on Tribulus Terrestris, Taurine and high dose of ALA had a significantly and successfully higher bypass potency and rehabilitation prognosis compare to patients without supplementation and postsurgical physical therapy concept. It is obviously the is certain link between physical activity, life style modification and serum testosterone on primary bypass potency.

scholarly journals Peripheral Neutrophil- Lymphocyte Ratio as a Predictor of Seizure in Preterm Infants with Intra-Ventricular Hemorrhage

2021 ◽  
pp. 13-21
Author(s):  
Heba Ibrahim Ashraf ◽  
Abd El-Rahman Mohamed El-Mashad ◽  
Mai Rabie El-Sheikh
Keyword(s):  
Preterm Infants ◽  
University Hospital ◽  
Neurological Dysfunction ◽  
P Value ◽  
Cranial Ultrasound ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Ventricular Hemorrhage ◽  
Peripheral Neutrophil

Background: Preterm infants with Intra-Ventricular Hemorrhage (IVH) are at risk for developing significant complications, including post hemorrhagic hydrocephalus and seizures. Neonatal seizures are the most common overt manifestation of neurological dysfunction in the newborn, and is associated with short- and long-term adverse effects. Objective: The aim of the study is to evaluate the value of Peripheral Neutrophil- lymphocyte ratio (NLR) as a predictor of seizure in preterm infants with intra-ventricular hemorrhage. Methods: This prospective cohort study that comprised 60 Preterm infants with IVH admitted at NICU pediatric department Tanta university hospital from November 2019 to May 2020, Preterm infants were divided into two groups according to incidence of seizure. Preterm infants in this study subjected to Careful history taking, clinical examination and investigations (laboratory and Trans-cranial ultrasound) as well as analysis of result and follow up clinical status for development of seizure. Results: There was a statistically highly significant difference regarding NLR and development of seizure with p value <0.001 (NLR ≥ 2.3 with sensitivity 96%, specificity 93%, Area under the curve 0.849 and accuracy 84.9%). Conclusion: NLR is a predictor of seizure in preterm infants with intra-ventricular hemorrhage.

Efficacy and safety of pharmacological cachexia interventions: systematic review and network meta-analysis

2020 ◽  
pp. bmjspcare-2020-002601
Author(s):  
Manit Saeteaw ◽  
Phitjira Sanguanboonyaphong ◽  
Jukapun Yoodee ◽  
Kaitlyn Craft ◽  
Ratree Sawangjit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Total Body Weight ◽  
Megestrol Acetate ◽  
High Dose ◽  
Efficacy And Safety ◽  
Pharmacological Interventions ◽  
Serious Adverse Events ◽  
Significant Difference

AimsRandomised controlled trials (RCTs) demonstrated benefits of pharmacological interventions for cachexia in improving weight and appetite. However, comparative efficacy and safety are not available. We conducted a systematic review and network meta-analysis (NMA) to evaluate the relative efficacy and safety of pharmacological interventions for cachexia.MethodsPubMed, EmBase, Cochrane, and ClinicalTrials.gov were searched for RCTs until October 2019. Key outcomes were total body weight (TBW) improvement, appetite (APP) score and serious adverse events. Two reviewers independently extracted data and assessed risk of bias. NMA was performed to estimate weight gain and APP score increase at 8 weeks, presented as mean difference (MD) or standardised MD with 95% CI.Results80 RCTs (10 579 patients) with 12 treatments were included. Majority is patients with cancer (7220). Compared with placebo, corticosteroids, high-dose megestrol acetate combination (Megace_H_Com) (≥400 mg/day), medroxyprogesterone, high-dose megestrol acetate (Megace_H) (≥400 mg/day), ghrelin mimetic and androgen analogues (Androgen) were significantly associated with MD of TBW of 6.45 (95% CI 2.45 to 10.45), 4.29 (95% CI 2.23 to 6.35), 3.18 (95% CI 0.94 to 5.41), 2.66 (95% CI 1.47 to 3.85), 1.73 (95% CI 0.27 to 3.20) and 1.50 (95% CI 0.56 to 2.44) kg. For appetite improvement, Megace_H_Com, Megace_H and Androgen significantly improved standardised APP score, compared with placebo. There is no significant difference in serious adverse events from all interventions compared with placebo.ConclusionsOur findings suggest that several pharmacological interventions have potential to offer benefits in treatment of cachexia especially Megace_H and short-term use corticosteroids. Nonetheless, high-quality comparative studies to compare safety and efficacy are warranted for better management of cachexia.

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