scholarly journals Acute methadone poisoning in children: diagnosis and treatment

2020 ◽  
Vol 17 (5) ◽  
pp. 31-39
Author(s):  
M. A. Udaltsov ◽  
K. V. Pshenisnov ◽  
Yu. S. Аleksandrovich ◽  
V. A. Kaziakhmedov
Keyword(s):  
Treatment Duration ◽  
Pulmonary Ventilation ◽  
Clinical Manifestations ◽  
Oxygenation Index ◽  
Duration Of Treatment ◽  
Coma Scale ◽  
Common Causes ◽  
Artificial Pulmonary Ventilation ◽  
Lactate Acidosis ◽  
Poisoning In Children

Methadone poisoning is one of the most common causes of unfavorable outcomes in children.The objective is to identify specific parameters of the course and intensive care for methadone poisoning in children.Subjects and methods. 30 children were examined. The average age made 16 (15‒17) years. The duration of treatment in ICU was 3 (1.5‒4.0) days.Results. The most frequent clinical manifestations of methadone poisoning included coma (40%), acute respiratory failure (70%), low body temperature (57%), and myosis (100%). By the admission, the oxygenation index was 4.5 r.u. 37% of patients had pronounced lactate acidosis. On day 1, the volemic support made 143 (124‒165)% of the estimated fluid demand. 21 (70%) children needed artificial pulmonary ventilation. The negative correlation was established between treatment duration in ICU, Glasgow coma scale (R = -0.41; p < 0.05), Glasgow-Pittsburgh coma scale (R = -0.52; p < 0.05) and urea concentration in blood within the first 24 hours (R = 0.44; p < 0.05).Conclusion. The main criteria determining the severity of the state of patients with acute methadone poisoning include the level of depression of consciousness, the presence of acute respiratory and renal failure.

scholarly journals Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Allen Abbing ◽  
Vasiliki Koretsi ◽  
Theodore Eliades ◽  
Spyridon N. Papageorgiou
Keyword(s):  
Treatment Duration ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Comprehensive Treatment ◽  
Orthodontic Appliances ◽  
Duration Of Treatment ◽  
Quality Of Evidence ◽  
Fixed Appliances

Abstract Objectives Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. Materials and methods Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. Conclusions While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. Trial registration PROSPERO: (CRD42019148169)

Carbon monoxide: mechanism of toxic action, pathogenesis and clinical manifestations of acute intoxication

2021 ◽  
pp. 4-9
Author(s):  
A. N. Grebenyuk ◽  
V. N. Bykov
Keyword(s):  
Carbon Monoxide ◽  
Clinical Manifestations ◽  
Acute Poisoning ◽  
Toxic Action ◽  
Acute Intoxication ◽  
Emergency Situations ◽  
Common Causes ◽  
The Central Nervous System ◽  
Regulatory Effects ◽  
Mitochondrial Cytochrome Oxidase

Introduction. Carbon monoxide (CO) remains one of the most common causes of acute poisoning and death, both in everyday life and in emergency situations, especially in fires.Material and methods. The paper summarizes information about the regulatory effects, mechanisms of toxic action, pathogenesis and clinical picture of intoxication, as well as predictors of the severity of CO poisoning.Results. The main mechanism of the toxic effect of CO is due to its ability to bind to the protohemal iron of hemoglobin (Hb) to form carboxyhemoglobin (HbCO). The toxicity of CO may also be enhanced by impaired functions of the myoglobin of the myocardium and skeletal muscles, mitochondrial cytochrome oxidase, and iron-containing enzymes of the antioxidant system. The leading link in the pathogenesis of acute CO intoxication is a violation of the oxygen transport function of hemoglobin and the associated development of hemic and tissue hypoxia. CO-induced cell and tissue damage due to the induction of mitochondrial dysfunction, oxidative stress, free radical hyperproduction, lipid peroxidation, inflammation, and apoptosis also play a role in the pathogenesis of intoxication.Conclusion. The mechanism of toxic action of CO, associated primarily with the formation of carboxyhemoglobin and the development of hypoxia, determines the clinical manifestations of acute intoxication, which depend on the concentration of CO and the duration of exposure, but are almost always associated with the central nervous system and cardiovascular system.

scholarly journals A foodborne norovirus outbreak among the film crew in the Autonomous Province of Vojvodina, Serbia

2019 ◽  
Vol 72 (7-8) ◽  
pp. 235-241
Author(s):  
Mirjana Strbac ◽  
Mioljub Ristic
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Manifestations ◽  
Food Poisoning ◽  
Medical Attention ◽  
Microbiological Analysis ◽  
Environmental Investigation ◽  
Common Causes ◽  
The World ◽  
Autonomous Province

Introduction. Norovirus is one of the most common causes of acute gastroenteritis in the world. The aim of this study was to describe characteristics of an outbreak of norovirus infection and present all the steps of an outbreak investigation. Material and Methods. A retrospective cohort study was conducted among all individuals who ate food from the same restaurant. All the exposed persons filled out an adapted questionnaire that is routinely used in patients with food poisoning. Results. This paper presents a norovirus outbreak among film crew members and measures taken to control the epidemic. Gastroenteritis was diagnosed in 20 exposed persons. In most patients, symptoms lasted 1 - 3 days, and every third patient sought medical attention. The predominant clinical manifestations were vomiting and diarrhea. The food that probably caused the infection were sandwiches with ham, cheese and lettuce and microbiological analysis confirmed that the outbreak was caused by norovirus. Conclusion. Although the source of this outbreak remains unclear, the results of environmental investigation of the restaurant showed several irregularities in the kitchen that may have caused norovirus transmission.

scholarly journals Antiviral Treatment on Pregnancy with COVID-19 Infection : A Systematic Review

2021 ◽  
Vol 4 (2s) ◽  
pp. 78-85
Author(s):  
Tigor Peniel Simanjuntak ◽  
◽  
Angela Putri Kakerissa ◽  
Grady Ivan Kurniawan
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Pregnant Women ◽  
Gestational Age ◽  
Treatment Duration ◽  
Case Reports ◽  
Antiviral Treatment ◽  
Inclusion Criteria ◽  
Duration Of Treatment ◽  
Retrospective Case

Abstract Objective to evaluate antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Method: a systematic review of antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. Result 948 papers accessed through Pubmed, Scopus, Science Direct, Cohcrane, and other with keywords “Antiviral”, “Pregnancy” “Pregnant” “Coronavirus” “COVID-19” “SARS-CoV-2”. Duplicate papers were excluded (n=302), topics and abstracts that do not meet the criteria (n=612), and 25 papers that did not meet the inclusion criteria. 9 papers that meet the inclusion criteria (case reports and cohort retrospective case study) discussed 20 pregnant women with COVID-19 infection (16 moderate and severe cases received Remdesivir, 3 moderate and mild cases received Lopinavir-ritonavir combination, and 1 moderate case received Arbidol). Conclusion, remdesivir is an antiviral frequently used in pregnancy on trimester II and III with severe COVID-19 infection with a duration of treatment of 5-10 days. Remdesivir should be monitored because some show side effects of increasing liver function. Key word: Antiviral, Pregnant, COVID-19

scholarly journals Evaluation of subclinical cardiotoxicity in patients with breast cancer and arterial hypertension in two regimens of anthracycline-containing chemotherapy

2018 ◽  
Vol 15 (4) ◽  
pp. 59-64 ◽  
Author(s):  
A A Avalyan ◽  
E V Oshchepkova ◽  
M A Saidova ◽  
V N Shitov ◽  
E V Glazkova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Arterial Hypertension ◽  
Cumulative Dose ◽  
Treatment Duration ◽  
Troponin T ◽  
Myocardial Damage ◽  
Breast Cancer Patients ◽  
Duration Of Treatment ◽  
Imaging Results ◽  
Group 2

Objective. To study of subclinical cardiotoxicity of two anthracycline-containing chemotherapy regimens in breast cancer patients with normotension and arterial hypertension. Materials and methods. 119 women (mean age 48,8±10,9 years) with triple negative breast cancer were enrolled. They are received one of two chemotherapy options that differed in the intensity and duration of treatment, including the total dose of anthracyclines. Depending on the chemotherapy option, the patients were divided into two groups: group 1 (n=54) - treatment duration ≤8 weeks, cumulative dose of doxorubicin was 200 mg/m2, group 2 (n=65) - treatment duration ≤16 weeks, the cumulative dose of doxorubicin was 320 mg/m2. Before and after chemotherapy completion of all patients, the level of troponin T (h.s.) and NT-proBNP was determined, and heart ultrasound was performed, 2D and 3D speckle tracking imaging. Results. In patients who received a higher cumulative dose of doxorubicin (group 2), a statistically significant increase in biomarkers of myocardial damage was observed (h.s. troponin T before chemotherapy was 7.8±0.5 pg/ml, after chemotherapy - 55.0±7.0 pg/ml, p

Studies on Tensile and Water Absorption Properties on Kenaf (Hibiscus Cannabinus) Fibre Mat/Polyester Composite Using Chemical Treatment

2013 ◽  
Vol 421 ◽  
pp. 290-295
Author(s):  
Mohammad Taib Mohamad Nurul Azman ◽  
Abu Kassim Masitah ◽  
Ariff Jamaludin Mohd ◽  
Ismail Tayibbah
Keyword(s):  
Water Absorption ◽  
Treatment Duration ◽  
Hibiscus Cannabinus ◽  
Absorption Test ◽  
Duration Of Treatment ◽  
Absorption Properties ◽  
Kenaf Fibre ◽  
Polyester Composite ◽  
Water Absorption Test ◽  
Polyester Composites

This research investigated the tensile and water absorption properties of kenaf fibre mat/polyester composites. Treatment using acetylation method has been introduced to improve the properties of product manufactured. The effects of acetylation treatment with three variations of time that were 1, 4 and 24 hours on the kenaf fibre mats were investigated. The MOE of the tensile of treated fibre mat/polyester composite for 1 hour was the highest with value 4589.61 MPa. The tensile strength of treated fibre mat/polyester composite for 4 hours was the highest with value 0.6213 MPa. For water absorption test, the results showed that fibre mat/polyester composite with treatment duration for 1 hour had the lowest water absorption that was 1.23% compared with treatment duration for 4 hours and 24 hours. For overall it can be concluded that the treatment duration of 1 hour was recommended for acetylation method when compared with 4 hours and 24 hours duration treatments. Using acetylation treatment on the kenaf fibre mat/polyester composites was showed improvement on composite and was recommended in short duration of treatment.

Platelet Function Disorders

2017 ◽  
pp. 117-137
Author(s):  
Zubair A. Karim ◽  
Fadi T. Khasawneh
Keyword(s):  
Clinical Practice ◽  
Molecular Characterization ◽  
Platelet Function ◽  
Clinical Manifestations ◽  
Functional Responses ◽  
Platelet Function Disorders ◽  
Coagulant Activity ◽  
Common Causes ◽  
Adp Receptor

Platelets play an important role in thrombosis and hemostasis. Moreover, platelet dysfunction due to congenital and acquired etiologies is also one of the most common causes of bleeding encountered in clinical practice. Mostly, platelet function disorders are deficiencies of glycoprotein mediators of adhesion and aggregation, whereas defects of primary receptors for stimuli include those of the P2Y12 ADP receptor. Studies on inherited defects of (1) secretion for storage organelles (dense and alpha-granules), (2) the platelet cytoskeleton, and (3) the generation of pro-coagulant activity have allowed for the identification of genes directly and/or indirectly controlling specific functional responses. This chapter will review recent advances in the molecular characterization of platelet function defects, the spectrum of clinical manifestations of these disorders and their management.

Anaphylaxis in the OR—Causes, Recognition, and Treatment

2018 ◽  
pp. 199-206
Author(s):  
Surangama Sharma ◽  
Lovkesh Arora
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Operating Room ◽  
Clinical Manifestations ◽  
Preventative Measures ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Elective Laparoscopic Cholecystectomy

Anaphylaxis in the operating room is a life-threatening condition that can evolve rapidly. As an anesthesiologist, it is important to understand the pathophysiology, diagnose the condition, recognize the inciting agent/agents, and manage it appropriately. It is equally important to confirm the diagnosis for preventing a catastrophic event from happening in future. This chapter defines anaphylaxis, discusses the clinical manifestations and most common causes, and describes ways it can be diagnosed. It also considers treatment and preventative measures. The chapter uses a case study of a 55-year-old female, weighing 85 kg and a body mass index of 36 with no other known comorbidities, who is scheduled to undergo elective laparoscopic cholecystectomy.

P4794Comparative effectiveness and safety of non-VKA oral anticoagulants versus warfarin in non-valvular atrial fibrillation patients with differential treatment duration: an ARISTOPHANES study analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Deitelzweig ◽  
A Keshishian ◽  
A Kang ◽  
A Dhamane ◽  
X Luo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Lower Risk ◽  
Treatment Duration ◽  
Oral Anticoagulants ◽  
Pooled Analysis ◽  
Incidence Rates ◽  
Duration Of Treatment ◽  
Cox Models ◽  
Hazard Ratios

Abstract Background The ARISTOPHANES (Anticoagulants for Reduction In STroke: Observational Pooled analysis on Health outcomes ANd Experience of patientS) study showed that non-vitamin K antagonist oral anticoagulants (NOACs) were associated with lower risks of stroke/systemic embolism (S/SE) and variable comparative risks of major bleeding (MB) versus warfarin. Purpose To assess long-term use of non-VKA oral anticoagulants (NOACs) vs. warfarin in ARISTOPHANES by evaluating the risk of S/SE and MB among non-valvular atrial fibrillation (NVAF) patients by duration of treatment (<1 and ≥1 year). Methods In the ARISTOPHANES study, NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin from 01/01/2013–09/30/2015 were identified from the CMS Medicare data and four US commercial claims databases, covering >180 million beneficiaries annually (∼56% of US population). After 1:1 propensity score matching (PSM) in each database between NOACs and warfarin (apixaban-warfarin, dabigatran-warfarin, and rivaroxaban-warfarin), the resulting patient records were pooled. Treatment duration was defined as time between the day after the treatment index date and discontinuation (30 days after a 30-day gap in the prescription), treatment switch, death, end of study period, or end of continuous medical and pharmacy enrollment, whichever occurred first. Matched patients with observed treatment duration <1 or ≥1 year were separately examined. Cox models were used to estimate hazard ratios of S/SE and MB (identified by inpatient claims) during observed treatment duration. Results The mean treatment duration for patients with shorter (<1 year) vs longer (≥1 year) duration was 4–5 months vs 18–21 months across the three matched cohorts. All the matched baseline variables remained balanced. The incidence rates of S/SE and MB and the proportion of patients with treatment discontinuation were higher in patients with shorter treatment duration. Regardless of treatment duration, apixaban patients had a lower risk of S/SE and MB versus warfarin; dabigatran patients had a lower risk of MB versus warfarin; and rivaroxaban patients had a lower risk of S/SE versus warfarin. Compared to warfarin patients, dabigatran patients with treatment duration <1 year had a similar risk of S/SE, while those with treatment duration ≥1 year had lower S/SE risk; rivaroxaban patients with treatment duration <1 year had a higher risk of MB, while those with treatment duration ≥1 year had similar MB risk. Conclusions Among NVAF patients with duration of treatment <1 and ≥1 year in the ARISTOPHANES study, apixaban and rivaroxaban were associated with lower risk of S/SE, while apixaban and dabigatran were associated with lower risk of MB, compared to warfarin. These findings indicate varying long-term effectiveness and safety outcomes between NOACs and warfarin. Acknowledgement/Funding This study was funded by Bristol-Myers Squibb and Pfizer Inc.

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