scholarly journals Differential Effects of Albumin Infusion between ICU and Non-ICU Hypoalbuminemia Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 15-20
Author(s):  
Nina Mariana ◽  
◽  
Surya Oto Wijaya ◽  
Siti Maemun ◽  
Nafrialdi Nafrialdi ◽  
...  

Background: Hypoalbuminemia is frequent among hospitalized patients and is associated with poor outcomes. ICU patients are widely associated with more severe condition making albumin correction seems to be less effective. This study was aimed to compare the results of albumin correction in ICU and non-ICU patients at Sulianti Saroso Hospital, Jakarta. Methods: A cross sectional study was conducted on adult patients in ICU and non-ICU wards who received intravenous albumin infusion at Sulianti Saroso hospital, between January 2013 to March 2018. Paired t-test was used to analyze the changes of albumin level before and after albumin infusion. Results: 123 ICU patients (41 sepsis, 82 non-sepsis) and 206 non-ICU patients (34 sepsis, 172 non-sepsis) who received 20% or 25% albumin infusions were included. Significant increase in albumin levels were observed in sepsis patients both in ICU and non-ICU, while in non-sepsis patients, the significant increase only observed in non-sepsis patients. Overall, mean increase in albumin levels in ICU-and non-ICU patients were 0.13 (0.63) g/dL vs 0.35(0.54) g/dL, respectively (P= < 0,001). Conclusion: Non-ICU patients show better response to albumin infusion compared to ICU patients. This difference is presumably due to different degree of inflammation. It is suggested that the quantity needed for albumin infusion is calculated differently according to clinical condition of the patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S416-S417
Author(s):  
Kamile Arıkan ◽  
Nuri Bayram ◽  
İlker devrim ◽  
Ayküke Akaslan-Kara

Abstract Background Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia. Methods Children who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included. Results In this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage. Characteristics of patients who received micafungin.and cultured Candida spp Antifungal resistance patterns of Candida spp. Laboratory change before and after micafungin treatment Conclusion Increase in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasis Disclosures All Authors: No reported disclosures


2020 ◽  
Vol 30 (11) ◽  
pp. 4505-4509
Author(s):  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Krzysztof Czajkowski ◽  
Maciej Walędziak

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.


Author(s):  
Amir Emami ◽  
Fatemeh Javanmardi ◽  
Ali Akbari ◽  
Babak Shirazi Yeganeh ◽  
Tahereh Rezaei ◽  
...  

Background: Identifying effective biomarkers plays a critical role on screening; rapid diagnosis; proper managements and therapeutic options, which is helpful in preventing serious complications. The present study aimed to compare the liver laboratory tests between alive and dead hospitalized cases for prediction and proper management of the patients. Methods: This retrospective, cross sectional study consists of all deceased patients admitted in one center in Shiraz, Iran during 19 Feb 2020 to 22 Aug 2021. For further comparison, we selected a 1:2 ratios alive group randomly. Results: Overall, 875 hospitalized cases died due to COVID-19. We selected 1750 alive group randomly. The median age was significantly higher in died group (65.96 vs 51.20). Regarding the laboratory findings during the hospitalization ALT, AST, Bili.D were significantly higher in non-survivors than survivors but Albumin was less in deceased patients. It was revealed elevated levels of Albumin, AST, Bili.T and Bili.D were associated with increasing the risk of in hospital death. Moreover, the predictive effect of ALP and Bili.D had significantly more than others with high sensitivity and specify. Conclusion: We found patients with COVID-19 have reduced serum albumin level, and increase ALT and AST. The current results revealed abnormal liver chemistries is associated with poor outcome, which highlighted the importance of monitoring these patients more carefully and should be given more caution.


Author(s):  
Ardhanarishwari Umi Salamah ◽  
Fita Rahmawati ◽  
Fivy Kurniawati

Drugs’ administration among hospitalized patients in ICU commonly is given intravenously. Mixing the intravenous drugs may result in incompatibility problem that might affect the drugs’ stability and bioavailability. The aim of the study was to investigate the potential incompatibility problem of  intravenous mixing drugs’ administration among ICU patients at PKU Muhammadiyah Yogyakarta Hospital. This study was a cross-sectional study in which design and data was obtained from ICU patients’ medical record retrospectively with purposive sampling in order to observe the pattern of intravenous drug’s combination. The potential incompatibility problem was analyzed using Handbook on Injectable Drugs. There were 79 out of 119 medical records which fulfilled sample inclusion criteria taken in this study. Parenteral dosage form was commonly used rather than non parenteral (62.06%) among ICUs’ patients. The potential incompatibility pattern consisted of incompatibility of intravenous drugs, electrolyte solutions/parenteral nutritions in mixture form, and the electrolyte solutions/parenteral nutritions, which are administrated simultaneously. Potential incompatibility of intravenous dosage was found in 50 events out of 79 patients (0.63 events per patients), which consisted of 8 events (8.51%) in using of drugs administrated simultaneously, 10 events (19.23%) in using of electrolyte solutions/parenteral nutritions in mixture form, and 32 events (11.72%) in using of electrolyte solutions/parenteral nutritions administrated simultaneously. Common potential incompatibilities types were precipitation of drugs and drug’s adsorption to packaging materials.


Author(s):  
Harold Rumopa ◽  
Freddy W. Wagey ◽  
Eddy Suparman

  Objective: Determine differences plasma levels MDA in preeclampsiabefore and 2 hours after delivery.   Methods: This was an analytic cross-sectional study. Subjectconsists of 23 pregnancies with preeclampsia, where 23 bloodsamples taken before delivery and 23 were taken 2 hours afterdelivery. This study was conducted from August 2016 untilDecember 2016 at Department of Obstetrics and GynecologyFaculty of Medicine Universitas Sam Ratulangi / Prof. Dr. R. D.Kandou Hospital Manado and satellite hospital. Samples weretaken from plasma and analysed using HPLC method at Prodiaclinical laboratory.   Results: In patients with severe preeclampsia before deliverywe found average value (1.4796  0.40819 nmol/ml), minimumvalue (1.03 nmol/ml) and maximal value (2.77 nmol/ml)and 2 hours after delivery with average value (1.2470 0.34324 nmol/ml), minimum value (0.91 nmol/ml), and maximumvalue (2.47 nmol/ml). by using Wilcoxon test, we foundthere were significant differences in plasma levels of MDA (p =0.000).   Conclusion: This significant difference suggests that decreasedplasma levels of MDA 2 hours after delivery and gives the sense thatthere is a relationship between oxidative stress of cells with severepreeclampsia before and shortly after delivery, that MDA is an indicatorof oxidative stress.   Keywords: malondialdehyde, oxidative stress, peroxidation lipid,preeclampsia


2021 ◽  
pp. tobaccocontrol-2020-056160
Author(s):  
Yanhui Liao ◽  
Jinsong Tang ◽  
Ann McNeill ◽  
Brian C Kelly ◽  
Joanna E Cohen

BackgroundSharing and gifting cigarettes are common in China. These social practices promote cigarette consumption, and consequently may reduce quit rates in China. This study investigated sharing and gifting cigarettes, and the relationship of observing pictorial health warnings to attitudes towards sharing and gifting cigarettes in China.MethodsWe conducted an online nationwide cross-sectional study of 9818 adults in China. Experiences of sharing and gifting cigarettes, and attitudes towards sharing and gifting cigarettes before and after viewing text and pictorial health warnings on the packages were assessed, and compared between smokers and non-smokers.ResultsMost current smokers reported experiences of sharing (97%) and gifting (around 90%) cigarettes. Less than half of non-smokers reported sharing cigarettes and receiving gifted cigarettes, but over half (61.4%) gave cigarettes as a gift to others. More than half of non-smokers but less than 10% of smokers disagreed with sharing and gifting cigarettes. After observing both text and pictorial health warnings on the packages, disagreement with sharing and gifting cigarettes increased by more than 10 percentage points among both smokers and non-smokers.ConclusionHaving pictorial health warnings on cigarette packages may reduce sharing and gifting cigarettes in China.


2019 ◽  
Vol 8 (9) ◽  
pp. 1290 ◽  
Author(s):  
Leila Jahangard ◽  
Thorsten Mikoteit ◽  
Saman Bahiraei ◽  
Mehrangiz Zamanibonab ◽  
Mohammad Haghighi ◽  
...  

Background: Within three to six months after delivery, 13%–19% of women suffer from post-partum depression (PPD), understood as a dysfunctional adaptation to the postpartum condition and motherhood. In the present cross-sectional study, we compared the hair steroid levels of women 12 weeks before and after delivery and with or without PPD. Method: The present study was a cross-sectional study conducted twelve weeks after delivery. At that time, 48 women (mean age: 25.9 years) with PPD and 50 healthy controls (mean age: 25.2 years) completed questionnaires on depressive symptoms. Further, at the same time point, 6 cm lengths of hair strands were taken, providing samples of hair steroids 12 weeks before and 12 weeks after delivery in order to analyze hair steroids (cortisol, cortisone, progesterone, testosterone, and dehydroepiandrosterone (DHEA)). Results: Compared to those of women without PPD, hair steroid levels (cortisol, cortisone, progesterone) were significantly lower in women with PPD both before and after delivery. Lower prenatal cortisone and progesterone levels predicted higher depression scores 12 weeks after delivery. Lower prenatal levels of cortisol and progesterone and higher levels of DHEA, and postnatal lower levels of cortisol, cortisone, and progesterone, along with higher levels of DHEA predicted PPD-status with an accuracy of 98%. Conclusions: PPD is associated with blunted hair cortisol, cortisone, and progesterone secretions both pre- and postpartum. Such blunted steroid levels appear to reflect a stress responsivity that is less adaptive to acute and transient stressors. It follows that prenatally assessed low hair cortisol and progesterone levels, along with high DHEA levels, are reliable biomarkers of post-partum depression 12 weeks after delivery.


2018 ◽  
Vol 31 (5) ◽  
pp. 346-352 ◽  
Author(s):  
Albert R Dreijer ◽  
Jeroen Diepstraten ◽  
Vera E Bukkems ◽  
Peter G M Mol ◽  
Frank W G Leebeek ◽  
...  

Abstract Objective To assess the proportion of all medication error reports in hospitals and primary care that involved an anticoagulant. Secondary objectives were the anticoagulant involved, phase of the medication process in which the error occurred, causes and consequences of 1000 anticoagulant medication errors. Additional secondary objectives were the total number of anticoagulant medication error reports per month, divided by the total number of medication error reports per month and the proportion of causes of 1000 anticoagulant medication errors (comparing the pre- and post-guideline phase). Design A cross-sectional study. Setting Medication errors reported to the Central Medication incidents Registration reporting system. Participants Between December 2012 and May 2015, 42 962 medication errors were reported to the CMR. Intervention N/A. Main outcome measure Proportion of all medication error reports that involved an anticoagulant. Phase of the medication process in which the error occurred, causes and consequences of 1000 anticoagulant medication errors. The total number of anticoagulant medication error reports per month, divided by the total number of medication error reports per month (comparing the pre- and post-guideline phase) and the total number of causes of 1000 anticoagulant medication errors before and after introduction of the LSKA 2.0 guideline. Results Anticoagulants were involved in 8.3% of the medication error reports. A random selection of 1000 anticoagulant medication error reports revealed that low-molecular weight heparins were most often involved in the error reports (56.2%). Most reports concerned the prescribing phase of the medication process (37.1%) and human factors were the leading cause of medication errors mentioned in the reports (53.4%). Publication of the national guideline on integrated antithrombotic care had no effect on the proportion of anticoagulant medication error reports. Human factors were the leading cause of medication errors before and after publication of the guideline. Conclusions Anticoagulant medication errors occurred in 8.3% of all medication errors. Most error reports concerned the prescribing phase of the medication process. Leading cause was human factors. The publication of the guideline had no effect on the proportion of anticoagulant medication errors.


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