scholarly journals TL 18094 - Fluorquinolones and the risk of Achilles tendon disorders

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 77S
Author(s):  
Alexandre Leme Godoy-Santos ◽  
Miguel Srougi ◽  
Homero Bruschini ◽  
Cesar de Cesar Netto ◽  
Lucas Furtado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Case Reports ◽  
Tendon Injury ◽  
Achilles Tendinopathy ◽  
The Body ◽  
Current Evidence ◽  
Drug Induced ◽  
Concurrent Use ◽  
Associated Risk Factors

Introduction: Achilles FQ-associated tendinopathy was first reported by Bailey et al. in 1983. Since then, nearly 200 case reports related to FQ-associated tendon injury have been published, as well as some case control and cohort studies. Today, drug-induced tendinopathy is accepted as a class effect of FQ. The Achilles tendon is affected in 90% of cases of FQ-related tendinopathy and rupture. Objective: To evaluate current evidence for the association between fluoroquinolones and Achilles tendinopathy and to identify associated risk factors that increase the incidence of this complication. Methods: We conducted a computerized search of the relevant scientific literature from 1988 to 2018 using electronic databases, including PubMed, Medline and Scopus. The search terms were fluoroquinolone-related tendinopathy. Eligible studies were any available reports of fluoroquinolone-related tendinopathy (tendinitis, tendon pain, or rupture); animal and human histologic studies were included. Data collected included any cases of fluoroquinolone-related tendinopathy, the particular tendon affected, type of FQ, dosage, and concomitant risk factors. Results: The references selected were reviewed by all authors and judged based on their contribution to the body of knowledge on this topic. The conduct and validity of any clinical studies were carefully considered, and the outcomes of management protocols were carefully scrutinized. Case reports mentioning a specific association with the condition that were thought to be relevant to the discussion were included. Only papers that made a significant contribution to understanding of this condition were included in the review. Thus, a total of 560 abstracts were screened, 79 of which were directly related to FQ-associated Achilles tendinopathy or tendon rupture. Conclusion: The association between the use of fluoroquinolone antibiotics and Achilles tendon disorders is well-established in the medical literature. We found that male gender, advanced age, normal BMI, chronic renal failure and concurrent use of corticosteroids increases the risk of Achilles tendon pathology. Caution should be exercised during the utilization of this antibiotic class in patients with these characteristics

scholarly journals Mechanotendography in Achillodynia shows reduced oscillation variability of pre-loaded Achilles tendon: a pilot study

2020 ◽  
Vol 30 (2) ◽  
pp. 247-257
Author(s):  
Laura Schaefer ◽  
Frank Bittmann
Keyword(s):  
Achilles Tendon ◽  
Rank Correlation ◽  
Achilles Tendinopathy ◽  
The Body ◽  
Mechanical Pressure ◽  
Mechanical Oscillations ◽  
Pressure Impact ◽  
The Subject ◽  
The Mean ◽  
Intrapersonal Variability

The present study focuses on an innovative approach in measuring the mechanical oscillations of pre-loaded Achilles tendon by using Mechanotendography (MTG) during application of a short yet powerful mechanical pressure impact. This was applied on the forefoot from the plantar side in direction of dorsiflexion, while the subject stood on the ball of the forefoot on one leg. Participants with Achilles tendinopathy (AT; n = 10) were compared to healthy controls (Con; n = 10). Five trials were performed on each side of the body. For evaluation, two intervals after the impulse began (0-100ms; 30-100ms) were cut from the MTG and pressure raw signals. The intrapersonal variability between the five trials in both intervals were evaluated using the arithmetic mean and coefficient of variation of the mean correlation (Spearman rank correlation) and the normalized averaged mean distances, respectively. The AT-group showed a significantly reduced variability in MTG compared to the Con-group (from p = 0.006 to p = 0.028 for different parameters). The 95% confidence intervals (CI) of MTG results were disjoint, whereas the 95% CIs of the pressure signals were similar (p = 0.192 to p = 0.601). We suggest from this work that the variability of mechanical tendon oscillations could be an indicative parameter of an altered Achilles tendon functionality.

scholarly journals ANTI-TUBERCULAR DRUG INDUCED HEPATOTOXICITY: ASSOCIATED RISK FACTORS UNDER RNTCP-DOTS PULMONARY TUBERCULOSIS PATIENTS.

2016 ◽  
Vol 4 (8) ◽  
pp. 1372-1376
Author(s):  
Ishan Parasher ◽  
◽  
Suryakant Nagtilak ◽  
Amit Jha ◽  
Naresh kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Drug Induced ◽  
Tuberculosis Patients ◽  
Associated Risk Factors

scholarly journals Zika Virus Pathogenesis: From Early Case Reports to Epidemics

Viruses ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 886 ◽  
Author(s):  
Ryan D. Pardy ◽  
Martin J. Richer
Keyword(s):  
Risk Factors ◽  
Zika Virus ◽  
Case Reports ◽  
Viral Persistence ◽  
The Body ◽  
Therapeutic Approaches ◽  
Zikv Infection ◽  
Congenital Zika Syndrome ◽  
Early Case ◽  
The Impact

For the first 60 years following its isolation, Zika virus (ZIKV) remained a relatively poorly described member of the Flaviviridae family. However, since 2007, it has caused a series of increasingly severe outbreaks and is now associated with neurological symptoms such as Guillain-Barré syndrome and congenital Zika syndrome (CZS). A number of reports have improved our understanding of rare complications that may be associated with ZIKV infection in adults, the areas of the body to which it spreads, and viral persistence in various tissues. Likewise, studies on the effect of ZIKV infection during pregnancy have identified risk factors for CZS and the impact this syndrome has on early childhood. Understanding these outcomes and the factors that drive ZIKV pathogenesis are key to developing vaccination and therapeutic approaches to avoid these severe and potentially debilitating symptoms.

scholarly journals Evaluation of Metabolic Syndrome and Its Associated Risk Factors in Type 2 Diabetes: A Descriptive Cross-Sectional Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Francis Agyemang-Yeboah ◽  
Benjamin Ackon Jnr. Eghan ◽  
Max Efui Annani-Akollor ◽  
Eliezer Togbe ◽  
Sampson Donkor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Teaching Hospital ◽  
The Body ◽  
Diabetic Patients ◽  
Study Population ◽  
Associated Risk Factors

Background. Metabolic syndrome (MS) is a collection of cardiovascular risk factors comprising insulin resistance, dyslipidemia, obesity, and hypertension, which may cause further complications in diabetes. Although metabolic syndrome (MS) is increasing in incidence in diabetics and leading to significant cardiovascular diseases and mortality, there is dearth of data in Ghana. This study investigated metabolic syndrome, its prevalence, and its associated risk factors in type 2 diabetes at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study involved 405 diabetic patients attending the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi, in the Ashanti Region of Ghana. A well-structured questionnaire was used to obtain demographic background such as their age and gender. Anthropometric measurements were obtained using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen and also by manual methods. Fasting venous blood was collected for the measurement of biochemical parameters comprising fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-c), and triglyceride (TG). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results. Out of the total of 405 participants, 81 were males and 324 were females, and the estimated mean age was 58.5 ± 9.9 years. The female patients exhibited higher mean waist circumference (WC) and mean hip circumference (HC) as well as an approximately higher body mass index than males (28.3 ± 5.1, 26.5 ± 4.2 for the female and male respectively). Overall, the prevalence of metabolic syndrome observed among the study population was 90.6%. Conclusions. The prevalence of metabolic syndrome observed among the study population was 90.6%, with a higher percentage in females than males. High triglyceride levels and high waist circumference were the main risk factors for MS in the diabetic population.

scholarly journals Lameness in Sheltered Cows and Its Association with Cow and Shelter Attributes

Animals ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. 360 ◽  
Author(s):  
Arvind Sharma ◽  
Clive J. C. Phillips
Keyword(s):  
Risk Factors ◽  
Body Condition ◽  
Body Condition Score ◽  
Cross Sectional Study ◽  
The Body ◽  
Cross Sectional ◽  
Joint Injuries ◽  
Condition Score ◽  
Carpal Joint ◽  
Associated Risk Factors

The sheltering of old, unproductive and abandoned cows in traditional cow shelters, known as gaushalas, has been practiced in India since ancient times. Cows are kept in these shelters until they die of natural causes. The welfare of the cows in these shelters was assessed through a cross-sectional study of 54 cow shelters in six states of India. A total of 1620 cows were examined to assess the prevalence of lameness in these cows, and the associated risk factors for lameness were identified through the measurement of animal-based and resource-based welfare indicators. The overall lameness prevalence was 4.2%. The majority (86%) had mild to moderate hock joint swellings but no or only mild carpal joint injuries. Approximately one-half had mild to moderate hock joint hair loss and most were free of hock joint ulcerations. Claw overgrowth was present in almost one half of the cows. Lameness prevalence was positively correlated with coat dirtiness, hock and carpal joint lesions, diarrhea and claw overgrowth scores. In a multivariate analysis, lameness prevalence increased as the Body Condition Score (BCS) decreased and was associated with increased udder dirtiness, the ulceration of the hock joint, carpal joint injuries and claw overgrowth. Resource-based indicators measured at the shelter level suggested that an absence of bedding in the sheds and an increase in the gradient of the shed flooring increased lameness. Addressing the principle risk factors identified for lameness in the sheltered cows (low body condition, dirty udders, lesions on the hock and carpal joints, overgrown claws, and a steep floor gradient) may help to reduce this serious animal welfare problem.

scholarly journals Antimicrobial-induced cognitive side effects

2016 ◽  
Vol 6 (4) ◽  
pp. 207-214 ◽  
Author(s):  
Amanda Warstler ◽  
Jennifer Bean
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Side Effects ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Time Frame ◽  
Drug Induced ◽  
Pubmed Search ◽  
Neuropsychiatric Side Effects ◽  
Cognitive Side Effects

Abstract Introduction: Antimicrobial-induced cognitive side effects are often overlooked or underreported. Literature often reports symptoms of antimicrobial-induced cognitive impairment under more general blanket terms, such as neuropsychiatric side effects, neurotoxicity, or drug-induced delirium or encephalopathy. Methods: A PubMed search using terms including antibiotics, antifungals, antivirals, antimalarials, side effects, cognitive, neurotoxicity, encephalopathy, and delirium was conducted. Respectively, symptoms of cognitive impairment were teased out of the multiple neurologic complications presented for each case and reported based on antimicrobial class. Articles were excluded if they focused solely on neuropsychiatric side effects such as seizures, psychosis, hallucinations, or mood disturbances, were conducted in animals, or involved antiretroviral medication therapies. Results: Of over 50 case reviews, case reports, retrospective chart reviews, and prospective cohort studies analyzed, 25 were deemed appropriate for purposes of this review. Common antimicrobial-induced cognitive side effects for all antimicrobial classes included confusion, delirium, encephalopathy, and impaired concentration or attention. Recurring risk factors included, but were not limited to, older age and renal impairment. Mechanisms of cognitive impairment were relatively specific to each antimicrobial class. Discussion: Awareness of the potential for antimicrobial-induced cognitive side effects, including the general time frame of symptom onset and symptom presentation, is critical in challenging patient cases. This review article aims to summarize the risk factors, clinical symptoms, mechanisms, and management of antimicrobial-induced cognitive side effects. Pharmacists can play a key role in prevention through adjustment of medications for renal or hepatic dysfunction, avoidance of polypharmacy, and knowledge of critical drug interactions that may precipitate cognitive decline.

Terfenadine-Induced Torsade de Pointes: Risk Factors and Mechanisms

1997 ◽  
Vol 13 (3) ◽  
pp. 127-132 ◽  
Author(s):  
Thomas Yk Chan
Keyword(s):  
Risk Factors ◽  
Liver Dysfunction ◽  
Qt Interval ◽  
Torsade De Pointes ◽  
Pharmacokinetic Studies ◽  
Drug Induced ◽  
Significant Prolongation ◽  
Concurrent Use ◽  
Cyp3a4 Inhibitors

Objective: To review the risk factors and mechanisms of terfenadine-induced torsade de pointes and to discuss how this adverse reaction might be avoided. Data Sources: Previous reports of terfenadine-induced torsade de pointes and studies of the underlying mechanisms were identified by a MEDLINE search or from the reference lists of pertinent articles. Study Selection and Data Extraction: All relevant articles were included in the review. Pertinent information was selected for discussion. Data Synthesis: Terfenadine is extensively (99%) metabolized by CYP3A4 to an active acid metabolite (terfenadine carboxylate), and with therapeutic dosages, unchanged terfenadine is usually undetectable in plasma. A review of all the reported cases of torsade de pointes indicated that most patients had one or more factors that would be expected to cause excessively high concentrations of unchanged terfenadine, such as overdose; use of supratherapeutic dosages; concurrent use of CYP3A4 inhibitors such as ketoconazole, itraconazole, erythromycin, and troleandomycin; and liver dysfunction. Many patients had one or more factors known to predispose to drug-induced torsade de pointes (e.g., preexisting prolonged QT interval, ischemic heart disease, hypokalemia). Pharmacokinetic studies in healthy volunteers have shown that ketoconazole, itraconazole, erythromycin, and clarithromycin can alter the metabolism of terfenadine and result in the accumulation of unchanged terfenadine, which is associated with significant prolongation of the QT interval. In vitro studies have shown that the proarrhythmic effects of terfenadine are secondary to the blockade of cardiac potassium channels. Terfenadine carboxylate does not have such an effect. Conclusions: Supratherapeutic dosages of terfenadine should never be used. The concurrent use of CYP3A4 inhibitors should be avoided. Terfenadine should be avoided in patients with liver dysfunction or factors known to predispose to drug-induced torsade de pointes.

Medication Bezoars: A Literature Review and Report of a Case

1998 ◽  
Vol 32 (9) ◽  
pp. 940-946 ◽  
Author(s):  
James R Taylor ◽  
Daniel S Streetman ◽  
Sharon S Castle
Keyword(s):  
Risk Factors ◽  
English Language ◽  
Case Reports ◽  
Relevant Literature ◽  
Significant Risk ◽  
Signs And Symptoms ◽  
The Body ◽  
Surgical Removal ◽  
Diagnostic Challenge ◽  
Medline Search

OBJECTIVE: To describe a case of a medication bezoar and to review the clinical presentation, diagnosis, risk factors, pathogenesis, complications, and treatment of medication bezoars. DATA SOURCES AND STUDY SELECTION: A MEDLINE search (January 1966–December 1997) of the English-language literature pertaining to bezoars was performed. These articles were scanned, and literature specifically discussing medication bezoars was selected. Additionally, the reference sections of pertinent review and case reports were scanned for additional relevant literature. DATA SYNTHESIS: Bezoars are concretions of foreign material within the body. In the case of medication bezoars, these concretions occur within the digestive tract and are composed of medications and/or medication vehicles. Rarely, however, is bezoar formation solely due to a medication. In nearly all reported cases the patient had one or more significant risk factors that contributed to bezoar formation. The exact method by which medication bezoars form is dependent on the particular type or combination of medications involved. Bezoar formation may be associated with significant complications for the patient due to the presence of the bezoar and because of the effects of the medication within the bezoar. Treatment of medication bezoars depends largely on the location and the cause of the bezoar. CONCLUSIONS: Medication bezoars are a rare but potentially serious complication of medication use in certain patients. These patients often present with signs and symptoms consistent with an obstruction of the gastrointestinal tract and represent an even greater diagnostic challenge due to the rarity of this complication. These patients also face significant complications from both the bezoar and the medication within the bezoar. To date, treatment of medication bezoars involves mainly physical manipulation of the bezoar through lavage, endoscopic removal, or, in most cases, surgical removal.

scholarly journals Assessment of Extrapyramidal Symptoms Associated with Psychotropics Pharmacological Treatments, and Associated Risk Factors

2021 ◽  
Vol 17 (1) ◽  
pp. 1-7
Author(s):  
Dania Abu-Naser ◽  
Sara Gharaibeh ◽  
Ahmad Z. Al Meslamani ◽  
Qais Alefan ◽  
Renad Abunaser
Keyword(s):  
Risk Factors ◽  
Extrapyramidal Symptoms ◽  
Drug Induced ◽  
Gender And Age ◽  
High Incidence ◽  
History Of ◽  
Baseline Factors ◽  
The Difference ◽  
Health Database ◽  
Associated Risk Factors

Background: Extrapyramidal Symptoms (EPS) are unwanted symptoms commonly originating from the use of certain medications. The symptoms can range from minimal discomfort to permanent involuntary muscular movements. The aims of the study were to examine the incidence of drug-induced extrapyramidal symptoms (di-EPS), associated risk factors, and clinical characteristics. Methods: This is a retrospective, observational study of di-EPS conducted in outpatient clinics of Jordan using the longitudinal health database (Hakeem®) for data collection. Patients who received drugs with the risk of EPS during the period 2010-2020 were included and followed. Patients with any of the known underlying conditions that may cause EPS or were currently taking drugs that may mask the symptoms were excluded. Gender and age-matched control subjects were included in the study. The Statistical Package for Social Science (SPSS®) version 26 was used for data analysis. Results: The final dataset included 34898 exposed patients and 69796 matched controls. The incidence of di-EPS ranged from 9.8% [Amitriptyline 25mg] to 28.9% (Imipramine 25mg). Baseline factors associated with a significantly higher risk of developing di-EPS were age {HR: 1.1 [95%CI: 0.8-1.2, p=0.003], smoking {HR: 1.7 (95%CI: 1.3-2.2), p=0.02}, tremor history {HR: 7.4 (95%CI: 5.9-8.3), p=.002} and history of taking antipsychotics {HR: 3.9, (95% CI: 2.5-4.6), p=0.001}. Patients taking paroxetine {HR: 8.6 [95%CI: 7.4-9.8], p=.0002},imipramine {HR: 8.3, [7.1-10.5], p=0.01}, or fluoxetine {HR: 8.2 (95%CI: 6.8-9.3), p=.006} had a significantly higher risk of developing di-EPS compared to patients taking citalopram. Myoclonus, blepharospasm, symptoms of the basal ganglia dysfunction, and organic writers' cramp were reported among participants. Conclusion: Patients treated with paroxetine, imipramine, fluoxetine, or clomipramine had a higher risk of developing di-EPS than patients treated with citalopram. The difference in gender was not significantly related to di-EPS development. Whereas age, smoking, and history of taking antipsychotics were significantly associated with di-EPS development. Key findings: • High incidence of drug-induced extrapyramidal symptoms (di-EPS) was reported • Age, smoking, tremor history, and history of taking antipsychotics were risk factors of drug-induced extrapyramidal symptoms. • Patients taking paroxetine, imipramine or fluoxetine had a significantly higher risk of developing di-EPS compared to patients taking citalopram

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