scholarly journals Drugs as diagnostic tools

2016 ◽  
Vol 85 (1) ◽  
pp. 43-45
Author(s):  
Nicole Arseneau ◽  
Carlos Muzlera
Keyword(s):  
Illicit Drugs ◽  
Diagnostic Tools ◽  
Past Medical History ◽  
Fat Pad ◽  
Mild Depression ◽  
Family History Of Diabetes ◽  
The Past ◽  
Multivitamin Supplement ◽  
History Of ◽  
Alcoholic Drinks

Mr Simon, age 36, presents to his family physician with concerns about his weight. He has gained 20 kg in the past 4 months, and has developed purple striae on his abdomen. His body mass index (BMI) is currently 34, and on physical examination, he is found to have a rounded face, a large dorsal fat pad, and a waist circumference of 112 cm. His blood pressure is elevated at 145/95 mmHg, while all other vitals are normal. He also mentions worsening acne on his face, shoulders, and upper back, as well as mild depression for the past 3 months. His past medical history is significant only for an appendectomy at age 10. He has no family history of diabetes, obesity, or cardiac disease. The only medication he has been on for the past 3 years is a multivitamin supplement. He does not smoke, drinks approximately 5 alcoholic drinks per week, and does not take any illicit drugs.

Rhabdomyolysis: An evidence-based approach

2021 ◽  
pp. 175114372110507
Author(s):  
Sarah Burgess
Keyword(s):  
Fluid Overload ◽  
Kidney Injury ◽  
Community Acquired Pneumonia ◽  
Evidence Based ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Urine Dipstick ◽  
The Past ◽  
Acting Insulin ◽  
History Of

A 76-year-old lady was found on the floor following a fall at home. She was uninjured, but unable to get up, and had been lying on the floor for roughly 18 hours before her son arrived. She had been unwell for the past 3 days with a cough and shortness of breath. She had a past medical history of diabetes, hypertension, hypercholesterolaemia and atrial fibrillation (AF). On examination, she was alert but distressed, clinically dehydrated, febrile and tachycardic. She was treated for community acquired pneumonia with co-amoxiclav and was fluid resuscitated with Hartmann’s solution. Her hyperkalaemia was treated with 50 mL of 50% glucose containing 10 units of rapid-acting insulin. Her creatinine kinase (CK) on admission was 200,000, and she had an acute kidney injury (AKI). Urine dipstick was positive for blood. However, her renal function continued to deteriorate over the succeeding 48 h, when she required renal replacement therapy (RRT) due to fluid overload and anuria.

scholarly journals Ossification of the Posterior Longitudinal Ligament

2003 ◽  
Vol 30 (1) ◽  
pp. 61-62
Author(s):  
A.P. Mitha ◽  
J.H. Wong ◽  
S.J. du Plessis
Keyword(s):  
Diabetes Mellitus ◽  
Neck Pain ◽  
Type Ii Diabetes ◽  
Posterior Longitudinal Ligament ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Past Medical History ◽  
The Past ◽  
Chinese Descent ◽  
History Of

A 51-year-old gentleman of Chinese descent presented for neurological evaluation following a two-year history of cervical neck pain associated with left arm numbness. His symptoms were initially stable, but had progressed over the past six months to include weakness of his entire left arm and leg and symptoms of bladder urgency. Two weeks prior to presentation, he suffered repeated falls due to worsening gait difficulties. The past medical history was significant for type II diabetes mellitus.

scholarly journals SNI case of the week: Initial concomitant use of gabapentin, clonidine, and prednisone may enhance suicidal ideation: A case report

2020 ◽  
Vol 11 ◽  
pp. 41
Author(s):  
Ramsis F. Ghaly ◽  
Ana Plesca ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Suicide Risk ◽  
Alcoholic Hepatitis ◽  
Gunshot Wound ◽  
Concomitant Administration ◽  
Hepatic Disease ◽  
Major Depressive ◽  
The Past ◽  
History Of ◽  
Alcoholic Drinks ◽  
First Time

Background: Suicide cases are the end product of a combination of biological, clinical, psychological, social, and cultural risk/protective factors, and attempts to remain unpredictable. Case Description: A 43-year-old male presented to the hospital with jaundiced skin/eyes of 7 days’ duration. He had a history of a major depressive disorder and chronic alcohol consumption (e.g., 3–5 alcoholic drinks/day for the past 15 years). Studies documented acute hepatic disease (e.g., biopsy-documented hepatocellular alcoholic hepatitis), accompanied by a cholestatic disease. The patient was discharged on clonidine, iron multivitamin, folic acid, gabapentin, and prednisone. Eight days postdischarge from the hospital, he committed suicide (e.g., self- inflicted gunshot wound to the head). Conclusion: Concomitant administration of gabapentin, prednisone, and clonidine, especially if used for the first time, may play a synergistic effect in increasing a patient’s suicide risk.

scholarly journals Illicit drug use and sexually transmitted infections among young adults in the US: evidence from a nationally representative survey

2020 ◽  
Vol 31 (13) ◽  
pp. 1238-1246
Author(s):  
Mohammad Rifat Haider ◽  
Caroline Kingori ◽  
Monique J Brown ◽  
Michele Battle-Fisher ◽  
Ilana Azulay Chertok
Keyword(s):  
Young Adults ◽  
Drug Use ◽  
Sexually Transmitted Infections ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
The United States ◽  
Sexually Transmitted ◽  
The Past ◽  
History Of

Young people aged 15–24 years account for half of all new sexually transmitted infections (STIs) in the United States. The aim of this study was to examine the cross-sectional associations of factors linked to STIs among US young adults (18–25 years). This study used the 2015–2018 pooled National Survey on Drug Use and Health data on 55,690 young adults. Almost 3.4% of the respondents reported having an STI in the past year. Among the participants, 38.4% used illicit drugs and 3.7% reported a history of delinquency in the past year. In the survey-weighted logistic regression model, odds for contracting STIs in the preceding year was higher among adults aged 22–25 versus 18–21 years (OR:1.26, 95%CI:1.12–1.42); male versus female (OR:2.44, 95%CI:2.11–2.82); non-Hispanic African American versus non-Hispanic White (OR:1.77, 95%CI:1.55–2.02); widowed/separated/divorced (OR:1.93, 95%CI:1.36–2.75) and never married (OR:1.29, 95%CI:1.07–1.55) versus married; full-time/part-time employed (aOR:1.17, 95% CI:1.04–1.31) compared to unemployed/other; history of delinquency (OR:2.31, 95%CI:1.89–2.83); and use of illicit drugs in the last year (OR:3.10, 95%CI:2.77–3.47). High incidence of illicit drug use by the young adults and its strong association with STI incidence in recent years warrant special attention. Tailored preventive measures should be focused on key predictors.

scholarly journals Acute pericarditis: A peculiar manifestation of common variable immune deficiency

2021 ◽  
Vol 49 (3) ◽  
pp. 115-119
Author(s):  
Nasim Ramzi ◽  
Shahrooz Yazdani ◽  
Hamed Talakoob ◽  
Hossein Karim ◽  
Mahnaz Jamee ◽  
...  
Keyword(s):  
Immune Deficiency ◽  
Medical History ◽  
Inborn Error ◽  
Common Variable Immune Deficiency ◽  
Recurrent Infections ◽  
Past Medical History ◽  
Acute Pericarditis ◽  
The Past ◽  
History Of ◽  
Common Variable

Common variable immune deficiency (CVID) is known as the most prevalent symptomatic inborn error of immunity associated with autoimmune and inflammatory complications in addition to recurrent infections. In this study, we investigated the prevalence of acute pericarditis as a complication in the past medical history of 337 CVID patients. We found five patients (1.5%) that had experienced acute pericarditis, and described the medical history of three patients.

Langanhaltende durch Tiklopidin ausgelöste Leukopenie eines an chronischer Hepatitis C und Immunozytom leidenden Patienten

VASA ◽  
1999 ◽  
Vol 28 (4) ◽  
pp. 301-303 ◽  
Author(s):  
Redlich ◽  
Parschalk ◽  
Ehringer ◽  
Minar
Keyword(s):  
Bone Marrow ◽  
Hepatitis C ◽  
Cell Count ◽  
White Cell Count ◽  
Secondary Prophylaxis ◽  
White Cell ◽  
Past Medical History ◽  
The Past ◽  
History Of ◽  
Arterial Occlusive Diseases

Ticlopidine is increasingly used in the secondary prophylaxis in patients with arterial occlusive diseases. Neutropenia is a well known side effect of this drug. We report a case of a 73 year old woman who was admitted because of severe prolonged ticlopidine induced leucopenia. The past medical history included an immunocytoma of the IgM-kappa type diagnosed seven years ago with less than 10% infiltration of the bone marrow and a chronic hepatitis C. On admission the white cell count was 1000/muL. Ticlopidine was stopped. The white cell count did not increase within one week, thus filgastrim was applied on two consecutive days. The leucocyte count promptly increased to 6000/muL but consecutively dropped within the next fortnight again to levels below 500/muL forcing daily filgastrim application for another 9 days. Four months after the initation of the therapy with filgastrim the patient had a white cell count of 4300/muL. We therefore conclude that in patients with a history of potentially bone marrow suppressing diseases the use of ticlopidine has to be carefully weighed against possible myelosuppressive effects.

scholarly journals Long-term use of antibiotics and risk of type 2 diabetes in women: a prospective cohort study

2020 ◽  
Vol 49 (5) ◽  
pp. 1572-1581
Author(s):  
Jinqiu Yuan ◽  
Yanhong Jessika Hu ◽  
Jie Zheng ◽  
Jean Hee Kim ◽  
Tim Sumerlin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Family History ◽  
Antibiotic Use ◽  
Family History Of Diabetes ◽  
The Past ◽  
Increased Risk ◽  
History Of

Abstract Background Accumulating evidence suggested that long-term antibiotic use may alter the gut microbiome, which has, in turn, been linked to type 2 diabetes. We undertook this study to investigate whether antibiotic use was associated with increased risk of type 2 diabetes. Methods This prospective cohort study included women free of diabetes, cardiovascular disease and cancer in the Nurses’ Health Study (NHS 2008–2014) and NHS II (2009–2017). We evaluated the overall duration of antibiotics use in the past 4 years and subsequent diabetes risk with Cox proportional-hazards regression adjusting for demography, family history of diabetes and lifestyle factors. Results Pooled analyses of NHS and NHS II (2837 cases, 703 934 person-years) revealed that a longer duration of antibiotic use in the past 4 years was associated with higher risk of diabetes [Trend-coefficient = 0.09, 95% confidence interval (CI) 0.04 to 0.13]. Participants who received antibiotics treatment for a medium duration of 15 days to 2 months [hazard ratio (HR) 1.23, 95% CI 1.10 to 1.39] or long duration of >2 months (HR 1.20, 95% CI 1.02 to 1.38) had higher risk of type 2 diabetes as compared with non-users. Subgroup analyses suggested that the associations were unlikely to be modified by age, family history of diabetes, obesity, smoking, alcohol drinking, physical activity and overall diet quality. Conclusions A longer duration of antibiotic use in recent years was associated with increased risk of type 2 diabetes in women. Physicians should exercise caution when prescribing antibiotics, particularly for long-term use.

Drug Use Among Adolescent Mothers: Profile of Risk

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 144-151
Author(s):  
Hortensia Amaro ◽  
Barry Zuckerman ◽  
Howard Cabral
Keyword(s):  
Drug Use ◽  
Adolescent Mothers ◽  
Illicit Drugs ◽  
Venereal Disease ◽  
Male Partner ◽  
High Risk Group ◽  
Adverse Outcomes ◽  
Targeted Prevention ◽  
The Past ◽  
History Of

Adolescent pregnancy and adolescent drug use are important clinical and public health problems. Yet, few studies have systematically investigated the patterns of substance use among pregnant and parenting adolescents. Because adverse outcomes are not found uniformly for all adolescent mothers, use of illicit drugs may be a key factor in determining which mothers and their infants will have poor outcomes. In this study, the patterns of drug use are described and differences in the demographic and psychosocial profile among 253 pregnant adolescents are investigated. Results obtained from interviews and urine assay for marijuana and cocaine indicate that lifetime use was 84% for alcohol, 62% for marijuana, and 23% for cocaine, whereas use in the past year was 40% for marijuana and 17% for cocaine. Compared with nonusers, pregnant adolescent drug users were more likely to be North American black, have a history of elective abortion and venereal disease, report more negative life events and violence during pregnancy, and receive more support from the father of the baby who was more likely to use marijuana and cocaine (P < .01). Furthermore, according to logistic regression analysis results after controlling for age and ethnicity, adolescents who used illicit substances in the past year were three times more likely to have a male partner who used marijuana or cocaine and were two times more likely to have a history of venereal disease compared with nonusers. The findings suggest that drug use, whether as a mechanism or a marker, is associated with social and medical characteristics that are likely to contribute to negative outcomes among adolescent mothers and their infants. Targeted prevention and intervention efforts to this high-risk group of adolescent mothers need to be developed and evaluated.

scholarly journals The characteristics and death risk factors of 132 COVID-19 pneumonia patients with comorbidities: a retrospective single center analysis in Wuhan, China

2020 ◽  
Author(s):  
Chen Chen ◽  
Jingyi Zhang ◽  
Chang Li ◽  
Zhishuo Hu ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Critical Group ◽  
Past Medical History ◽  
Factors Associated ◽  
The Past ◽  
Survivor Group ◽  
History Of ◽  
D Dimer

AbstractBackgroundThe new coronavirus pneumonia (COVID-19) has evolved into a global pandemic disease, and the epidemiological characteristics of the disease have been reported in detail. However, many patients with new coronary pneumonia have comorbidities, and there are few researches reported in this special population.Methodsa retrospective analysis was performed on 132 consecutive COVID-19 patients with comorbidities from January 19, 2020 to March 7, 2020 in Hubei Third People’s Hospital. Patients were divided into mild group and critical group and were followed up to the clinical endpoint. The observation biomarkers include the clinical feature, blood routine, blood biochemistry, inflammation biomarkers, and coagulation function. Univariate and multivariate logistic regression was used to analyze the risk factors associated with death.Results132 patients were enrolled in this study and divided into the mild group (n=109, 82.6%) and critical group (n=23, 17.4%), of whom 119 were discharged and 13 were died in hospital. The all-cause mortality rate was 9.8%, of which 7 patients died of respiratory failure, 5 patients died of heart failure, and 1patient died of chronic renal failure. There was significant statistical difference of mortality rates between the mild group (5.5%) and the critical group (30.4%). The average time of hospitalization was 16.9 (9, 22) days. Hypertension was the most common comorbidity (n=90, 68.2%), followed by diabetes (n=45, 34.1%), coronary heart disease (31, 23.5%). Compared with the mild group, the patients were older in critical group (P <0.05), and neutrophils, neutrophil ratio, neutrophil-lymphocyte ratio (NLR), serum urea nitrogen (BUN), procalcitonin (PCT), C-reactive protein CRP), serum amyloid protein (SSA), N-terminal brain natriuretic peptide precursor (NT-pro BNP) were significantly increased (P <0.05). However, lymphocytes lymphocyte ratio, albumin were lower than those in the critical group (P <0.05). The patients were further divided into the survivor group (n=119, 90.2%) and the non-survivor group (n=13, 9.8%). Compared with the survivor group, the death rate of patients with coronary heart disease was significantly increased (53.8% vs 20.2%), and The neutrophil ratio, aspartate aminotransferase (AST), BUN, PCT, CRP, SAA, interleukin-6(IL-6) and D-dimer were significantly increased (P <0.05), while the lymphocytes and NLR reduced (P <0.05). Multivariate logistic stepwise regression analysis showed that the past medical history of coronary heart disease[OR:2.806 95%CI:0.971~16.795], decreased lymphocytes [OR: 0.040, 95%CI:0.001~2.306], increased AST[OR:1.026, 95%CI:1.000~1.052], increased SSA[OR:1.021, 95%CI:1.001~1.025], and increased D-dimer[OR:1.231, 95%CI:1.042~1.456] are risk factors associated with death in COVID-19 patients pneumonia with comorbidities.ConclusionThe mortality rate of COVID-19 patients with coronary heart disease is relatively high. In all patients, the lower lymphocytes, and higher NLR, BUN, PCT, CRP, SSA, D-dimer are significant characteristics. The past medical history of coronary heart disease, decreased lymphocytes, increased AST, SSA and D-dimer are risk factors associated with death in COVID-19 patients’ pneumonia with comorbidities

Potential drug-drug interactions in ICU patients: a retrospective study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Iyad Ali ◽  
Alaa Bazzar ◽  
Nadine Hussein ◽  
Emile Sahhar
Keyword(s):  
Diabetes Mellitus ◽  
Healthcare Professionals ◽  
Chronic Illnesses ◽  
Potential Drug ◽  
Past Medical History ◽  
Icu Patients ◽  
The Past ◽  
Adequate Knowledge ◽  
Ensure Patient Safety ◽  
History Of

AbstractObjectivesA “potential drug-drug interaction” (pDDI) is the possibility one drug has to alter the effects of another when both are administered simultaneously. Intensive care unit (ICU) patients are especially prone to these pDDIs. This study aimed to determine the frequency and severity of pDDIs during the hospitalization of patients in the ICU.MethodsThis study was conducted retrospectively in three hospitals, including both governmental and non-governmental hospitals in Nablus, Palestine, over the course of six months; starting in January 2018 and ending in June 2018. The sample size included 232 ICU patients, and medications prescribed during the hospitalization of these patients were evaluated for pDDIs using the drugs.com application.ResultsA total of 167 patients (72%) were found to have at least one pDDI, while the total number of pDDIs in the study was 422, resulting in an average of 1.82 pDDIs per patient. Out of the total identified pDDIs, 41 interactions (9.7%) were major interactions, 281 (66.6%) were moderate interactions and 100 (23.7%) were minor interactions. The past medical history of these patients showed that many had hypertension (29%), diabetes mellitus (25%) and ischemic heart disease (10%). A serious combination, enoxaparin and aspirin, was found in six patients. Furthermore, as the number of administered drugs increased, the number of interactions increased as well.ConclusionsThe pDDIs are common in ICU patients. The most common and clinically most important pDDIs require special attention. Polypharmacy significantly increases the number and level of pDDIs, especially in patients with multiple chronic illnesses. Adequate knowledge regarding the most common pDDIs is necessary to enable healthcare professionals to implement ICU strategies that ensure patient safety.

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