Successful Outpatient Management of Severe Ionized Hypercalcemia Secondary to Cholecalciferol Ingestion in a Puppy

2022 ◽  
Vol 58 (1) ◽  
pp. 37-41
Author(s):  
Adrienne M. Felix ◽  
Rebecca K. Davies
Keyword(s):  
Body Weight ◽  
Medical Management ◽  
Biochemical Parameters ◽  
Reference Range ◽  
Oral Prednisone ◽  
Standard Of Care ◽  
Outpatient Management ◽  
Published Report ◽  
Life Threatening

ABSTRACT A 4 mo old female intact boxer was presented because of polyuria, lethargy, and vomiting after ingestion of cholecalciferol rodenticide roughly 3 days prior. Blood work revealed an ionized hypercalcemia 2.23 mmol/L (reference range 1.04–1.33 mmol/L) on presentation. Because of financial limitations, the patient was unable to be hospitalized for standard of care. She was treated with a pamidronate infusion and discharged with medical management to include oral prednisone, furosemide, and subcutaneous fluids. The dog’s signs, body weight, and biochemical parameters were serially monitored over 3 wk as the ionized hypercalcemia resolved. To the authors’ knowledge, this is the first published report documenting a successful outpatient medical protocol for potentially life-threatening hypercalcemia secondary to cholecalciferol toxicosis in a puppy.

scholarly journals 1174. Phase 2 STRIVE Clinical Trial of Rezafungin for Treatment of Candidemia and/or Invasive Candidiasis Demonstrates Consistent Trough Concentrations Across Diverse Patient Populations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
Shawn Flanagan ◽  
Christopher M Rubino ◽  
Taylor Sandison
Keyword(s):  
Body Weight ◽  
Invasive Candidiasis ◽  
Fungal Infections ◽  
Standard Of Care ◽  
Geographic Region ◽  
Continuous Variables ◽  
Phase 2 ◽  
Double Blind ◽  
Wide Range ◽  
Diverse Patient Populations

Abstract Background Rezafungin is a novel echinocandin antifungal in development for treatment as well as prevention (prophylaxis) of invasive fungal infections. STRIVE (NCT02734862) is a global, randomized, double-blind, placebo-controlled, Phase 2 trial evaluating safety and efficacy of IV rezafungin once weekly (QWk) for treatment of candidemia and/or invasive candidiasis compared with standard-of-care (IV caspofungin once daily with optional oral stepdown). Here we report pharmacokinetic (PK) data from the completed STRIVE trial analyzed by patient demographics at baseline. Methods Rezafungin Day 8 trough (Cmin) concentrations from patients treated with rezafungin were summarized categorically by race (black or white), sex (male or female), and geographic region (North America [NA], or Europe [EU]), or plotted versus continuous variables of age, body weight, body mass index (BMI), and body surface area (BSA). As the first dose of rezafungin was 400 mg for all rezafungin-treated patients, data from both dose groups (Group 1: 400 mg QWk; Group 2: 400 mg in Week 1 followed by 200 mg QWk) were combined in this analysis. Results Rezafungin mean Cmin (SD) values were 1.8 (0.7) and 2.3 (1.2) in black and white patients, 1.9 (1.0) and 2.6 (1.2) in males and females, and 1.9 (0.6) and 2.4 (1.3) in patients from NA and EU. There were small differences in point estimates between the groups, but there was a great deal of overlap and the differences are not expected to be clinically meaningful (Figure). Similarly, no trends in Cmin values were observed across a range of ages (20-80 years), weights (~40-155 kg), BMI (~15-65 kg/m2), and BSA (~1.4-2.4 m2). Figure Conclusion No meaningful differences in rezafungin Cmin values were observed in patients grouped by sex, race, or geographic region, or across a wide range of patient factors, including age and body weight and size. These findings indicate that a single rezafungin dose regimen can be expected to provide consistent PK across diverse patient populations. Disclosures Shawn Flanagan, PhD, Cidara Therapeutics, Inc. (Employee, Shareholder) Christopher M. Rubino, PharMD, Institute for Clinical Pharmacodynamics, Inc. (Employee)Spero Therapeutics (Grant/Research Support) Taylor Sandison, MD, MPH, Cidara Therapeutics, Inc. (Employee, Shareholder)

Nutritional Status of Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)

1983 ◽  
Vol 3 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Brigitte Heide ◽  
Andreas Pierratos ◽  
Ramesh Khanna ◽  
Jean Pettit ◽  
Raymond Ogilvie ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Intake ◽  
Biochemical Parameters ◽  
Total Body Potassium ◽  
Total Body ◽  
Over Time

Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. There was no correlation between changes in TBN and the biochemical parameters measured. Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.

Management of an unusual cause of life-threatening haemoptysis: a multidisciplinary approach

2021 ◽  
Vol 14 (5) ◽  
pp. e240448
Author(s):  
Kim Pramanik ◽  
Philip Webb ◽  
RanaShoaib Hamid
Keyword(s):  
Cystic Fibrosis ◽  
Interventional Radiology ◽  
Tranexamic Acid ◽  
Medical Management ◽  
Multidisciplinary Approach ◽  
Bronchial Artery ◽  
Successful Resuscitation ◽  
Emergency Medical ◽  
Life Threatening

We present to you a case of life-threatening haemoptysis secondary to non-cystic fibrosis bronchiectasis complicated by bronchial artery pseudoaneurysms. We discuss this patient’s emergency medical management using intravenous tranexamic acid, which resulted in successful resuscitation and eventual survival, and evaluate the need for urgent anaesthetic and interventional radiology input in such a case.

scholarly journals Effects of Vitamin E and Vitamin C on Mercury Induced Toxicity in Mice

2013 ◽  
Vol 19 (2) ◽  
pp. 93-100 ◽  
Author(s):  
MA Huq ◽  
MA Awal ◽  
M Mostofa ◽  
A Ghosh ◽  
AR Das
Keyword(s):  
Body Weight ◽  
Vitamin E ◽  
Vitamin C ◽  
Biochemical Parameters ◽  
Hematological Parameters ◽  
Protective Role ◽  
Alpha Tocopherol ◽  
Post Mortem ◽  
Group B ◽  
Vitamin E And C

The present study was undertaken to find out the efficacy of vitamin E and/or vitamin C against mercury (Hg) induced toxicity in mice. Sixty mice were randomly divided into 5 equal groups (n=12). One group of mice (Group A) was kept as control and each of rest four groups (B, C, D and E) were fed with mercuric chloride (HgCl2) in drinking water @ 65 mg/L. In addition to HgCl2 alpha-tocopherol (vitamin E) @ 100 mg/L, ascorbic acid (vitamin C) @ 250 mg/L and combination of vitamin E and vitamin C at same dose were given to the mice of groups C, D and E respectively. All treatments were continued for 28 consecutive days. Four mice of each group were sacrificed on day 1, 14 and 28 and efficacy of vitamin E and vitamin C against Hg induced toxicity were evaluated by observing toxic signs, body weight, hemato-biochemical parameters and postmortem lesions. Mild (++) toxic signs as evident by reduced feed and water intake, salivation, vomiting, excitement, muscle tremor, ataxia, restlessness, incordination and ruffled hair coat were observed from 2nd week (group B) and from 3rd week (group C and D) by intoxication with HgCl2. Significant (P<0.01) reduction of body weight (18.38%) and hematological parameters i.e. TEC (19.88%), TLC (27.89%), Hb content (34.09%) and PCV (9.15%) were observed at day 28 in HgCl2 induced intoxicated mice (group B). At identical period in same group biochemical parameters i.e. AST (46.99%) and ALT (58.72%) increased significantly (p<0.01). Pinpoint hemorrhages throughout the liver and highly (++++) congested kidney was also observed at post mortem (group B). All the parameters i.e. toxic signs, body weight, hemato-biochemical and post mortem lesions were found to be slight (+) or mild (++) and/or improved in rest three groups of mice following treatment with vitamin E, vitamin C and combination of vitamin E and vitamin C. The present study reveals that vitamin E and C have a protective role against Hg poisoning. However, combination of vitamin E and C gave better results.DOI: http://dx.doi.org/10.3329/pa.v19i2.16949 Progress. Agric. 19(2): 93 - 100, 2008

scholarly journals Assessment of anti-diabetic activity of alcoholic and hydro-alcoholic extract of Terminalia arjuna & Syzygium cumini in streptozotocin-induced diabetes in Wistar rats

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1870-1882
Author(s):  
Takru Harshit ◽  
Dixit Praveen K ◽  
Kumar Kapil ◽  
Nagarajan K
Keyword(s):  
Body Weight ◽  
Glucose Level ◽  
Biochemical Parameters ◽  
Wistar Rats ◽  
Diabetic Rats ◽  
Terminalia Arjuna ◽  
Alcoholic Extract ◽  
Syzygium Cumini ◽  
Liver And Pancreas ◽  
Streptozotocin Induced Diabetes

We aimed to evaluate the effect of anti-diabetic activity of Terminalia arjuna, and Syzygium cumini extracts in Streptozotocin (STZ) induced diabetes in Wistar rats. STZ (55mg/kg) followed by nicotinamide (100mg/kg) was given to rats by intraperitoneal route to induce diabetes. Oral administration of alcoholic and hydro-alcoholic extracts of T. arjuna (TAAE) (250mg/kg and 500mg/kg), S. cumini (SCAE) (200mg/kg and 400mg/kg) and their composite extract were given to rats along with standard anti-diabetic drug Glibenclamide (5mg/kg). We evaluated body weight, glucose level, lipid profile and biochemical parameters in STZ induced diabetic rats. Also, histopathological studied were done in liver, kidney and pancreatic tissues of rats. Our finding revealed that TAAE and TAHE at 250mg/kg b.w. and 500mg/kg b.w., SCAE and SCHE at 400mg/kg b.w. and combination of TAAE (250mg/kg b.w.)+SCAE (400mg/kg b.w.) had a positive effect in lowering the blood glucose level and body weight on 28th day as compared to the initial observation on 0th day and also restored all the biochemical parameters such as LDL, VLDL, triglycerides and total Cholesterol and HDL towards the normal levels as well as histopathological improvement in Kidney, Liver and Pancreas. Data analysis showed that composite extract of TAAE (250mg/kg) and SCAE (400mg/kg ) improved diabetic consequences more effectively than composite extract of TAHE (500mg/kg) and SCHE (400mg/kg). TAAE and SCHE, in combination, demonstrate as a potential therapeutic agent against diabetes.

scholarly journals A 90-Day Oral Toxicity of Hydroethanolic Root Extract of Carissa spinarum in Wistar Rats

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Komlan M. Dossou-Yovo ◽  
Aboudoulatif Diallo ◽  
Povi Lawson-Evi ◽  
Yendubé T. Kantati ◽  
Tchin Darré ◽  
...  
Keyword(s):  
Body Weight ◽  
Biochemical Parameters ◽  
Wistar Rats ◽  
Hematological Parameters ◽  
Relative Weight ◽  
Control Group ◽  
Root Extract ◽  
Weight Changes ◽  
Oral Toxicity ◽  
Significant Difference

Background. Herbal medication is a worldwide and ancient practice, mostly in developing countries, where a large part of the population is involved in this practice. Hence, studies must be conducted to evaluate their safety and efficiency to avoid or prevent toxicological risks due to their usage. In Togo, Carissa spinarum is a medicinal plant belonging to Apocynaceae family, used as an aphrodisiac or to heal some ailments including malaria, sickle cell anemia, hypertension, pain, and asthma. Notwithstanding its several ethnomedicinal benefits, just a few toxicological data associated with its chronic use are available. Objective. Therefore, this study aims to assess the toxicity of an ethanolic root extract of Carissa spinarum in Wistar rats. Methods. The 90-day oral toxicity process following OECD TG 408 guidelines is used. Male Wistar rats received Carissa spinarum root hydroethanolic extract at 500 and 1000 mg/kg for 90 days by oral gavage. Body weight changes, hematological and blood biochemical parameters, organ weight changes, malondialdehyde as a lipoperoxidation marker expressed according to tissue proteins, and histopathology of vital organs were assessed. Results. No signs of toxicity or mortality were observed during the 90 days experiment. Hematological parameters have not shown any treatment-related abnormalities. According to biochemical parameters, an increase in the chloride ion level was observed at 1000 mg/kg p < 0.01 . There was no significant difference between the treated groups and the control group concerning the malondialdehyde concentration, body weight, and organ relative weight. No changes in necropsy and histopathology of vital organs associated with extract treatment were observed. Conclusion. The results indicated that an ethanolic root extract of Carissa spinarum does not cause adverse effects, which can lead to Wistar rats’ death after 90-day oral administration at 500 and 1000 mg.

scholarly journals Three-dimensional Printing of Customized Bioresorbable Airway Stents

2020 ◽  
Author(s):  
Nevena Paunović ◽  
Yinyin Bao ◽  
Fergal Brian Coulter ◽  
Kunal Masania ◽  
Anna Karoline Geks ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Standard Of Care ◽  
Time Frame ◽  
Psychological Burden ◽  
Three Dimensional Printing ◽  
Life Threatening ◽  
Reasonable Time Frame ◽  
Printed Materials ◽  
Airway Stents

AbstractCentral airway obstruction is a life-threatening disorder causing a high physical and psychological burden to patients due to severe breathlessness and impaired quality of life. Standard-of-care airway stents are silicone tubes, which cause immediate relief, but are prone to migration, especially in growing patients, and require additional surgeries to be removed, which may cause further tissue damage. Customized airway stents with tailorable bioresorbability that can be produced in a reasonable time frame would be highly needed in the management of this disorder. Here, we report poly(D,L-lactide-co-ε-caprolactone) methacrylate blends-based biomedical inks and their use for the rapid fabrication of customized and bioresorbable airway stents. The 3D printed materials are cytocompatible and exhibit silicone-like mechanical properties with suitable biodegradability. In vivo studies in healthy rabbits confirmed biocompatibility and showed that the stents stayed in place for 7 weeks after which they became radiographically invisible. The developed biomedical inks open promising perspectives for the rapid manufacturing of the customized medical devices for which high precision, tuneable elasticity and predictable degradation are sought-after.

Fibrinolytic Agents

2006 ◽  
Author(s):  
Richard C. Becker ◽  
Frederick A. Spencer
Keyword(s):  
Body Weight ◽  
Patient Management ◽  
Factor Viia ◽  
Plasminogen Activators ◽  
Common Complication ◽  
Fibrinolytic Agents ◽  
Life Threatening ◽  
Potential Factor ◽  
Tissue Factor Pathway ◽  
High Concentrations

The generation of plasmin from plasminogen by plasminogen activators (fibrinolytic agents) induces a variety of effects in addition to dissolving fibrin strands, degrading fibrinogen, and inhibiting tissue factor pathway and factor VIII. It also, in high concentrations, causes platelet activation. Thus, fibrinolytic agents have both prothrombotic and antihemostatic properties—the latter of which is often augmented by the concomitant use of anticoagulants and platelet antagonists (see Chapter 12). Bleeding is the most common complication of fibrinolytic (and adjunctive antithrombotic) therapy. The most important predictors of nonintracranial hemorrhage are older age, invasive procedures, low body weight, and female sex (de Jaegre et al, 1992; GISSI 2 Investigators, 1990; GUSTO-III Investigators, 1997; INJECT Investigators, 1995). Predictors of intracranial hemorrhage include age (>65 years), low body weight (<70 kg), hypertension on admission, and alteplase (vs. streptokinase) (GUSTO-III Investigators, 1997). The approach to patient management in cases of fibrinolytic-induced bleeding is summarized in Figure 30.1. It is important to consider antithrombotic agents that may concomitantly increase hemorrhagic potential. Factor VIIa (recombinant; NovoSeven) represents a treatment alternative for life-threatening hemorrhagic complications.

Vascular Diseases of the Hepaticopancreaticobiliary System

2018 ◽  
pp. 388-424
Author(s):  
Kyle J. Cooper ◽  
Sara E. Smolinski-Zhao ◽  
Wael E. Saad
Keyword(s):  
Medical Management ◽  
Vascular Diseases ◽  
Biliary Tree ◽  
Natural Course ◽  
Interventional Radiologist ◽  
System P ◽  
Life Threatening ◽  
Enteric Tract ◽  
Clinical Overview

The liver, pancreas, and biliary tree exist within a complex, interconnected relationship among each other and the enteric tract. They play vital roles in endocrine physiology, metabolism, and immunity. These anatomically complex organs can be affected by a variety of vascular conditions, ranging from acute and self-limited to chronic and life-threatening. The clinical workup and management of these conditions are as important to the interventional radiologist as the procedures that they are asked to perform to treat them. Knowledge of the diseases themselves, their natural course, and medical management can help to familiarize proceduralists with the reasons for referral and the complications and comorbidities that one can expect when treating these patients. In this chapter, we present a clinical overview of vascular diseases affecting the hepaticopancreaticobiliary systems.

scholarly journals Management of pulmonary toxicity associated with immune checkpoint inhibitors

2019 ◽  
Vol 28 (154) ◽  
pp. 190012 ◽  
Author(s):  
Myriam Delaunay ◽  
Grégoire Prévot ◽  
Samia Collot ◽  
Laurent Guilleminault ◽  
Alain Didier ◽  
...  
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Pulmonary Toxicity ◽  
Immune Checkpoint Inhibitors ◽  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitors ◽  
Standard Of Care ◽  
Serious Adverse Events ◽  
Programmed Cell Death 1 ◽  
Life Threatening

Immunotherapy has become a standard of care in oncology, following the recent approvals of cytotoxic T-lymphocyte-associated protein-4 and programmed cell death-1 inhibitors in lung cancer, melanoma, renal cell carcinoma, Hodgkin's lymphoma, bladder, head and neck cancers. Besides their efficacy, these agents also generate specific immune-related adverse events. Due to the increasing prescription of immune-checkpoint inhibitors, the incidence of immune toxicity will continue to rise. The awareness of immune-related adverse events is key to ensuring both diagnosis and management of the possible serious adverse events. Although severe immune-related adverse events remain rare, they can lead to discontinued treatment or to death if they are not forecasted and managed properly. Even if lung toxicity is not the most frequent adverse event, it remains critical as it can be life-threatening. Herein, the main aspects of pulmonary toxicity are reviewed and guidelines are also proposed in order to manage the possible side-effects.

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