Fracture Healing

2015 ◽  
Vol 105 (2) ◽  
pp. 160-172 ◽  
Author(s):  
Robert G. Smith
Keyword(s):  
Adverse Effects ◽  
Fracture Healing ◽  
Bone Health ◽  
Case Reports ◽  
Drug Effects ◽  
Delayed Union ◽  
Adverse Drug Effects ◽  
Drug Adverse Effects ◽  
Definitive Statement ◽  
Medical Causation

Background Recognizing the existence of adverse drug effects of frequently prescribed drugs can empower a clinician with knowledge to avoid dangerous adverse effects that may result in hazardous, negative patient outcomes on either fracture healing or bone health. Pharmacovigilance reports have described the influence of medications, allowing for bone health to be quite unpredictable. Methods First, mechanisms found in the medical literature of potential drug adverse effects regarding fracture healing are presented. Second, the 100 most frequently prescribed medications in 2010 are reviewed regarding adverse effects on fracture healing. These reported adverse effects are evaluated for medical causation. Last, a data table describing the 100 reviewed medications and their reported effects on fracture healing is provided. Results The actual number of different medications in the review was 72. Reported drug adverse effects on bone and fracture healing occurred with 59 of the 72 drugs (81.9%). These adverse effects are either described as a definitive statement or represented by postmarketing case reports. Thirteen of the 72 review drugs (18.1%) did not have any description of the possible effects on bone health. A total of 301 cases reports describing delayed union, malunion, and nonunion of fractures represent 31 of the 72 medications reviewed (43.1%). Conclusions This review offers the health-care provider information regarding potential adverse drug effects on bone health. Empowered with this information, clinicians may assist their patients in maximizing pharmacologic outcomes by avoiding these reported harmful adverse effects.

scholarly journals Assessment of the cardiovascular adverse effects of drug-drug interactions through a combined analysis of spontaneous reports and predicted drug-target interactions

2019 ◽  
Author(s):  
Sergey Ivanov ◽  
Alexey Lagunin ◽  
Dmitry Filimonov ◽  
Vladimir Poroikov
Keyword(s):  
Ventricular Tachycardia ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Cardiovascular System ◽  
Drug Target ◽  
Drug Effects ◽  
Classification Models ◽  
Adverse Drug Effects ◽  
Combined Analysis ◽  
Spontaneous Reports

AbstractAdverse drug effects (ADEs) are one of the leading causes of death in developed countries and are the main reason for drug recalls from the market, whereas the ADEs that are associated with action on the cardiovascular system are the most dangerous and widespread. The treatment of human diseases often requires the intake of several drugs, which can lead to undesirable drug-drug interactions (DDIs), thus causing an increase in the frequency and severity of ADEs. An evaluation of DDI-induced ADEs is a nontrivial task and requires numerous experimental and clinical studies. Therefore, we developed a computational approach to assess the cardiovascular ADEs of DDIs.This approach is based on the combined analysis of spontaneous reports (SRs) and predicted drug-target interactions to estimate the five cardiovascular ADEs that are induced by DDIs, namely, myocardial infarction, ischemic stroke, ventricular tachycardia, cardiac failure, and arterial hypertension.We applied a method based on least absolute shrinkage and selection operator (LASSO) logistic regression to SRs for the identification of interacting pairs of drugs causing corresponding ADEs, as well as noninteracting pairs of drugs. As a result, five datasets containing, on average, 3100 ADE-causing and non-ADE-causing drug pairs were created. The obtained data, along with information on the interaction of drugs with 1553 human targets predicted by PASS Targets software, were used to create five classification models using the Random Forest method. The average area under the ROC curve of the obtained models, sensitivity, specificity and balanced accuracy were 0.838, 0.764, 0.754 and 0.759, respectively.The predicted drug targets were also used to hypothesize the potential mechanisms of DDI-induced ventricular tachycardia for the top-scoring drug pairs.The created five classification models can be used for the identification of drug combinations that are potentially the most or least dangerous for the cardiovascular system.Author summaryAssessment of adverse drug effects as well as the influence of drug-drug interactions on their manifestation is a nontrivial task that requires numerous experimental and clinical studies. We developed a computational approach for the prediction of adverse effects that are induced by drug-drug interactions, which are based on a combined analysis of spontaneous reports and predicted drug-target interactions. Importantly, the approach requires only structural formulas to predict adverse effects, and, therefore, may be applied for new, insufficiently studied drugs. We applied the approach to predict five of the most important cardiovascular adverse effects, because they are the most dangerous and widespread. These effects are myocardial infarction, ischemic stroke, ventricular tachycardia, arterial hypertension and cardiac failure. The accuracies of predictive models were relatively high, in the range of 73-81%; therefore, we performed a prediction of the five cardiovascular adverse effects for the large number of drug pairs and revealed the combinations that are the most dangerous for the cardiovascular system. We consider that the developed approach can be used for the identification of pairwise drug combinations that are potentially the most or least dangerous for the cardiovascular system.

scholarly journals Evaluation of Medline Utility for the Retrieval of Case Reports of Drug Adverse Effects.

2000 ◽  
Vol 26 (1) ◽  
pp. 27-35
Author(s):  
JUN HAMADA ◽  
TAKAO ORII ◽  
ETSUKO NEGISHI ◽  
YASUHIKO YAMADA ◽  
HITOSHI SATO ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Case Reports ◽  
Drug Adverse Effects

scholarly journals Teriparatide in fracture healing: Case series and review of literature

2022 ◽  
Vol 7 (2) ◽  
pp. 93-100
Author(s):  
S S Jha ◽  
Amit B Jain ◽  
Nilanj Dave ◽  
Alok Chaturvedi ◽  
Sandesh Warudkar
Keyword(s):  
Fracture Healing ◽  
Case Reports ◽  
Case Series ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Published Data ◽  
Mechanical Instability ◽  
Mineral Density ◽  
Non Union

Teriparatide (TPTD) (recombinant Parathyroid Hormone 1-34) is one of the pioneer osteo-anabolic agents approved for management of osteoporosis. Being an anabolic agent, it increases bone mineral density by inducing formation of new bone by the action on osteoblasts. As new bone formation is an important aspect of fracture healing as well, Teriparatide has long been a product of interest with respect to its effect on the process of fracture healing. Though fracture healing is not an approved indication for Teriparatide, there is quite a substantial amount of published data related to its effectiveness in fracture healing. With an intent to better understand the role of teriparatide in fracture, we share few case reports of successful fracture healing after giving Teriparatide and also review the published evidences of union taking place in difficult delayed union and non-union cases secondary to mechanical instability, inadequate fixation support or other reasons. This article thus, intended to summarize the accumulating preclinical and clinical evidence for role of TPTD in accelerating fracture healing in various conditions like conservative management of fractures, vertebral fractures, non-unions, delayed unions and atypical femoral fractures.

scholarly journals Challenges of Pharmacovigilance in Brazil

2020 ◽  
Vol 13 (2) ◽  
pp. 1
Author(s):  
Vanessa M. de Oliveira ◽  
Vanessa T. Gubert-Matos ◽  
Alexandre A. Tutes ◽  
Cristiane M. Ferreira ◽  
Erica F. Vasconcelos-Pereira ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Effects ◽  
Healthcare Spending ◽  
Adverse Drug Effects ◽  
Medicinal Products ◽  
Notification System ◽  
Safety Issues ◽  
Potential Safety ◽  
Hospital Stays ◽  
Detection Evaluation

Pharmacovigilance encompasses the detection, evaluation, understanding, and prevention of adverse effects or any other drug-related problems. Knowledge of real and independent pharmacovigilance data is essential because clinical trials with medicinal products are limited and do not reveal all adverse effects of a product. The spontaneous notification system is one of the main tools used in pharmacovigilance. However, important remaining challenges for health professionals are the accurate recognition of adverse drug reactions and reporting routinely and systematically during their work. Once low notification rates make it harder to detect and monitor potential safety issues, it is needed risk assessment, and regulatory actions to safeguard patient safety. The objective of this study is to present the challenges of pharmacovigilance in Brazil. The implementation of computerized active search tools significantly improves the identification of possible adverse drug effects. Effective pharmacovigilance is crucial to ensure the safety and integrity of healthcare systems, to avoid lengthy hospital stays and to optimize healthcare spending. However, pharmacovigilance tools remain underused, undervalued, or even unknown in Brazil.

scholarly journals Microengineered systems with iPSC-derived cardiac and hepatic cells to evaluate drug adverse effects

2020 ◽  
pp. 153537022095959
Author(s):  
Keri Dame ◽  
Alexandre JS Ribeiro
Keyword(s):  
Adverse Effects ◽  
Drug Development ◽  
Drug Effects ◽  
In Vitro Models ◽  
Development Programs ◽  
Physiological Relevance ◽  
Drug Adverse Effects ◽  
Induced Pluripotent ◽  
Clinical Drug

Hepatic and cardiac drug adverse effects are among the leading causes of attrition in drug development programs, in part due to predictive failures of current animal or in vitro models. Hepatocytes and cardiomyocytes differentiated from human induced pluripotent stem cells (iPSCs) hold promise for predicting clinical drug effects, given their human-specific properties and their ability to harbor genetically determined characteristics that underlie inter-individual variations in drug response. Currently, the fetal-like properties and heterogeneity of hepatocytes and cardiomyocytes differentiated from iPSCs make them physiologically different from their counterparts isolated from primary tissues and limit their use for predicting clinical drug effects. To address this hurdle, there have been ongoing advances in differentiation and maturation protocols to improve the quality and use of iPSC-differentiated lineages. Among these are in vitro hepatic and cardiac cellular microsystems that can further enhance the physiology of cultured cells, can be used to better predict drug adverse effects, and investigate drug metabolism, pharmacokinetics, and pharmacodynamics to facilitate successful drug development. In this article, we discuss how cellular microsystems can establish microenvironments for these applications and propose how they could be used for potentially controlling the differentiation of hepatocytes or cardiomyocytes. The physiological relevance of cells is enhanced in cellular microsystems by simulating properties of tissue microenvironments, such as structural dimensionality, media flow, microfluidic control of media composition, and co-cultures with interacting cell types. Recent studies demonstrated that these properties also affect iPSC differentiations and we further elaborate on how they could control differentiation efficiency in microengineered devices. In summary, we describe recent advances in the field of cellular microsystems that can control the differentiation and maturation of hepatocytes and cardiomyocytes for drug evaluation. We also propose how future research with iPSCs within engineered microenvironments could enable their differentiation for scalable evaluations of drug effects. Impact statement Cardiac and hepatic adverse drug effects are among the leading causes of attrition in preclinical and clinical drug development programs as well as marketing withdrawals. The insufficiency of animal testing models has led to considerable interest in the employment of cardiac and hepatic models using human-induced pluripotent stem cells (iPSCs) for drug toxicity testing. However, current batches of iPSC-derived cardiomyocytes and hepatocytes are variable and not matured as adult primary tissues, which limit their prediction of drug effects. This article discusses how the use of microfluidics can create microenvironments to better control differentiation protocols and increase the physiological relevance of iPSC-derived cardiomyocytes and hepatocytes. Development and standardization of technologies will enable evaluation of the potential value of cellular microsystems to improve the in vitro models used in drug development programs. Future steps in this field include controlled connections of organ systems to better recreate clinical metabolism and pharmacokinetics.

Adverse drug effects attributed to phenylpropanolamine: A review of 142 case reports

1990 ◽  
Vol 89 (2) ◽  
pp. 195-208 ◽  
Author(s):  
C.Raymond Lake ◽  
Sheryle Gallant ◽  
Elizabeth Masson ◽  
Peggy Miller
Keyword(s):  
Case Reports ◽  
Drug Effects ◽  
Adverse Drug Effects

scholarly journals Systematic Review of Adverse Effects: A Further Step towards Modernization of Acupuncture in China

2015 ◽  
Vol 2015 ◽  
pp. 1-19 ◽  
Author(s):  
Junyi Wu ◽  
Yanmei Hu ◽  
Yin Zhu ◽  
Ping Yin ◽  
Gerhard Litscher ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Systematic Review ◽  
Central Nervous System ◽  
Adverse Effects ◽  
Scientific Literature ◽  
Acupuncture Treatment ◽  
Case Reports ◽  
The World ◽  
Organ Tissue

As a further step towards the modernization of acupuncture, the objective of this review was to figure out the frequency and severity of adverse complications and events in acupuncture treatment reported from 1980 to 2013 in China. All first-hand case reports of acupuncture-related complications and adverse events that could be identified in the scientific literature were reviewed and classified according to the type of complication and adverse event, circumstance of the event, and long-term patient outcome. The selected case reports were published between 1980 and 2013 in 3 databases. Relevant papers were collected and analyzed by 2 reviewers. Over the 33 years, 182 incidents were identified in 133 relevant papers. Internal organ, tissue, or nerve injury is the main complications of acupuncture especially for pneumothorax and central nervous system injury. Adverse effects also included syncope, infections, hemorrhage, allergy, burn, aphonia, hysteria, cough, thirst, fever, somnolence, and broken needles. Qualifying training of acupuncturists should be systemized and the clinical acupuncture operations should be standardized in order to effectively prevent the occurrence of acupuncture accidents, enhance the influence of acupuncture, and further popularize acupuncture to the rest of the world.

Incidence rate of adverse drug effects in a hospital emergency unit and its associated factors

2010 ◽  
Vol 34 (6) ◽  
pp. 271-278
Author(s):  
S. Ramos Linares ◽  
P. DíazRuiz ◽  
J. Mesa Fumero ◽  
S. Núñez Díaz ◽  
M. Suárez González ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Associated Factors ◽  
Drug Effects ◽  
Emergency Unit ◽  
Adverse Drug Effects ◽  
Hospital Emergency
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