scholarly journals Evolution of Drug Interactions With Antiretroviral Medication in People With HIV

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Majdouline El Moussaoui ◽  
Iseult Lambert ◽  
Nathalie Maes ◽  
Anne-Sophie Sauvage ◽  
Frédéric Frippiat ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Antiretroviral Drugs ◽  
University Hospital ◽  
Hiv Care ◽  
Antiretroviral Medication ◽  
High Prevalence ◽  
Two Factors ◽  
Red Flag ◽  
The University ◽  
Over Time

Abstract Background Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. Methods This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions. Results We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor–based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016. Conclusions This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care.

scholarly journals Clinical and Technical Overview of Preimplantation Genetic Diagnosis for Fragile X Syndrome: Experience at the University Hospital Virgen del Rocio in Spain

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Raquel M. Fernández ◽  
Ana Peciña ◽  
Maria Dolores Lozano-Arana ◽  
Beatriz Sánchez ◽  
Juan Carlos García-Lozano ◽  
...  
Keyword(s):  
Fragile X Syndrome ◽  
Preimplantation Genetic Diagnosis ◽  
Birth Rate ◽  
Fragile X ◽  
Genetic Diagnosis ◽  
Live Birth Rate ◽  
University Hospital ◽  
Mental Impairment ◽  
High Prevalence ◽  
The University

Fragile X syndrome (FXS) accounts for about one-half of cases of X-linked intellectual disability and is the most common monogenic cause of mental impairment. Reproductive options for the FXS carriers include preimplantation genetic diagnosis (PGD). However, this strategy is considered by some centers as wasteful owing to the high prevalence of premature ovarian failure in FXS carriers and the difficulties in genetic diagnosis of the embryos. Here we present the results of our PGD Program applied to FXS, at the Department of Genetics, Reproduction and Fetal Medicine of the University Hospital Virgen del Rocío in Seville. A total of 11 couples have participated in our PGD Program for FXS since 2010. Overall, 15 cycles were performed, providing a total of 43 embryos. The overall percentage of transfers per cycle was 46.67% and the live birth rate per cycle was 13.33%. As expected, these percentages are considerably lower than the ones obtained in PGD for other pathologies. Our program resulted in the birth of 3 unaffected babies of FXS for 2 of the 11 couples (18.2%) supporting that, despite the important drawbacks of PGD for FXS, efforts should be devoted in offering this reproductive option to the affected families.

scholarly journals Diagnosis of Dizziness Due to a Core Vestibular Projection Injury in a Patient with Intracerebral Hemorrhage

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 220 ◽  
Author(s):  
Hyeok Gyu Kwon ◽  
Chul Hoon Chang ◽  
Sung Ho Jang
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Physical Examination ◽  
Left Hemisphere ◽  
Diffusion Tensor ◽  
Insular Cortex ◽  
University Hospital ◽  
The Core ◽  
The University ◽  
Over Time

Herein, we present a patient diagnosed with dizziness due to a core vestibular projection injury following intracerebral hemorrhage (ICH). A 51-year-old female patient underwent conservative management for a spontaneous ICH in the left hemisphere (mainly affecting the basal ganglia and insular cortex). When she visited the rehabilitation department of the university hospital at two years after the ICH onset, she advised of the presence of moderate dizziness (mainly, light-headedness) that started after ICH onset. She mentioned that her dizziness had decreased slightly over time. No abnormality was observed in the vestibular system of either ear on physical examination by an otorhinolaryngologist. However, diffusion tensor tractography results showed that the core vestibular projection in the left hemisphere was discontinued at the basal ganglia level compared with the patient’s right core vestibular projection and that of a normal subject. Therefore, it appears that the dizziness in this patient can be ascribed to a left core vestibular projection injury.

scholarly journals Evolution over 11 years of the characteristics of walk-in patients at the emergency department of a university hospital in Brussels

2019 ◽  
Vol 12 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Merita Hysenbegasi ◽  
◽  
Ives Hubloue ◽  
Rita Vanobberghen ◽  
Jan Kartounian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Family Physician ◽  
University Hospital ◽  
The Mean ◽  
The University ◽  
Standing Problem ◽  
Over Time

Walk-in patients who do not require urgent treatment at an emergency department (ED) are a known and long-standing problem. This study aims to investigate the characteristics of walk-in patients visiting the ED over time. During four days in June 2012, all walk-in patients attending the ED of the University Hospital Brussels between 8 AM and 11 PM were recorded. A similar registration took place in the same ED in June 2001. Patients completed a questionnaire about their characteristics and the reason for the encounter. Data of both study periods were compared. The mean age of the patients attending the ED was significantly lower in 2001 (40.9 years) than in 2012 (43.9 years) (p=0,02). In 2001, 81% of the participants had Belgian nationality, but in 2012 this proportion increased to 90% (p=0.008). In 2001 as well as in 2012, 21% of the participants had a referral from their family physician (FP) (p=0.9). The proportion of patients that were aware that FP could also handle some emergencies increased from 17% in 2001 to 29% in 2012 (p=0.003). More patients had complaints that begun less than 24h before they attended the ED (48% in 2001 and 58% in 2012) (p=0.03). The walk-in patients at the ED are getting slightly older and are attending the ED faster after the onset of the complaints. More patients judge their complaints as urgent. However, more patients are getting aware that FP also could handle some emergencies.

scholarly journals Drug Related Problems at the Intensive Care Unit of a University Hospital in Saudi Arabia

2015 ◽  
Vol 5 (1) ◽  
pp. 11-18
Author(s):  
Mohammad A. Randhawa ◽  
Hatem O. Qutub ◽  
Mastour S. Alghamdi ◽  
Raniah A. Al-Jaizani ◽  
Rayan Y. Mushtaq ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Drug Interactions ◽  
Medication Errors ◽  
Drugs Of Abuse ◽  
Improve Patient Care ◽  
University Hospital ◽  
Drug Related Problems ◽  
The University

Background: Medication errors can lead to mild or severe drug related problems. Drug related problems are sometimes unpredictable and can occur without medication errors. Awareness and identification of medication errors and drug related problems aids in adoption of measures to prevent and treat them. Objective: Present study aimed to find out prevalence of drug related problems reporting or occurring at Intensive Care Unit of King Fahd Hospital of the University, Alkhobar, Saudi Arabia. Methods: Scrutinizing written files of all patients reporting to Intensive Care Unit, from January to December 2012. Results: Out of 193 files reviewed, 33 patients (17.1%) had trivial to serious drug related problems, including 8 (4.1%) deaths. Drugs commonly involved in these problems were anticoagulants (Warfarin and heparin, alone or in combination with aspirin or clopidogrel; 8 cases, 24.2%), antiepileptic drugs (Carbamazepine and phenytoin; 6 cases, 18.2%), immune suppressants (Azathioprine and prednisolone; 4 cases, 12.1%), antibiotics (Ciprofloxacin, imipenum, tazocin and vancomycin; 4 cases, 12.1%) and drugs of abuse and dependence (Alcohol, benzodiazepines, cannabis and opioids; 4 cases, 12.1%). Amongst drug related problems detected, 6 cases (18.2%) were linked to drug interactions. Almost 60% of drug related problems found were preventable, including those due to overdose toxicity, non-compliance and drug-drug interactions. Conclusions: Mild to severe drug related problems occurred in intensive care unit of a university hospital and about half of them were preventable. It is hoped that the awareness and insight of drug related problems will help to improve patient care.

Current Therapeutic Approach in EDNOS

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F. Fernandez-Aranda ◽  
I. Krug ◽  
N. Riesco ◽  
I.M. Sanchez-Diaz
Keyword(s):  
University Hospital ◽  
Motivation To Change ◽  
Case Control Studies ◽  
Pilot Studies ◽  
Psychosocial Impairment ◽  
Face To Face ◽  
High Prevalence ◽  
Long Term Prognosis ◽  
The University

Background and aims:Despite the high prevalence of EDNOS only a small proportion of individuals with this disorder seek treatment, which may be due in part to difficulties in finding specialized treatment settings for EDNOS and the high costs and logistics associated with face-to-face individual psychotherapy. This omission is critical since there is evidence that the severity of psychopathology and degree of secondary psychosocial impairment in those with EDNOS are comparable to those seen in patients with anorexia nervosa (AN) or bulimia nervosa (BN). There has been hardly any research on the treatment of atypical EDs other than the promising effort on BED, for which Cognitive Behavior Therapy (CBT) is proposed to be the most effective treatment. The aim of this presentation is to show several pilot studies and our experience of treating EDNOS cases, but also to analyze variables associated to good-outcome.Method:We performed several clinical studies with EDNOS patients at the University Hospital of Bellvitge to assess the effectiveness and efficiency of specific outpatient CBT programs of short and long term duration.Results and conlusions:The few case-control studies where the effect of diagnosis on the prognosis has been analyzed have shown differential course and outcome in EDs. EDNOS (with exception of BED) showed the poorest long-term prognosis, due to their heterogeneity and, in many cases, to their lower motivation to change. Specific therapy programs, based on our experience, will be discussed.

Incidence of potential drug interactions in medication prescriptions for children and adolescents in the University Hospital Olomouc, Czech Republic

2013 ◽  
Vol 172 (5) ◽  
pp. 631-638 ◽  
Author(s):  
Petra Langerová ◽  
Michal Prokeš ◽  
Martin Konvalinka ◽  
Jana Fürstová ◽  
Karel Urbánek
Keyword(s):  
Czech Republic ◽  
Drug Interactions ◽  
Children And Adolescents ◽  
University Hospital ◽  
Potential Drug ◽  
The University

scholarly journals High Prevalence of Isolates with Reduced Glycopeptide Susceptibility in Persistent or Recurrent Bloodstream Infections Due to Methicillin-Resistant Staphylococcus aureus

2011 ◽  
Vol 56 (3) ◽  
pp. 1258-1264 ◽  
Author(s):  
Ilker Uçkay ◽  
Louis Bernard ◽  
Marta Buzzi ◽  
Stephan Harbarth ◽  
Patrice François ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bloodstream Infections ◽  
Poor Response ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Content Type ◽  
Vancomycin Mics ◽  
High Prevalence ◽  
The University

ABSTRACTReduced susceptibility to glycopeptides in methicillin-resistantStaphylococcus aureus(MRSA) clinical isolates is considered a risk factor for failure of glycopeptide therapy. We compared the prevalences of MRSA isolates with reduced glycopeptide susceptibility in patients with versus without persistent or recurrent MRSA bloodstream infections. A retrospective cohort study at the University Hospital of Geneva identified 27 patients with persistent or recurrent clonally related MRSA bacteremic episodes over an 8-year period, which included 208 consecutive nosocomial MRSA bacteremic episodes. Vancomycin and teicoplanin MICs were determined by a modified macrodilution assay allowing improved detection of glycopeptide-intermediate MRSA isolates (GISA), characterized by elevated teicoplanin or/and vancomycin MICs (≥4 μg/ml). For 16 patients (59%), their pretherapy and/or posttherapy MRSA isolates showed elevated teicoplanin MICs, among which 10 (37%) concomitantly displayed elevated vancomycin MICs. In contrast, 11 other patients (41%) were persistently or recurrently infected with non-GISA isolates. In comparison, only 39 (22%) of 181 single isolates from patients with no microbiological evidence of persistent or recurrent infections showed elevated teicoplanin MICs, among which 14 (8%) concomitantly displayed elevated vancomycin MICs. Clinical, microbiological, and pharmacokinetic variables for patients persistently or recurrently infected with GISA or non-GISA isolates were similar. Bacteremic patients with a poor response to glycopeptide therapy had a 2.8-fold- and 4.8-fold-higher rates of MRSA isolates displaying elevated teicoplanin and vancomycin MICs, respectively, than patients with single isolates (P< 0.0001). Detection of elevated teicoplanin MICs may help to predict a poor response to glycopeptide therapy in MRSA bacteremic patients.

scholarly journals Study on the Effect of Malnutrition in the Readmission of Patients Receiving Home-Based Hospital Care

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1120-1120
Author(s):  
Mónica Carabot ◽  
Carmen Mias ◽  
Sandra Bertran
Keyword(s):  
Hospital Readmission ◽  
Hospital Care ◽  
Hospital Readmissions ◽  
University Hospital ◽  
Severe Malnutrition ◽  
Bivariate Analysis ◽  
P Value ◽  
Home Based ◽  
High Prevalence ◽  
The University

Abstract Objectives Malnutrition has a high prevalence among patients of Home-Based Hospital Care (HBHC) and can aggravate medical prognosis including early hospital readmission. The primary goal of this study is to determine whether malnutrition could be a predictive factor of patient readmission to HBHC occurring within 30 days of discharge. The secondary aims are to establish the number of hospital readmissions within 30 days of discharge, and to identify nutritional indicators that predict readmission within 30 days. Furthermore, to determine the type, degree and risk of malnutrition in patients and to evaluate the effectiveness of nutritional support in the patients who received it. Methods We performed an observational, cross-sectional study of the HBHC's patients of the University Hospital Arnau de Vilanova (HUAV) in Lleida, Spain, who were readmitted to the hospital or to the HBHC service after HBHC's discharge between June and December of 2018. We also collected a descriptive study and a bivariate analysis on the relationship between the survey data and the number of days until hospital readmission with a cut-off point at 30 days. Results Those who were readmitted after 30 days were statistically more likely to have a greater number of associated pathologies (2,20 (SD = 0,92) vs 1,16 (SD = 1,07); P value = 0012), especially, diabetes mellitus (5 (50,0%) vs 2 (10,5%); P value = 0030). Strong trends were seen between low serum albumin and lymphocytes levels and readmission within 30 days. Conclusions No statistically significant relationship was found between nutritional parameters and readmission rates due to the high prevalence of high and severe malnutrition in both groups (readmitted before and after 30 days). These findings reinforced the need to introduce a standard protocol such as screening with an easy and safe nutritional evaluation tool as well as the incorporation of a dietitian to HBHC. Funding Sources Home-Based Hospital Care section of the University Hospital Arnau de Vilanova (HUAV) in Lleida, Biomedical Research Institute of Lleida and University of Lleida.

scholarly journals Granulomatosis with polyangiitis in Tunisia

Reumatismo ◽  
2017 ◽  
Vol 69 (1) ◽  
pp. 23 ◽  
Author(s):  
I. Ben Ghorbel ◽  
N. Belfeki ◽  
N. Baouendi ◽  
T. Ben Salem ◽  
M.H. Houman
Keyword(s):  
Cardiac Involvement ◽  
Granulomatosis With Polyangiitis ◽  
Renal Involvement ◽  
University Hospital ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Intravenous Cyclophosphamide ◽  
Lymph Node Enlargement ◽  
High Prevalence ◽  
The University ◽  
Pleural Involvement

Granulomatosis with polyangiitis (GPA) is more frequent in Northern rather than Southern countries. Very few studies have been conducted in Africa. We have performed a retrospective descriptive study including clinical and laboratory profiles of 30 Tunisian GPA patients seen at the department of Internal Medicine of the University Hospital of la Rabta from 2000 to 2014. Mean age at initial GPA diagnosis was 46±12 years, and the average number of months between the onset of symptoms and diagnosis was 25. Seventeen (56%) were male, and 13 (44%) were female. Ear/nose/throat involvement occurred in 83%. Lung and renal involvement were observed in respectively 70% and 56% followed by mucocutaneous (50%), neurological (50%), ocular (33%), vascular (20%), ureteral (16%), and cardiac involvement in 10%. Cytoplasmic pattern-antineutrophil cytoplasmic antibodies (ANCA) was detected in 27 (90%) patients. Induction therapy consisted of intravenous cyclophosphamide pulses in 27 patients (90%) and oral methotrexate in 3 patients (10%). Trimethoprime-sulfamethoxazole was used in 26 patients (86%). Maintenance therapy consisted of azathioprine in 17 cases and methotrexate in 13 cases. Relapses occurred in 36%. Eighteen patients had favorable outcome and 12 died. Our patients had a distinct phenotype with high prevalence of pleural involvement, lymph node enlargement, sensorimotor neuropathy and ureter stenosis. ENT symptoms were less frequent as inaugural presentation. Overall 2-year survival was 60%.

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