Search

Supplemental material, sj-docx-1-opp-10.1177_10781552221122026 for Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy by Astrid Eliasen, J Kornholt, R Mathiasen, J Brok, C Rechnitzer, K Schmiegelow and K Dalhoff in Journal of Oncology Pharmacy Practice

Supplemental material, sj-docx-2-opp-10.1177_10781552221122026 for Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy by Astrid Eliasen, J Kornholt, R Mathiasen, J Brok, C Rechnitzer, K Schmiegelow and K Dalhoff in Journal of Oncology Pharmacy Practice

Supplemental material, sj-docx-2-opp-10.1177_10781552221122026 for Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy by Astrid Eliasen, J Kornholt, R Mathiasen, J Brok, C Rechnitzer, K Schmiegelow and K Dalhoff in Journal of Oncology Pharmacy Practice

Supplemental material, sj-docx-1-opp-10.1177_10781552221122026 for Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy by Astrid Eliasen, J Kornholt, R Mathiasen, J Brok, C Rechnitzer, K Schmiegelow and K Dalhoff in Journal of Oncology Pharmacy Practice

Paracetamol is a very frequently used drug for overdose and enquiries to poison information centres (PIC) concerning paracetamol-related poisonings are common. Availability of paracetamol varies in European countries; some have no pack size restriction in pharmacies, while others do. The aim of the study was to describe availability of paracetamol sold over-the counter (OTC) in European pharmacies, secondly to investigate the association between availability and the frequencies of enquiries to PICs concerning poisoning with paracetamol.

Mild analgesics are sold in all European countries, and some countries have observed increased contact with emergency departments due to overdose by these agents, especially paracetamol. There is significant evidence that restricting access to means is an effective suicide prevention strategy, and moreover controlling availability of analgesics has proven to be effective. The aim of the study was to investigate changes in numbers and rates of overdose before and after the pack size restriction on mild analgesics sold over-the-counter (OTC) in pharmacies in Denmark implemented in September 2013, and secondly to investigate potential substitution of self-harming agents.

AIMS: To test the in vivo activity of Cytochrome P450 (CYP) 2E1 in obese children vs. nonobese children, aged 11–18 years. Secondly, whether the activity of CYP2E1 in these patients is associated with NALFD, diabetes or hyperlipidaemia. METHODS: Seventy children were divided into groups by body mass index (BMI) standard deviation score (SDS). All children received 250 mg oral chlorzoxazone (CLZ) as probe for CYP2E1 activity. Thirteen blood samples and 20‐h urine samples were collected per participant. RESULTS: Obese children had an increased oral clearance and distribution of CLZ, indicating increased CYP2E1 activity, similar to obese adults. The mean AUC(0–∞) value of CLZ was decreased by 46% in obese children compared to nonobese children. The F was was increased twofold in obese children compared to nonobese children, P

A 33-year-old man, who two months previously had been treated for bronchopneumonia with cefuroxime, fell ill again with cough, dyspnoea and fever up to 39.8 degrees C. Auscultation and lung function tests indicated respiratory tract obstruction. The chest radiograph revealed an infiltrate of the left lower lobe and bronchoscopy showed hypertrophic bronchitis. Empirical antibiotic treatment with clarithromycin (initially 500 mg twice daily, continued on half this dose) lead to rapid improvement of clinical symptoms and the patient could be discharged after 9 days. A follow-up examination 3 months later showed no abnormality. A cell culture procedure using bronchoalveolar lavage fluid obtained during bronchoscopy permitted the continuous demonstration of Chlamydia pneumoniae inclusions in HEp-2 host cells by immunofluorescence microscopy. In parallel, Chlamydia pneumoniae DNA was specifically demonstrated in the lavage fluid by use of the polymerase chain reaction. This is the first reported isolation of a replicative Chlamydia pneumoniae strain in Germany.

Four weeks after an attack of pneumonia of unknown aetiology a 40-year-old woman was hospitalized because of a nonpurulent, predominantly basal meningoencephalitis and infratentorial abscesses. She had dysarthria, mild right-sided motor hemiparesis and central paresis affecting the 7th cranial nerve. An area of fluctuating resistance, about 3 cm in diameter, was noticed over the left thigh. Serology indicated inflammatory disease, but there was no immunodeficiency. The CSF showed lymphocytic pleocytosis with mild protein increase but no evidence of infective agent. As tubercular meningitis was suspected she was treated with rifampicin (300 mg i.v. twice daily), isoniazid (300 mg i.v. once daily), streptomycin (800 mg i.m. once daily), cefotaxime (2.0 g i.v. three times daily), fluconazole (200 mg i.v. once daily) and dexamethasone (16-8-8 mg i.v.). She suddenly died two days after admission, probably as the result of central regulatory failure. Generalized nocardiosis involving lung, subcutaneous tissue and brain was revealed at autopsy. Although nocardiosis occurs predominantly in patients under immunosuppression, this infection should be considered in the differential diagnosis of treatment-resistant pneumonia and meningoencephalitis without obvious predisposition.

24 days after starting treatment of psoriasis with fumaric acid derivatives (0.8-1.0 g orally, plus unknown quantities locally) a 21-year-old woman developed acute oliguric renal failure with a rise of serum creatinine levels to 1094 mumol/l (12.4 mg/dl). Deterioration of renal function had been preceded by severe abdominal symptoms with nausea, vomiting and colicky pain. On admission to hospital she was dehydrated with hyponatraemia and hypokalaemia. There was glomerular microhaematuria, increased excretion of renal epithelia, and tubular proteinuria. Renal biopsy demonstrated acute tubular damage with vacuolization of proximal epithelia, dilated tubules and scattered necroses. After intermittent haemodialysis (13 courses over two weeks) renal function gradually recovered, as demonstrated at a follow-up examination four months after discharge.

Background: Outpatient treatment is an increasingly used option in Community-Acquired Pneumonia (CAP). Risk factors for deterioration and subsequent hospitalization are poorly characterized. Material and Methods: A prospective study was conducted to assess risk factors associated with hospitalization of CAP-patients initially treated in an outpatient setting. Clinical history, severity of disease, physical examination findings, laboratory test results, initial treatment and outcome were prospectively documented in both groups. Data derived from a multicenter prospective study initiated by the German competence network for communityacquired pneumonia CAPNETZ. The network includes 10 clinical centers representing hospital and outpatient facilities from all levels of health care. 5431 patients with CAP were screened for inclusion. 1517 of these patients were initially treated as outpatients and included. 1403 patients were treated exclusively in an outpatient setting, 114 (8.1%) were hospitalized after initial outpatient treatment. Results: Compared to patients treated exclusively in an outpatient setting patients with subsequent hospitalization had a significantly higher 28-day mortality rate (4.2% vs. 0.2%, p= 65 years as the only risk factor. Cerebrovascular disease, chronic kidney disease and diabetes mellitus were overrepresented in this patient group. In addition, cephalosporin monotherapy was identified as independent risk factor for hospitalization. Conclusion: In ambulatory CAP patients subsequent hospitalization was observed mainly in low CRB-65 risk classes and was associated with comorbidities and the choice of initial therapy

The etiology of postoperative cognitive dysfunction (POCD) remains unclear but toxicity of anesthetic drugs and their metabolites could be important. We aimed to assess the possible association between POCD after propofol anesthesia and various phenotypes owing to polymorphisms in cytochrome P450 encoding genes.We included patients who underwent non-cardiac surgery under total intravenous anesthesia with propofol. POCD was identified using a neuropsychological test-battery administered preoperatively, one week, and three months after surgery. Genotyping of CYP2C19*2, *3, CYP2D6*3, *4, *5 and *6 was performed using pyrosequencing, and patients were characterized according to their phenotype as ultra, extensive, intermediate, or poor metabolizers.In total, 337 patients with a median age of 67 years were included. 30 (9.4%) out of the 319 patients who underwent neuropsychological testing at one week had POCD, and 24 out of 307 (7.8%) had POCD at three months. None of the examined CYP2C19, 2D6 alleles, or various phenotypes were significantly associated with POCD.Polymorphisms in CYP2C19, or 2D6 genes do not seem to be related to the occurrence of cognitive dysfunction after non-cardiac surgery in patients anesthetised with propofol.

In 29 patients with community-acquired pneumonia, 24 patients with hospital-acquired pneumonia and 35 patients with pneumonia in the immunocompromised host the diagnostic value of bronchoalveolar lavage (BAL) with quantitative bacterial and fungal cultures was studied; 32 patients with noninfectious pulmonary diseases and 14 healthy volunteers served as controls. An infectious etiology could be established in 81% of the pneumonia patients without differences between the three groups; significant infection was associated with colony counts ofor = 10(4) cfu/ml. Prior antibiotic therapy lowered the yield of BAL culture only in community-acquired pneumonia (94% vs 55% positive cultures in untreated vs pretreated patients, p0.02). Furthermore the culture results were related to the radiographic extension of pulmonary infiltrates (92% positive cultures in multilobar vs 54% in lobar or segmental infiltrates, p0.001). Therapeutic consequences of BAL were shown by resistance of the isolated organisms to predefined empiric treatment regimens in 41% community-acquired pneumonia, 43% pneumonia in the immunocompromised host and 67% hospital-acquired pneumonia patients.