ABSTRACT
A case is presented involving a female patient who experienced rhabdomyolysis following high-dose therapy with a statin. Acute renal failure was a complicating factor necessitating the use of hemodialysis. The patient recovered fully within about 6 weeks.
Subject(s)
Anticholesteremic Agents/adverse effects , Fatty Acids, Monounsaturated/adverse effects , Indoles/adverse effects , Rhabdomyolysis/chemically induced , Simvastatin/adverse effects , Acute Kidney Injury/chemically induced , Adult , Female , Fluvastatin , Hepatitis, Viral, Human/diagnosis , HumansABSTRACT
Antimicrobial resistance among bacteria has arisen ever since antimicrobial agents were introduced in the clinic. Unfortunately, it seems that resistance is now emerging at a more rapid rate than ever before, as a consequence of the widespread use of antimicrobial agents. The spread of these multiresistant microorganisms is an increasing threat in many countries. The human intestinal flora is a huge potential reservoir of resistant microorganisms. Antimicrobial resistance in clinical isolates may cause serious infections and treatment failure, and lead to the use of higher doses or more toxic alternative drugs. This study was planned so as to compare the effects of hospitalization and antibiotic usage on the aerobic intestinal flora and included 43 hospitalized adult patients without any previous history of hospitalization and antibiotic usage during the last 30 d. Patients were divided according to their antimicrobial therapy, into treated and untreated groups. The individual use of antimicrobials was recorded. Antibiotic usage was found to be more effective on the aerobic intestinal flora compared with hospitalization without such medication.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Enterobacteriaceae/drug effects , Hospitalization , Intestines/microbiology , Adolescent , Adult , Aged , Drug Resistance, Microbial , Female , Humans , MaleSubject(s)
Peritoneal Dialysis, Continuous Ambulatory , Peritoneum/physiology , Adolescent , Adult , Aged , Biological Transport , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
BACKGROUND: The present study was performed to assess the value of ambulatory blood pressure monitoring (ABPM) in determining the adequacy of blood pressure (BP) control, and its relationship to echocardiographic findings in haemodialysis (HD) patients. METHODS: We studied 40 non-diabetic adult patients who had been on regular HD treatment for a median duration of 43 months. Twenty-four-hour ABPM was performed using a non-invasive ABP monitor (Pressurescan, ERKA). Casual BP (cBP) was defined as the average of two measurements obtained at two HD sessions, one preceding and one following the ABP recordings, and was calculated for both the predialysis and postdialysis phases. Two-dimensional and M-mode echocardiography were performed in each patient to determine interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular fractional shortening (FS), and left ventricular mass index (LVMI). RESULTS: According to average 24-h BP levels, 50% of the patients had systolic hypertension (HT) (> 139 mmHg), and 72.5% had diastolic HT (> 87 mmHg), while only 25% had been diagnosed as HT by cBP measurements (P < 0.01 and P < 0.0001 respectively). Diurnal variation in BP was not present in about 80% of the patients. Echocardiography was normal in only four patients (10%). LVMI and LV wall thickness were correlated to ABPM data better than to cBP measurements. Using stepwise linear regression analysis, LVMI and IVS were positively correlated with systolic BP load (P < 0.0001 and P = 0.0001 respectively), and LVPW was positively correlated with night-time systolic BP level (P < 0.001). CONCLUSIONS: ABPM is necessary to assess the adequacy of BP control, and is well correlated to end-organ damage of HT in HD patients.
