RESUMEN
Use of oral hypoglycemic agents during pregnant women with type 2 diabetes is controversial due to safety issues. Recently, randomized controlled trials support short-term safety of glyburide and metformin for the treatment of gestational diabetes mellitus. However, long-term safety data are not available. Moreover, use of oral hypoglycemic agents, except for metformin and glyburide, during pregnancy were limited to a few case reports. We report the case of a pregnant woman with type 2 diabetes unintentionally exposed to metformin and voglibose in addition to lercanidipine and bisoprolol during fetal organogenesis. The patient was continuously exposed to oral agents because we were not aware of her pregnancy until 22 weeks of gestation. After pregnancy was confirmed, we replaced oral hypoglycemic agents with insulin and discontinue betablockers. Delivery occurred without maternal or fetal complications.
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Femenino , Humanos , Embarazo , Embarazo , Bisoprolol , Diabetes Gestacional , Gliburida , Hipoglucemiantes , Insulina , Metformina , Organogénesis , Segundo Trimestre del Embarazo , Mujeres EmbarazadasRESUMEN
BACKGROUND: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. METHODS: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. RESULTS: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. CONCLUSION: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.
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Humanos , Masculino , Área Bajo la Curva , Fibrilación Atrial , Toma de Decisiones Clínicas , Registros Médicos , Estudios Retrospectivos , Curva ROC , Accidente CerebrovascularRESUMEN
BACKGROUND/AIMS: There are no studies that looked into the bubble eliminating efficacy of polyethylene glycol with ascorbic acid (PEGA), which has been one of the shortcomings of polyethylene glycol (PEG). In this study, we compared newly introduced PEGA regimen by adding either simethicone or 1 L of water. METHODS: A prospective randomized controlled study was carried out at Dongguk Universtiy Gyeongju Hospital from July 2014 to September 2014. A total of 90 patients were randomly assigned to 3 groups; PEGA group (n=30) which served as control, simethicone addition group (n=30) to which simethicone 400 mg was additionally prescribed, and water addition group (n=30) to whom additional 1 L of water was given. Cleansing effectiveness, gas elimination efficacy, side effects, and patient satisfaction were compared between the groups. RESULTS: PEGA group demonstrated the highest cleansing effectiveness, but there was no statistically significant difference among the groups. Simethicone addition group showed significantly lesser amount of bubbles than the other groups (2.57±2.05 vs. 1.10±1.83 vs. 2.60±2.84, p=0.017). The rates of side effects in each group were 20.00% vs. 16.77% vs. 53.33%. Water addition group had significantly more side effects than the PEGA group and the simethicone addition group (p=0.003). The patient satisfaction score of each group was 3.37±0.85 vs. 3.73±0.74 vs. 3.20±0.66 with simethicone addition group showing significantly higher satisfaction than water addition group (p=0.020). CONCLUSIONS: PEGA bowel preparation agent showed satisfactory bowel cleansing despite the decrease in dosage, and addition of simethicone resulted in better bubble elimination.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ácido Ascórbico/química , Catárticos/efectos adversos , Colon/efectos de los fármacos , Colonoscopía , Cooperación del Paciente , Polietilenglicoles/efectos adversos , Estudios Prospectivos , Simeticona/química , Agua/químicaRESUMEN
Recently, we reported violapyrones B, C, H and I, unusual 3, 4, 6-trisubstituted alpha-pyrone derivatives, from the culture broth of the marine Streptomyces sp. 112CH148. In previous studies, violapyrones have been shown to have antibacterial and antitumor activities. However, the anti-inflammatory effect of violapyrones has not been reported yet. As part of our ongoing study for the discovery of bioactive metabolites from marine microorganisms, we found that violapyrones also have anti-inflammatory activity. In this study, we investigated the effect of violapyrones on LPS-induced inflammatory responses in vitro. Violapyrones B and C did not affect the viability of RAW 264.7 cells at concentrations up to 25 microM. However, violapyrones B and C inhibited the production of NO compared to the LPS-induced control. In addition, violapyrones B and C down-regulated the expression of iNOS protein in LPS-stimulated RAW 264.7 cells. To the best of our knowledge, this is the first report on the anti-inflammatory activity of violapyrones B and C.
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StreptomycesRESUMEN
OBJECTIVES: An exact diagnosis and comorbidity analysis are important in psychiatric disorders. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is both useful as a self-reporting test for screening psychiatric disorders and available for clinical settings due to its simplicity and convenience. This study, as a part of standardization of Korean version of Psychiatric Diagnostic Screening Questionnaire (K-PDSQ), evaluated optimal cutoff scores. METHODS: The samples were 696 patients in total, who were selected from the psychiatric departments of 3 university hospitals from March 2008 to August 2011. Diagnosing by Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), we evaluated sensitivity, specificity, cutoff scores, ROC curve, and area under the curve (AUC) of K-PDSQ. SPSS version 12.0 for Windows and MedCalc version 12.0 were used to analyze the results. RESULTS: With a cutoff score of 9 for major depressive disorder in K-PDSQ, both the sensitivity and specificity were 80%. The cutoff scores of PTSD, OCD, panic disorder, agoraphobia, psychosis, alcohol related problem, GAD, hypochondriasis, and social phobia of K-PDSQ were 5, 2, 4, 2, 1, 2, 5, 4, and 5, respectively. In most of the subscales, each AUC was above 0.75. CONCLUSION: By applying the cutoff scores estimated above, we expect K-PDSQ to help provide diagnostic assessments and to grasp comorbidities before a clinical interview in the setting of busy outpatient clinics.