Current medical research and opinion
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The worsening of renal function after the start of valsartan therapy is relatively common in clinical practice. However, few data are available on the incidence of worsening renal function after the beginning of therapy with sacubitril/valsartan. ⋯ WRF occurs in nearly 30% of HFrEF patients without impacting clinical outcomes; HF specialists should be aware of these changes to avoid unnecessary discontinuation of sacubitril/valsartan therapy.
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Coronavirus disease 2019 (COVID-19) has now brought major challenges to public health and the economy globally since December 2019, which requires effective treatment and prevention strategies to adapt to the impact of the pandemic. We, therefore, explored the prognostic factors for patients with COVID-19 and the contribution of immunomodulatory therapy on COVID-19 outcome. ⋯ For in-hospital patients with COVID-19 of all severity levels, a high risk for fatal outcome was observed in those treated with glucocorticoids, immunoglobulin, thymosin, and ammonium glycyrrhizinate. The results of this study do not support immunomodulatory therapy in patients admitted to the hospital with COVID-19. Further prospective studies are essential to clarify our findings, especially for non-critically ill patients.
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Clinical observations demonstrated that COVID-19 related pneumonia is often accompanied by hematological and coagulation abnormalities including lymphopenia, thrombocytopenia, and prolonged prothrombin time. The evaluation of laboratory findings including coagulation and inflammation parameters may represent a promising approach for early determination of COVID-19 severity. ⋯ We suggest that CRP and PT levels present on admission in COVID-19 patients may be used as early prognostic markers of severe pneumonia requiring transfer to ICU.
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To assess the burden of treatment-resistant depression (TRD) among privately insured patients with anxiety disorder and/or substance use disorders (SUD). ⋯ In patients with an anxiety disorder and/or SUD, TRD was associated with higher HRU, healthcare costs, work loss days and work loss-related costs.
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Spontaneous reporting of adverse drug reactions (ADRs) to pharmacovigilance centers is a common and inexpensive method of ADR detection. Although China requires patients to report ADRs directly, the reporting rate is extremely low. We assessed public knowledge, attitudes, and practice (KAP) regarding pharmacovigilance in Shaanxi Province, China. ⋯ The public has poor awareness about, but a positive attitude toward, pharmacovigilance. Unclear feedback pathways and lack of understanding about the seriousness of ADRs were the main reasons patients did not report ADRs, and respondents had difficulty with parts of the reporting form. The government should publicize the importance of ADR monitoring and develop more suitable forms and measures for patients to report ADR.