Current medical research and opinion
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Efforts toward eradicating the Hepatitis C virus (HCV) have advanced rapidly, due to the development of direct-acting antivirals (DAAs), especially with the appearance of pan-genotypic combinations. Real-world studies, in particular, have verified the efficacy and safety of DAA combinations documented in registration trials. This review documents the results of using DAA combinations in real-life settings in everyday clinical practice in Egypt, the country with the highest prevalence of HCV. ⋯ Most adverse reactions reported in real-world settings were mild and resulted in treatment discontinuation in only a minority of cases. Data from real-life studies covered most aspects of HCV management that were lacking after initial approval studies. More research is needed to tailor treatment and produce generic HCV combinations to overcome the residual limitations of the currently available DAAs.
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Multicenter Study
A multicenter cohort analysis of fractures in histamine-2-receptor antagonist treated pediatric patients.
Histamine 2 receptor antagonists (H2RA) are amongst the most entrenched antacid therapies available including over-the-counter. They have an excellent safety profile including no known teratogenic risk. Fracture risk is generally recognized with chronic proton pump inhibitor (PPI) therapy in adults and children although the related mechanism is poorly understood. The analogous risk in H2RAs, including in children, is unclear. We studied the fracture risk and characteristics among hospitalized pediatric patients exposed to H2RA compared to an untreated cohort. ⋯ H2RA exposure is not associated with an increased risk of fracture in hospitalized children exposed to H2RA when compared with a matched untreated cohort, further studies are needed to determine if long-term exposure to H2RA may be associated with fracture risk in both those with and without comorbidities or on fracture predisposing medication.
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Acute respiratory failure increases short-term mortality in sepsis patients. Hence, in this study, we aimed to develop a novel model for predicting the risk of hospital mortality in sepsis patients with acute respiratory failure. ⋯ The model shows a good performance in predicting the mortality risk of patients with sepsis-related acute respiratory failure. Hence, this model can be used to evaluate the short-term prognosis of critically ill patients with sepsis and acute respiratory failure.
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To compare treatment patterns of United States (US) veterans stable on innovator infliximab (IFX) who switched to an IFX biosimilar (switchers) or remained on innovator IFX (continuers). ⋯ Patients switching from innovator to biosimilar IFX were more likely to discontinue treatment and switch to another innovator biologic (notably back to innovator IFX) than those remaining on innovator IFX; however, reasons for discontinuation and switching are unknown.
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Observational Study
Calcium and PH-value might predict persistent renal failure in acute pancreatitis in the early phase.
Persistent renal failure (PRF) increases morbidity and mortality in acute pancreatitis (AP). Traditional scoring systems achieve good diagnostic value of AP but not PRF alone. Our study aimed to determine PRF predictors in AP patients for early intervention in the disease development. ⋯ AP patients with PRF had higher morbidity and mortality rate. Our study showed that Ca < 1.94 mmol/L and pH < 7.37 when patients on admission could be used to predict PRF in AP.