Expert opinion on pharmacotherapy
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Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Management decisions regarding site of care, extent of assessment and level of treatment are based primarily on disease severity (outpatient, inpatient and ICU admission). Despite the developments in antibiotic therapy, CAP is still the most common infectious cause of death. ⋯ Effective management of CAP requires risk stratification of patients by severity and proper place of therapy. Additional therapeutic interventions along with antibiotics may help to improve outcome in patients with CAP, especially in severe CAP.
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Expert Opin Pharmacother · Jul 2013
Improved perioperative blood pressure control leads to reduced hospital costs.
Perioperative hypertension affects 80% of cardiac surgery patients and is associated with an increased risk of complications. ⋯ Improved perioperative BP control may reduce hospital costs. Given the low cost of IV antihypertensives, the total hospital cost reductions may offset any incremental cost increases associated with newer, more effective therapies.
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Acute chest syndrome (ACS), a leading cause of morbidity and mortality in sickle cell disease (SCD), is an acute illness characterized by fever and/or respiratory symptoms, accompanied by a new pulmonary infiltrate on a chest X-ray. There is increasing knowledge regarding the etiology and pathogenesis of ACS in SCD. A high index of suspicion is required for the diagnosis of ACS. Treatment of ACS involves the judicious use of intravenous fluids and analgesics, aggressive incentive spirometer and pulmonary toileting, antibiotics and transfusion therapy. ⋯ Despite an increased understanding of its etiology and pathogenesis, ACS remains a leading cause of morbidity and mortality in SCD. In patients admitted with a painful crisis, there is need for a high index of suspicion, as pain episodes may be a prodrome for the development of ACS. Patients with a diagnosis of ACS should be aggressively managed to prevent clinical deterioration. Clinical trials using novel drugs for the treatment of ACS are greatly warranted.
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Expert Opin Pharmacother · Jun 2013
ReviewJuvenile idiopathic arthritis: an update on current pharmacotherapy and future perspectives.
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Therapeutic advances in the treatment of JIA are occurring at a rapid rate, resulting in more ambitious therapeutic goals and increasing numbers of children experiencing complete clinical remission. ⋯ With advances in pharmacotherapy, physical and functional outcomes in children with JIA have improved immensely. The establishment of research consortia among the pediatric rheumatology community has allowed for large controlled studies and enabled a better understanding of the safety and efficacy of these therapeutic agents in children. Long-term safety data remain limited and thus longer, larger safety studies are warranted.
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Expert Opin Pharmacother · Jun 2013
EditorialPerioperative statin therapy: current knowledge and future directions.
Perioperative statin therapy has come to represent a cornerstone of risk reduction for millions of patients who undergo cardiac and noncardiac surgeries. While large-scale, robust, randomized controlled studies support the use of statins in cardiac surgery, their role in noncardiac surgery has become ambiguous following concerns regarding scientific misconduct in many pivotal studies. In this edition of the Expert Opinion on Pharmacotherapy, Irwin et al. comprehensively summarize the evidence for perioperative statin treatment. The authors add to this review by providing expert opinions regarding the state of the science and future paths for research and enquiry.