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Likely Etiology (likely + etiology)
Selected AbstractsCase series of liver failure associated with rosiglitazone and pioglitazone,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 12 2009James S. Floyd MD Abstract Purpose The thiazolidinedione drugs rosiglitazone and pioglitazone are not widely known to be hepatotoxic. We evaluated the FDA Adverse Event Reporting System (AERS) to determine the number of reported cases of liver failure associated with rosiglitazone and pioglitazone between 1997 and 2006, and described their clinical characteristics. Methods Adverse event reports spontaneously submitted to the FDA AERS from 1997 to 2006 were examined. Liver failure associated with rosiglitazone or pioglitazone was defined as liver injury accompanied by hepatic encephalopathy, liver transplantation, placement on a liver transplant list, or death in which all other likely etiologies were excluded. Using prescribing data, the number of reported cases of liver failure per million patient-years of exposure was calculated for each drug. Results Twenty-one cases met our case definition. Clinical characteristics, outcomes, and pathologic data were similar between cases of liver failure associated with rosiglitazone and with pioglitazone. The median duration of therapy was 9 weeks and 85% of cases were acute, defined as symptom onset to liver failure in less than 26 weeks. The case-fatality rate was 81% (17/21), and only 14% (3/21) spontaneously recovered. Accounting for underreporting, the number needed to harm (NNH) for each case of liver failure was 44,000 patient-years of exposure for rosiglitazone and 52,000 patient-years of exposure for pioglitazone. Conclusions This is the largest case series of liver failure associated with rosiglitazone or pioglitazone reported to date, strengthening the evidence that these drugs can cause severe hepatotoxicity. Copyright © 2009 John Wiley & Sons, Ltd. [source] Recurrent Wernicke's Aphasia: Migraine and Not Stroke!HEADACHE, Issue 5 2009Nishant Kumar Mishra MBBS We report the clinical findings of a 40-year-old woman with recurrent migraine presenting with Wernicke's aphasia in accordance with the results of a standardized battery for language assessment (Boston Aphasia Diagnostic Examination). The patient had no evidence of parenchymal or vascular lesions on MRI and showed delta and theta slowing over the left posterior temporal leads on the EEG. Although the acute onset of a fluent aphasia suggested stroke as a likely etiology, the recurrence of aphasia as the initial symptom of migraine was related to cortical spreading depression and not to stroke. [source] Pubic symphyseal face eburnation: an Egyptian sport story?INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 3 2010M. A. Judd Abstract Strenuous physical activity leaves scars on bone that attest to the demands of occupation, sport, aggression and recreation. During the assessment of 74 C-Group Nubians from Hierakonpolis (Egypt) dated to the Egyptian Middle Kingdom,Second Intermediate Period (2080,1700 BC), robust muscle insertions along the ilia and ischia were observed among some adults. In addition, a disproportionate degeneration of the pubic symphyseal faces when compared to other age-related features was also noted. In the case of one male (Burial 32), the pubic symphyseal faces were completely flattened and polished so that they resembled the eburnation that is pathognomic of osteoarthritis. Differential diagnoses are discussed and osteitis pubis, an increasingly diagnosed injury among modern athletes who participate in intense activity that involves running, kicking, twisting or leaping, is proposed as the most likely etiology. The exaggerated muscle insertions and pubic symphyseal wear, epitomised by the individual interred in Burial 32, are unique features that may be linked to the unexplained presence of this Nubian group deep in Egyptian territory during a period of political instability. Artefactual, artistic and documentary evidence records how the Egyptian pharaohs and elites conscripted Nubian athletes to the royal courts for staged contests and entertainment, part of a propaganda program engineered to reinforce among the general populace the dogma of Egyptian supremacy over the enemy. This Nubian community, serviced by Cemetery HK27C, may have functioned as a source for individuals skilled in athletics or other activities that required exceptional physical dexterity. The extraordinary modification of these pubic symphyseal faces underscores the importance of recognising paleopathological conditions that may further confound current macroscopic methods used to ascertain the chronological age of an individual. Copyright © 2009 John Wiley & Sons, Ltd. [source] Hearing Loss in Union Army Veterans from 1862 to 1920,THE LARYNGOSCOPE, Issue 12 2004Ryan K. Sewell MD Abstract Objectives: To examine the prevalence of hearing loss (HL) in Union Army (UA) veterans by year, birth cohort, and occupation, and to compare Civil War pension and contemporary disability programs by examining monthly dollar awards. Study Design: A retrospective review of medical records for 17,722 UA veteran pension applicants, a subset of some 35,000 soldiers retrieved randomly from the Military Archives. Methods: The diagnosis of HL was based on review of medical records, which used gross measurements because of the unavailability of audiometric testing. Results: One third (5,891 or 33%) of pensioners sampled received compensation for HL. The veterans with HL suffered predominantly from left-sided HL (4,091 or 70%), which is consistent with noise-induced HL in a right-handed individual firing a rifle. Comparison of civilian occupations reveals minimal variation in prevalence of HL. Civil War pensions for unilateral HL averaged $134.04 per year, representing nearly one third of the average annual income in 1890. Bilateral HL received nearly twice that amount. Today, military veterans receive $1,248 annually for unilateral loss and $27,288 annually for bilateral loss. Social Security disability benefits are granted only for bilateral HL, with an average 60-year-old individual receiving $11,400 per year. Conclusion: HL was a common disability among UA Civil War veterans, with noise exposure a likely etiology for the HL. The differing levels of compensation for HL may reflect differing perceptions on the incapacitating effects of HL. [source] Hepatitis C virus infection as a likely etiology of intrahepatic cholangiocarcinomaCANCER SCIENCE, Issue 7 2004Satoshi Yamamoto Although hepatitis C virus (HCV)-related cirrhosis has been suggested as a risk factor for intrahepatic cholangiocarcinoma (ICC), few sizeable studies have tested this hypothesis. We investigated ICC risk factors, with special reference to HCV infection. We conducted a hospital-based case-control study including 50 ICC patients and 205 other surgical patients without primary liver cancer. HCV seropositivity was detected in 36% of ICC patients and 3% of controls. By univariate analysis, the odds ratio (OR) for association of anti-HCV antibodies with development was 16.87 (95% confidence interval (CI), 5.69 to 50.00). History of blood transfusion or diabetes mellitus, elevated serum total bilirubin, elevated aspartate aminotransferase and alanine aminotrans-ferase, decreased serum albumin and decreased platelet count were identified as other possible ICC risk factors. By multivariate analysis, anti-HCV antibodies (adjusted OR, 6.02; 95% Cl, 1.51 to 24.1), elevated alanine aminotransferase, decreased serum albumin, and decreased platelet count were found to be independent risk factors for ICC development. As liver status worsened, the adjusted OR for ICC tended to increase. HCV infection is a likely etiology of ICC in Japan. [source] | ||||||||||