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Appropriate Monitoring (appropriate + monitoring)
Selected AbstractsLong-term safety of biologics in dermatologyDERMATOLOGIC THERAPY, Issue 1 2009Xinaida T. Lima ABSTRACT The use of biologics in dermatology has increased rapidly. Although most are relatively safe when correctly used and monitored, there are known side effects and adverse events that occur. Selection of patients should be done on a case-by-case basis. Severity of disease, comorbidity profile, drug profile, and cost-effectiveness should be all taken into consideration while deciding to start and/or maintain one of these therapies. Dermatologists should be aware of the benefits and limitations of this class of drugs, as well as the appropriate monitoring. The authors propose a concise overview of the safety profiles of some of the biologics currently used in the dermatologic field. [source] Features of Saccharomyces cerevisiae as a culture starter for the production of the distilled sugar cane beverage, cachaça in BrazilJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2010C.R. Campos Abstract Aims:, To evaluate the dominance and persistence of strains of Saccharomyces cerevisiae during the process of sugar cane fermentation for the production of cachaça and to analyse the microbial compounds produced in each fermentative process. Methods and Results:, Three S. cerevisiae strains were evaluated during seven consecutive 24-h fermentation batches using recycled inocula. The UFLA CA 116 strain had the largest population of viable organisms, and the maximum population was achieved in the fourth batch after 96 h of fermentation. The UFLA CA 1162 and UFLA CA 1183 strains grew more slowly, and the maximum population was reached in the seventh batch. Molecular characterization of isolated yeast cells using PFGE (pulse field gel electrophoresis) revealed that more than 86% of the isolates corresponded to the initially inoculated yeast strain. The concentration of aldehydes, esters, methanol, alcohol and volatile acids in the final-aged beverages were within the legal limits. Conclusions:, Cachaça produced by select yeast strains exhibits analytical differences. UFLA CA 1162 and UFLA CA 116 S. cerevisiae isolates can be considered the ideal strains for the artisanal production of cachaça in Brazil. Significance and Impact of the Study:, The use of select yeast strains can improve the quality and productivity of cachaça production. Our findings are important for the appropriate monitoring of yeast during sugar cane fermentation. In addition, we demonstrate that UFLA CA 116 and UFLA CA 1162, the ideal yeast strains for cachaça production, are maintained at a high population density. The persistence of these yeast strains in the fermentation of sugar cane juice promotes environmental conditions that prevent or decrease bacterial contamination. Thus, the use of select yeast strains for the production of cachaça is a viable economic alternative to standardize the production of this beverage. [source] Percutaneous endoscopic gastrostomy feeding in haemodialysis out-patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2000H. A. Sayce Introduction Malnutrition is highly prevalent in haemodialysis (HD) patients and plays a major role in influencing outcome. Although use of home enteral feeding is expanding rapidly in the UK, it is a method of nutritional support which remains under-utilized in HD out-patients. We report our experience and outcomes in a series of eight cases. Methods Home gastrostomy feeding was initiated in eight malnourished HD out-patients, administered either continuously overnight or as daily bolus feeds. Nutritional parameters were monitored weekly by the renal dietitian and included dry weight, upper-arm anthropometry and serum albumin. The number and duration of hospitalizations during the period of feeding were recorded. Results After 3 months of feeding, median dry weight increased from 43.0 to 48.3 kg (P = 0.012), mid-upper arm circumference increased from 20.2 to 24.8 cm (P = 0.018), triceps skinfold thickness increased from 7.3 to 11.3 mm (P = 0.046), mid-upper arm muscle circumference increased from 17.7 to 19.8 cm (P = 0.027) and serum albumin increased from 29.5 to 36.5 g L,1 (P = 0.011). Few complications were encountered and hospital admission rates were low. Conclusion Home gastrostomy feeding, with appropriate monitoring and support, is an effective method of improving and maintaining nutritional status in this vulnerable group. [source] Safety and efficacy of peginterferon plus ribavirin in patients with chronic hepatitis C and bridging fibrosis or cirrhosisJOURNAL OF VIRAL HEPATITIS, Issue 4 2005F. Marrache Summary., The combination of pegylated interferon and ribavirin is the most effective therapy in patients with chronic hepatitis C. We evaluated this combination in unselected patients with bridging fibrosis or cirrhosis. Eighty patients were treated with peginterferon alpha-2b plus ribavirin. Hepatitis C virus serum RNA was monitored. Tolerance and safety were evaluated by the rate of treatment's discontinuation for any reason, and occurrence of serious clinical adverse events, respectively. Sustained virologic response (SVR) rate was 36.3% overall, and was observed in every group of patients except those who had previously failed to respond to the combination of interferon and ribavirin. No serious clinical adverse event occurred. Treatment was withdrawn in 18.7% of patients. Variables associated with discontinuation of treatment were low prothrombin index [OR: 1.16 (1.05;1.27)] and low body mass index [OR: 1.47 (1.12;1.92)]. Initial blood count abnormalities were not associated with cessation of treatment. Furthermore, early virologic response at week 8 and week 12 of treatment had similar predictive value for SVR. Combination therapy with peginterferon plus ribavirin seems effective in this group of patients, except in those who had previously failed to respond to the combination of interferon and ribavirin. This therapy is safe with appropriate monitoring, but tolerance seems worse in patients with the most advanced liver disease. [source] Review article: practical management of inflammatory bowel disease patients taking immunomodulatorsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2005C. A. SIEGEL Summary Azathioprine, mercaptopurine, methotrexate, ciclosporin and tacrolimus all have their respective niches in the treatment of inflammatory bowel disease. These immunomodulators are potent and effective medications; however, they potentially have serious toxicity. To maximize benefit and minimize risk, clinicians must understand the mechanism of action, appropriate indications, range of toxicity and proper dosing of these medications. Furthermore, once initiating therapy, patients need to be monitored appropriately for evidence of efficacy and toxicity. This review includes the rationale behind recommendations for the management and monitoring of patients using immunomodulators. For the purine antagonists , azathioprine and mercaptopurine , the evidence for utility of thiopurine methyltransferase testing and mercaptopurine metabolite monitoring is addressed. The roles of liver biopsy and screening for methylenetetrahydrofolate reductase mutations in patients taking methotrexate are reviewed. With appropriate monitoring, the calcineurin inhibitors , ciclosporin and tacrolimus , can be used safely and effectively. Immunomodulators are important agents for the treatment of Crohn's disease and ulcerative colitis, and prescribing clinicians should be comfortable recognizing both their value and their limitations. [source] Improving processes of care in patient-controlled analgesia: the impact of computerized order sets and acute pain service patient managementPEDIATRIC ANESTHESIA, Issue 11 2007CPNP, SHARON WRONA RN Summary Background:, In an effort to combat opioid induced side effects within the first 24 h of patient-controlled analgesia (PCA) induction, it has been recommended that care be provided by an Acute Pain Treatment Service (APS) and that computerized PCA order sets with patient monitoring requirements be implemented. To date, there are few published studies on the role of computerized order sets or APS in improving the quality and safety of pediatric PCA use. This retrospective analysis sought to determine if the implementation of computerized order sets would increase appropriate monitoring and problem recognition. Methods:, Analysis included 536 patients prescribed PCA in one of three ways: an anesthesia order set with APS support (n = 285), a general PCA order set (n = 95), or no order set (n = 156). We analyzed the use of order sets by unit; the incidence of appropriate monitoring (,12 recordings within 24 h) of respiratory rate, oxygen saturation, and sedation level and the recognition of low respiration rate and low oxygen saturation between the types of PCA order. Results:, We found a significant difference in type of PCA order used by unit. Appropriate documentation of respiratory rate and oxygen saturation occurred significantly more often if the order set with APS was used. Low respiration rate was also recognized significantly more frequently (P , 05) in the APS order set group. Conclusions:, These findings show that use of a computerized PCA order set with monitoring requirements and an APS can increase monitoring and documentation of important vital signs and increase identification of potential negative events. [source] | ||||||||||