Activity

Drug-induced hepatotoxicity or drug-induced liver injury (DILI) is an acute or chronic response to a natural or manufactured compound. DILI can be classified based on clinical presentation (hepatocellular, cholestatic, or mixed), mechanism of hepatotoxicity, or histological appearance from a liver biopsy. The true incidence is difficult to estimate, yet it has become the leading cause of acute liver failure (ALF) in the United States. The two mechanisms of hepatotoxicity are intrinsic, which is dose-dependent, and idiosyncratic, which is more unpredictable. Most cases of DILI are asymptomatic; however, the most common sign is jaundice. Laboratory tests in hepatocellular injury will have elevation in aminotransferases, while in cholestatic injury, alkaline phosphatase (ALP) is elevated. Liver biopsy is not mandatory for diagnosis but could exclude other causes of liver disease. Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug.Left ventricular hypertrophy (LVH) is a condition in which there is an increase in left ventricular mass, either due to an increase in wall thickness or due to left ventricular cavity enlargement, or both. Most commonly, the left ventricular wall thickening occurs in response to pressure overload, and chamber dilatation occurs in response to the volume overload.The United States Center for Health Statistics defines a fetal death as the delivery of a fetus showing no sign of life, as indicated by absent breathing, heartbeats, pulsation of the umbilical cord, or definite movements of voluntary muscles, irrespective of the duration of pregnancy. Stillbirth is a fetal death after a defined gestational age and/or fetal weight, both of which have historically lacked uniformity. Currently, the most recognized definition of stillbirth is a fetal death that occurs at or greater than 20 weeks gestation or at a birth weight greater than or equal to 350 grams. Standardization of the definition of stillbirth is a current priority. In the United States, termination of pregnancy for fetal anomalies, and labor induction for pre-viable premature rupture of membranes are reported as terminations of pregnancy and not as stillbirths. “Stillbirth” has replaced “intrauterine fetal demise” as the terminology of choice based on the opinions of parent groups. An attempt is now underway to uimated 98% of global stillbirths occur in low and middle-income countries. Stillbirth has many causes intrapartum complications, hypertension, diabetes, infection, congenital and genetic abnormalities, placental dysfunction, and pregnancy continuing beyond forty weeks. This is a catastrophic event with lasting consequences on all of society. We need to learn more about why stillbirths occur. This knowledge can help those impacted deal with grief and, more importantly, prepare to reduce the risk of stillbirth in subsequent pregnancies. This activity reviews the role of the healthcare team in evaluating, managing, and improving care for patients diagnosed with stillbirth.Furrow degeneration (FD) is a unique pathology that goes by various names in the limited published literature. It is most commonly referred to as furrow degeneration; however, many articles interchangeably use senile furrow degeneration of cornea, corneal furrow degeneration, or age-related marginal corneal degeneration when referring to FD. FD is characterized by a decreasing width of the peripheral cornea between the arcus senilis and limbus. Very little focus has been made on further examining the pathophysiology and etiology of furrow degeneration, possibly due to its benign course. Unlike many other corneal degenerative diseases, furrow degeneration lacks true vascularization and inflammation as part of the pathological pathway, leading to a painless, and asymptomatic, thinning of the peripheral cornea with a low risk of perforation and little need for medical follow up. Patients with FD will not experience any changes in vision due to the circumferential thinning that occurs evenly throughout the cornea. A few case studies have been conducted that show the natural progression of the disease; however, due to its rarity, many questions remain unanswered. Selleckchem NSC125066 This article will focus on the history and physical examination found in most patients with FD. The article will also emphasize the importance of identifying other corneal degenerations and differentiating FD from other pathologies. The specific anatomy and physiology of the cornea will not be discussed in-depth, mainly focusing on the clinical picture and medical management of FD.Dronabinol is a synthetic form of tetrahydrocannabinol (‘THC’), which obtained FDA approval in 1985 for the treatment of HIV/AIDs-induced anorexia and chemotherapy-induced nausea and vomiting (‘CINV’) in patients who do not successfully respond to conventional antiemetics. Dronabinol has also been used off-label for the treatment of OSA with mixed and unclear efficacy (only Phase II trials performed). Therefore, the American Academy of Sleep Medicine does not support its use until reliable data is available (such as Phase III trials). There are also recent studies utilizing dronabinol in chronic pain patients, which showed efficacy compared to placebo, but further research is necessary. Additionally, current fields exploring the use of dronabinol include substance abuse and withdrawal.Healthcare professionals, when determining the impact of patient interventions in clinical studies or research endeavors that provide evidence for clinical practice, must distinguish well-designed studies with valid results from studies with research design or statistical flaws. This article will help providers determine the likelihood of type I or type II errors and judge adequacy of statistical power. Then one can decide whether or not the evidence provided should be implemented in practice or used to guide future studies.The name osteopetrosis is derived from the Greek language. ‘Osteo’ means bone and ‘petrosis,’ meaning stone. Therefore, the disease is often referred to colloquially as “marble bone disease.” The disease was originally described by a radiologist in Germany, Dr. Albers-Schonberg, in 1904. Bone with abnormally increased density is the key radiographic finding. This increased density is secondary to osteoclast dysfunction and leads to the affected bones being abnormally brittle. The name osteopetrosis encompasses a group of hereditary metabolic bone diseases, all of which detrimentally affect bone growth and remodeling leading to generalized osteosclerosis and the potential of pathologic fractures, pancytopenia, and even cranial neuropathies and hepatosplenomegaly in severe cases. Four disease forms are known. The malignant autosomal recessive form, not named malignant due to any relation to oncology but rather due to the degree of condition severity, is very severe and often leads to mortality in early childhood.