Fibromuscular dysplasia presenting as a renal infarction: a case report

<p>Abstract</p> <p>Introduction</p> <p>Fibromuscular dysplasia is a non-atherosclerotic, non-inflammatory disease that most commonly affects the renal and internal carotid arteries.</p> <p>Case presentation</p> <p>We present the case of a 44-year-old Caucasian man who was admitted with complaints of loin pain and hypertension. A computed tomography scan of the abdomen revealed a right renal infarction with a nodular aspect of the right renal artery. Subsequent renal angiography revealed a typical 'string of beads' pattern of the right renal artery with thrombus formation. Oral anticoagulation was started and the secondary hypertension was easily controlled with anti-hypertensive drugs. At follow-up, our patient refused percutaneous transluminal renal angioplasty as a definitive treatment.</p> <p>Conclusions</p> <p>Fibromuscular dysplasia is the most common cause of renovascular hypertension in patients under 50 years of age. Presentation with renal infarction is rare.</p> <p>In fibromuscular dysplasia, angioplasty has been proven to have, at least for some indications, an advantage over anti-hypertensive drugs. Therefore, hypertension secondary to fibromuscular dysplasia is the most common cause of curable hypertension.</p

Modelling Metrics for Transparency in Medical Systems

Transparency is a novel non-functional requirement for software systems. It is acclaimed to improve the quality of service since it gives users access to information concerning the system’s processes, clarifying who is responsible if something goes wrong. Thus, it is believed to support people’s right to a secure and private processing of their personal data. We define eight quality metrics for transparency and we demonstrate the usage and the effectiveness of the metrics by assessing transparency on the Microsoft HealthVault, an on-line platform for users to collect, store, and share medical records

Aktivitas Meronce dengan Media Tangkai Ubi Kayu terhadap Kemampuan Berhitung Permulaan Anak

Kegiatan meronce dengan media tangkai ubi kayu pada kemampuan berhitung, awal anak merupakan penelitian yang bertujuan untuk meningkatkan kemampuan anak melalui kerja sama dengan orang tua anak dan untuk meningkatkan pelaksanaan perencanaan program dengan lebih tepat lebih baik membuat sesuatu yang baru atau memodifikasi yang sudah ada. Teknik pengumpulan datanya adalah dokumentasi dan untuk analisis datanya menggunakan metode analisis isi. Hasil analisis bertujuan bahwa kegiatan meronce dengan media tangkai ubi kayu bermanfaat untuk meningkatkan perkembangan otak terkait kemampuan berhitung yaitu pembelajaran konsep bilangan

Impact of IL28B polymorphism on treatment induced viral clearance in HCV infected Egyptian patients

Background and objective: Interleukin (IL) 28B single nucleotide polymorphisms (SNP) was recently recognized as predictor of SVR in HCV infected patients treated by combination therapy of pegylatedinterferon (Peg-IFN) and ribavirin (RBV). The aim of the current study was to assess IL 28B polymorphism SNP (rs12979860) as a predictor of response to combined Peg-INF/RBV therapy in Egyptian chronic HCV infected patients.Design and methods: The study was conducted on 247 HCV infected patients and 100 apparently healthy control subjects. All patients were treated with PEG-IFN-α/ribavirin; and they were classified according to their response to treatment. Genotyping of IL28B rs12979860 was performed on peripheral blood DNA using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) assay.Results: The overall frequency of IL28B genotypes was 24.7%, 50.2% and 25.1% for genotypes CC, CT and TT respectively, while the response rate was 82%, 38.7% and 43.8% for genotypes CC, CT and TT respectively, moreover, genotype CC had increased probability to HCV clearance than both genotypes CT and TT with OR 7.71 (95%CI: 3.71-15.79).Conclusion: Genotyping of IL28B at SNP rs12979860 could be used as a guide to tailor treatment in Egyptian patients infected with HCV for better outcome.Key wards: Hepatitis C virus, Pegylated-interferon, ribavirin, sustained virological response, IL28

Physician-pharmacist agreement about off-label use of medications in private clinical settings in Baghdad, Iraq

Objective: 1) To evaluate the relationship between physician-pharmacist agreement about the off-label drug use and 2) and to identify the most common off-label medication category/indications and prescriber clinical disciplines in private settings in Baghdad area, IraqMethods: This study evaluated 980 off-label use requests in the private clinical settings within Baghdad area, Iraq from October 2013 to September 2015. The efficacy, safety, and convenience of each drug request and its alternative options were evaluated according to the patient health and demographic characteristics and standard guidelines.Results: Of the 980 physician off-label requests, only 22.7% were approved by the pharmacists. Rheumatology and Nephrology accounted for the highest ratio of off-label use requests for adults (30.3% and 26.3%). The pharmacist rejection ratio of off-label use was comparable between the two groups (p>0.05). Most of the issued requests were attributed either to unapproved indication or to combination of more than one drug (38% and 35.3%). A low acceptance rate was reported in the requests issued for treatment in different clinical lines to the authorized one (11.9%). The lowest rate of acceptance was reported in the requests that had very low evidence level (9.1%). The mostly prescribed medications were musculoskeletal agents (28.9%). Finally, 78.2% of the requests came from clinical branches for adults. Although the agreement rate for requests in adults was higher than that in pediatrics, the two rates were not significantly different.Conclusion: Community pharmacists should effectively take responsibility for assessing off-label drug requests in Iraqi private settings. The quality of evidence does not represent the major factor influencing the approval rate of off-label drug use. The availability of safer and/or affordable alternatives and prescribing for a different patient age category highly impacted the pharmacists’ approval rate