Ihmisten itsehoitokipulääkkeiden käyttö koirilla

Kirjallisuuskatsauksessa käsitellään ihmisten itsehoitokipulääkkeiden ibuprofeenin, ketoprofeenin, asetyylisalisyylihapon ja parasetamolin käyttöä ja haittavaikutuksia koirilla. Yleisimmät tulehduskipulääkkeiden aiheuttamat haittavaikutukset koirilla ovat ruoansulatuskanavan ärsytys ja limakalvovauriot. Tulehduskipulääkkeet ja parasetamoli voivat myös heikentää munuaisten verenvirtausta, mutta terveillä koirilla ja oikein annosteltuna vaikutukset ovat yleensä vähäisiä ja palautuvia. Tulehduskipulääkkeet voivan myös vaikuttaa veren hyytymiseen, mutta tällä ei ole yleensä suurta kliinistä merkitystä. Parasetamoli aiheuttaa koirilla yleisimmin naaman ja tassujen turvotusta, methemoglobinemiaa ja maksavaurioita. Jo terapeuttisina pidetyt annokset ihmisten itsehoitokipulääkkeitä voivat aiheuttaa haittavaikutuksia koirilla. Tutkimusosion tarkoituksena oli selvittää farmasistien käsitystä ihmisten itsehoitokipulääkkeiden käytöstä koirilla ja kissoilla. Tutkimuksen aihe on tärkeä, koska ihmisten itsehoitokipulääkkeet voivat aiheuttaa vakaviakin haittavaikutuksia eläimillä. Työn hypoteesina oli, että koiran- ja kissanomistajat käyttävät toisinaan lemmikeilleen ihmisten itsehoitokipulääkkeitä. Tutkimus suoritettiin kyselytutkimuksena verkkolomakkeella Suomen pääapteekkeihin. Tuloksia analysoitiin SPSS-ohjelmalla. Vastauksia saatiin 313 ja vastausprosentti oli 51,7 %. Farmasistien mukaan ihmisten itsehoitokipulääkkeitä käytetään koirilla ja kissoilla harvoin, mutta tulosten perusteella voidaan arvioida, että apteekeista myydään ihmisten itsehoitokipulääkkeitä jopa n. 2000–4000 kertaa vuodessa tietäen, että lääkkeet tulevat koiralle tai kissalle. Vain osa ihmisten itsehoitokipulääkkeiden käytöstä eläimille tulee farmasistien tietoon ja luultavasti todellinen määrä on paljon suurempi. Kyselytutkimuksen mukaan ketoprofeeni on yleisin koirille ja kissoille käytetty ihmisten itsehoitokipulääke. Ihmisten itsehoitokipulääkkeiden myynti koirille ja kissoille on yleisempää pohjoisessa kuin eteläisessä Suomessa. Maa- ja metsätalousministeriön asetuksen 6/EEO/2008 mukaan eläimille on ensisijaisesti käytettävä kyseiselle eläinlajille hyväksyttyä lääkevalmistetta ja vain eläinlääkäri saa tehdä päätöksen eläimen lääkitsemisestä muille eläinlajeille tai ihmisille rekisteröidyllä valmisteella. Suomessa käytetään kohtalaisen paljon ihmisten itsehoitokipulääkkeitä koirille ja kissoille. Määrää olisi hyvä saada vähennettyä ja tässä tärkeässä osassa on farmasistien, eläinlääkäreiden ja omistajien valistaminen

Reduced dose folinic acid rescue after rapid high-dose methotrexate clearance is not associated with increased toxicity in a pediatric cohort

Publisher Copyright: © 2021, The Author(s).Purpose: Low doses of folinic acid (FA) rescue after high-dose methotrexate (HD-MTX) have been associated with increased toxicity, whereas high doses may be related to a decreased antileukemic effect. The optimal dosage and duration of FA rescue remain controversial. This study was designed to investigate, whether a shorter duration of FA rescue in the setting of rapid HD-MTX clearance is associated with increased toxicity. Methods: We reviewed the files of 44 children receiving a total of 350 HD-MTX courses during treatment for acute lymphoblastic leukemia according to the NOPHO ALL-2000 protocol. Following a 5 g/m2 HD-MTX infusion, pharmacokinetically guided FA rescue commenced at hour 42. As per local guidelines, the patients received only one or two 15 mg/m2 doses of FA in the case of rapid MTX clearance (serum MTX ≤ 0.2 μmol/L at hour 42 or hour 48, respectively). Data on MTX clearance, FA dosing, inpatient time, and toxicities were collected. Results: Rapid MTX clearance was observed in 181 courses (51.7%). There was no difference in the steady-state MTX concentration, nephrotoxicity, hepatotoxicity, neutropenic fever, or neurotoxicity between courses followed by rapid MTX clearance and those without. One or two doses of FA after rapid MTX clearance resulted in a 7.8-h shorter inpatient time than if a minimum of three doses of FA would have been given. Conclusion: A pharmacokinetically guided FA rescue of one or two 15 mg/m2 doses of FA following HD-MTX courses with rapid MTX clearance results in a shorter hospitalization without an increase in toxic effects.Peer reviewe

Haihtuvat orgaaniset yhdisteet asunnoissa : Pitoisuustasot, yleisimmät yhdisteet ja terveysvaikutukset

Haihtuvat orgaaniset yhdisteet ovat yleisiä sisäilman yhdisteitä. Niitä vapautuu asuntojen sisäilmaan esimerkiksi rakennus- ja sisustusmateriaaleista, kuluttajatuotteista sekä tilan käyttäjistä ja heidän toiminnastaan. Haihtuvia orgaanisia yhdisteitä tutkitaan, koska suurina pitoisuuksina ne voivat aiheuttaa terveysvaikutuksia, kuten ärsytysoireita. Tässä katsauksessa tarkastellaan VOC-alueella esiintyvien haihtuvien orgaanisten yhdisteiden sekä formaldehydin esiintymistä, pitoisuuksia ja muutostrendejä Suomessa sijaitsevissa asunnoissa vuosina 2010 2019. Lisäksi selvitetään, ovatko terveysvaikutukset todennäköisiä asunnoissa esiintyvillä pitoisuuksilla. Tuloksia verrataan asumisterveysasetuksen ja sen soveltamisohjeen toimenpiderajoihin sekä kansainvälisiin terveysperusteisiin ohjearvoihin

Cropping system impact on soil quality determinants

Worldwide interest in soil quality evaluation has increased rapidly throughout the past decade, prompting us to evaluate the long-term impact of four cropping systems on several biological, chemical and physical determinants of soil quality. We hypothesized that after 17 years several of the determinants would show significant differences between conventional cereal and low input/organic rotations. Four crop rotations were imposed on a silt soil from 1982 through 1999. Rotation A was a conventionally managed cereal rotation that received 100% of the recommended mineral fertilizer each year. Rotation B was also managed conventionally from 1982 until 1993, although it received only 50% of the recommended mineral fertilizer. From 1994 through 1999, rotation B was managed as an organic rotation. Rotations C and D were low-input rotations with plant residues returned either untreated (C)or composted (D)from 1982 until 1994.From 1994 through 1999,they were also anaged organically. Significant decreases in extractable phosphorus (P)and potassium were observed in rotations C and D compared with rotation A, presumably because their yearly nutrient inputs were somewhat lower. The amount of soil organic carbon (Corg), soil water holding capacity, the numbers and biomass of earthworms and the microbial biomass carbon and nitrogen were or tended to be higher in low input/organic than in conventionally managed plots. These effects may be in connection with the slightly increased levels of Corg in soil of the organic rotations. Activities of twelve enzymes were strongly affected by sampling time (early-versus late-summer), but much less by long-term management. Litter decomposition, numbers of soil nematodes, arbuscular mycorrhizal (AM)fungal diversity,AM spore density and AM functioning were little affected by rotation. However,AM spore density correlated positively with the high amounts of extractable calcium and P which were a result from excessive liming applied to some plots in 1982. The crucial question to be answered in future is whether plant growth and yield will correlate with the changes in soil properties. This question will be dealt with in a further paper using data from the same experiment

Bisphosphonate treatment in children with acute lymphoblastic leukemia and osteonecrosis - radiological and clinical findings in a national cohort

Background: Osteonecrosis (ON) is a recognized complication of childhood ALL, but its optimal management remains unestablished. This study evaluated the effect of bisphosphonate (BP) treatment on the evolution of ON lesions in childhood ALL. Material and Methods: We included a national cohort of ALL patients diagnosed with symptomatic ON before 18 years of age and treated with BPs (N = 10; five males). Patients were followed both clinically and with serial MRIs. ON lesions were graded according to the Niinimaki classification. Results: The 10 patients had a total of 55 ON lesions. The median age was 13.3 years at ALL diagnosis and 14.8 years at ON diagnosis. Four patients had received HSCT before the ON diagnosis. BPs used were pamidronate (N = 7), alendronate (N = 2) and ibandronate (N = 1). The duration of BP treatment varied between 4 months and 4 years. In 4/10 patients, BP treatment was given during the chemotherapy. BPs were well-tolerated, with no severe complications or changes in kidney function. At the end of follow up 13/55 (24%) ON lesions were completely healed both clinically and radiographically; all these lesions were originally graded 3 or less. In contrast, ON lesions originally classified as grade 5 (joint destruction; N = 4) remained at grade 5. All grade 5 hip joint lesions needed surgical treatment. During BP treatment, the pain was relieved in 7/10 patients. At the end of follow-up, none of the patients reported severe or frequent pain. Conclusion: BP treatment was safe and seemed effective in relieving ON-induced pain in childhood ALL. After articular collapse (grade 5) lesions did not improve with BP treatment. Randomized controlled studies are needed to further elucidate the role of BPs in childhood ALL-associated ON.Peer reviewe

Pienentynyt ferritiinipitoisuus lapsella: Niukat rautavarastot ilman anemiaa

Laadukas tutkimusnäyttö puuttuu rautalisän hyödystä lapsille, joilla ei ole raudanpuuteanemiaa.Lapsia ei tulisi seuloa raudanpuutteen varalta, eikä diagnoosia tehdä yksin seerumin ferritiinipitoisuuden perusteella.Jos lapsella on raudanpuutteeseen sopivia oireita ja ferritiinipitoisuus on pienempi kuin 15 µg/l, suun kautta otettavan rautalisän voi aloittaa, mikäli lapsella ei ole raudan kertymiselle altistavaa sairautta. Hoidon vastetta tulee seurata.Lapselle suoneen annosteltavan rautalääkityksen tarpeen arvioiminen ja toteutus kuuluvat erikoissairaanhoitoon

Asymptomatic Right Atrial Thrombosis After Acute Lymphoblastic Leukemia Treatment

Right atrial thrombosis is a rare, but potentially serious complication of acute lymphoblastic leukemia treatment. We conducted a retrospective multicenter study to assess the incidence, treatment, and outcome of asymptomatic right atrial thrombosis detected at routine echocardiography of children after acute lymphoblastic leukemia treatment in the Nordic and Baltic countries. Eleven (2.7%, 95% confidence interval, 1.4-4.9) of 406 patients had asymptomatic right atrial thrombosis, ranging from 10 to 25 mm at detection. Three patients were treated with anticoagulation. None of the thromboses affected cardiac function, and they showed neither sign of progress nor spontaneous or treatment-related regress at follow-up.Peer reviewe

A survey on thromboprophylaxis and coagulation assessment in children and young adults with acute lymphoblastic leukaemia (ALL) in the Nordic and Baltic countries: Different practices of assessment and management

Patients undergoing treatment for acute lymphoblastic leukaemia (ALL) are at risk of coagulopathy, especially thromboembolism. We conducted a survey on practices in the assessment and management of coagulopathy during the new ALLTogether protocol in 29 (17 paediatric, 12 adult) Nordic and Baltic cancer centres. While 92% of adult centres used thromboprophylaxis with low-molecular-weight heparin, no paediatric centre did. Almost all providers performed baseline coagulation studies, but only 59% continued the assessment. Fibrinogen replacement was conducted in 59%, and antithrombin replacement in 28% of the centres. The survey highlights the need for guidelines in the management of coagulopathy during ALL therapy

Pediatric-type high-grade neuroepithelial tumors with CIC gene fusion share a common DNA methylation signature

Pediatric neoplasms in the central nervous system (CNS) show extensive clinical and molecular heterogeneity and are fundamentally different from those occurring in adults. Molecular genetic testing contributes to accurate diagnosis and enables an optimal clinical management of affected children. Here, we investigated a rare, molecularly distinct type of pediatric high-grade neuroepithelial tumor (n = 18), that was identified through unsupervised visualization of genome-wide DNA methylation array data, together with copy number profiling, targeted next-generation DNA sequencing, and RNA transcriptome sequencing. DNA and/or RNA sequencing revealed recurrent fusions involving the capicua transcriptional repressor (CIC) gene in 10/10 tumor samples analyzed, with the most common fusion being CIC::LEUTX (n = 9). In addition, a CIC::NUTM1 fusion was detected in one of the tumors. Apart from the detected fusion events, no additional oncogenic alteration was identified in these tumors. The histopathological review demonstrated a morphologically heterogeneous group of high-grade neuroepithelial tumors with positive immunostaining for markers of glial differentiation in combination with weak and focal expression of synaptophysin, CD56 and CD99. All tumors were located in the supratentorial compartment, occurred during childhood (median age 8.5 years) and typically showed early relapses. In summary, we expand the spectrum of pediatric-type tumors of the CNS by reporting a previously uncharacterized group of rare high-grade neuroepithelial tumors that share a common DNA methylation signature and recurrent gene fusions involving the transcriptional repressor CIC. Downstream functional consequences of the fusion protein CIC::LEUTX and potential therapeutic implications need to be further investigated