The high prevalence of diabetes has become a major public health issue worldwide[1], particularly in middle-and low-income countries[2]. The prevalence of diabetes in China, the largest developing country,has more tha...The high prevalence of diabetes has become a major public health issue worldwide[1], particularly in middle-and low-income countries[2]. The prevalence of diabetes in China, the largest developing country,has more than quadrupled in recent decades, and many cases of diabetes are undiagnosed[3]. The problem with missed diabetes diagnoses is a challenge faced both by China and the rest of the world[4].展开更多
Patients undergoing total hip arthroplasty(THA)are at high risk for developing venous thromboembolism and,therefore,require short term prophylaxis with antithrombotic agents.Recently,target specific oral anticoagulant...Patients undergoing total hip arthroplasty(THA)are at high risk for developing venous thromboembolism and,therefore,require short term prophylaxis with antithrombotic agents.Recently,target specific oral anticoagulants(TSOA)including the direct thrombin inhibitor,dabigatran,and the factorⅩa inhibitors rivaroxaban,apixaban,and edoxaban have been approved for THA thrombopropylaxis in various countries.The TSOAs provide a rapid acting,oral alternative to parenteral agents including low-molecular weight heparins(LMWH)and fondaparinux;and compared to warfarin,they do not require routine laboratory monitoring and possess much fewer drug-drug interactions.Based on phaseⅢclinical studies,TSOAs have established themselvesas an effective and safe option for thromboprophylaxis after THA compared to LMWH,particularly enoxaparin,but require additional evaluation in specific populations such as the renally impaired or elderly.The ability to monitor and reverse these TSOAs in the case of bleeding complications or suspected sub-or supra-therapeutic anticoagulation is of importance,but remains investigational.This review will focus on the drug-specific characteristics,efficacy,safety,and economic impact of the TSOAs for thromboprophylaxis following THA,as well as the aspects of therapeutic monitoring and anticoagulation reversal in the event of bleeding complications or a need for urgent reversal.展开更多
Background:Kidney injuries caused by several viral diseases have been reported worldwide among all age groups,races,and genders.Of particular importance is coronavirus disease 2019(COVID-19),and its prevalence in comm...Background:Kidney injuries caused by several viral diseases have been reported worldwide among all age groups,races,and genders.Of particular importance is coronavirus disease 2019(COVID-19),and its prevalence in communities infecting all patient populations with symptoms ranging from asymptomatic to severe,including complications and mortality.Methods:Data were acquired from PubMed,Scopus,Google Scholar,Centers for Disease Prevention and Control(CDC),and Lexi-Comp using the following search terms:“COVID-19 and renal pathology,”“COVID-19 induced kidney disease,”“Viral infection induced kidney disease,”and“Viral infection induced renal damage.”Titles and abstracts were manually analyzed as per the exclusion and inclusion criteria of relevant articles;relevance of articles included studies on the pathology of a specific viral infection and the impact of the virus on the adult renal system.Results:The mechanisms for renal disease due to COVID-19 include direct renal tubular injury,cytokine storm,inflammation,thrombosis vs.acute tubular necrosis,thrombotic events,and direct renal injury.Although some mechanisms behind renal dysfunction among the studied viral infections are similar,the prevalence rates of kidney injury or damage differ.This might be described by recommended prophylactic and therapeutic approaches that can alter the viral infection characteristics and possibly the impact a particular organ system.Conclusion:The patient population at risk was old in age and had a high body mass index.The mechanisms associated with renal dysfunction are similar,including direct renal injury through angiotensin converting enzyme 2(ACE2)entry,inflammation,and thrombosis.The renal pathology of coronaviruses that differs from that of other prevalent viral infections is the activation of cytokine storm,which causes elevations of a greater number and different kinds of cytokines than other viral infections.展开更多
基金supported by the Szechwan Province Science and Technology Agency Fund Project [2009FZ 0027]Chengdu,China and the Population and Health Project of the Chengdu Municipal Science and Technology Bureau[10YTYB272SF-182]
文摘The high prevalence of diabetes has become a major public health issue worldwide[1], particularly in middle-and low-income countries[2]. The prevalence of diabetes in China, the largest developing country,has more than quadrupled in recent decades, and many cases of diabetes are undiagnosed[3]. The problem with missed diabetes diagnoses is a challenge faced both by China and the rest of the world[4].
文摘Patients undergoing total hip arthroplasty(THA)are at high risk for developing venous thromboembolism and,therefore,require short term prophylaxis with antithrombotic agents.Recently,target specific oral anticoagulants(TSOA)including the direct thrombin inhibitor,dabigatran,and the factorⅩa inhibitors rivaroxaban,apixaban,and edoxaban have been approved for THA thrombopropylaxis in various countries.The TSOAs provide a rapid acting,oral alternative to parenteral agents including low-molecular weight heparins(LMWH)and fondaparinux;and compared to warfarin,they do not require routine laboratory monitoring and possess much fewer drug-drug interactions.Based on phaseⅢclinical studies,TSOAs have established themselvesas an effective and safe option for thromboprophylaxis after THA compared to LMWH,particularly enoxaparin,but require additional evaluation in specific populations such as the renally impaired or elderly.The ability to monitor and reverse these TSOAs in the case of bleeding complications or suspected sub-or supra-therapeutic anticoagulation is of importance,but remains investigational.This review will focus on the drug-specific characteristics,efficacy,safety,and economic impact of the TSOAs for thromboprophylaxis following THA,as well as the aspects of therapeutic monitoring and anticoagulation reversal in the event of bleeding complications or a need for urgent reversal.
文摘Background:Kidney injuries caused by several viral diseases have been reported worldwide among all age groups,races,and genders.Of particular importance is coronavirus disease 2019(COVID-19),and its prevalence in communities infecting all patient populations with symptoms ranging from asymptomatic to severe,including complications and mortality.Methods:Data were acquired from PubMed,Scopus,Google Scholar,Centers for Disease Prevention and Control(CDC),and Lexi-Comp using the following search terms:“COVID-19 and renal pathology,”“COVID-19 induced kidney disease,”“Viral infection induced kidney disease,”and“Viral infection induced renal damage.”Titles and abstracts were manually analyzed as per the exclusion and inclusion criteria of relevant articles;relevance of articles included studies on the pathology of a specific viral infection and the impact of the virus on the adult renal system.Results:The mechanisms for renal disease due to COVID-19 include direct renal tubular injury,cytokine storm,inflammation,thrombosis vs.acute tubular necrosis,thrombotic events,and direct renal injury.Although some mechanisms behind renal dysfunction among the studied viral infections are similar,the prevalence rates of kidney injury or damage differ.This might be described by recommended prophylactic and therapeutic approaches that can alter the viral infection characteristics and possibly the impact a particular organ system.Conclusion:The patient population at risk was old in age and had a high body mass index.The mechanisms associated with renal dysfunction are similar,including direct renal injury through angiotensin converting enzyme 2(ACE2)entry,inflammation,and thrombosis.The renal pathology of coronaviruses that differs from that of other prevalent viral infections is the activation of cytokine storm,which causes elevations of a greater number and different kinds of cytokines than other viral infections.
