Pharmacotherapy
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To identify the factors affecting tacrolimus apparent total body clearance (Cl/F [F = bioavailability]) in adult liver transplant recipients. ⋯ These findings could be useful to the health care provider for adjustment of tacrolimus dosage in adult liver transplant recipients with various clinical factors.
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To determine the risk factors for venous thromboembolism (VTE) and the rates of prophylactic measures used in acutely ill medical patients. ⋯ Rates of VTE prophylaxis were higher than previously reported rates, although no formalized guidelines, standardized order sets, alerting programs, training, or risk-stratification tools were used during the study period. Rates of adverse events were low.
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ST-segment-elevation myocardial infarction: guidelines and the challenge of real-world patient care.
ST-segment-elevation myocardial infarction (STEMI) is a serious condition that requires early, aggressive management to reduce infarction damage and the risk of mortality. Although evidence-based guidelines recognize the clear benefits of early, effective reperfusion in STEMI, a number of barriers interfere with prompt delivery of care. Delays in treatment that exceed current evidence-based recommendations often plague reperfusion with either fibrinolytic therapy or percutaneous coronary intervention (PCI). ⋯ Under investigation are new therapeutic strategies that take advantage of improved coordination of care, such as the administration of bolus fibrinolytic therapy in the prehospital environment followed by immediate transfer of the patient for PCI. This approach may shorten the time to effective reperfusion and improve outcomes. Ongoing studies will help in determining the role this facilitated-PCI strategy may play in effective management of STEMI.