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Author |
Kane, S.P.; Hanes, S.D. |
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Title |
Unexplained increases in serum vancomycin concentration in a morbidly obese patient |
Type |
Journal Article |
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Year |
2017 |
Publication  |
Intensive & Critical Care Nursing |
Abbreviated Journal |
Intensive Crit Care Nurs |
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Volume |
39 |
Issue |
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Pages |
55-58 |
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Keywords |
Anti-Bacterial Agents/administration & dosage/therapeutic use; Cross Reactions/physiology; Drug-Related Side Effects and Adverse Reactions/*physiopathology; Female; Humans; Middle Aged; Obesity, Morbid/*drug therapy/physiopathology; Pneumonia, Ventilator-Associated/drug therapy/prevention & control; Vancomycin/*administration & dosage/therapeutic use; Central venous catheters; Critical care; Drug monitoring; Infectious disease; Medication safety; Vancomycin |
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Abstract |
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection. There is no clear explanation for the increase in the patient's vancomycin concentration. Drug leaching from the CVC, enterohepatic recycling, drug redistribution from adipose or other tissues, and assay cross-reactivity with other medications are all potential explanations for the increased vancomycin concentrations. CONCLUSION: This case report describes an unexplained increase in vancomycin concentrations and reinforces both the fallibility of laboratory testing and that unusual circumstances do occur. Several potential causes are hypothesised with CVC drug leaching being the most likely. Nurses and other healthcare providers with similar scenarios should consider a peripheral blood sample to rule out the potential for CVC drug leaching as a possible explanation. |
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Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States. Electronic address: scott.hanes@rosalindfranklin.edu |
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0964-3397 |
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PMID:27899248 |
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no |
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Call Number |
ref @ user @ |
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100001 |
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Author |
Jahan, N.; Lee, J.M.; Shah, K.; Wakimoto, H. |
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Title |
Therapeutic targeting of chemoresistant and recurrent glioblastoma stem cells with a proapoptotic variant of oncolytic herpes simplex virus |
Type |
Journal Article |
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Year |
2017 |
Publication |
International Journal of Cancer |
Abbreviated Journal |
Int J Cancer |
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Volume |
141 |
Issue |
8 |
Pages |
1671-1681 |
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Keywords |
Animals; Apoptosis/physiology; Brain Neoplasms/drug therapy/*therapy/virology; Cell Line, Tumor; Cohort Studies; Dacarbazine/analogs & derivatives/pharmacology; Drug Resistance, Neoplasm; Glioblastoma/drug therapy/*therapy/virology; HEK293 Cells; Humans; Mice; Neoplasm Recurrence, Local/drug therapy/therapy/virology; Neoplastic Stem Cells/drug effects/pathology/*virology; Oncolytic Virotherapy/*methods; Simplexvirus/genetics/*physiology; TNF-Related Apoptosis-Inducing Ligand/biosynthesis/genetics; TNF-related apoptosis inducing ligand (TRAIL); glioblastoma; oncolytic herpes simplex virus; recurrence; temozolomide |
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Abstract |
Temozolomide (TMZ) chemotherapy, in combination with maximal safe resection and radiotherapy, is the current standard of care for patients with glioblastoma (GBM). Despite this multimodal approach, GBM inevitably relapses primarily due to resistance to chemo-radiotherapy, and effective treatment is not available for recurrent disease. In this study we identified TMZ resistant patient-derived primary and previously treated recurrent GBM stem cells (GSC), and investigated the therapeutic activity of a pro-apoptotic variant of oHSV (oHSV-TRAIL) in vitro and in vivo. We show that oHSV-TRAIL modulates cell survival and MAP Kinase proliferation signaling pathways as well as DNA damage response pathways in both primary and recurrent TMZ-resistant GSC. Utilizing real time in vivo imaging and correlative immunohistochemistry, we show that oHSV-TRAIL potently inhibits tumor growth and extends survival of mice bearing TMZ-insensitive recurrent intracerebral GSC tumors via robust and selective induction of apoptosis-mediated death in tumor cells, resulting in cures in 40% of the treated mice. In comparison, the anti-tumor effects in a primary chemoresistant GSC GBM model exhibiting a highly invasive phenotype were significant but less prominent. This work thus demonstrates the ability of oHSV-TRAIL to overcome the therapeutic resistance and recurrence of GBM, and provides a basis for its testing in a GBM clinical trial. |
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Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA |
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ISSN |
0020-7136 |
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Notes |
PMID:28567859 |
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no |
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Call Number |
ref @ user @ |
Serial |
96584 |
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Author |
Corburn, J.; Sverdlik, A. |
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Title |
Slum Upgrading and Health Equity |
Type |
Journal Article |
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Year |
2017 |
Publication |
International Journal of Environmental Research and Public Health |
Abbreviated Journal |
Int J Environ Res Public Health |
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Volume |
14 |
Issue |
4 |
Pages |
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Keywords |
Africa; Asia; Climate Change; Employment; Environmental Health; *Health Equity; Housing; Humans; Latin America; *Poverty Areas; Socioeconomic Factors; Urban Health; Urban Population; climate change adaptation; health equity; health in all policies; housing; participation; slum upgrading; slums; social determinants of health; sustainable development goals |
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Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits. |
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Department of City and Regional Planning & School of Public Health, University of California, Berkeley, CA 94720, USA. sverdlik@berkeley.edu |
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1660-4601 |
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Notes |
PMID:28338613 |
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no |
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Call Number |
ref @ user @ |
Serial |
97044 |
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Author |
Corburn, J.; Sverdlik, A. |
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Title |
Slum Upgrading and Health Equity |
Type |
Journal Article |
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Year |
2017 |
Publication |
International Journal of Environmental Research and Public Health |
Abbreviated Journal |
Int J Environ Res Public Health |
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Volume |
14 |
Issue |
4 |
Pages |
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Keywords |
Africa; Asia; Climate Change; Employment; Environmental Health; *Health Equity; Housing; Humans; Latin America; *Poverty Areas; Socioeconomic Factors; Urban Health; Urban Population; climate change adaptation; health equity; health in all policies; housing; participation; slum upgrading; slums; social determinants of health; sustainable development goals |
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Abstract |
Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits. |
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Department of City and Regional Planning & School of Public Health, University of California, Berkeley, CA 94720, USA. sverdlik@berkeley.edu |
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1660-4601 |
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Notes |
PMID:28338613 |
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Call Number |
ref @ user @ |
Serial |
97084 |
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Author |
Corburn, J.; Sverdlik, A. |
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Title |
Slum Upgrading and Health Equity |
Type |
Journal Article |
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Year |
2017 |
Publication |
International Journal of Environmental Research and Public Health |
Abbreviated Journal |
Int J Environ Res Public Health |
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Volume |
14 |
Issue |
4 |
Pages |
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Keywords |
Africa; Asia; Climate Change; Employment; Environmental Health; *Health Equity; Housing; Humans; Latin America; *Poverty Areas; Socioeconomic Factors; Urban Health; Urban Population; climate change adaptation; health equity; health in all policies; housing; participation; slum upgrading; slums; social determinants of health; sustainable development goals |
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Abstract |
Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits. |
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Address |
Department of City and Regional Planning & School of Public Health, University of California, Berkeley, CA 94720, USA. sverdlik@berkeley.edu |
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1660-4601 |
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PMID:28338613 |
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Call Number |
ref @ user @ |
Serial |
97124 |
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