2.Advances in clinical diagnosis and treatment of drug-induced liver injury in children.
Xiao Rong PENG ; Yu Nan CHANG ; Tao QIN ; Ting Ting SHANG ; Hong Mei XU
Chinese Journal of Hepatology 2023;31(4):440-444
Drug-induced liver injury (DILI) is one of the most common adverse drug reactions that may seriously threaten the health of children and is receiving increasing clinical attention day by day. There is still no independent diagnosis and treatment guideline for DILI in children, but its clinical features are not completely similar to those in adults. This article reviews the epidemiology, clinical features, diagnosis, and treatment progress in order to provide a reference for the management of DILI in children.
Child
;
Humans
;
Chemical and Drug Induced Liver Injury/therapy*
;
Drug-Related Side Effects and Adverse Reactions
;
Liver/pathology*
;
Risk Factors
3.Genetic susceptibility to drug-induced liver injury.
Yang ZHI ; Jie Ting TANG ; Yi Min MAO
Chinese Journal of Hepatology 2023;31(6):653-658
Drug-induced liver injury (DILI) risk prediction, diagnosis establishment, clinical management, and all other aspects are facing great challenges. Although the current understanding of its pathogenesis is still incomplete, research over the past 20 years has shown that genetic susceptibility may play an important role in the occurrence and development of DILI. In recent years, pharmacogenomics studies have further revealed the association between human leukocyte antigen (HLA) genes, some non-HLA genes, and hepatotoxicity from certain drugs. However, due to the lack of well-designed, prospective, large-sample cohort validation and low positive predictive values, there may still be some way to go before the current results can be truly translated into clinical practice for precise prediction and prevention of DILI risk.
Humans
;
Genetic Predisposition to Disease
;
Prospective Studies
;
Risk Factors
;
Chemical and Drug Induced Liver Injury/genetics*
;
Drug-Related Side Effects and Adverse Reactions
;
Liver
4.Chinese guideline for diagnosis and management of drug-induced liver injury (2023 version).
Chinese Journal of Hepatology 2023;31(4):355-384
Drug-induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver disease, drug-induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti-tuberculosis drugs, anti-neoplastic drugs), and signal and assessment of DILI in clinical trials.
Humans
;
Chemical and Drug Induced Liver Injury/therapy*
;
Drug-Related Side Effects and Adverse Reactions
;
Liver Failure, Acute
;
Dietary Supplements/adverse effects*
;
Risk Factors
5.Risk factors for peripherally inserted central catheterization-associated bloodstream infection in neonates.
Yan-Ping XU ; Zhen-Ru SHANG ; Robert M DORAZIO ; Li-Ping SHI
Chinese Journal of Contemporary Pediatrics 2022;24(2):141-146
OBJECTIVES:
To study the features of catheter-related bloodstream infection (CRBSI) or central line-associated bloodstream infection (CLABSI) after peripherally inserted central catheterization (PICC) in neonates admitted to the neonatal intensive care unit (NICU) and the risk factors for CRBSI or CLABSI.
METHODS:
A retrospective analysis was performed on the medical data of the neonates who were treated and required PICC in the NICU of the Children's Hospital, Zhejiang University School of Medicine from June 1, 2018 to May 1, 2020. The catheterization-related data were collected, including placement time, insertion site, removal time, and antimicrobial lock of PICC. The multivariate logistic regression model was used to investigate the risk factors for CRBSI or CLABSI in the neonates.
RESULTS:
A total of 446 neonates were enrolled, with a mean gestational age of (30.8±4.0) weeks, a mean birth weight of (1 580±810) g, a median age of 9 days, and a median duration of PICC of 18 days. The incidence rates of CLABSI and CRBSI were 5.6 and 1.46 per 1 000 catheter days, respectively. Common pathogens for CLABSI caused by PICC included Staphylococcus epidermidis (n=19) and Klebsiella pneumoniae (n=11), and those for CRBSI caused by PICC included Klebsiella pneumoniae (n=6). The risk of CLABSI caused by PICC increased significantly with prolonged durations of PICC and antibiotic use, and the PICC-related infection probability at head and neck was significantly lower than that in the upper and low limbs (P<0.05), while the above conditions were more obvious in neonates with a birth weight of <1 500 g. The risk of CRBSI caused by PICC decreased with the increase in gestational age (P<0.05).
CONCLUSIONS
CRBSI and CLABSI remain serious issues in NICU nosocomial infection. The identification of the risk factors for CRBSI and CLABSI provides a basis for improving the quality of clinical care and management.
Catheter-Related Infections/etiology*
;
Catheterization, Central Venous/adverse effects*
;
Catheterization, Peripheral/adverse effects*
;
Central Venous Catheters/adverse effects*
;
Child
;
Humans
;
Infant
;
Infant, Newborn
;
Retrospective Studies
;
Risk Factors
;
Sepsis/etiology*
6.Associations between adverse childhood experiences and adulthood substance use among lesbians.
Biao ZHU ; Chang Mian DING ; Qing Qing JIANG ; Meng Xi ZHAI ; Jia Wei TIAN ; Bin YU ; Hong YAN
Chinese Journal of Epidemiology 2022;43(2):248-253
Objective: To investigate the associations between adverse childhood experiences (ACE) and substance use behaviors among lesbians to provide a scientific basis for high-risk population identification and formulation of targeted intervention measures. Methods: Lesbians who participated in routine AIDS voluntary counseling, testing services, activities, and peer recommendations were recruited from July to December 2018, with the help of LesPark in Beijing. Convenient sampling method was used. Demographic characteristics, ACE, and substance use behaviors of subjects were investigated using an online platform powered by www.wjx.cn. Subsequently, the associations between ACE and adulthood substance use behaviors were evaluated using the logistic regression model. The SPSS 22.0 was used for statistical analysis. Results: A total of 294 lesbians were recruited in the study, 81.3% (239/294) of them were lesbians, and 18.7% (55/294) were bisexuals. Besides, 55.8% (164/294) of subjects reported they had had ACE, with proportions of lesbians experiencing abuse, neglect, and family dysfunction as 33.3% (98/294), 24.5% (72/294), and 32.7% (96/294), respectively. 55.1% (162/294) of the lesbians reported they had smoked in the past 30 days, 11.2% (33/294) reported having drug-use behavior in the past three months, and 22.8% (67/294) claimed drinking alcohol weekly. Multivariate logistic regression analysis showed that lesbians with ACE were at high risks to smoke (OR=1.87, 95%CI: 1.13-3.08), drink (OR=2.13, 95%CI: 1.18-3.84), and use drugs (OR=3.33, 95%CI: 1.29-8.61) in adulthood. Moreover, lesbians with childhood family dysfunction were at higher risk of smoking cigarettes (OR=2.60, 95%CI: 1.46-4.62) and drinking alcohol (OR=2.65, 95%CI: 1.44-4.87). At the same time, those with abuse experience were at higher risk of drug use (OR=3.17, 95%CI: 1.26-7.96). Conclusions: Substance use behaviors, including cigarette smoking, drinking alcohol, and drugs use, were common among lesbians. Positive associations were found between ACE and adulthood substance use behaviors.
Adult
;
Adverse Childhood Experiences
;
Child
;
Child Abuse/psychology*
;
Female
;
Humans
;
Risk Factors
;
Sexual and Gender Minorities
;
Substance-Related Disorders/psychology*
7.Early childhood traffic-related air pollution and risk of allergic rhinitis at 2-4 years of age modification by family stress and male gender: a case-control study in Shenyang, China.
Shuai HAO ; Fang YUAN ; Pai PANG ; Bo YANG ; Xuejun JIANG ; Aihui YAN
Environmental Health and Preventive Medicine 2021;26(1):48-48
BACKGROUND:
Few studies have explored the modifications by family stress and male gender in the relationship between early exposure to traffic-related air pollution (TRAP) and allergic rhinitis (AR) risk in preschool children.
METHODS:
We conducted a case-control study of 388 children aged 2-4 years in Shenyang, China. These children AR were diagnosed by clinicians. By using measured concentrations from monitoring stations, we estimated the exposures of particulate matter less than 10 μm in diameter (PM
RESULTS:
The prevalence of AR in children aged 2-4 years (6.4%) was related to early TRAP exposure. With an IQR (20 μg/m
CONCLUSIONS
Family stress and male gender may increase the risk of AR in preschool children with early exposure to PM
Air Pollution/adverse effects*
;
Case-Control Studies
;
Child, Preschool
;
China/epidemiology*
;
Cities
;
Family/psychology*
;
Female
;
Humans
;
Male
;
Prevalence
;
Rhinitis, Allergic/epidemiology*
;
Risk Factors
;
Stress, Psychological/complications*
;
Traffic-Related Pollution/adverse effects*
8.Effect of
Hong-Kui KE ; Shao-Heng TU ; Yu-Jie SHEN ; Qun-Wei QU
Chinese Acupuncture & Moxibustion 2021;41(10):1079-1083
9.Substance use and associated factors among preparatory school students in Kolfe-Keranyo sub-city of Addis Ababa, Ethiopia.
Leila SEID ; Binyam GINTAMO ; Zelalem Negash MEKURIA ; Hussien Seid HASSEN ; Zemichael GIZAW
Environmental Health and Preventive Medicine 2021;26(1):110-110
BACKGROUND:
Substance abuse is a worldwide problem that primarily affects adolescents, resulting in chronic health complications as well as psychosocial challenges and economic losses. However, the magnitude of the problem and the factors that contribute to it are not well studied in Ethiopia, particularly in the study area. As a result, this study was carried out to determine the prevalence and associated factors of substance use among preparatory school students in the Kolfe-Keraniyo sub-city of Addis Ababa, Ethiopia.
METHODOLOGY:
An institution-based cross-sectional study of 383 randomly selected preparatory school students in the Kolfe-Keraniyo sub-city was conducted. The data were gathered using a pretested self-administered structured questionnaire. Multivariable binary logistic regression analysis was employed to identify factors associated with substance use based on the adjusted odds ratio (AOR) and 95% confidence interval (CI) with p values less than 0.05.
RESULT:
This study revealed that the lifetime prevalence of substance use among preparatory students in Kolfe-Keraniyo sub-city, Addis Ababa, Ethiopia, was 26.5% (95% CI, 22.2, 30.7%). Specifically, 16% drunk alcohol, 9.6% smoked cigarette, and 9.4% chewed khat. The 16.3% were current users, of which 8.3% were drinkers, 6.4% were smokers, and 5.9% were khat chewers. Substance use was significantly associated with being male (AOR, 3.3; 95% CI, 1.284, 8.613), having alcohol drinking family member (AOR, 4.0; 95% CI, 1.704, 9.196), having khat chewing family member (AOR, 2.87; 95% CI, 1.161, 7.070), poor school substance use controlling rule (AOR, 6.64; 95% CI, 1.863, 23.687), availability of substance retailing shops in residential areas (AOR, 2.9; CI, 1.303, 6.606), strong relationship with parents (AOR, 0.005; 95% CI, 0.001, 0.026), and being member of school mini-media (AOR, 0.177; 95% CI, 0.048, 0.657).
CONCLUSION
According to the findings of this study, one-quarter of the study participants were substance users. Alcohol, khat, and cigarettes were all commonly used substances. Gender, parent-child relationship, family member substance use history, school substance use controlling rules, school mini-media and pro-social involvement, and the availability of substance retailing shops were all strongly associated with substance use. Strengthening school rules on substance use, controlling substance retailing shops near schools and residential areas, and providing students with health education are all strategies for reducing substance use among students.
Adolescent
;
Cross-Sectional Studies
;
Ethiopia/epidemiology*
;
Female
;
Humans
;
Male
;
Prevalence
;
Risk Factors
;
Schools
;
Students/statistics & numerical data*
;
Substance-Related Disorders/epidemiology*
;
Surveys and Questionnaires
;
Young Adult
10.Updates in penile prosthesis infections.
Amanda R SWANTON ; Ricardo M MUNARRIZ ; Martin S GROSS
Asian Journal of Andrology 2020;22(1):28-33
Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction. One of the major complications associated with these prostheses is infections, which ultimately require device explanation and placement of a new device. Over the past several decades, significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity. This article reviews the current state of knowledge surrounding penile prosthesis infections, with attention to the evidence for methods to prevent infection and best practices for device reimplantation.
Anti-Bacterial Agents/therapeutic use*
;
Anti-Infective Agents, Local/therapeutic use*
;
Antibiotic Prophylaxis/methods*
;
Bandages
;
Carrier State/drug therapy*
;
Chlorhexidine/therapeutic use*
;
Coated Materials, Biocompatible
;
Device Removal
;
Diabetes Mellitus/epidemiology*
;
Erectile Dysfunction/surgery*
;
Gram-Negative Bacterial Infections/therapy*
;
Hair Removal/methods*
;
Humans
;
Immunocompromised Host/immunology*
;
Male
;
Penile Implantation/methods*
;
Penile Prosthesis
;
Preoperative Care/methods*
;
Prosthesis-Related Infections/therapy*
;
Reoperation
;
Risk Factors
;
Spinal Cord Injuries/epidemiology*
;
Staphylococcal Infections/therapy*
;
Staphylococcus aureus
;
Staphylococcus epidermidis
;
Surgical Drapes
;
Surgical Instruments
;
Surgical Wound Infection/therapy*

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