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1.
論文(リポジトリ) |
Nakamura, Hideta ; Ouchi, Gen ; Miyagi, Kazuya ; Higure, Yuuri ; Otsuki, Mariko ; Nishiyama, Naoya ; Kinjo, Takeshi ; Nakamatsu, Masashi ; Tateyama, Masao ; Kukita, Ichiro ; Fujita, Jiro
概要:
Anticoagulation plays a major role in reducing the risk of systematic thrombosis in patients with severe COVID-19. Serious hemorrhagic complications, such as intracranial hemorrhage, have also been recognized. However, intra-abdominal
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hemorrhage is under-recognized because of its rare occurrence, despite high mortality. Here, we discuss two cases of spontaneous iliopsoas hematoma (IPH) likely caused by anticoagulants during the clinical course of COVID-19. We also explored published case reports to identify clinical characteristics of IPH in COVID-19 patients. The use of anticoagulants may increase the risk of lethal IPH among COVID-19 patients becsuse of scarce data on optimal dosage and adequate monitoring of anticoagulant effects. Rapid diagnosis and timely intervention are crucial to ensure good patient outcomes.
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2.
論文(リポジトリ) |
Nakamura, Hideta ; Miyagi, Kazuya ; Otsuki, Mariko ; Higure, Yuuri ; Nishiyama, Naoya ; Kinjo, Takeshi ; Nakamatsu, Masashi ; Haranaga, Shusaku ; Tateyama, Masao ; Fujita, Jiro
概要:
Treatment with tocilizumab (TCZ) to block interleukin-6 (IL-6) signalling is predicted to mitigate cytokine release synd
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rome (CRS) caused by coronavirus disease 2019 (COVID-19). However, the adverse effects of TCZ on patients with COVID-19 remain unclear. We herein report a patient with COVID-19 treated with TCZ who developed acute hypertriglyceridaemia. Despite favipiravir treatment, acute respiratory distress syndrome developed in a 45-year-old patient with COVID-19; thus, TCZ was initiated. The triglyceride levels greatly increased after TCZ administration. Physicians should consider the negative impact of TCZ on the lipid profile in patients with COVID-19, although COVID-19-induced CRS itself may be an aggravating factor.
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3.
論文(リポジトリ) |
Shiohira, Hideo ; Nakamatsu, Masashi ; Kise, Yuya ; Higa, Futoshi ; Tateyama, Masao ; Hokama, Nobuo ; Kuniyoshi, Yukio ; Ueda, Shinichiro ; Nakamura, Katsunori ; Fujita, Jiro
概要:
Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic d
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rug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment. Plasma teicoplanin trough levels were maintained at a high range (20-30 μg/mL). Although the patient required long-term teicoplanin treatment, a further decline in renal function was not observed, and blood culture remained negative after the start of treatment. Teicoplanin treatment that is maintained at a high trough level by therapeutic drug monitoring might be beneficial for severe methicillin-resistant Staphylococcus aureus infection accompanied by renal impairment.
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