02 Mar
In studies evaluating PPIs as a risk factor for CDAD, results have been mixed. This relationship has been somewhat ambiguous, and the exact mechanism of action is only speculative. C. difficile is a gram-positive, spore-forming anaerobic bacillus. The spores are acid-resistant, and they are not affected by the gastric pH. By contrast, a vegetative inoculum of C. difficile is easily destroyed by stomach acid. Suppressing gastric acid secretion may allow actively growing bacteria and ingested spores that germinate in the stomach to survive until they pass into the bowel, increasing the likelihood of colonization. PPIs have also been implicated in diminishing neutrophil activity, thereby further increasing the risk of an infectious disease. Overall, it has been proposed that PPIs either suppress the body’s natural barrier defense to infection or alter the immune response to infection.
Continue Reading »
01 Mar
Primary Outcome
The difference in the rate of exposure to a PPI in the case and control groups was not statistically significant. Thirty-four case subjects and 37 controls were exposed to a PPI (P = 0.442). In a separate analysis, we examined each of the criteria for PPI exposure independently and found no statistical difference between case subjects and controls for each variable (P = 0.424) (Table 1).
Continue Reading »
28 Feb
Study Design
Our study was a retrospective case-control review that included patients admitted to the hospital over a 10-month period. All study subjects developed diarrhea and were subsequently tested for the presence of C. difficile toxin A in the stool, as determined by an enhanced optical immunoassay. The study took place in a 420-bed tertiary hospital serving a rural population in a 10-county region.
Continue Reading »
27 Feb
ABSTRACT
Purpose: We analyzed the relationship between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients .
Methods: We conducted a retrospective case-control study in a 420-bed tertiary hospital serving a rural population in a 10-county region. We identified all patients in the hospital who had been tested for the presence of C. difficile toxin A in the stool from January 1, 2005, to October 31, 2005. Potential case subjects were those who tested positive for toxin A (n = 81); potential control subjects tested negative (n = 706). Each case subject was matched to a control subject based on age (within five years), sex, chronic dialysis, acute dialysis, and the use of histamine H2-receptor antagonists (H2RAs) and total parenteral nutrition. Fifty-seven case subjects were randomly matched to 57 control subjects. Thirty-four case subjects and 37 controls were exposed to a PPI.
Continue Reading »
25 Feb
A study by Kramer and associates also evaluated the efficacy of paliperidone ER in a multiphase trial. In an eight-week run-in phase, 530 patients were hospitalized and received open-label paliperi-done. Dosing was flexible, starting at 9 mg once daily, and the dose could be adjusted between 3 and 15 mg once daily. The most commonly used dose was 9 mg. The dose was increased to 12 or 15 mg in 47% of patients and was decreased to 3 or 6 mg in 8% of the patients.
Continue Reading »
24 Feb
INDICATIONS
Paliperidone was approved in December 2006 for the acute treatment of schizophrenia and for the long-term maintenance treatment of schizophrenia in April 2007.
Continue Reading »
22 Feb
INTRODUCTION
Schizophrenia is a chronic mental illness that affects between 0.5% and 1% of the population in the U.S. today. Even though schizophrenic patients characteristically have psychoses, including hallucinations and delusions, this debilitating disease impairs their functional capacity to learn, work, care for themselves, maintain interpersonal relationships, and sustain general living skills. Forty percent to 60% of schizophrenic patients endure lifelong impairment. The illness has created an enormous economic burden on society at a cost of more than $62 billion annually over the past two decades.
Continue Reading »