Advance Access published on July 17 8. No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19 2020. Available from: https:// www.recoverytrial.net/news/statement-from-the-chiefinvestigators-of-the-randomised-evaluation-of-covid-19therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19. [Accessed 17 May 2020] 9. Baum A, Schwartz MD. Admissions to Veterans Affairs hospitals for emergency conditions during the COVID-19 pandemic. JAMA 2020; 324: 96e9 10. Quilter-Pinner H. The hidden cost of Covid-19 on the NHSand how to 'build back better' 2020.
-Serum acetaminophen concentrations are of critical importance in determining the need for acetylcysteine therapy after acute acetaminophen overdose. Limited data suggest opioid co-ingestion might alter acetaminophen pharmacokinetics. The present study was designed to examine serum acetaminophen concentrations after acute overdose, and to compare between patients that co-ingested an opioid and those that did not. A prospective study of consecutive patients that presented to hospital within 16 hr of acute acetaminophen overdose. Equivalent 4-hr acetaminophen concentrations were calculated using -pared using Mann Whitney tests. There were 990 patients; 295 (29.8%) had co-ingested an opioid, and 695 had not. The median (interquartile range) stated dose was 10 g (6-16 g) vs. 10 g (7-16 g) respectively (P = 0.94), interval between ingestion and acetaminophen determination was 4.5 hr (4.0-6.0 hr) vs. 4.5 hr (4.0-5.5 hr) respectively (P = 0.41), and serum acetaminophen concentration was 56 mg/l (24-105 mg/l) va. 60 mg/l (23-129 mg/l) respectively (P = 0.25). A positive relationship was noted between stated dose and equivalent 4-hr serum acetaminophen concentration, but did not differ between groups. The acetaminophen dose-concentration relationship was similar in patients that did and did not co-ingest an opioid. Therefore, early serum acetaminophen concentrations can be used to determine the extent of drug exposure, irrespective of whether an opioid has been co-ingested.
Background: Acute renal failure is a recognized complication of acute acetaminophen overdose. Its detection depends on rising creatinine concentrations, which is an insensitive method. The present study examined whether proteinuria might correspond with the extent of acute acetaminophen exposure as a possible early marker of renal effects.Methods: A prospective case-control study included patients attending the emergency department within 24 hours of acetaminophen ingestion. A urine specimen was collected within 12 hours of hospital attendance for creatinine, albumin, and protein determination. Equivalent 4-hour acetaminophen concentrations were used to indicate drug exposure:. Data are presented as median (interquartile range) and groups compared using Mann Whitney and chi-square tests.Results: Seventy patients were studied (17 men, 53 women), age 37 years (23-45 years). The stated acetaminophen dose was 15 g (8-20 g), and interval between ingestion and presentation was 4.6 hours (4.1-7.9 hours). Urinary albumin concentrations were 8 mg/L (0-12 mg/L) in the mild group, 12 mg/L (5-25 mg/L) in the moderate group, and 11 mg/L (6-22 mg/L) in the severe group. Total protein concentrations were 90 mg/L (50-183 mg/L), 70 mg/L (40 to 130 mg/L), and 110 mg/L (75-205 mg/L), respectively. The proportions of patients who had urine albumin:creatinine ratio Ͼ3 mg/mmol were 20.8%, 23.5%, and 21.2%, respectively. None of the patients developed acute renal failure. Conclusions:No relationship was found between the extent of acute acetaminophen exposure and proteinuria. Further work is required to examine whether urinary protein excretion is altered in patients who subsequently develop acute renal failure following acetaminophen overdose.
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