The use of filgrastim in kidney transplant recipients demonstrated success in reversing neutropenia. Short courses of therapy were required with minimal adverse events. Patients who required readmission were successfully re-treated. Additional studies are required to determine the most effective dose and duration of treatment.
Beginning in March 2020, New York City began the fight against coronavirus disease 2019. Health care workers were faced with a disease that led to significant morbidity and mortality with no proven therapies. As hospitals became inundated with patients and underwent rapid expansion of capacity, resources such as drugs, protective and medical equipment, and hospital staff became limited. Pharmacists played a critical role in the management of clinical care and drug delivery during the pandemic. As members of the department of pharmacy within NewYork-Presbyterian Hospital, we describe our experiences and processes to overcome challenges faced during the pandemic. Strict inventory management through the use of daily usage reports, frequent communication, and minimization of waste was critical for the management of drug shortages. The creation of guidelines, protocols, and restrictions were not only used to mitigate drug shortages, but also helped educate health care providers and guided medication use. Managing technology through setting up new automatic dispensing cabinets to address hospital expansions and modifying the electronic order entry system to include new protocols and drug shortage information were also vital. Additional key pharmacist functions included provision of investigational drug service support and training of pharmacists, prescribers, nurses, and respiratory therapists to educate and standardize medication use. Through implementation of operational and clinical processes, pharmacists managed critical drug inventory and guided patient treatment. As the pandemic continues, pharmacists will remain vital members of the multidisciplinary team dedicated to the fight against the virus.
A short-course corticosteroid taper in critically ill patients with AECOPD is associated with reduced hospital length of stay and decreased corticosteroid exposure without increased risk of treatment failure. A prospective randomized trial is warranted.
To determine the prevalence of hyperchloraemia (plasma chloride concentration of 107 mmol/l or above) in chronic renal failure (CRF), we retrospectively analysed the acid-base and electrolyte status of 102 Italian and 53 English patients with impaired renal function. Hyperchloraemia was a frequent finding at all stages of CRF with a prevalence ranging from 30 to 50%. It was common both in tubulointerstitial nephropathies (45%) and chronic glomerulonephritis (39%). Hyperchloraemic patients were more acidotic than the normochloraemic.
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