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Recommendations for obesity prevention and treatment confront biological adaptations

Posted by Unknown Labels: adaptations, biological, confront, obesity, prevention, Recommendations, treatment

Recommendations for obesity prevention and treatment confront biological adaptations | American Pharmacists Association Skip to main content

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Recommendations for obesity prevention and treatment confront biological adaptations Share This Page
February 12, 2015Experts suggest obesity is a chronic disease with largely biological causes. "For most individuals, these biological adaptations need to be addressed for weight loss to be sustained long-term," they note.

Experts suggest obesity is a chronic disease with largely biological causes. "For most individuals, these biological adaptations need to be addressed for weight loss to be sustained long-term," they note. "We believe these mechanisms largely explain the poor long-term success rates of lifestyle modification, and obligate clinicians to go beyond mere recommendations to eat less and move more." They suggest that many clinicians may not be familiar enough with the reasons that people with obesity face in achieving and maintaining weight loss. The authors' clinical recommendations for obesity prevention and treatment include proactively addressing prevention with overweight patients, focusing on lifestyle choices, and continuing to monitor progress and adjust strategy as necessary. In terms of treatment, they recommend encouraging patients with obesity to consider treatment, even if it is not the primary complaint; considering biologically based interventions; implementing a multifaceted treatment strategy; recommending surgery when appropriate; and informing patients of the challenges to weight-loss maintenance.

The Lancet Diabetes & Endocrinology (02/11/2015) Ochner, Christopher N.; Tsai, Adam G.; Kushner, Robert F.; et al.

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Health care technologies to improve adherence to pediatric asthma treatment

Posted by Unknown Labels: adherence, asthma, Health, improve, pediatric, technologies, treatment

Health care technologies to improve adherence to pediatric asthma treatment | American Pharmacists Association Skip to main content

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February 13, 2015Most patients with asthma do not take all of their prescribed medication, but new research shows that speech recognition (SR) adherence programs could improve this. In the 24-month Breathe Well study, researchers tested an SR intervention to improve adherence to asthma controller medication.

Most patients with asthma do not take all of their prescribed medication, but new research shows that speech recognition (SR) adherence programs could improve this. In the 24-month Breathe Well study, researchers tested an SR intervention to improve adherence to asthma controller medication. The study included 1,187 children, aged 3 to 12 years, with a persistent asthma diagnosis and prescription for an inhaled corticosteroid. Patients were randomized to either the computerized SR intervention or usual care. The intervention involved SR telephone calls made to parents when a refill for the asthma medication was due or overdue. The calls were automatically tailored with medical and demographic information from the patient's electronic health record and from parents' answers to questions regarding recent refills, a need for assistance in refilling, learning about asthma control, or speaking with an asthma nurse or pharmacist. Results showed that inhaled corticosteroid adherence was about 25% higher in the intervention group compared with the usual care group. Asthma-related urgent-care events did not differ between the two groups, but the researchers suggest the intervention may have a greater impact in a population with less-controlled asthma.

JAMA Pediatrics (02/09/2015) Bender, Bruce G.; Cvietusa, Peter J.; Goodrich, Glenn K.; et al.

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Safe and effective use of eculizumab in the treatment of severe Shiga toxin Escherichia coli-associated hemolytic uremic syndrome [Case Report]

Posted by Unknown Labels: coliassociated, eculizumab, effective, Escherichia, hemolytic, Report, severe, Shiga, syndrome, toxin, treatment, uremic

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Safe and effective use of eculizumab in the treatment of severe Shiga toxin Escherichia coli-associated hemolytic uremic syndrome Alex Dinh, Ashok Anathasayanan and Lisa M. Rubin?

Alex Dinh, B.S., is Medical Extern, Department of Medicine and Biomedical Sciences, SUNY at Buffalo, Buffalo, NY. Ashok Anathasayanan, M.D., is Nephrology Fellow, Department of Nephrology; and Lisa M. Rubin, Pharm.D., is Clinical Pharmacy Specialist, Nephrology and Formulary Management, Department of Pharmacy, Veterans Affairs Western New York Healthcare System, Buffalo. Address correspondence to Dr. Rubin (lisa.rubin{at}va.gov). Abstract Purpose A severe case of Shiga toxin Escherichia coli (STEC)-associated hemolytic uremic syndrome (HUS) successfully treated with eculizumab is reported.

Summary An 18-year-old man was admitted to the intensive care unit with HUS due to laboratory-confirmed STEC O121. He was initially treated with plasmapheresis and required hemodialysis for anuric acute kidney injury. Plasmapheresis was stopped due to complications. He continued to show evidence of ongoing hemolysis and kidney injury. Due to the lack of clinical improvement in renal function and hematologic status as well as the severity of the patient’s symptoms, the decision was made to initiate eculizumab. The patient was given i.v. eculizumab 900 mg infused over 35 minutes weekly for four weeks, followed by 1200 mg infused over 35 minutes one week later as the fifth dose and then every two weeks thereafter. The patient also received i.v. ciprofloxacin 400 mg infused over 60 minutes once every 24 hours for meningococcal prophylaxis and bacterial eradication. After initiation of eculizumab, the patient’s platelet count rapidly improved. After three doses of eculizumab, the patient’s renal function improved, and further hemodialysis was no longer required. The patient continued to receive twice-monthly eculizumab infusions to complete a two-month treatment course (seven doses), at which point his renal function returned to baseline. The initial two infusions were administered as an inpatient, and the remainder was infused in the outpatient setting.

Conclusion An 18-year-old man who developed severe HUS due to STEC O121 and was unresponsive to traditional supportive therapies was successfully treated with eculizumab.

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? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140134 American Journal of Health-System Pharmacy January 15, 2015 vol. 72 no. 2 117-120 ? Abstract Full Text Full Text (PDF) Classifications Print Content Case Report Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Dinh, A. Articles by Rubin, L. M. PubMed PubMed citation Articles by Dinh, A. Articles by Rubin, L. M. Related Content Load related web page information Social Bookmarking Add to CiteULike

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Current Issue February 15, 2015, 72 (4)

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pharmacy teaching programs

Recommendations for obesity prevention and treatment confront biological adaptations

Health care technologies to improve adherence to pediatric asthma treatment

Safe and effective use of eculizumab in the treatment of severe Shiga toxin Escherichia coli-associated hemolytic uremic syndrome [Case Report]

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