Parenteral nutrition is a life-saving therapy for patients with intestinal failure. It may be associated with transient elevations of liver enzyme concentrations, which return to normal after parenteral nutrition is discontinued. Prolonged parenteral nutrition is associated with complications affecting the hepatobiliary system, such as cholelithiasis, cholestasis, and steatosis. The most common...

Parenteral nutrition is life saving in patients with intestinal failure but liver dysfunction is commonly encountered, especially in neonates. Although abnormal liver function tests associated with short-term parenteral nutrition are usually benign and transient, liver dysfunction in both children and adults receiving long-term parenteral nutrition can progress to end-stage liver disease and li...

body, being contained in infusion solutions not only cause infusion-related phlebitis but also have been suggested to damage various organs such as the lungs, brain, kidneys, liver, and spleen. However, in Asian countries such as Japan, adequate attention is not paid to particulate contamination of parenteral solutions. For example, many drugs in glass ampoules are added to parenteral nutrition...

Hypertension is an uncommon but significant problem in high-risk neonates and infants, and the spectrum of potential causes is broad. Here, we describe an extremely premature infant (birth weight, 728 g; gestational age, 27 weeks) with multiple complications and hypertension. During admission, umbilical artery catheters were used for a period of time, and he suffered from respiratory distress s...

Hypomagnesemia is not a typical concern in patients with stage 5 chronic kidney disease. Magnesium (Mg) is cleared renally, so Mg concentration is usually normal or even elevated in patients with chronic kidney disease. Up to 95% of renally filtered Mg can be reabsorbed in the nephron. Certain medications, such as diuretics (loop, thiazide, and osmotic), cisplatin, gentamicin, and ß-lactam anti...

Contrast induced nephropathy (CIN) is the third leading cause of hospital acquired renal failure and is associated with significant morbidity and mortality. Chronic kidney disease is the primary predisposing factor for CIN. As estimated glomerular filtration rate<60 ml/1.73 m2 represents significant renal dysfunction and defines patients at high risk. Modifiable risk factors for CIN include hyd...

A 74-year-old Asian woman was referred for outpatient upper and lower endoscopic screening. She had history of hyperlipidemia and vegetarianism. Her medications included atorvastatin and self-medication of oral iron for the last 10 years. Routine blood tests were normal. Esophagogastroduodenoscopy was macroscopically and histologically normal. Colonoscopy disclosed diffuse brownish tiny spots o...

BACKGROUND The Internet enables businesses to advertise their pharmaceutical products and services without medical supervision. The Internet also allows for the unsupervised purchase of medications that may have neurologic consequences. OBJECTIVE To describe acute withdrawal delirium following the abrupt discontinuation of Fioricet. PATIENT The patient was a 37-year-old woman with a history...

I t has long been known that 50–90% of medications used in children are ‘‘off-label’’ or unlicensed, and this is associated with an increased risk of adverse events [1–14]. This means that some of the most vulnerable people in the European Union (EU), sick children, are being treated in a non-evidence-based, unregulated fashion. Even commonly prescribed respiratory medicines, such as short-acti...

The safety of neuraxial anesthetic techniques in the setting of oral and parenteral anticoagulation is an area of growing interest and clinical inquiry as the multitude of anticoagulant medications rapidly increases. Additionally, the indications for spinal cord stimulation therapy are evolving as both technique and technology in the field continue to advance. The estimated incidence of spinal ...