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Biomedical subjects

Kelly M Smith

Publications and source records attributed to Kelly M Smith.

At least 37 records · Page 2Linked to original sources
PubMed2006

Prevention of contrast-induced nephropathy: a pharmacological overview.

The use of contrast media in diagnostic procedures is a potential risk for the development of acute renal failure. To reduce the occurrence of contrast-induced nephropathy, assessment and subsequent minimization of risk factors is important. If risk factors are present, consider discontinuing concomitant nephrotoxic drugs, limiting exposure to contrast media or using an alternative imaging technique. Additionally, adequate intravenous hydration is universally recommended and should be employed in all patients.

Contrast Media↗
PubMed2005

The role of coenzyme Q10 in heart failure.

OBJECTIVE: To review the clinical data demonstrating the safety and efficacy of coenzyme Q10 (CoQ10) in heart failure (HF). DATA SOURCES: Pertinent literature was identified through MEDLINE (1966-January 2005) using the search terms coenzyme Q10, heart failure, antioxidants, and oxidative stress. Only articles written in the English language and evaluating human subjects were used. DATA SYNTHESIS: HF impairs the ability of the heart to maintain its normal cardiac output. Following an initial insult, cardiac remodeling ensues, resulting in left ventricular dilation and hypertrophy. Oxidative stress is also increased, while CoQ10 levels are decreased in patients with HF. This has led to the hypothesis that CoQ10, an antioxidant, may decrease oxidative stress, impair remodeling, and improve cardiac function. CONCLUSIONS: Large, well-designed studies on this topic are lacking. The limited data from well-designed trials indicate there may be some minor benefits with CoQ10 therapy in ejection fraction and end diastolic volume. CoQ10 therapy has been shown to be relatively safe with a low incidence of adverse effects.

Antioxidants↗
PubMed2005

The use of tricyclic antidepressants and selective serotonin reuptake inhibitors in women who are breastfeeding.

Postpartum depression is a well-recognized psychiatric condition that has gained increased attention over the past decade due to several nationally publicized tragedies. Medical management of this condition in women who are breastfeeding provides a unique challenge to health care professionals who may seek to maintain a fine balance between limiting the infant's exposure to hormone-altering drugs and maintaining the benefits of breastfeeding. No controlled trials have examined antidepressant therapy in nursing women; however, numerous case reports and case series have been published. Relatively few serious adverse effects have been reported. Although tricyclic antidepressants have been the treatment of choice in the past, selective serotonin reuptake inhibitors are gaining popularity due to their superior safety profiles. Of all the agents reviewed in the literature, sertraline was the most prescribed, and no adverse effects were reported. Therefore, this agent would be a good first choice for treatment-naive women. For treatment of postpartum depression in women with a history of successfully treated depression, the most practical approach may be to continue therapy with the previously effective agent. Treatment should be maintained at the lowest effective dosage to minimize infant exposure. Both mother and child should be closely monitored; in addition, collaboration between the prescribing physician and the child's pediatrician is essential.

Antidepressive Agents, Tricyclic↗
PubMed2005

"Collateral damage": antibiotics and the risk of Clostridium difficile infection.

Patients undergoing orthopedic surgery are at increased risk for infection, and antimicrobial use continues to be required. Antimicrobial selection, however, is an important consideration given the increasing incidence and severity of C. difficile infection described in the literature. When choosing antimicrobials for prophylaxis and treatment, evaluate patients for risk factors that may predispose them to C. difficile infection. Patients receiving multiple antibiotics or broad-spectrum antibiotics, women, patients with concurrent proton pump inhibitor use, and those with renal failure are at increased risk. Choice of antibiotics should be evaluated for their potential or likelihood to cause C. difficile infection. When a number of these risk factors are present, avoiding the use of high-risk antibiotics may be warranted.

Antibiotic Prophylaxis↗
PubMed2005

The paradox of heparin-induced thrombocytopenia: future anticoagulation.

Heparin and low molecular weight heparin agents are frequently administered to postoperative orthopedic patients. In patients with a history of heparin-induced thrombocytopenia, alternative anticoagulant agents to heparin for prophylaxis and treatment must be considered. Unfortunately, the data is limited in this patient population. Upon transitioning from heparin-induced thrombocytopenia treatment with direct thrombin inhibitors, argatroban, or lepirudin, careful consideration must be taken to avoid further thrombotic complications.

Antibodies↗