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Clozapine has a unique efficacy profile among individuals suffering from treatment-resistant schizophrenia, but is associated with hematological side effects. The use of granulocyte colony-stimulating factors (G-CSF) to allow clozapine continuation or rechallenge has emerged as a promising option, but evidence is still scarce.
To describe the largest case series so far published regarding this practice.
A national clozapine hematological monitoring database was consulted to identify all patients who had had neutrophil count <1.5 × 10
/L since 2004 in Quebec and was cross-referenced with hospital pharmacy software to identify patients who had received at least one dose of G-CSF, such as filgrastim, while being exposed to clozapine. All data were collected retrospectively, using patients' medical files, from January to July 2019.
Using G-CSF, three out of eight patients could maintain clozapine despite neutropenia episodes that otherwise would have required treatment discontinuation. The only side effect reported was mild short-lived back pain, over a mean 3-year follow-up period. In all but one case, filgrastim was used on an "as-needed" basis at doses of 300 mcg administered subcutaneously.
These results suggest that the "as-needed" use of G-CSF is well-tolerated and may allow clozapine rechallenge in some well-selected patients, adding to the paucity of data regarding long-term safety and efficacy of this strategy. More research may help to better define potential candidates and optimal regimen of such practice.
These results suggest that the "as-needed" use of G-CSF is well-tolerated and may allow clozapine rechallenge in some well-selected patients, adding to the paucity of data regarding long-term safety and efficacy of this strategy. More research may help to better define potential candidates and optimal regimen of such practice.This study examined the association between hand disorders and time spent using information and communication devices. The participants in this study, conducted between January 2017 and 2020, were 150 healthy university students. They were tested for carpal tunnel syndrome and De Quervain's tenosynovitis. Average daily device usage time was found to be 5.76 ± 3.00 (1.9-16.2) h. Smartphones were used the most, followed by personal computers and gaming consoles. However, usage time did not vary significantly by device type. Intensive users were significantly more likely to have De Quervain's tenosynovitis (P less then .001), while non-intensive users were significantly less likely to have hand disorders (P less then .001) and less likely to have De Quervain's tenosynovitis. These results can form the basis of guidelines for the prevention of information and communication device overuse.Construction workers, their unions, and the construction industry face important challenges in addressing substance use disorders and mental health issues. To examine these issues further, we spoke with Chris Trahan Cain, Executive Director of CPWR-The Center for Construction Research and Training, a nonprofit organization that is affiliated with North America's Building Trades Unions and the National Institute for Occupational Safety and Health. As the chair of the North America's Building Trades Unions opioid task force, she has been working with construction unions and employers to develop primary, secondary, and tertiary prevention methods to help combat the opioid epidemic, other substance use disorders and to improve worker mental health.
Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers.
(1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs.
Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted.
Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR] 0.27, 95% CI [0.15, 0.48]
.001), 4 days (OR 0.16, 95% CI [0.11, 0.22],
< .001), and 5-7 daystfeeding by mothers.The Nepalese constitution guarantees equal rights to both men and women regardless of caste, race, or ethnicity. However, the centuries-old superstitious practice of caste-based hierarchy in the Hindu community and discrimination against people of lower caste are still prevalent. Furthermore, witchcraft allegations are also not uncommon. Both these practices are derogatory and humiliating and violate human rights, and the law can penalise them in both instances. Due to the intersection of gender and caste, women often face multiple forms of discrimination and violence as the patriarchal society considers them a weaker gender. The present study aimed to see the trend of crimes upon women reported by Nepal Police in the form of witchcraft allegations and untouchability between the fiscal years 2013/14 and 2019/20.Previous research has identified several factors, including sexual risk behaviors, alcohol consumption, sexual refusal assertiveness, impulse control difficulties, drinking to cope, and sex to cope, as being associated with sexual assault victimization. Data were collected from 465 adult, undergraduate women, and analyzed using structural equation modeling to determine how these variables related to one another. Results showed that together, these factors predicted 17.1% of the variance in victimization frequency. this website These findings may help future researchers better understand the etiology of sexual assault victimization on college campuses and prove crucial to the development of future intervention programs which reduce victimization.