Emerging new chemokine CXCR3 antagonists and their potential clinical and therapeutic applications
✍ Scribed by Shailendra Kapoor
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 47 KB
- Volume
- 49
- Category
- Article
- ISSN
- 0270-9139
No coin nor oath required. For personal study only.
✦ Synopsis
hospitalized in urban teaching centers (52% versus 41%; P Ͻ 0.0001). ALI and liver failure 7 occurred in 8.2% and 4.5% of patients, respectively; 1.4% died. ALI (16.7% versus 8.0%; P Ͻ 0.0001), liver failure (11.4% versus 4.4%; P Ͻ 0.0001), and death (3.0% versus 1.4%; P ϭ 0.01), but not transplantation (0.13% versus 0.08%; P ϭ 0.68), were more common in HCV patients. The risk of ALI was higher in HCV patients with intentional (12.2% versus 6.4%) and unintentional (29.6% versus 18.4%; P Ͻ 0.005) overdoses. In multivariate analysis, HCV remained a significant predictor of ALI (OR, 1.42; 95% CI, 1.12-1.79; Fig. 1) and liver failure (OR, 1.60; 95% CI, 1.22-2.10) but not mortality. Sensitivity analyses excluding patients with acute HCV (OR for ALI, 1.52; 95% CI, 1.15-2.00) and cirrhosis revealed similar results. Unintentional AOs (OR, 2.94; 95% CI, 2.69-3.21), alcohol abuse (OR, 1.10; 95% CI, 1.00-1.20), and African American (versus whites: OR, 0.72; 95% CI, 0.62-0.0.84) and Hispanic race (OR, 0.53; 95% CI, 0.44-0.64) were also associated with hepatotoxicity.
In summary, our reanalysis supports Nguyen and colleagues' findings 1 of an increased risk of acetaminophen-related hepatotoxicity in patients with HCV, although the magnitude of this risk was attenuated. We confirmed observations that AO-related ALI is more common in patients with unintentional overdoses and alcohol abuse. 4,[10][11][12] These findings may have substantial public health importance because rates of unintentional AO are rising 10,13 It emphasizes the necessity of clear package labeling of acetaminophen content and perhaps reductions in the maximum daily dosage recommended in at-risk populations. 2 If this is confirmed, studies exploring the mechanisms behind the racial differences that we observed may help explain heterogeneity in AO outcomes.