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Article ; Online: Massive acetaminophen ingestion managed successfully with N-acetylcysteine, fomepizole, and renal replacement therapy.

Williams, Elizabeth E / Quach, Duc / Daigh, Arthur

Clinical nephrology. Case studies

2024 Volume 12, Page(s) 22–25

Abstract: Acetaminophen ingestion is routinely managed with the antidote, N-acetylcysteine (NAC). Massive acetaminophen poisoning has been treated successfully with adjunctive therapies such as fomepizole and hemodialysis. Fomepizole functions by inhibiting ... ...

Abstract	Acetaminophen ingestion is routinely managed with the antidote, N-acetylcysteine (NAC). Massive acetaminophen poisoning has been treated successfully with adjunctive therapies such as fomepizole and hemodialysis. Fomepizole functions by inhibiting cytochrome p560, which prevents tylenol from forming its toxic metabolite, NAPQI. Prior cases have demonstrated favorable outcomes and a significant drop in acetaminophen levels after a single session of intermittent hemodialysis and continuous veno-venous hemofiltration (CVVH). However, the recommended dosage adjustments of NAC and fomepizole while a patient is undergoing CVVH has not been well reported. We present a case of an 18-year-old male who presented after ingesting 125 g of tylenol. His 4-hour acetaminophen level was 738.6 µg/mL. He was treated with NAC, fomepizole, and a single 4-hour session of hemodialysis. His acetaminophen level remained elevated at 730 µg/mL despite the hemodialysis session. CVVH was initiated, and he was given intravenous NAC at 12.5 mg/kg/h, oral NAC at 70 mg/kg every 4 hours, and intravenous fomepizole at 10 mg/kg every 6 hours. His tylenol levels became undetectable 57 hours after ingestion, and he did not develop permanent liver toxicity. This case encourages the use of CVVH for massive tylenol ingestion when a single run of intermittent hemodialysis is not effective in lowering the tylenol level. NAC, fomepizole, and CVVH can prevent unfavorable outcomes in massive acetaminophen ingestion when provided at an appropriate dose and frequency.
Language	English
Publishing date	2024-03-02
Publishing country	Germany
Document type	Case Reports
ISSN	2196-5293
ISSN (online)	2196-5293
DOI	10.5414/CNCS111275
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Article ; Online: Natural history of occult hernias in adults at a safety-net hospital.

Quach, D / Lyons, N B / Nguyen, K / Olavarria, O A / Bernardi, K / Neela, N / Dhanani, N H / Jackson, A / Ali, Z / Liang, M K

Hernia : the journal of hernias and abdominal wall surgery

2023 Volume 27, Issue 6, Page(s) 1467–1472

Abstract: Purpose: Occult hernias, hernias seen on radiologic imaging but not felt on physical exam, are common. Despite their high prevalence, little is known about the natural history of this finding. Our aim was to determine and report on the natural history ... ...

Abstract	Purpose: Occult hernias, hernias seen on radiologic imaging but not felt on physical exam, are common. Despite their high prevalence, little is known about the natural history of this finding. Our aim was to determine and report on the natural history of patients with occult hernias including the impact on abdominal wall quality of life (AW-QOL), need for surgery, and risk of acute incarceration/strangulation. Methods: This was a prospective cohort study of patients who underwent a computed tomography (CT) abdomen/pelvis scan from 2016 to 2018. Primary outcome was change in AW-QOL using the modified Activities Assessment Scale (mAAS), a hernia-specific, validated survey (1 = poor, 100 = perfect). Secondary outcomes included elective and emergent hernia repairs. Results: A total of 131 (65.8%) patients with occult hernias completed follow-up with a median (IQR) of 15.4 (22.5) months. Nearly half of these patients (42.8%) experienced a decrease in their AW-QOL, 26.0% were unchanged, and 31.3% reported improvement. One-fourth of patients (27.5%) underwent abdominal surgery during the study period: 9.9% were abdominal procedures without hernia repair, 16.0% involved elective hernia repairs, and 1.5% were emergent hernia repairs. AW-QOL improved for patients who underwent hernia repair (+ 11.2 ± 39.7, p = 0.043) while those who did not undergo hernia repair experienced no change in AW-QOL (- 3.0 ± 35.1). Conclusion: When untreated, patients with occult hernias on average experience no change in their AW-QOL. However, many patients experience improvement in AW-QOL after hernia repair. Additionally, occult hernias have a small but real risk of incarceration requiring emergent repair. Further research is needed to develop tailored treatment strategies.
MeSH term(s)	Adult ; Humans ; Quality of Life ; Prospective Studies ; Safety-net Providers ; Herniorrhaphy/methods ; Hernia, Ventral/surgery ; Hernia, Ventral/etiology
Language	English
Publishing date	2023-02-16
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-023-02754-7
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Zs.A 5390: Show issues

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Article ; Online: Risks and benefits of oral modified-release compared with oral immediate-release opioid use after surgery: a systematic review and meta-analysis.

Liu, S / Athar, A / Quach, D / Patanwala, A E / Naylor, J M / Stevens, J A / Levy, N / Knaggs, R D / Lobo, D N / Penm, J

Anaesthesia

2023 Volume 78, Issue 10, Page(s) 1225–1236

Abstract: Prescription of modified-release opioids for acute postoperative pain is widespread despite evidence to show their use may be associated with an increased risk of adverse effects. This systematic review and meta-analysis aimed to examine the available ... ...

Abstract	Prescription of modified-release opioids for acute postoperative pain is widespread despite evidence to show their use may be associated with an increased risk of adverse effects. This systematic review and meta-analysis aimed to examine the available evidence on the safety and efficacy of modified-release, compared with immediate-release, oral opioids for postoperative pain in adults. We searched five electronic databases from 1 January 2003 to 1 January 2023. Published randomised clinical trials and observational studies on adults who underwent surgery which compared those who received oral modified-release opioids postoperatively with those receiving oral immediate-release opioids were included. Two reviewers independently extracted data on the primary outcomes of safety (incidence of adverse events) and efficacy (pain intensity, analgesic and opioid use, and physical function) and secondary outcomes (length of hospital stay, hospital readmission, psychological function, costs, and quality of life) up to 12 months postoperatively. Of the eight articles included, five were randomised clinical trials and three were observational studies. The overall quality of evidence was low. Modified-release opioid use was associated with a higher incidence of adverse events (n = 645, odds ratio (95%CI) 2.76 (1.52-5.04)) and worse pain (n = 550, standardised mean difference (95%CI) 0.2 (0.04-0.37)) compared with immediate-release opioid use following surgery. Our narrative synthesis concluded that modified-release opioids showed no superiority over immediate-release opioids for analgesic consumption, length of hospital stay, hospital readmissions or physical function after surgery. One study showed that modified-release opioid use is associated with higher rates of persistent postoperative opioid use compared with immediate-release opioid use. None of the included studies reported on psychological function, costs or quality of life.
MeSH term(s)	Adult ; Humans ; Analgesics, Opioid/therapeutic use ; Quality of Life ; Pain, Postoperative/drug therapy ; Opioid-Related Disorders ; Risk Assessment
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2023-07-06
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.16085
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Zs.A 388: Show issues

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Article ; Online: Letter: extensive intestinal metaplasia is associated with the presence of incomplete intestinal metaplasia subtype and could be an easier marker for high risk of gastric cancer.

Quach, D T / Hiyama, T

Alimentary pharmacology & therapeutics

2018 Volume 47, Issue 7, Page(s) 1045–1046

MeSH term(s)	Follow-Up Studies ; Humans ; Metaplasia ; Precancerous Conditions ; Stomach Neoplasms
Language	English
Publishing date	2018-03-06
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.14553
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Zs.A 2206: Show issues

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Article ; Online: A practical guide to feedback in the workplace: Interpreting and acting on feedback from learners and direct reports.

Quach, David / Gore, Stephanie / Schlosser, Elizabeth G

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

2020 Volume 77, Issue 19, Page(s) 1552–1555

MeSH term(s)	Clinical Competence ; Feedback ; Humans ; Internship and Residency
Language	English
Publishing date	2020-07-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1224627-x
ISSN	1535-2900 ; 1079-2082
ISSN (online)	1535-2900
ISSN	1079-2082
DOI	10.1093/ajhp/zxaa155
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Zs.A 419: Show issues

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Article ; Online: Maternal and fetal characteristics for predicting risk of Cesarean section following induction of labor: pooled analysis of PROBAAT trials.

Quach, D / Ten Eikelder, M / Jozwiak, M / Davies-Tuck, M / Bloemenkamp, K W M / Mol, B W / Li, W

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology

2021 Volume 59, Issue 1, Page(s) 83–92

Abstract: Objective: Induction of labor (IOL) is one of the most widely used obstetric interventions. However, one-fifth of IOLs result in Cesarean section (CS). We aimed to assess maternal and fetal characteristics that influence the likelihood of CS following ... ...

Abstract	Objective: Induction of labor (IOL) is one of the most widely used obstetric interventions. However, one-fifth of IOLs result in Cesarean section (CS). We aimed to assess maternal and fetal characteristics that influence the likelihood of CS following IOL, according to the indication for CS. Methods: This was a secondary analysis of pooled data from four randomized controlled trials, including women undergoing IOL at term who had a singleton pregnancy and an unfavorable cervix, intact membranes and the fetus in cephalic presentation. The main outcomes of this analysis were CS for failure to progress (FTP) and CS for suspected fetal compromise (SFC). Restricted cubic splines were used to determine whether continuous maternal and fetal characteristics had a non-linear relationship with outcome. Optimal cut-offs for those characteristics with a non-linear pattern were determined based on the maximum area under the receiver-operating-characteristics curve. Adjusted odds ratios (aOR) were computed, using multivariable logistic regression analysis, for the associations between optimally categorized characteristics and outcome. Results: Of a total of 2990 women undergoing IOL, 313 (10.5%) had CS for FTP and 227 (7.6%) had CS for SFC. The risk of CS for FTP was increased in women aged 31-35 years compared with younger women (aOR, 1.51 (95% CI, 1.15-1.99)), in nulliparous compared with parous women (aOR, 8.07 (95% CI, 5.34-12.18)) and in Sub-Saharan African compared with Caucasian women (aOR, 2.09 (95% CI, 1.33-3.28)). Higher body mass index (BMI) increased incrementally the risk of CS for FTP (aOR, 1.06 (95% CI, 1.04-1.08)). High birth-weight percentile was also associated with an increased risk of CS due to FTP (aOR, 2.66 (95% CI, 1.74-4.07) for birth weight between the 80.0 Conclusions: In women undergoing IOL, maternal age, BMI, parity, ethnicity and birth-weight percentile are predictors of CS due to FTP and of CS due to SFC, but the direction and magnitude of the associations differ according to the indication for CS. These characteristics should be considered in combination with the Bishop score to stratify the risk of CS for different indications in women undergoing IOL. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
MeSH term(s)	Adult ; Birth Weight ; Body Mass Index ; Cervix Uteri/diagnostic imaging ; Cesarean Section/statistics & numerical data ; Female ; Fetus/diagnostic imaging ; Humans ; Labor, Induced/statistics & numerical data ; Labor, Obstetric ; Logistic Models ; Maternal Age ; Obstetric Labor Complications/diagnosis ; Obstetric Labor Complications/surgery ; Odds Ratio ; Parity ; Predictive Value of Tests ; Pregnancy ; Prenatal Diagnosis/methods ; Prenatal Diagnosis/statistics & numerical data ; Randomized Controlled Trials as Topic ; Risk Factors
Language	English
Publishing date	2021-09-07
Publishing country	England
Document type	Journal Article ; Meta-Analysis
ZDB-ID	1073183-0
ISSN	1469-0705 ; 0960-7692
ISSN (online)	1469-0705
ISSN	0960-7692
DOI	10.1002/uog.24764
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Zs.A 3214: Show issues

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Article: Gut Microbiota and Bone Health.

Quach, Darin / Britton, Robert A

Advances in experimental medicine and biology

2017 Volume 1033, Page(s) 47–58

Abstract: The past decade has seen an explosion of research in the area of how the bacteria that inhabit the human body impact health and disease. One of the more surprising concepts to emerge from this work is the ability of the intestinal microbiota to impact ... ...

Abstract	The past decade has seen an explosion of research in the area of how the bacteria that inhabit the human body impact health and disease. One of the more surprising concepts to emerge from this work is the ability of the intestinal microbiota to impact virtually all systems in the body. Recently, the role of gut bacteria in bone health and disease has received more significant attention. In this chapter, we review what has been learned about how the gut microbiome impacts bone health and discuss possible mechanisms of how the gut-bone axis may be connected. We also discuss the use of therapeutic microbes in the modulation of bone health. Finally, we propose an emerging field of the gut-brain-bone axis, in which the gut drives bone physiology via regulation of key hormones that are originally synthesized in the brain.
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ISSN	2214-8019 ; 0065-2598
ISSN (online)	2214-8019
ISSN	0065-2598
DOI	10.1007/978-3-319-66653-2_4
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Article ; Online: Identification of Sjögren's syndrome patient subgroups by clustering of labial salivary gland DNA methylation profiles.

Chi, Calvin / Solomon, Olivia / Shiboski, Caroline / Taylor, Kimberly E / Quach, Hong / Quach, Diana / Barcellos, Lisa F / Criswell, Lindsey A

PloS one

2023 Volume 18, Issue 3, Page(s) e0281891

Abstract: Heterogeneity in Sjögren's syndrome (SS), increasingly called Sjögren's disease, suggests the presence of disease subtypes, which poses a major challenge for the diagnosis, management, and treatment of this autoimmune disorder. Previous work ... ...

Abstract	Heterogeneity in Sjögren's syndrome (SS), increasingly called Sjögren's disease, suggests the presence of disease subtypes, which poses a major challenge for the diagnosis, management, and treatment of this autoimmune disorder. Previous work distinguished patient subgroups based on clinical symptoms, but it is not clear to what extent symptoms reflect underlying pathobiology. The purpose of this study was to discover clinical meaningful subtypes of SS based on genome-wide DNA methylation data. We performed a cluster analysis of genome-wide DNA methylation data from labial salivary gland (LSG) tissue collected from 64 SS cases and 67 non-cases. Specifically, hierarchical clustering was performed on low dimensional embeddings of DNA methylation data extracted from a variational autoencoder to uncover unknown heterogeneity. Clustering revealed clinically severe and mild subgroups of SS. Differential methylation analysis revealed that hypomethylation at the MHC and hypermethylation at other genome regions characterize the epigenetic differences between these SS subgroups. Epigenetic profiling of LSGs in SS yields new insights into mechanisms underlying disease heterogeneity. The methylation patterns at differentially methylated CpGs are different in SS subgroups and support the role of epigenetic contributions to the heterogeneity in SS. Biomarker data derived from epigenetic profiling could be explored in future iterations of the classification criteria for defining SS subgroups.
MeSH term(s)	Humans ; Sjogren's Syndrome/genetics ; DNA Methylation ; Autoimmune Diseases ; Cluster Analysis ; Salivary Glands, Minor
Language	English
Publishing date	2023-03-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0281891
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Article ; Online: Enhancement of Mitochondrial Function by the Neurogenic Molecule NSI-189 Accompanies Reversal of Peripheral Neuropathy and Memory Impairment in a Rat Model of Type 2 Diabetes.

Jolivalt, C G / Aghanoori, M R / Navarro-Diaz, M C / Han, M M / Sanchez, G / Guernsey, L / Quach, D / Johe, K / Fernyhough, P / Calcutt, N A

Journal of diabetes research

2022 Volume 2022, Page(s) 8566970

Abstract: Aims: Mitochondrial dysfunction contributes to many forms of peripheral and central nervous system degeneration. Therapies that protect mitochondrial number and function have the potential to impact the progression of conditions such as diabetic ... ...

Abstract	Aims: Mitochondrial dysfunction contributes to many forms of peripheral and central nervous system degeneration. Therapies that protect mitochondrial number and function have the potential to impact the progression of conditions such as diabetic neuropathy. We therefore assessed indices of mitochondrial function in dorsal root ganglia (DRG) and brain cortex of the Zucker diabetic fatty (ZDF) rat model of type 2 diabetes and tested the therapeutic impact of a neurogenic compound, NSI-189, on both mitochondrial function and indices of peripheral and central neurological dysfunction. Materials and methods: ZDF rats were maintained for 16 weeks of untreated diabetes before the start of oral treatment with NSI-189 for an additional 16 weeks. Nerve conduction velocity, sensitivity to tactile and thermal stimuli, and behavioral assays of cognitive function were assessed monthly. AMP-activated protein kinase (AMPK) phosphorylation, mitochondrial protein levels, and respiratory complex activities were assessed in the DRG and brain cortex after 16 weeks of treatment with NSI-189. Results: Treatment with NSI-189 selectively elevated the expression of protein subunits of complexes III and V and activities of respiratory complexes I and IV in the brain cortex, and this was accompanied by amelioration of impaired memory function and plasticity. In the sensory ganglia of ZDF rats, loss of AMPK activity was ameliorated by NSI-189, and this was accompanied by reversal of multiple indices of peripheral neuropathy. Conclusions: Efficacy of NSI-189 against dysfunction of the CNS and PNS function in type 2 diabetic rats was accompanied by improvement of mitochondrial function. NSI-189 exhibited actions at different levels of mitochondrial regulation in central and peripheral tissues.
MeSH term(s)	AMP-Activated Protein Kinases/metabolism ; Aminopyridines ; Animals ; Diabetes Mellitus, Experimental/metabolism ; Diabetes Mellitus, Type 2/metabolism ; Diabetic Neuropathies ; Mitochondria/metabolism ; Piperazines ; Rats ; Rats, Zucker
Chemical Substances	Aminopyridines ; NSI-189 ; Piperazines ; AMP-Activated Protein Kinases (EC 2.7.11.31)
Language	English
Publishing date	2022-07-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2711897-6
ISSN	2314-6753 ; 2314-6753
ISSN (online)	2314-6753
ISSN	2314-6753
DOI	10.1155/2022/8566970
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Article ; Online: Correction: Hypomethylation mediates genetic association with the major histocompatibility complex genes in Sjögren's syndrome.

Chi, Calvin / Taylor, Kimberly E / Quach, Hong / Quach, Diana / Criswell, Lindsey A / Barcellos, Lisa F

PloS one

2021 Volume 16, Issue 7, Page(s) e0255549

Abstract: This corrects the article DOI: 10.1371/journal.pone.0248429.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0248429.].
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Published Erratum
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0255549
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