MULTIPLE MYELOMA

Clinical

• Average age is 60-70
• Men much more common than women
• Most have an elevated serum protein with 80-90% in the globulin fraction, especially IgG
• Bence-Jones protein in 40-60% of patients (light chains)

X-ray findings

• Osteoporosis is most common skeletal abnormality in this disease
• Lesions are usually multiple and found in vertebrae, ribs, skull, pelvis, and femur
• Over 50% of solitary lesions are found in vertebrae
• Mandible involved in 1/3 of patients with diffuse involvement
• Widespread lucencies in bone
  • Discrete, “punched-out” lesions
  • Uniform in size
• Distinctive to MM are the lucent, elliptical, subcortical shadows, especially in long bones=endosteal scalloping
  • Due to buttressing since MM is usually a slower process than mets
• In spine, MM destroys body and spares pedicle

DDX: mets and disuse osteoporosis

• MM is more widespread
• More discrete holes in MM
• Large foci of coalescence more often due to mets
• Severe disuse osteoporosis may simulate bone changes of MM

Sclerosis is usually seen only with treatment or fracture

• Bone scans may typically be negative and many hot  areas on scan may be healing fractures

Most believe that almost all patients with a solitary plasmacytoma will develop multiple myeloma

• Solitary plasmacytoma produces “soap-bubbly” expansile, septated lesion, when characteristic

 

Multiple myeloma . The pelvis contains numerous lytic lesions without reactive sclerosis which
have an almost "soap-bubbly" appearance in the ischia. There are also lytic lesions in
both proximal femora.
Other examples of Multiple Myeloma (Click on each to enlarge)

retrieved from: http://www.learningradiology.com/archives06/COW%20223-Multiple%20myeloma/mmccorrect.html

ERGONOMIC IN THE WORKPLACE

Each year, employees miss work and potential wages due to work-related musculoskeletal disorders (MSDs). According to the Bureau of Labor Statistic (BLS), 335,390 American workers experienced MSDs serious enough to require time off work in 2007.

In fact, injuries to the muscles and skeleton are among the most common lost time illnesses and injuries in virtually every industry.

Musculoskeletal disorders occur when there is a mismatch between what your job requires you to do and what your body is capable of doing. MSDs can affect worker in job activities across many diverse workplaces and tasks.

The Institute of Medicine estimates that the economic burden of MSDs in the workplace, as measured by compensation costs, lost wages, and lost productivity, are between $45 and $54 billion annually. Historically, overexertion, one form of MSDs, is the number one cause of workplace injury.

In 2007, there were 1,2 million MSD cases requiring days away from work in private industry out of 4 million total recordable cases. Of these, 335, 390 cases required an average of nine days away from work, two more days than the average for all days away from work cases.

Because of statistics like these, ergonomics has become an important and serious issue for industry.

The term “ergonomic” is derived from two Greek words: “erg” meaning work and “nomas” meaning natural laws.

Basically, ergonomics is the science of adjusting job conditions, equipment, and tasks to match the body’s natural ways of functioning.

The goal of ergonomics is to prevent illness and injury, assure high productivity, and promote satisfaction in the workplace.

In the absence of a federal ergonomics standard, the Occupational Safety and Health Administration (OSHA) has addressed ergonomics in the workplace under the authority of section 5 (a)(1) of the Occupational Safety and Health Act.

This section is referred to as the General Duty Clause and requires employers to provide work and a work environment free from recognized hazards.

Many employers have realized that the implementation of an ergonomics program is in their best interest for the reduction of injuries and illnesses.

An ergonomics program addresses some basic elements such as employers and employee responsibilities, hazards identification and information, job hazard analysis and control, training, medical management, records, and programs evaluation.

Your company’s ergonomics programs is designed to help keep you healthy, productive and motivated while making your working life as enjoyable as possible.

Your company can express its commitment in a variety of ways. These include holding employee meeting to discuss ergonomics operational goals and priorities that are firm, achievable, and in line with cost reduction, productivity, and quality initiatives.

In addition, your employer may commit resources to training, administrative needs, expertise, and ergonomics improvements or issue policy statements that define support and cooperation from management, supervision, and employees.

 

Musculoskeletal Disorders (MSDs) definitions: Are disorders of the muscles, ligaments, tendons, cartilage, joints, nerves, or spinal discs that have been diagnosed by physical exam, medical history, or specific medical test.

They typically result from gradual or chronic development, as opposed to an acute event or injury caused by, for example, a slip or fall. MSDs like carpal tunnel syndrome have very distinct signs and symptoms. Other disorders, such as lower back pain, are simply defined by the location of the pain.

To better understand ergonomics, you should be familiar with the major parts of the musculoskeletal system:

Ø Bones: Provide structural support and are connected to one another at joints, which allow movement between body segments.

Ø Muscles: Contract and shorten, causing movement, just contract to provide stability. The respiratory and circulatory systems supply nutrients and oxygen necessary for movement of muscles.

Ø Ligaments and tendons: ligaments connect bone to bone and provide stability at the joints, while tendons attach muscle to the bone.

Ø Cartilage: Provides the joints with low friction surface that help with movement.

Ergonomics Awareness

Recognizing the early signs and symptoms of injuries to the muscles and skeleton and reporting them as soon as possible is very important. A health care provider (HCP) can observe the signs. Symptoms, however, are subjective and a patient needs to report them to HCP.

Signs of injury to the muscles and skeleton include redness or loss of color, swelling, loss of function, deformity such as a lump, decreased range of motion, and decreased grip strength.

Symptoms are your body’s way of warning you that you may be developing an injury. Symptoms of injury to the muscles and skeleton can vary in severity, depending on the amount of your exposure.

Eventually the symptoms become more severe as exposure continues and will appear even after rest. The pain may increase to a point where it becomes difficult to perform your work or even to a point where you are unable to perform any physical work activities.

Examples of symptoms of injury to the muscles and skeleton include numbness, burning, tingling, aching, pain or soreness, stiffness, and cramping.

Early reporting is vital in preventing or minimizing injury to the muscles and skeleton. As an employee, you must feel free to report any signs or symptoms of physical discomfort as soon as possible to your supervisor or other personnel, such as a plant nurse or HCP.

Employers can also gather information by conducting symptoms surveys and interviews.

Risk Factors

The OSHA has identified a high rate of injury among workers in various industries. It is impossible to determine the exact weight lifted or the number of repetition that will either cause or prevent injury.

However, establishing a systematic approach to address such issues as repetition, excessive force, awkward posture, and heavy lifting reduces the chance that you may ne injured.

Identifying risk factors in the workplace, before injuries to the muscle and skeleton are discovered, is an important step in keeping you healthy.

Your employer can use several methods to detect risk factors, such as interviews with workers and supervisors, and walk-through observations of the workplace.

A more formal approach would be to use a standardized checklist to evaluate job tasks against risk factors.

There are many different types of risk factors for injuries to the muscle and skeleton, some of which are not entirely work-related.

Risk factors for work-related musculoskeletal disorders are cumulative and can include off-work activities as well. Physical limitations, previous injuries, or existing health problems can contribute to increased risk.

It is often difficult to determine the impact that work activities versus non-work activities (sport or medical conditions such as rheumatoid arthritis, diabetes, and thyroid conditions) have on the disorder.

For example, in the general population, non-work causes of lower back pain are probably more common than workplace causes.

When jobs have risk factors in combinations and high levels, the risk of developing a musculoskeletal disorder will increase. The level of risk also depends on the intensity, frequency, and duration of exposure. Examples of risk factors include repetitive, forceful, or prolonged exertion and pushing, pulling, or carrying heavy objects.

Risk factors (Actions)

·        Repetitive, forceful, or prolonged exertion

·        Frequent or heavy lifting

·        Pushing, pulling, or carrying of heavy objects

·        Prolonged awkward postures

·        Work in the cold

·        Insufficient pauses and rest breaks for recovery

Risk factors (Conditions)

·        Contact stresses

·        Machine-paced work

·        Stress

·        Unfamiliar or unaccustomed work

·        Vibration

 

Gathering data is a vital step toward the identification of a problem. Checklists can be used to provide the initial identification of a job or task which may put a worker at risk for developing an injury to the muscles or skeleton.

It is important to understand that the checklist findings must be viewed as a whole to determine if the individual problems suggest the same underlying root cause.

Control Methods

Many employers provide engineering controls, such as lift-assist equipment, that go unused or under-used as the employees hurry to complete their tasks.

Engineering controls reduce or eliminate the condition by modifying or redesigning workstations, environmental conditions, tools and equipment, processes, or materials.

For instance, a situation was reviewed in the electrical industry, where tasks included hammering, crimping, wrapping, winding, soldering, painting, and various electric motor assemble operations.

Problem: risk factor involved in these types of tasks included repetitive and forceful exertions, awkward postures, and contact stress. Workers were found to suffer from upper limb and neck illnesses and injuries.

Solutions: included raised standing surfaces, a modified mallet handle, and low force clamps. Job rotation, training programs, and early reporting were also needed.

Workstation should be adjustable to fit your body. Furniture and equipment should be positioned to prevent excessive twisting, reaching, and leaning.

Eyes: Computer monitors should be placed so that the top of the screen is just below eye level.

Arms and back: Chair should have adjustable armrests to take the load off your neck and shoulders. Chair should have back rests that fit your back.

Knees and feet: Chair should ne adjustable to allow your knees to be bent at a right angle. Chair should be adjustable to allow your feet to rest flat on the floor. Footrest may be used.

When your finger are on the keyboard, your wrist should be straight in a neutral position with the upper arm vertical and the forearm at a 90 degree angle to the upper arm.

Your shoulders should be relaxed and your elbows close to your sides. Reclining and reaching should also be avoided.

When using the mouse, you should be able to maintain the correct arm and wrist position. The mouse should be at the same levels as the keyboard and the same distance from your body as the keyboard.

Administrative controls are changes in the workplace that adjust work practices, procedures, and management policies.

Specific examples include rest breaks, alternative tasks, slower work pace, redesign of work methods, and employee rotation.

Consider his example of an office work setting. Management reviewed an office environment that involved primarily data entry and tasks involving video display units.

Problems: risk factors identified from these tasks included repetitive exertions, awkward postures, glare, and poor illumination. Personnel experienced problems with upper limbs, neck, back, and eyestrain.

Solutions: included reduction glare and improving workstation design. A vision test program and a rest break schedule where also suggested.

You would use personal protective equipment (PPE), such as gloves, to reduce vibration and prevent injury.

Always use engineering control s first if possible, followed by administrative controls. Use PPE only as a last resort.

Studies show that wearing a back belt does not reduce injury rates or the number of lost work days. However, wearing a back belt and having training on lifting techniques may reduce lost work days for people who have had lower back pain in the past.

Because musculoskeletal disorders involving the back are among the most costly occupational injuries, it is important to review back safety and some basic techniques for prevention of back injuries.

These techniques include good posture, proper lifting, and the practice of basic exercises, such as stretching.

To evaluate your posture, stand with your back against a doorframe and slip your hand between the doorframe and the small of your back. Your hand should slide in easily and slightly touch your back and the doorframe.

When possible, plan jobs to avoid unnecessary lifting. Improper lifting, especially when combined with twisting, is the most common way to injure your back.

Correct posture: Place feet firmly apart with one foot forward for stability. Bend at the knees (not at the waist) and keep your back as close to vertical as possible.

Incorrect posture: two of the most common mistake made when lifting are bending at the waist instead of the knees and holding the load too far out in front of you.

When lifting, tighten your stomach muscle as soon as you lift to support your spine, breathing out as you lift. Do not hold your breath.

Remember t use your leg muscles instead of your back muscle to lift the load. Do not twist your body while lifting and keep the load close to your body as you lift.

The best path to a healthy back is to control your weight, exercise, and reduce back stress caused by lifting or poor posture.

Excessive upper body weight such as potbelly contributes to poor back posture and back pain because of the added stress placed on the components of the back.

A regular exercise program that includes flexibility and strengthening exercises can help prevent injury or re-injury to your back. Consult your healthcare provider before beginning an exercise program.

Remember to report signs, symptoms, and hazards of MSDs and make recommendations on appropriate ways to control them. Ways to make these recommendations include e-mail, letters, and notes to your supervisor.

Recommendations can also be made verbally through an employee representative or by serving on health and safety committees. Always follow applicable workplace procedures and safety and health rule.

 

Summary:

Employers are not the only ones with specific responsibilities. You, as an employee, have an important role also.

Your responsibilities include:

v Recognizing the signs and symptoms of MSDs and the value of reporting them early

v Identifying MSD hazards in your job

v Knowing how to use and evaluate the control measures your employers implements, and

v Working in ways that will reduce the risks in your job

 

Retrieved from: http://berryplastics.skillport.com/skillportfe/main.action?content=myprogressNew

JOB SAFETY ANALYSIS AND HAZARD CONTROL METHODS

Summary: The Job Safety Analysis is one of the tools available for identifying safety hazards in the workplace, as well as the safety control methods that can be used to minimize hazards. It can take the form of a group discussion or direct observation.

The first step in the JSA is to identify every step of a job sequence. The second step is to identify the potential hazards in each step. The final step is to find controls methods that could eliminate or minimize employee exposure to each hazard. Control measures include design, safety interlock, warning devices, and procedural controls.

Safe work practice can prevent injury. They form the foundation of a company’s safety program which is developing based on the belief that all accidents are preventable.

Job Safety Analysis and Workplace Inspections are two methods used to identify workplace hazards and the hazards control measures that will be put in place to prevent accidents the hazards may cause.

Safety can only be ensured when there is a clear understanding of a potential hazard in the work environment, and appropriate safe work practices are put in place to prevent accident. The hazard control measures will then become the safe work practices for the job.

One method used to identify hazards associated with a specific job is the Job Safety Analysis (JSA).

The JSA is an analytical tool that is used to:

Ø  Record each step of a job in sequence

Ø  Identify and explain the hazards encountered at each step

Ø  Identify hazard control method

There are two basic methods for performing a JSA: group discussion and direct observation.

During group discussion, the supervisor and employees meet away from the work area or location to discuss the JSA. This method is used to analyze jobs not often performed or those that are difficult to observe, such as those performed in confined spaces, the discussion group may include other experienced persons.

In the other hand, on direct observation, the supervisor observes the employee performing a task to identify hazards within each step. The advantage of this method is that the supervisor does not have to recall how the task is actually done.

The first step in conducting the JSA is to identify each step of the task in sequence of how the job is performed, describe what is done, not how it is done. Avoid making the breakdown so general those important steps are left out.

The second step is to identify how each step in a task is performed so that the associated hazards can be identified. Identify every possible hazard, even if it seems improbable.

One of the most common errors is to only identify the most obvious hazards, some hazard may be overlooked. Past accident history can also be reviewed to identify possible hazards.

The final step is to think of methods to eliminate or minimize employee exposure to the hazards previously identified. It is important to list more than one control method, and they should be listed in order of preference. The supervisor or person in charge should choose the best control method considering benefits, costs, and all hazard control method.

There are a variety of ways hazards identified through a job safety analysis that can be controlled.

Hazard Control Method can be listed from the most effective to the least effective:

Ø  Design

Ø  Safety interlocks

Ø  Warning devices

Ø  Procedure control

The most effective hazards control method is to design the work environment to eliminate hazards; this method is also commonly referred to as engineering controls. An example is a filter ventilation system for cool dust removal.

If the hazard cannot be eliminated by design controls, consider controlling the hazard with a safety interlock, these devices operate automatically and do not require an employee to do anything, an example is an electrical interlock system.

The next chose for controlling hazard is the use of a warning device, it automatically detects the condition and gives a warning signal, audio or visual indicator are the most commonly used; however, unlike safety devices, warning devices require an employee to react to the warning. The warning device should be designed to minimize the probability of incorrect employee reaction.

Procedure Control attempt to control a certain hazard by use of a procedure, this is the least effective control measure because it relies on person fully following the steps of the procedure. Lock-out and tag-out boundaries should be identified and written on the JSA.

Other method used to minimize employee exposure to hazard is the Personal Protective Equipment, commonly known as PPE. It requires for the job or task will be identified as part of the JSA. This step ensures and documents that the PPE hazard assessment has been conducted.

As noted, the PPEs can be a highly effective method for minimize exposure to a hazards. However, you must be aware that the equipment does not eliminate the hazard when used properly; it protects workers from the hazard that still exist.

A completed JSA is not effective until it is incorporated into the task through employee training and management direction.

JSAs are very helpful in planning jobs and should be reviewed with employees before performing the task. One of the best uses of JSAs is for on-the-job training of new employee.

Change in personnel, processes, equipment, or materials can introduce new hazards that may require JSAs to be revised.

Regardless of the methods used, the supervisor or person in charge should encourage everyone’s participation in the JSA process. Employee’s involvement helps ensure a more thorough analysis by identifying and eliminating hazards that may otherwise be overlooked. Employee involvement allows employees to establish their own safe work practices.

Retrieved:http://berryplastics.skillport.com/skillportfe/SbJaSummaryPage.action?id=ESH_SAH_A52_SH_ENUS_sbESH_SAH_A52_SH_ENUS009011&time=34&displayDevPlanEditDeleteIcon=1&lpName=

 

 

 

 

 

SUPPORT YOUR HEART

“If you exercise regularly, eat right and don’t smoke, you are on your way to healthier heart”, says Dr. Willet.

Taking a few healthy lifestyle steps can help you feel better and reduce your risk of heart attack and stroke. Here, what you need to know to eat right, get active and quit smoking.

To put the pieces of an ideal heart-healthy eating plan together, “think of diet and nutrition like an orchestra- all components should be balanced for optimal heart health”, says Walter Willett, MD chair of the nutrition department at the Harvard School of Public Health.

EAT FOR YOUR HEART:

To get started, try these six simple steps:

Ø Control your portion size

Fill half a normal dinner plate with green leafy, bright or deeply colored vegetables such as spinach and beets. These veggies are packed with heart-healthy nutrients. Leave a quarter each for lean protein and complex carbohydrates, such as potatoes (no fried), brown rice and whole wheat pasta.

Ø Eat less red meat

It’s high in saturated fat, which boosts cholesterol levels. Instead, choose proteins such as broiled or grilled fish, skinless poultry and beans. Consider eating one meat-free meal a day.

Ø Choose nonfat and low-fat dairy

Opt for skim or soy milk, fat-free yogurt and low fat cheese. Dairy is rich in potassium, which reduce stroke risk, according to recent research.

Ø Fill up on fruits and vegetables

The American Heart Association (AHA) recommends you get at least four to five cups of fruit and the same amount of vegetable daily. One cup is about of woman’s fist.

Ø Favor fiber-filled foods

Fiber-rich foods such as produce and whole grains are satiating- so you may feel fuller longer. Soluble fiber, found in beans, peas, oats, apples, citrus, barley and psyllium, can help lower cholesterol.

Ø Toss the salt shaker

Salt causes fluid retention, which raises blood pressure and can worsen angina. Follow the AHA recommendation of less than 1500 mg a day, unless your doctor suggest otherwise. To reduce salt in your diet, eat more fresh food and fewer processed products, which tend to be loaded with sodium. If you’re out at a restaurant, ask if the chef can prepare low salt versions of menu items for you.

 

          GET MOVING:

          Exercise will help make you stronger and increase what’s known as exercise tolerance, how much you can physically exert yourself before becoming exhausted. The better your exercise tolerance becomes, the harder you can work out without experiencing angina pain. Exercise also helps lower blood pressure, cholesterol and blood glucose levels.

Ø Enlist a buddy

Plan to exercise with your spouse, a family member or friends to help you stay committed.

Ø Start slow and build up

“You don’t have to work out like an Olympic athlete”, says Robert Eckel, MD, head of preventive cardiology at the University of Colorado Anschutz Medical Campus in Aurora.

How much exercise is enough to help your heart?

Thirty minutes a day, at least five days a week, of brisk walking is fairly standard. However, if you heart’s sake, your doctor may want you to strive for an hour of physical activity daily. You can break it up into 15 minute chunks.

Ø Log it

Keep track of the time, speed and duration of you walks.

 

          KICK BUTTS

          Quitting is essential for anyone who smokes, but it’s especially important for people with angina.

Smoking causes your arteries to constrict, which can make angina worse. Talk to your doctor about tools for quitting. Research shows that combining support and medical therapy is most effective.

 

Get helpful tips and information….at www.SpeakFromTheHeart.com

 

 

FISH OIL MAY PROTECT AGAINST ALCOHOL-RELATED DEMENTIA

Exposure to a compound found in fish oil may protect against the development of dementia in heavy drinkers, new research suggests.
A study presented at the recent Congress of the European Society for Biomedical Research on Alcohol in Warsaw, Poland, examined rat brain cells exposed to alcohol levels equivalent to 4 times the legal driving limit.
Results showed that the cell cultures that were also exposed to omega-3 docosahexanenoic acid (DHA) showed approximately 90% less neuroinflammation and 90% less neuronal brain cell death compared with the cells that were not exposed to the fish oil compound.
"We hypothesized that omega-3 fatty acids, specifically DHA (which has been shown to neuroprotect from other acquired brain insults in the laboratory and to some degree in human studies) would suppress or prevent the neuronal degeneration due to binge alcohol exposure," principal investigator Michael A. Collins, PhD, professor in the Department of Molecular Pharmacology and Therapeutics at the Stritch School of Medicine at Loyola University, Chicago, Illinois, told Medscape Medical News.
"And basically, that is what we found," he added.
Relevant to Humans
Dr. Collins noted that although this was an animal study designed to measure neurodegeneration and related phenomena, and not a study specifically of dementia, "since brain degeneration underlies persistent or permanent dementia, the results were extrapolated to what might happen in humans."
And although he noted in a release that further studies are now needed, "fish oil has the potential of helping preserve brain integrity in abusers. At the very least, it wouldn't hurt them."
In 2011, Dr. Collins and colleagues published a meta-analysis of 143 studies showing that consuming up to 2 alcoholic drinks a day for men and 1 drink a day for women appeared to reduce the risk for dementia and cognitive impairment.
However, "too much alcohol overwhelms the cells," they noted in a release.
"Our previous work and that of others had linked neurodegeneration to 'neuroinflammatory'-like mechanisms that include oxidative stress (oxygen and nitrogen free radicals). The oxidative stress, we suspected, resulted in part from alcohol-induced excessive release of unsaturated fatty acids from brain membranes," explained Dr. Collins.
In the current study, the researchers exposed brain cell cultures from adult rats to heavy amounts of alcohol and then compared half the cells, which were further exposed to omega-3 DHA, with the other nonexposed half.
"Our results indicate excessive arachidonic acid (AA) mobilization due to increased phospholipase A2 (PLA2) levels/activity, and this appears related to elevations in astroglial aquaporin-4 (AQP4) and brain edema," write the investigators.
In other words, excessive drinking can cause higher levels of PLA2 activity, leading to excessive production of AA (a polyunsaturated omega-6 fatty acid), which in turn leads to increased AQP4/neuroinflammation and swelling of the brain.
However, inhibiting AQP4 was found to be neuroprotective to the cells.

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Adding omega-3 DHA to the cell cultures not only significantly decreased the release of AA and the elevated levels of PLA2 and AQP4 but also decreased ADP-ribose polymerase-1 (PARP1) elevations and overall neurodamage.
Dr. Collins reported that the investigators are planning now to conduct studies that replicate the findings in intact adult rats exposed to binge-drinking levels of alcohol and that elucidate how DHA exerts its protection in the brain.
However, he stressed that helping heavy drinkers to cut back the amounts they consume or to quit altogether is the best way to protect their brains.
"We don't want people to think it's okay to take a few fish oil capsules and then continue to go on abusing alcohol," he said.
The study was supported by the Loyola University Alcohol Research Program and a grant from the United States Public Health Service.
The 14th Congress of the European Society for Biomedical Research on Alcoholism. Abstract 01.2, presented September 8, 2013.


http://www.medscape.com/viewarticle/811196

LA FDA REFUERZA LA ADVERTENCIA DE NEUROPATÍAS POR FLUOROQUINOLONAS

La Administración de Drogas y Alimentos de los EE.UU.  (FDA) ha anunciado  que los antibióticos de Fluoroquinolonas por vía oral o por inyección plantean el riesgo de neuropatía periférica permanente, un riesgo que aparecerá en las etiquetas actualizadas de los medicamentos.

Hay 6 medicamentos de Fluoroquinolonas aprobados por la FDA en el mercado: ciprofloxacina, gemifloxacina, levofloxacina, moxifloxacina, norfloxacino y ofloxacino. En 2011, 23 millones de pacientes recibieron una receta para medicamentos de Fluoroquinolonas orales en farmacias minoristas ambulatorias; alrededor de 3,8 millones de pacientes hospitalizados se facturan para las versiones inyectables de estos fármacos.

Las Fluoroquinolonas tópicas, aplicados a los ojos o los oídos, no se sabe que tienen el riesgo de neuropatía periférica, según la FDA.

La FDA agregó la posibilidad de neuropatía periférica en las etiquetas de las Fluoroquinolonas orales e inyectables en 2004. La agencia dijo que ha seguido recibiendo informes de este evento adverso desde entonces. Una revisión reciente de los casos con el resultado de la discapacidad en el Adverse Event Reporting System FDA a partir del 1 de enero de 2003 al 1 de agosto de 2012, mostró que la aparición de la neuropatía periférica después del inicio de la terapia con Fluoroquinolonas fue rápida, a menudo dentro de los primeros días, declaro la FDA. Algunos pacientes que habían dejado de tomar el medicamento continuaron experimentando síntomas de daño del nervio durante más de un año.

La agencia aconseja a los médicos a poner a los pacientes que reciben un medicamento de Fluoroquinolonas, en otra clase de antibióticos si se desarrollan síntomas de la neuropatía periférica, a menos que el médico considera que los beneficios del tratamiento con Fluoroquinolonas son mayores que los riesgos.

Más información sobre este anuncio está disponible en el sitio web de la FDA.

Para reportar problemas con Fluoroquinolonas, contacto MedWatch, información de seguridad de la FDA y el programa de eventos adversos, por teléfono al 1-800-FDA-1088, por fax al 1-800-FDA-0178; en línea en https://www.accessdata .fda.gov / scripts / MedWatch / medwatch-online.htm, con franqueo pagado formulario FDA 3500, disponible en http://www.fda.gov/MedWatch/getforms.htm, o por correo a MedWatch, 5600 Fishers Lane , Rockville, Maryland 20852-9787.