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Nohria A, Desai D, Sikora M, Mandal S, Shapiro J, Lo Sicco K. Combating "dread shed": The impact of overlapping topical and oral minoxidil on temporary hair shedding during oral minoxidil initiation. JAAD Int 2024; 15:220-224. [PMID: 38707927 PMCID: PMC11067493 DOI: 10.1016/j.jdin.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 05/07/2024] Open
Abstract
Background Low dose oral minoxidil (LDOM) is a preferred treatment for alopecia due to ease of use and efficacy. While LDOM is typically well tolerated, patients may experience a temporary increase in hair shedding starting treatment, colloquially regarded as "dread shed". One proposed method to combat this is to overlap therapies by maintaining use of topical minoxidil when initiating LDOM. Objective To evaluate the impact of maintaining topical minoxidil when initiating LDOM on "dread shed". Methods We performed a retrospective chart review of patients seen at New York University Langone Health Dermatology from January 1, 2008 to August 1, 2023 prescribed LDOM. Results A total of 115 patients met inclusion criteria, of whom 37 maintained use of topical minoxidil when initiating LDOM. Six patients experienced "dread shed" when initiating LDOM, 2 of whom overlapped therapies. We did not find that overlapping therapies had a significant impact on decreasing rates of "dread shed". Limitations Limitations include retrospective design, sample size, and subjective patient-reported assessment of hair shedding. Conclusions A total of 5.2% of patients experienced dread shed, which is lower than previously reported in literature. Maintaining topical minoxidil during LDOM initiation does not significantly impact "dread shed". This remains a significant side effect deserving of further research.
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Affiliation(s)
- Ambika Nohria
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Deesha Desai
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Michelle Sikora
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
- New York Medical College, Valhalla, New York
| | - Soutrik Mandal
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
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Trojan A, Kühne C, Kiessling M, Schumacher J, Dröse S, Singer C, Jackisch C, Thomssen C, Kullak-Ublick GA. Impact of Electronic Patient-Reported Outcomes on Unplanned Consultations and Hospitalizations in Patients With Cancer Undergoing Systemic Therapy: Results of a Patient-Reported Outcome Study Compared With Matched Retrospective Data. JMIR Form Res 2024; 8:e55917. [PMID: 38710048 DOI: 10.2196/55917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The evaluation of electronic patient-reported outcomes (ePROs) is increasingly being used in clinical studies of patients with cancer and enables structured and standardized data collection in patients' everyday lives. So far, few studies or analyses have focused on the medical benefit of ePROs for patients. OBJECTIVE The current exploratory analysis aimed to obtain an initial indication of whether the use of the Consilium Care app (recently renamed medidux; mobile Health AG) for structured and regular self-assessment of side effects by ePROs had a recognizable effect on incidences of unplanned consultations and hospitalizations of patients with cancer compared to a control group in a real-world care setting without app use. To analyze this, the incidences of unplanned consultations and hospitalizations of patients with cancer using the Consilium Care app that were recorded by the treating physicians as part of the patient reported outcome (PRO) study were compared retrospectively to corresponding data from a comparable population of patients with cancer collected at 2 Swiss oncology centers during standard-of-care treatment. METHODS Patients with cancer in the PRO study (178 included in this analysis) receiving systemic therapy in a neoadjuvant or noncurative setting performed a self-assessment of side effects via the Consilium Care app over an observational period of 90 days. In this period, unplanned (emergency) consultations and hospitalizations were documented by the participating physicians. The incidence of these events was compared with retrospective data obtained from 2 Swiss tumor centers for a matched cohort of patients with cancer. RESULTS Both patient groups were comparable in terms of age and gender ratio, as well as the distribution of cancer entities and Joint Committee on Cancer stages. In total, 139 patients from each group were treated with chemotherapy and 39 with other therapies. Looking at all patients, no significant difference in events per patient was found between the Consilium group and the control group (odds ratio 0.742, 90% CI 0.455-1.206). However, a multivariate regression model revealed that the interaction term between the Consilium group and the factor "chemotherapy" was significant at the 5% level (P=.048). This motivated a corresponding subgroup analysis that indicated a relevant reduction of the risk for the intervention group in the subgroup of patients who underwent chemotherapy. The corresponding odds ratio of 0.53, 90% CI 0.288-0.957 is equivalent to a halving of the risk for patients in the Consilium group and suggests a clinically relevant effect that is significant at a 2-sided 10% level (P=.08, Fisher exact test). CONCLUSIONS A comparison of unplanned consultations and hospitalizations from the PRO study with retrospective data from a comparable cohort of patients with cancer suggests a positive effect of regular app-based ePROs for patients receiving chemotherapy. These data are to be verified in the ongoing randomized PRO2 study (registered on ClinicalTrials.gov; NCT05425550). TRIAL REGISTRATION ClinicalTrials.gov NCT03578731; https://www.clinicaltrials.gov/ct2/show/NCT03578731. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29271.
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Affiliation(s)
- Andreas Trojan
- Oncology, Breast Center Zürichsee, Horgen, Switzerland
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian Kühne
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Kiessling
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Christian Singer
- Center for Breast Health and Female Medicine, University Hospital Vienna, Vienna, Austria
| | - Christian Jackisch
- Sana Clinic Offenbach, Offenbach, Germany
- Evangelische Kliniken Essen-Mitte GmbH, Essen, Germany
| | - Christoph Thomssen
- Department of Gynecology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Gerd A Kullak-Ublick
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Schenk LA, Fadai T, Büchel C. How side effects can improve treatment efficacy: a randomized trial. Brain 2024:awae132. [PMID: 38701224 DOI: 10.1093/brain/awae132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024] Open
Abstract
While treatment side effects may adversely impact patients, they could also potentially function as indicators for effective treatment. In this study, we investigated whether and how side effects can trigger positive treatment expectations and enhance treatment outcomes. In this preregistered trial (DRKS00026648), 77 healthy participants were made to believe that they will receive fentanyl nasal sprays before receiving thermal pain in a controlled experimental setting. However, nasal sprays did not contain fentanyl, rather they either contained capsaicin to induce a side effect (mild burning sensation) or saline (inert). After the first session, participants were randomized to two groups and underwent functional magnetic resonance imaging (fMRI). One group continued to believe that the nasal sprays could contain fentanyl while the other group was explicitly informed that no fentanyl was included. This allowed for the independent manipulation of the side effects and the expectation of pain relief. Our results revealed that nasal sprays with a side effect lead to lower pain than inert nasal sprays without side effects. The influence of side effects on pain was dependent on individual beliefs about how side effects are related to treatment outcome, as well as on expectations about received treatment. FMRI data indicated an involvement of the descending pain modulatory system including the anterior cingulate cortex and the periaqueductal gray during pain after experiencing a nasal spray with side effects. In summary, our data show that mild side effects can serve as a signal for effective treatment thereby influencing treatment expectations and outcomes, which is mediated by the descending pain modulatory system. Using these mechanisms in clinical practice could provide an efficient way to optimize treatment outcome. In addition, our results indicate an important confound in clinical trials, where a treatment (with potential side effects) is compared to placebo.
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Affiliation(s)
- Lieven A Schenk
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tahmine Fadai
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Frederiksen H. Toxicity due to steroid treatment in ITP remains a concern. Br J Haematol 2024; 204:1600-1601. [PMID: 38553954 DOI: 10.1111/bjh.19426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 05/15/2024]
Abstract
Corticosteroids are the preferred first-line treatment in ITP in guidelines. The analyses by Wang et al. shows that hospital-registered steroid-related toxicity occurs frequently and emphasizes that exposure should be for a limited duration of time. Commentary on: Wang et al. Longitudinal evaluation of adverse events due to steroid use in primary immune thrombocytopenia: a population-based study. Br J Haematol 2024;204:1986-1993.
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Affiliation(s)
- Henrik Frederiksen
- Department of Haematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Rahmanipour E, Askari E, Ghorbani M, Mirzaei M, Rahimi B, Daskareh M, Mirshahvalad SA. Eye-Related Adverse Events after I-131 Radioiodine Therapy: A Systematic Review of the Current Literature. Endocr Pract 2024:S1530-891X(24)00507-X. [PMID: 38697307 DOI: 10.1016/j.eprac.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/11/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in thyroid cancer patients. METHODS A systematic review based on the PRISMA guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus and Web of Science were searched until October 2023 with specific MeSH terms. After thorough screening and review, relevant data were extracted. RESULTS The database search yielded 3,434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (e.g., nasolacrimal duct obstruction [NLDO; median incidence rate: 6.8%]), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100-150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with NLDO. CONCLUSION The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients' quality of life.
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Affiliation(s)
- Elham Rahmanipour
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Emran Askari
- Nuclear Medicine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ghorbani
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Mirzaei
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behrooz Rahimi
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Mahyar Daskareh
- Department of Radiology, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mirshahvalad
- Joint Department of Medical Imaging, University Medical Imaging Toronto (UMIT), University Health Network, Mount Sinai Hospital & Women's College Hospital; University of Toronto, Toronto, ON, Canada; Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Nishioka S, Watabe S, Yanagisawa Y, Sayama K, Kizaki H, Imai S, Someya M, Taniguchi R, Yada S, Aramaki E, Hori S. Adverse Event Signal Detection Using Patients' Concerns in Pharmaceutical Care Records: Evaluation of Deep Learning Models. J Med Internet Res 2024; 26:e55794. [PMID: 38625718 PMCID: PMC11061790 DOI: 10.2196/55794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/14/2024] [Accepted: 03/09/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Early detection of adverse events and their management are crucial to improving anticancer treatment outcomes, and listening to patients' subjective opinions (patients' voices) can make a major contribution to improving safety management. Recent progress in deep learning technologies has enabled various new approaches for the evaluation of safety-related events based on patient-generated text data, but few studies have focused on the improvement of real-time safety monitoring for individual patients. In addition, no study has yet been performed to validate deep learning models for screening patients' narratives for clinically important adverse event signals that require medical intervention. In our previous work, novel deep learning models have been developed to detect adverse event signals for hand-foot syndrome or adverse events limiting patients' daily lives from the authored narratives of patients with cancer, aiming ultimately to use them as safety monitoring support tools for individual patients. OBJECTIVE This study was designed to evaluate whether our deep learning models can screen clinically important adverse event signals that require intervention by health care professionals. The applicability of our deep learning models to data on patients' concerns at pharmacies was also assessed. METHODS Pharmaceutical care records at community pharmacies were used for the evaluation of our deep learning models. The records followed the SOAP format, consisting of subjective (S), objective (O), assessment (A), and plan (P) columns. Because of the unique combination of patients' concerns in the S column and the professional records of the pharmacists, this was considered a suitable data for the present purpose. Our deep learning models were applied to the S records of patients with cancer, and the extracted adverse event signals were assessed in relation to medical actions and prescribed drugs. RESULTS From 30,784 S records of 2479 patients with at least 1 prescription of anticancer drugs, our deep learning models extracted true adverse event signals with more than 80% accuracy for both hand-foot syndrome (n=152, 91%) and adverse events limiting patients' daily lives (n=157, 80.1%). The deep learning models were also able to screen adverse event signals that require medical intervention by health care providers. The extracted adverse event signals could reflect the side effects of anticancer drugs used by the patients based on analysis of prescribed anticancer drugs. "Pain or numbness" (n=57, 36.3%), "fever" (n=46, 29.3%), and "nausea" (n=40, 25.5%) were common symptoms out of the true adverse event signals identified by the model for adverse events limiting patients' daily lives. CONCLUSIONS Our deep learning models were able to screen clinically important adverse event signals that require intervention for symptoms. It was also confirmed that these deep learning models could be applied to patients' subjective information recorded in pharmaceutical care records accumulated during pharmacists' daily work.
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Affiliation(s)
- Satoshi Nishioka
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Satoshi Watabe
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Yuki Yanagisawa
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Kyoko Sayama
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Hayato Kizaki
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Shungo Imai
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | | | | | - Shuntaro Yada
- Nara Institute of Science and Technology, Nara, Japan
| | - Eiji Aramaki
- Nara Institute of Science and Technology, Nara, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
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Zhang D, Lv W, Xu Y, Zhang Z, Zeng S, Zhang W, Gong L, Shao L, Zhang M, He T, Liu Y, Wang Y, Liu L, Hu X. Microbial bile acid metabolite ameliorates mycophenolate mofetil-induced gastrointestinal toxicity through vitamin D3 receptor. Am J Transplant 2024:S1600-6135(24)00171-0. [PMID: 38452932 DOI: 10.1016/j.ajt.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Mycophenolate mofetil (MMF) is one of the most used immunosuppressive drugs in organ transplantation, but frequent gastrointestinal (GI) side effects through unknown mechanisms limit its clinical use. Gut microbiota and its metabolites were recently reported to play a vital role in MMF-induced GI toxicity, but the specific mechanism of how they interact with the human body is still unclear. Here, we found that secondary bile acids (BAs), as bacterial metabolites, were significantly reduced by MMF administration in the gut of mice. Microbiome data and fecal microbiota transfer model supported a microbiota-dependent effect on the reduction of secondary BAs. Supplementation of the secondary BA lithocholic acid alleviated MMF-induced weight loss, colonic inflammation, and oxidative phosphorylation damage. Genetic deletion of the vitamin D3 receptor (VDR), which serves as a primary colonic BA receptor, in colonic epithelial cells (VDRΔIEC) abolished the therapeutic effect of lithocholic acid on MMF-induced GI toxicity. Impressively, we discovered that paricalcitol, a Food and Drug Administration-approved VDR agonist that has been used in clinics for years, could effectively alleviate MMF-induced GI toxicity. Our study reveals a previously unrecognized mechanism of gut microbiota, BAs, and VDR signaling in MMF-induced GI side effects, offering potential therapeutic strategies for clinics.
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Affiliation(s)
- Di Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Wei Lv
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Xu
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Zijian Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Song Zeng
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Weixun Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Lian Gong
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Limei Shao
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Zhang
- Department of Research Ward, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Tian He
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yingying Liu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuxuan Wang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China
| | - Ling Liu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xiaopeng Hu
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Institute of Urology, Capital Medical University, Beijing, China.
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Finsterer J. SARS-CoV-2 Vaccination- or Infection-related Trigeminal Neuralgia/Radiculitis. Intern Med 2024; 63:761. [PMID: 38104985 PMCID: PMC10982005 DOI: 10.2169/internalmedicine.3152-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023] Open
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Golovan' TV. [The on-line turnover of biologically active additives. Part I. Legal regulation of on-line market of imported biologically active additives in Russia]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:162-168. [PMID: 38640207 DOI: 10.32687/0869-866x-2024-32-2-162-168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/02/2023] [Indexed: 04/21/2024]
Abstract
The interest of population to biologically active additives drastically increased both due to consequences of the COVID-19 corona-virus infection and dynamic development of online trade and active propaganda of healthy lifestyle through mass media. Such production contains in its compound substances that are necessary for maintaining normal vital activity of organism and increasing human immunity. In other cases it can be used as additional and auxiliary agent of treatment of various diseases. In Russia, biologically active additives can be sold through three channels: pharmacies, on-line market and network marketing. In Russia, the results of monitoring of on-line market in 2021-2022 testifies that purchasing of such biologically active additives at on-line platforms turned out to be the riskiest action for human life and health. The biologically active additives were sold at on-line market with serious violations that confirms their danger to health and in some cases for human life. The study demonstrated that nowadays there is no clear-cut legal regulation of turn-over of imported biologically active additives at on-line market. The article presents detailed analysis of normative legal field that regulates in Russia on-line trade of imported biologically active additives and relevant conclusions and recommendations.
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Affiliation(s)
- T V Golovan'
- The Federal State Budget Educational Institution of Higher Education "The Admiral F. F. Ushakov State Maritime University", 353924, Novorossiysk, Russia,
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Mencia MM, Beharry A, Goalan R. Skin Numbness after Total Knee Arthroplasty: Complication or Side-Effect? Ortop Traumatol Rehabil 2024; 26:363-368. [PMID: 38646901 DOI: 10.5604/01.3001.0054.4649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
BACKGROUND Peri-incisional numbness occurs frequently after Total Knee Arthroplasty (TKA), yet its impact on clinical outcomes remains controversial. With some studies reporting 100% incidence and patients often perceiving it as a minor inconvenience, its categorisation as a complication is controversial. This study investigates the prevalence and temporal changes of numbness post-TKA to refine the informed consent process and improve patient satisfaction. MATERIAL AND METHODS A convenience sample of patients who underwent primary cemented TKA was studied. Demographic data, scar length, tourniquet time, and WOMAC scores were collected. Patients were grouped based on time from surgery, and areas of numbness for light touch and pinprick sensations measured. RESULTS The study included 49 patients with a mean age of 68.9 years. While all patients reported numbness, the area decreased for both pinprick and light touch sensations over time. No significant correlation was found between WOMAC scores and the area of numbness. DISCUSSION Numbness post-TKA is common, and the affected area contracts over time, implying a natural healing process. The study's findings challenge the perception of numbness as a complication and emphasise the importance of informed consent in managing patient expectations. CONCLUSIONS 1. Postoperative numbness around the incision site following TKA is a common occurrence with minimal clinical impact on patients. 2. It is important to inform patients that this numbness will improve, although some residual numbness may remain.
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Affiliation(s)
- Marlon M Mencia
- Department of Clinical Surgical Sciences, Port of Spain General Hospital, Port of Spain, Trinidad
| | - Allan Beharry
- Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad
| | - Raakesh Goalan
- Department of Orthopaedics, Sangre Grande Hospital, Sangre Grande, Trinidad
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Arora S, Suhas S, Gowda GS, Reddi VSK, John JP. DRESS syndrome, seizures, and myocarditis on low dose clozapine - A case report. Schizophr Res 2024:S0920-9964(24)00044-6. [PMID: 38413285 DOI: 10.1016/j.schres.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/27/2024] [Accepted: 02/10/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Simran Arora
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India
| | - Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India.
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India
| | - Venkata Senthil Kumar Reddi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India
| | - John P John
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India.
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Darvishi M, Nouri M, Rahimi R, Heidari-Soureshjani S, Hashemi Rafsanjani SMR. A Systematic Review of the Impact of Resveratrol on Viral Hepatitis and Chronic Viral Hepatitis-related Hepatocellular Carcinoma. Curr Mol Med 2024; 24:CMM-EPUB-138603. [PMID: 38375839 DOI: 10.2174/0115665240284347240125072555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND Resveratrol (RSV) is used for the treatment of various diseases due to their anti-inflammatory and antioxidant activities. However, its beneficial aspects on viral hepatitis have been less investigated. OBJECTIVE This report reviews the impact of resveratrol on viral hepatitis and chronic viral hepatitis-related hepatocellular carcinoma (HCC). METHODS The systematic review was performed and reported according to the PRISMA 2020 statement. Several core databases, such as Cochrane Library, PubMed, Web of Science, EMBASE, and Scopus, were used for search on September 6, 2023. After extraction of the data, the desired information of the full text of the studies was recorded in Excel, and the outcomes and mechanisms were reviewed. RESULTS RSV inhibits viral replication through anti-HCV NS3 helicase activity, maintains redox homeostasis via glutathione (GSH) synthesis, improves T and B cell activity, and suppresses miR-155 expression. It also enhances viral replication by enhancing hepatitis C virus (HCV) RNA transcription, activating sirtuin-1 (SIRT1), which can increase peroxisome proliferator-activated receptor (PPAR), and SIRT1 activates the HBV X protein (HBx). Moreover, RSV is responsible for hepatitis-related HCC proliferation via suppression of mammalian target of rapamycin (mTOR), SIRT1 up-regulation, inhibiting expression of HBx, and reducing expression of cyclin D1. CONCLUSION Despite the promising properties of RSV in inhibiting hepatitis-related HCC cell proliferation, its antiviral effects in viral hepatitis are controversial. The antihepatitis behaviors of RSV are mainly dose-dependent, and in some studies, activating some hepatoprotective pathways increases the transcription and replication of chronic HBV and HCV. Therefore, healthcare providers should be aware of viral hepatitis before using RSV supplements.
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Affiliation(s)
- Mohammad Darvishi
- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), School of Aerospace and Subaquatic Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Majid Nouri
- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Aja University of Medical Sciences, Tehran, Iran
| | - Rasoul Rahimi
- Department of Surgery, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Liao CK, Lin SK, Hsiu H. Assessing the severity of AstraZeneca COVID-19 vaccine-related side effects through pulse spectrum analysis. Medicine (Baltimore) 2024; 103:e37132. [PMID: 38335378 PMCID: PMC10860989 DOI: 10.1097/md.0000000000037132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
AstraZeneca (AZ) vaccine is one of the most common vaccines against COVID-19 used globally. However, adverse reactions post-vaccination have been reported, including severe symptoms and cases of sudden death within several hours. Therefore, this study aimed to establish a database of spectral characteristics of blood pressure waveforms (BPWs) for the AZ vaccine and analyze reactions after vaccine administration using objective physiological signal and symptom analyses for identifying potential differences between heavy and slight groups defined in the study. In total, 24 participants were enrolled in the case-control study. BPW measurements were acquired pre- and post-vaccination. A questionnaire survey on side effects was conducted 5 days after vaccination. The related spectral characteristics of heavy and slight groups were acquired after Fourier transform analysis. Four types of harmonic indexes from BPW signals, including amplitude proportion (Cn), coefficient of variation of Cn (CVn), phase angle (Pn), and standard deviation of Pn (Pn_SD), were derived. The characteristics of harmonic indexes of arterial BPW for the AZ vaccine were in C6 (P = .011), CV2 (P = .027), P5 (P = .009), and P2_SD (P = .027) on the radial pulse. C5 (P = .037), C8 (P = .007), C9 (P = .037), CV5 (P = .015), CV8 (P = .005), and CV9 (P = .028) were significantly different at posttest between heavy and slight groups. In both pretest or posttest, C8 was almost significantly different between slight and heavy groups. More parameters changed significantly post-vaccination, with more severe side effects. Most average values of posttest/pretest of CVn and Pn_SD in the slight group exceeded 100%. All average values of posttest/pretest of CVn and Pn_SD in the heavy group were smaller than 100%. This approach may enable prediction of the risk of reactions post-vaccination to determine suitability of the AZ vaccine and evaluation of side effect severity in vaccinated individuals using pulse analysis to ensure relevant precautions are taken.
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Affiliation(s)
- Chen-Kai Liao
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Shun-Ku Lin
- Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin Hsiu
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
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Igyártó BZ, Qin Z. The mRNA-LNP vaccines - the good, the bad and the ugly? Front Immunol 2024; 15:1336906. [PMID: 38390323 PMCID: PMC10883065 DOI: 10.3389/fimmu.2024.1336906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
The mRNA-LNP vaccine has received much attention during the COVID-19 pandemic since it served as the basis of the most widely used SARS-CoV-2 vaccines in Western countries. Based on early clinical trial data, these vaccines were deemed safe and effective for all demographics. However, the latest data raise serious concerns about the safety and effectiveness of these vaccines. Here, we review some of the safety and efficacy concerns identified to date. We also discuss the potential mechanism of observed adverse events related to the use of these vaccines and whether they can be mitigated by alterations of this vaccine mechanism approach.
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Affiliation(s)
- Botond Z. Igyártó
- Department of Microbiology and Immunology, Thomas Jefferson University, Philadelphia, PA, United States
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15
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Sasher T, Bomar P, Feuer D, McDonald L. Anisocoria in patients with hyperhidrosis: A case series for the primary care physician. J Family Med Prim Care 2024; 13:797-799. [PMID: 38605781 PMCID: PMC11006025 DOI: 10.4103/jfmpc.jfmpc_698_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 04/13/2024] Open
Abstract
The differential diagnosis for anisocoria is broad and ranges from benign to life-threatening causes. Often, patients with new onset anisocoria present to their primary care physician, an urgent care center, or an emergency room. As such, it is important for non-ophthalmologist physicians to be familiar with its common causes. We present two cases of pharmacologic anisocoria from Qbrexza (glycopyronnium), a wipe used in the treatment of hyperhidrosis. Identifying this medication as a cause of anisocoria in patients with hyperhidrosis can reduce costs and unnecessary testing. Furthermore, physician education about safer usage can be provided.
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Affiliation(s)
- Tianna Sasher
- Lake Erie College of Osteopathic Medicine, Bradenton, FL, United States
| | - Parker Bomar
- Edward Via College of Osteopathic Medicine, Auburn, AL, United States
| | - Daniel Feuer
- University of Florida College of Medicine, Florida, United States
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16
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Said EA, Al-Rubkhi A, Jaju S, Koh CY, Al-Balushi MS, Al-Naamani K, Al-Sinani S, Al-Busaidi JZ, Al-Jabri AA. Association of the Magnitude of Anti-SARS-CoV-2 Vaccine Side Effects with Sex, Allergy History, Chronic Diseases, Medication Intake, and SARS-CoV-2 Infection. Vaccines (Basel) 2024; 12:104. [PMID: 38276676 PMCID: PMC10820381 DOI: 10.3390/vaccines12010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Vaccination provides the best protection against the increasing infections of SARS-CoV-2. The magnitude and type of anti-SARS-CoV-2 vaccine side effects (SEs) depend on parameters that are not fully understood. In this cross-sectional study, the associations between different anti-SARS-CoV-2 vaccine SEs and age, sex, the presence of chronic diseases, medication intake, history of allergies, and infections with SARS-CoV-2 were investigated. Our survey used the Google platform and had 866 participants, contacted through e-mails, social media and chain referral sampling (margin of error ≈ 4.38%, 99% confidence). More than 99% of the participants received the BNT162b2 and ChAdOx1-S vaccines. Being female, having chronic diseases, taking medicines routinely and the presence of a SARS-CoV-2 infection (p < 0.05) were associated with strong SEs after the BNT162b2 vaccine second dose. Having a history of allergies and a female sex (p < 0.01) were associated with strong SEs after the ChAdOx1-S vaccine second dose. Furthermore, the results reveal, for the first time, the associations between having a history of allergies, chronic diseases, medication usage, and SEs of a strong magnitude for the BNT162b2 and ChAdOx1-S vaccines. Additionally, this study supports the association of the female sex and infection with SARS-CoV-2 with an increased potential of developing stronger SEs with certain anti-SARS-CoV-2 vaccines.
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Affiliation(s)
- Elias A. Said
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Afnan Al-Rubkhi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Sanjay Jaju
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman;
| | - Crystal Y. Koh
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Mohammed S. Al-Balushi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Khalid Al-Naamani
- Department of Medicine, Armed Forces Hospital, P.O. Box 726, Muscat 111, Oman
| | - Siham Al-Sinani
- Oman Medical Specialty Board, P.O. Box 1948, Muscat 130, Oman
| | - Juma Z. Al-Busaidi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Ali A. Al-Jabri
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
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Lau EY, Cragg A, Small SS, Butcher K, Hohl CM. Characterizing and Comparing Adverse Drug Events Documented in 2 Spontaneous Reporting Systems in the Lower Mainland of British Columbia, Canada: Retrospective Observational Study. JMIR Hum Factors 2024; 11:e52495. [PMID: 38236629 PMCID: PMC10835584 DOI: 10.2196/52495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Robust adverse drug event (ADE) reporting systems are crucial to monitor and identify drug safety signals, but the quantity and type of ADEs captured may vary by system characteristics. OBJECTIVE We compared ADEs reported in 2 different reporting systems in the same jurisdictions, the Patient Safety and Learning System-Adverse Drug Reaction (PSLS-ADR) and ActionADE, to understand report variation. METHODS This retrospective observational study analyzed reports entered into PSLS-ADR and ActionADE systems between December 1, 2019, and December 31, 2022. We conducted a comprehensive analysis including all events from both reporting systems to examine coverage and usage and understand the types of events captured in both systems. We calculated descriptive statistics for reporting facility type, patient demographics, serious events, and most reported drugs. We conducted a subanalysis focused on adverse drug reactions to enable direct comparisons between systems in terms of the volume and events reported. We stratified results by reporting system. RESULTS We performed the comprehensive analysis on 3248 ADE reports, of which 12.4% (375/3035) were reported in PSLS-ADR and 87.6% (2660/3035) were reported in ActionADE. Distribution of all events and serious events varied slightly between the 2 systems. Iohexol, gadobutrol, and empagliflozin were the most common culprit drugs (173/375, 46.2%) in PSLS-ADR, while hydrochlorothiazide, apixaban, and ramipril (308/2660, 11.6%) were common in ActionADE. We included 2728 reports in the subanalysis of adverse drug reactions, of which 12.9% (353/2728) were reported in PSLS-ADR and 86.4% (2357/2728) were reported in ActionADE. ActionADE captured 4- to 6-fold more comparable events than PSLS-ADR over this study's period. CONCLUSIONS User-friendly and robust reporting systems are vital for pharmacovigilance and patient safety. This study highlights substantial differences in ADE data that were generated by different reporting systems. Understanding system factors that lead to varying reporting patterns can enhance ADE monitoring and should be taken into account when evaluating drug safety signals.
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Affiliation(s)
- Erica Y Lau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Amber Cragg
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Serena S Small
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Katherine Butcher
- Pharmaceutical Science, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
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18
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Takagi M, Hasegawa Y, Tateoka K, Takada Y, Hareyama M. Dosimetric Comparison Study of Proton Therapy Using Line Scanning versus Passive Scattering and Volumetric Modulated Arc Therapy for Localized Prostate Cancer. Cancers (Basel) 2024; 16:403. [PMID: 38254892 PMCID: PMC10814771 DOI: 10.3390/cancers16020403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The proton irradiation modality has transitioned from passive scattering (PS) to pencil beam scanning. Nevertheless, the documented outcomes predominantly rely on PS. METHODS Thirty patients diagnosed with prostate cancer were selected to assess treatment planning across line scanning (LS), PS, and volumetric modulated arc therapy (VMAT). Dose constraints encompassed clinical target volume (CTV) D98 ≥ 73.0 Gy (RBE), rectal wall V65 < 17% and V40 < 35%, and bladder wall V65 < 25% and V40 < 50%. The CTV, rectal wall, and bladder wall dose volumes were calculated and evaluated using the Freidman test. RESULTS The LS technique adhered to all dose limitations. For the rectal and bladder walls, 10 (33.3%) and 21 (70.0%) patients in the PS method and 5 (16.7%) and 1 (3.3%) patients in VMAT, respectively, failed to meet the stipulated requirements. The wide ranges of the rectal and bladder wall volumes (V10-70) were lower with LS than with PS and VMAT. LS outperformed VMAT across all dose-volume rectal and bladder wall indices. CONCLUSION The LS method demonstrated a reduction in rectal and bladder doses relative to PS and VMAT, thereby suggesting the potential for mitigating toxicities.
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Affiliation(s)
- Masaru Takagi
- Department of Radiation Oncology, Sapporo Teishinkai Hospital, Sapporo 065-0033, Japan
| | - Yasuhiro Hasegawa
- Department of Radiation Physics, Sapporo Teishinkai Hospital, Sapporo 065-0033, Japan
| | - Kunihiko Tateoka
- Department of Radiation Physics, Sapporo Teishinkai Hospital, Sapporo 065-0033, Japan
| | - Yu Takada
- Department of Radiation Oncology, Sapporo Teishinkai Hospital, Sapporo 065-0033, Japan
| | - Masato Hareyama
- Department of Radiation Oncology, Sapporo Teishinkai Hospital, Sapporo 065-0033, Japan
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Zhao H, Lu Y, Li S, Qin J, Xu M, Ye H, Yang Z, Rao J, Chen G, Su F, Hu Z, Xu L. Voriconazole plus flucytosine is not superior to amphotericin B deoxycholate plus flucytosine as an induction regimen for cryptococcal meningitis treatment. Mycoses 2024; 67:e13674. [PMID: 37986630 DOI: 10.1111/myc.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The efficacy and side effects of voriconazole plus 5-flucytosine (Vori + 5-FC) versus amphotericin B deoxycholate plus 5-flucytosine (AmBd + 5-FC) as an induction treatment for cryptococcal meningitis are unknown. METHODS Forty-seven patients treated with Vori + 5-FC and 92 patients treated with AmBd + 5-FC were included in the current study after propensity score matching (PSM) at a ratio of 1:2. Two-week laboratory test results and 90-day mortality were compared between the two groups. RESULTS After 2 weeks of induction treatment, the CSF Cryptococcus sterile culture rate was 57.1% in the Vori + 5-FC group and 76.5% in the AmBd + 5-FC group (p = .026). No difference was found in the normalization of CSF indicators (glucose, total protein, intracranial pressure and India ink sterile rate) between the two groups. Both the Vori + 5FC regimen and AmBd + 5-FC regimen obviously decreased haemoglobin concentrations, platelet counts and serum potassium levels (all p ≤ .010). Notably, the Vori + 5FC regimen did not influence serum creatinine levels (p = .263), while AmBd + 5FC increased serum creatinine levels (p = .019) after 2-week induction treatment. The Vori + 5-FC group and AmBd + 5-FC group had similar 90-day cumulative survival rates (89.9% vs. 87.8%, p = .926). CONCLUSION The Vori + 5-FC regimen was associated with low 2-week CSF sterile culture and was not superior to AmBd + 5-FC as induction therapy in terms of the 90-day cumulative survival rate of CM patients.
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Affiliation(s)
- Handan Zhao
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yanqiu Lu
- Chongqing Public Health Medical Center, Southwest University Public Health Hospital, Chongqing, China
| | - Shan Li
- Department of Infectious Diseases, The Ninth Hospital of Nanchang, Nanchang, China
| | - Jiangying Qin
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Miaomiao Xu
- Department of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hui Ye
- Department of Infectious Diseases, Wenzhou Central Hospital, Wenzhou, China
| | - Zongxing Yang
- Xixi Hospital of Hangzhou, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianfeng Rao
- Department of Infectious Diseases, The Ninth Hospital of Nanchang, Nanchang, China
| | - Guochun Chen
- Department of Infectious Diseases, The Third Peoples' Hospital of Changzhou, Changzhou, China
| | - Feifei Su
- Department of Infectious Diseases, Wenzhou Central Hospital, Wenzhou, China
| | - Zhiliang Hu
- Department of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lijun Xu
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Ezemma O, Devjani S, Jothishankar B, Kelley KJ, Senna M. Drug-induced alopecia areata: A systematic review. J Am Acad Dermatol 2024; 90:133-134. [PMID: 37207950 DOI: 10.1016/j.jaad.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/01/2023] [Accepted: 05/06/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Ogechi Ezemma
- Department of Dermatology, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Shivali Devjani
- Department of Dermatology, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | | | - Kristen J Kelley
- Department of Dermatology, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Maryanne Senna
- Department of Dermatology, Lahey Hospital & Medical Center, Burlington, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
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Özbilen M, Savrun ŞT, Aygün A, Kaya Y. Ferric Carboxymaltose-mediated Methemoglobinemia. Curr Drug Saf 2024; 19:134-137. [PMID: 36779493 DOI: 10.2174/1574886318666230213111038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/17/2022] [Accepted: 12/12/2022] [Indexed: 02/14/2023]
Abstract
BACKGROUND Methemoglobinemia is a life-threatening disorder, with levels above 1 percent considered abnormal and typically resulting from drug or toxic substance exposure. CASE PRESENTATION In this study, we describe a case of a 43-year-old woman with a long-standing complaint of fatigue. Iron deficiency anemia was diagnosed based on the blood test findings of hemoglobin of 101 g/L, mean red blood cell volume of 75 fL, ferritin of 2.81 ug/L, transferrin saturation of 4.3 percent, and C-reactive protein of 0.6 mg/L. As a preferred treatment option, 1000 mg ferric carboxymaltose on two distinct days was preferred. After administering the first dose of the medication, we noticed incidentally that methemoglobin levels increased to 2.3%. When venous blood gas was repeated before and after administration of the second dose of the drug, methemoglobin levels were found to be 0.8% and 1.8%, respectively. There was no change in vital signs in both two dosages, and she only suffered a temporary sore throat. Her anemia improved with intravenous iron therapy, and she is currently being followed in our clinic. CONCLUSION No case or research reporting an increase in methemoglobin levels following oral and/or intravenous treatment to patients with iron deficiency anemia has been found in the literature. Therefore, this is the first contribution to the existing literature.
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Affiliation(s)
- Muhammet Özbilen
- Department of Internal Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Şeyda Tuba Savrun
- Department of Emergency Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Ali Aygün
- Department of Emergency Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Yasemin Kaya
- Department of Internal Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey
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Tan X, Goh SE, Lee JJ, Vanniasingham SD, Brunelin J, Lee J, Tor PC. Efficacy of Using Intermittent Theta Burst Stimulation to Treat Negative Symptoms in Patients with Schizophrenia-A Systematic Review and Meta-Analysis. Brain Sci 2023; 14:18. [PMID: 38248233 PMCID: PMC10813174 DOI: 10.3390/brainsci14010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 01/23/2024] Open
Abstract
Negative symptoms in schizophrenia impose a significant burden with limited effective pharmacological treatment options. Recent trials have shown preliminary evidence for the efficacy of using intermittent theta burst stimulation (iTBS) in treating negative symptoms in schizophrenia. We aim to systematically review the current evidence of iTBS in the treatment of the negative symptoms of schizophrenia as an augmentation therapy. The study protocol was developed and registered on Prospero (registration ID: 323381). MEDLINE, EMBASE, Web of Science (Scopus), PsycINFO and Wan Fang databases were searched for sham-controlled, randomized trials of iTBS among patients with schizophrenia. The mean difference in major outcome assessments for negative symptoms was calculated. The quality of evidence was assessed using the Cochrane Risk of Bias Tool (version 1) and the GRADE system. Moreover, 12 studies including a total of 637 participants were included. Compared to sham treatment, the pooled analysis was in favor of iTBS treatment for negative symptoms (mean weight effect size: 0.59, p = 0.03) but not for positive symptoms (mean weight effect size: 0.01, p = 0.91) and depressive symptoms (mean weight effect size: 0.35, p = 0.16). A significant treatment effect was also observed on the iTBS target site left dorsal prefrontal cortex (mean weight effect size: 0.86, p = 0.007) and for stimulation with 80% motor threshold (mean weight effect size: 0.86, p = 0.02). Thus, our synthesized data support iTBS as a potential treatment for negative symptoms among patients with schizophrenia. However, the long-term efficacy and safety issues of iTBS in a larger population have yet to be examined.
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Affiliation(s)
- Xiaowei Tan
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore; (X.T.); (S.E.G.); (J.J.L.)
| | - Shih Ee Goh
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore; (X.T.); (S.E.G.); (J.J.L.)
| | - Jonathan Jie Lee
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore; (X.T.); (S.E.G.); (J.J.L.)
| | | | - Jérôme Brunelin
- PSYR2 Team, Lyon Neuroscience Research Center, University Lyon 1, INSERM U1028, CNRS UMR5292, 69000 Lyon, France;
- Centre Hospitalier Le Vinatier, 69500 Bron, France
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore 539747, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
| | - Phern Chern Tor
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore; (X.T.); (S.E.G.); (J.J.L.)
- Department of Psychiatric Medicine, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
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Sui M, Wei H, Shen X, Gao K, Zhang Z, Zhang Q. Sulfhydryl compound levels are associated with ATO-induced side effects in acute promyelocytic leukemia patients. Hematology 2023; 28:2231738. [PMID: 37417768 DOI: 10.1080/16078454.2023.2231738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE The remarkable effect of arsenic trioxide (ATO) was verified, but side effects are generally observed in acute promyelocytic leukemia (APL) patients, especially leukocytosis and hepatotoxicity. Our aims are to study predictors and reduce ATO-induced side effects without inhibiting efficacy. METHODS Sulfhydryl in ATO-treated APL patients was detected by the Spectra Max M5 microplate reader. And patients were divided into high and low sulfhydryl groups according to median sulfhydryl concentration. The onset time of leukocytosis and the peak value of WBC were compared . Correlations between hepatotoxicity indicators and sulfhydryl concentrations were analysed. RESULTS The concentration of sulfhydryl before treatment was significantly higher in the high sulfhydryl group. Leukocytosis ((7.0 ± 5.5) vs. (14.6 ± 8.5) day) and the peak value of WBC occurred earlier in the low sulfhydryl group ((10.8 ± 5.9) vs. (19.3 ± 5.5) day) than in the high group, and the peak value was significantly lower in the low sulfhydryl group ((24.04 ± 15.05) × 109/L) than in the high group ((42.95 ± 25.57) × 109/L). The elevated liver enzymes were smaller in the higher sulfhydryl group between time points before treatment and the treatment one week later (ΔALT 66.57 vs. 9.85 U/L, ΔAST 59.52 vs. 17.76 U/L), as between time points before treatment and peak value. There was a negative correlation between sulfhydryl and elevated liver enzymes. CONCLUSIONS Higher sulfhydryl compounds contribute to ameliorating ATO-induced leukocytosis and hepatotoxicity in APL patients. The low sulfhydryl before treatment can advance the onset of leukocytosis. For patients with higher sulfhydryl in the early stage, close monitoring of liver enzymes is warranted instead of prophylactic applying any hepatoprotective intervention, to maintain ATO efficacy.
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Affiliation(s)
- Meijuan Sui
- Central Laboratory of The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Hong Wei
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Xiaohan Shen
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Keke Gao
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Zhuo Zhang
- Central Laboratory of The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Qian Zhang
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
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Toft Morén A, Bull C, Bergmark K. Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report. J Int Med Res 2023; 51:3000605231208596. [PMID: 38082467 PMCID: PMC10718054 DOI: 10.1177/03000605231208596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/29/2023] [Indexed: 12/18/2023] Open
Abstract
Pelvic radiotherapy is a powerful treatment for a broad range of cancers, including gynecological, prostate, rectal, and anal cancers. Despite improvements in the delivery of ionizing beams, damage to non-cancerous tissue can cause long-term effects that are potentially severe, affecting quality of life and daily function. There is an urgent need for new strategies to treat and reverse the side effects of pelvic radiotherapy without compromising the antitumor effect. A woman with severe radiation-induced intestinal side effects was treated with the tumor necrosis factor-alpha inhibitor infliximab with a dose of 3 mg/kg every 4 to 6 weeks. With infliximab treatment, a remarkable improvement in her bowel health was observed. The patient's late bowel toxicity was reduced from Grade 2 to Grade 0 (RTOG/EORTC Late Radiation Morbidity Scale). Although it is necessary to proceed cautiously because of the risk of serious side effects from immunosuppressants, our case suggests that infliximab can be used to treat symptoms of chronic bowel dysfunction after radiotherapy.
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Affiliation(s)
- Amelie Toft Morén
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Cecilia Bull
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Karin Bergmark
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden
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Evans JB, Chou L, Kaeberlein M, Promislow DE, Creevy KE. Case report: Severe asymptomatic hypertriglyceridemia associated with long-term low-dose rapamycin administration in a healthy middle-aged Labrador retriever. Front Vet Sci 2023; 10:1285498. [PMID: 38094495 PMCID: PMC10716302 DOI: 10.3389/fvets.2023.1285498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024] Open
Abstract
Rapamycin is an mTOR inhibitor that has been shown to extend the lifespan of laboratory model organisms. In humans, rapamycin is used at higher doses as an immunosuppressive medication to prevent organ rejection. Numerous adverse effects are seen with rapamycin treatment in humans, with one of the most common being dysregulation of lipid metabolism. In humans, this often manifests as mild to moderate serum lipid elevations, with a small subset developing extreme triglyceride elevations. This case report describes an eight-year-old, castrated male, clinically healthy Labrador retriever who developed severe hypertriglyceridemia associated with low-dose rapamycin administration over a six-month period. During this time, the dog was asymptomatic and displayed no other clinical abnormalities, aside from a progressive lipemia. Within 15 days of discontinuing rapamycin treatment, and with no targeted lipemic intervention, the dog's lipemia and hypertriglyceridemia completely resolved.
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Affiliation(s)
- Jeremy B. Evans
- Department of Small Animal Clinical Sciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Lucy Chou
- Department of Small Animal Clinical Sciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
- Optispan, Inc., Seattle, WA, United States
| | - Daniel E.L. Promislow
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
- Department of Biology, University of Washington, Seattle, WA, United States
| | - Kate E. Creevy
- Department of Small Animal Clinical Sciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
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26
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Finsterer J. Small fiber neuropathy with normal intra-epidermal nerve fiber density but reduced sweat gland density after third BNT162b2 shot. Arch Clin Cases 2023; 10:153-156. [PMID: 38026108 PMCID: PMC10660248 DOI: 10.22551/2023.41.1004.10264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Small fiber neuropathy (SFN) has not been reported after the third dose of BNT162b2 in a previously healthy vaccinee. A 44-year-old previously healthy female developed pain and sensory disturbances in varying locations after the third BNT162b2 dose. Additionally, she developed recurrent tinnitus, headaches, arthralgia, neck stiffness, and motor dysfunction. A skin biopsy five months after symptom onset revealed normal intra-epidermal nerve fiber density (IENFD) but reduced sweat gland nerve fiber density. She is intended for a first series of intravenous immunoglobulins. SARS-CoV-2 vaccinations may be complicated by SFN; the diagnosis SARS-CoV-2 vaccination SFN may be delayed; IENFD may be normal, but sweat gland nerve fiber density may document SFN; and full recovery after SFN cannot always be achieved quickly.
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27
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Shigaki R, Yoshida R, Yagita A, Nagasue K, Naraoka T, Nitanai K, Yanada H, Tenma T, Kida R, Umekage Y, Mori C, Minami Y, Sato H, Iwayama K, Hashino Y, Fukudo M, Sasaki T. Case Report: Case series: association between blood concentration and side effects of sotorasib. Front Oncol 2023; 13:1269991. [PMID: 38044989 PMCID: PMC10690615 DOI: 10.3389/fonc.2023.1269991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Sotorasib is a crucial therapeutic agent for patients with non-small cell lung cancer (NSCLC) harboring the KRAS p.G12C mutation. Despite its efficacy, the relationship between blood sotorasib concentrations and side effects remains largely unexplored. Methods This study enrolled five patients with KRAS p.G12C-positive NSCLC treated with sotorasib (LUMAKRAS® Tablets, Amgen, Japan) between July 2022 and February 2023 at Asahikawa Medical University Hospital. Blood sotorasib levels were monitored, and their association with adverse events was examined, with no adjustments made to drug dosages based on these levels. Results Variable blood sotorasib levels were observed among the participants. Notably, one patient developed interstitial pneumonitis, although a definitive attribution to sotorasib was uncertain due to prior pembrolizumab treatment. The study revealed no consistent association between blood sotorasib levels and adverse events or therapeutic outcomes, with some patients experiencing severe side effects at higher concentrations, while others did not. Conclusion Preliminary findings suggested that monitoring blood sotorasib levels may aid in anticipating adverse events in this small cohort. However, future studies with larger sample sizes and extended follow-up periods are required to validate these initial observations. Such studies could potentially offer insights into personalized dosing strategies, thereby mitigating adverse effects and enhance patient care for individuals with KRAS p.G12C-positive NSCLC.
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Affiliation(s)
- Ryota Shigaki
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Ryohei Yoshida
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
- Department of Respiratory Medicine, Yoshida Hospital, Hokkaido, Japan
| | - Akari Yagita
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Kazunori Nagasue
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Taeka Naraoka
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Kiichi Nitanai
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Hiraku Yanada
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Toshiyuki Tenma
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Ryotaro Kida
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Yasuhiro Umekage
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Chie Mori
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Yoshinori Minami
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Hideki Sato
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Kuninori Iwayama
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Yasuhisa Hashino
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Masahide Fukudo
- Department of Pharmacy, Sapporo Medical University Hospital, Hokkaido, Japan
| | - Takaaki Sasaki
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
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28
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Bourdin V, Bigot W, Vanjak A, Burlacu R, Lopes A, Champion K, Depond A, Amador-Borrero B, Sene D, Comarmond C, Mouly S. Drug-Drug Interactions Involving Dexamethasone in Clinical Practice: Myth or Reality? J Clin Med 2023; 12:7120. [PMID: 38002732 PMCID: PMC10672071 DOI: 10.3390/jcm12227120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Concomitant administration of multiple drugs frequently causes severe pharmacokinetic or pharmacodynamic drug-drug interactions (DDIs) resulting in the possibility of enhanced toxicity and/or treatment failure. The activity of cytochrome P450 (CYP) 3A4 and P-glycoprotein (P-gp), a drug efflux pump sharing localization and substrate affinities with CYP3A4, is a critical determinant of drug clearance, interindividual variability in drug disposition and clinical efficacy, and appears to be involved in the mechanism of numerous clinically relevant DDIs, including those involving dexamethasone. The recent increase in the use of high doses of dexamethasone during the COVID-19 pandemic have emphasized the need for better knowledge of the clinical significance of drug-drug interactions involving dexamethasone in the clinical setting. We therefore aimed to review the already published evidence for various DDIs involving dexamethasone in vitro in cell culture systems and in vivo in animal models and humans.
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Affiliation(s)
- Venceslas Bourdin
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - William Bigot
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Anthony Vanjak
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Ruxandra Burlacu
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Amanda Lopes
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Karine Champion
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Audrey Depond
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Blanca Amador-Borrero
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
| | - Damien Sene
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
- INSERM U976, Hôpital Saint-Louis, 75010 Paris, France
| | - Chloe Comarmond
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
- INSERM U976, Hôpital Saint-Louis, 75010 Paris, France
| | - Stéphane Mouly
- Internal Medicine Department, Département Médico-Universitaire INVICTUS, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (APHP).Nord—Université Paris-Cité, 75010 Paris, France; (V.B.); (W.B.); (A.V.); (R.B.); (A.L.); (K.C.); (A.D.); (B.A.-B.); (D.S.); (C.C.)
- INSERM UMR-S1144, Hôpital Fernand Widal, 75010 Paris, France
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Albright N, McGhee S, Morrison-Beedy D. Nausea, Vomiting, and Nonbloody Diarrhea in the Emergency Department. J Nurse Pract 2023; 19:104783. [PMID: 38496365 PMCID: PMC10939130 DOI: 10.1016/j.nurpra.2023.104783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Nausea, vomiting and diarrhea are frequent co-occurring symptoms that can mask or mimic commonly occurring conditions, or rarely, more serious concerns. The Ending the HIV Epidemic's focus on increased widespread use of PrEP, a biomedical HIV prevention strategy, highlights the importance of discussing common clinical management scenarios. The use of oral PrEP formulations has demonstrated a "startup syndrome" which involves GI upset. This case challenge of a 32year old client admitted to the ED with GI symptoms highlights key PrEP considerations including a sexual health history. Clinicians should understand common complaints associated with oral PrEP start to improve differential diagnosis and appropriate intervention.
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Affiliation(s)
- Nate Albright
- College of Nursing, The Ohio State University, Columbus, OH
| | - Stephen McGhee
- College of Nursing, The Ohio State University, Columbus, OH
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Sahin S, Buyuktiryaki M, Okur N, Akcan AB, Deveci MF, Yurttutan S, Gunes S, Anik A, Ozdemir R, Uygur O, Oncel MY. Effect of partially hydrolyzed synbiotic formula milk on weight gain of late preterm and term infants-a multicenter study. Front Pediatr 2023; 11:1270442. [PMID: 37928348 PMCID: PMC10623126 DOI: 10.3389/fped.2023.1270442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Data on the effectiveness of hydrolyzed infant formula containing both pre- and probiotics (synbiotic formula) on the growth of infants is still scarce. This retrospective study was designed to evaluate the effect of a partially hydrolyzed synbiotic formula on growth parameters and the possible occurrence of major gastrointestinal adverse events or morbidities in infants born via cesarean section (C-section) delivery. Methods C-section-delivered term and late preterm infants who received either partially hydrolyzed synbiotic formula, standard formula, or maternal milk and followed at seven different hospitals from five different regions of Turkey, during a 1-year period with a minimum follow-up duration of 3 months were evaluated retrospectively. All the included infants were evaluated for their growth patterns and any kind of morbidity such as diarrhea, constipation, vomiting, infection, or history of hospitalization. Results A total of 198 infants (73 in the human milk group, 61 in the standard formula group, and 64 in the partially hydrolyzed synbiotic formula group) reached the final analysis. The groups were similar regarding their demographic and perinatal characteristics. No difference was observed between the three groups regarding gastrointestinal major side effects. Growth velocities of the infants in the human milk and partially hydrolyzed synbiotic formula groups during the first month of life were similar whereas the weight gain of infants in the standard formula group was significantly less than these two groups (p < 0.001). Growth velocities were similar among the three groups between 1st and 3rd months of age. Discussion A partially hydrolyzed synbiotic formula provided better weight gain in late-preterm and term infants who were delivered via C-section delivery compared to the standard formula during the first month of life. This weight gain was similar to the infants receiving exclusively human milk. This difference was not observed in length and head circumference gain. No difference was observed in any of the parameters during the 1st-3rd months of age. Specially formulated partially hydrolyzed synbiotic formulas may reverse at least some of the negative impacts of C-section delivery on the infant and help to provide better growth, especially during the early periods of life.
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Affiliation(s)
- Suzan Sahin
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir Democracy University, Izmir, Türkiye
| | - Mehmet Buyuktiryaki
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul Medipol University, Istanbul, Türkiye
| | - Nilufer Okur
- Department of Pediatrics, Division of Neonatology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Türkiye
| | - Abdullah Baris Akcan
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adnan Menderes University, Aydin, Türkiye
| | - Mehmet Fatih Deveci
- Faculty of Medicine, Turgut Ozal Medical Center, Department of Pediatrics, Division of Neonatology, Inonu University, Malatya, Türkiye
| | - Sadik Yurttutan
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Türkiye
| | - Sezgin Gunes
- Department of Pediatrics, Division of Neonatology, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Türkiye
| | - Ayse Anik
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adnan Menderes University, Aydin, Türkiye
| | - Ramazan Ozdemir
- Faculty of Medicine, Turgut Ozal Medical Center, Department of Pediatrics, Division of Neonatology, Inonu University, Malatya, Türkiye
| | - Ozgun Uygur
- Department of Pediatrics, Division of Neonatology, Tepecik Training and Research Hospital, Izmir Health Sciences University, Izmir, Türkiye
| | - Mehmet Yekta Oncel
- Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir Katip Celebi University, Izmir, Türkiye
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31
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Navabi N, Afshari Z, Kamyabi H, Mohammadi M. Side effects and short effects of using three common mouthwashes on oral health and quality of life: A quasi-experimental study. Int J Dent Hyg 2023. [PMID: 37793064 DOI: 10.1111/idh.12761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/28/2023] [Accepted: 08/06/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Antiseptic mouthwashes are useful adjuncts to daily brushing and flossing for the control of dental plaque and gingivitis. The objective of the present study was to compare the effect of three mouthwashes: chlorhexidine, essential oils and cetylpyridinium chloride on oral health-related quality of life, gingival health, tongue coating and also to compare their potential side effects after 2-week consumption. METHODS Sixty participants were enrolled in this study and were divided into four groups (three mouthwash groups plus no mouthwash group). At the beginning, scaling and cleaning were performed and the following parameters were recorded: oral health impact profile (OHIP-5) questionnaire, tongue coating index, modified gingival index, calculus surface index, modified Lobene stain index and a questionnaire for side effects. Each group has followed up in 2 weeks. Data were analysed using paired t-test, ANOVA, Fisher's exact test and Pearson chi-square. RESULTS At the end of second week, all three mouthwashes significantly improved OHIP-5 score and reduced modified gingival index whereas essential oils and cetylpyridinium chloride significantly reduced tongue coating index when compared to control group (p < 0.05). The differences between four groups were significant for calculus formation, dental staining and reported burning sensation and changes of taste sensation and perception (p < 0.05). CONCLUSION The use of all three mouthwashes has been effective in controlling and reducing gingivitis and tongue coating; however, it appeared that essential oils has the minimum and Chlorhexidine has the maximum side effects. Moreover, the use of all three mouthwashes has been examined to improve the quality of life. Overall, essential oils mouthwash has the best performance among these three mouthwashes.
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Affiliation(s)
- Nader Navabi
- Department of Oral Medicine, Dentistry School, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Homa Kamyabi
- Department of Oral Medicine, Dentistry School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Mohammadi
- Department of Periodontics, Dentistry School, Kerman University of Medical Sciences, Kerman, Iran
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32
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Yao G, Fan X, Lu D. Efficacy and safety of probiotic-supplemented bismuth quadruple therapy for the treatment of Helicobacter pylori infection: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231203841. [PMID: 37848344 PMCID: PMC10586011 DOI: 10.1177/03000605231203841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE We performed a meta-analysis to determine whether the addition of probiotics to the bismuth quadruple therapy (BQT) for Helicobacter pylori would improve the incidence of eradication and reduce that of side effects. METHODS Randomized controlled trials matching the inclusion criteria were collected from PubMed, Embase, Web of Science, and The Cochrane Central Register of Controlled Trials. A Mantel-Haenszel random-effects model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for the incidences of eradication rate, side effects as a whole, diarrhea, and other side effects. RESULTS Ten studies were selected for inclusion in the meta-analysis. The pooled RRs for the eradication rates in intention-to-treat and per-protocol analyses of the probiotic group vs. the control group were 1.07 (95% CI: 1.02-1.11) and 1.04 (95% CI: 1.00-1.07), respectively. Probiotic supplementation reduced the incidences of side effects (RR 0.58, 95% CI: 0.37-0.91), diarrhea (RR 0.41, 95% CI: 0.25-0.67), and bitter taste (RR 0.63, 95% CI: 0.40-0.99). CONCLUSIONS The results of this meta-analysis support the use of probiotics in combination with BQT in the clinical management of patients with H. pylori infection.
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Affiliation(s)
- Gaoyan Yao
- Department of Gastroenterology, The Affiliated People’s Hospital of Ningbo University, Ningbo, China
| | - Xiaoyuan Fan
- Department of Gastroenterology, The Affiliated People’s Hospital of Ningbo University, Ningbo, China
| | - Dewen Lu
- Department of Gastroenterology, The Affiliated People’s Hospital of Ningbo University, Ningbo, China
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Yasmin F, Kumari K, Saleem K, Lareeb I, Shaikh A, Ashfaq R, Ahmed B, Bashar N, Najeeb H, Asghar MS. Caregiver's perceptions of COVID-19 vaccination, and intention to vaccinate their children against the disease: a questionnaire based qualitative study. Ann Med Surg (Lond) 2023; 85:4757-4763. [PMID: 37811020 PMCID: PMC10553153 DOI: 10.1097/ms9.0000000000001165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/02/2023] [Indexed: 10/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccine side effects have an important role in the hesitancy of the general population toward vaccine administration. Another reason for vaccine hesitancy might be that healthcare professionals may not address their concerns regarding vaccines appropriately. Regardless, hesitancy in the form of delay, refusal, or acceptance with doubts about its usefulness can limit the downward trajectory of the COVID-19 pandemic. Therefore, the authors conducted a national cross-sectional study (n=306) to assess causes and concerns for vaccine hesitancy in caregivers in Pakistan toward getting their children vaccinated. The questions identified caregivers by socioeconomic demographics, perceived COVID-19 pandemic severity, and concerns toward the COVID-19 vaccine. The majority of the participants were 45-59 years of age (42.8%) with a mean age of 36.11 years (SD: 7.81). A total of 80% of these participants were willing to vaccinate their child with any COVID-19 vaccine. Present comorbidities had a frequency of 28.4% (n=87/306) and only 26.9% (n=66/245) participants were willing to vaccinate their child. Participants with high social standing were 15.4% (n=47/306) with the majority of them being willing to vaccinate their children (45/47). Socioeconomic status (OR:2.911 [0.999-8.483]), and the child's vaccinations being up to date (OR:1.904 [1.078-3.365]) were found to be independent factors for caregivers to be willing to vaccinate their child. Around 62% (n=191/306) were not willing to vaccinate due to the concern for side effects, 67.6% (n=207/306) were not willing because they did not have ample information available, and 51% (n=156/306) were not willing as they were concerned about vaccine effectiveness. Further studies on vaccine safety in the pediatric population are required to improve caregivers' perceptions.
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Affiliation(s)
| | | | | | - Iqra Lareeb
- Liaquat National Hospital and Medical College
| | - Asim Shaikh
- Civil Hospital, Dow University of Health Sciences
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Urakawa R, Isomura ET, Matsunaga K, Kubota K. Multivariate Analysis of Adverse Reactions and Recipient Profiles in COVID-19 Booster Vaccinations: A Prospective Cohort Study. Vaccines (Basel) 2023; 11:1513. [PMID: 37896917 PMCID: PMC10611183 DOI: 10.3390/vaccines11101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND This study investigated the impact of vaccinated population profiles, vaccine type/interval, and the number of vaccine doses on adverse reactions to receiving a coronavirus disease 2019 (COVID-19) booster vaccination. METHODS A survey of adverse reactions was conducted from January 2022 to December 2022 among Osaka University Dental Hospital employees who received their third or fourth doses. The study included 194 third-dose recipients and 131 fourth-dose recipients. Comparisons of the occurrence of adverse reactions between the third- and fourth-dose groups were analyzed via a chi-squared test. The relationships between each adverse reaction occurrence and recipient profiles, vaccine type/interval, and the number of vaccine doses were analyzed via a logistic regression analysis. RESULTS No significant differences were found in the occurrence of adverse reactions between the third and fourth doses. Younger recipients often developed injection site reaction, fatigue, chills, fever, arthralgia, headache, diarrhea, and any adverse reactions more often. Females had higher frequencies of fatigue, chills, headache, and nausea compared to males. Recipients without underlying diseases had higher frequencies of fever and nausea than those with underlying diseases. CONCLUSIONS Younger recipients and females were at higher risk for adverse reactions to a COVID-19 booster vaccination, while the number of vaccinations, vaccination interval, vaccine type, and cross-vaccination showed no significant associations.
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Affiliation(s)
- Ryuta Urakawa
- Department of Pharmacy, Osaka University Dental Hospital, 1-8 Yamada-oka, Suita, Osaka 565-0871, Japan
- Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Emiko Tanaka Isomura
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Kazuhide Matsunaga
- Department of Oral & Maxillofacial Oncology and Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Kazumi Kubota
- Department of Healthcare Information Management, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Rissardo JP, Medeiros Araujo de Matos U, Fornari Caprara AL. Gabapentin-Associated Movement Disorders: A Literature Review. Medicines (Basel) 2023; 10:52. [PMID: 37755242 PMCID: PMC10536490 DOI: 10.3390/medicines10090052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical-epidemiological profile, pathological mechanisms, and management of GBP-associated MD. METHODS Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. RESULTS A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10-89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100-9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. CONCLUSIONS Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.
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Pouessel G, Petitpain N, Tanno LK, Gautier S. Adverse drug reactions from adrenaline auto-injectors: Analysis of the French pharmacovigilance database. Clin Exp Allergy 2023; 53:955-958. [PMID: 37464961 DOI: 10.1111/cea.14375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Guillaume Pouessel
- F-59100, Department of Paediatrics, Children's Hospital, Roubaix, France
- F-59,000, Paediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Nadine Petitpain
- F-54,000, Regional Pharmacovigilance Center, CHRU Nancy, Nancy, France
| | - Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11, INSERM, University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Sophie Gautier
- F-59,000, Regional Pharmacovigilance Center, CHRU Lille, Lille, France
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Coskun O, Sahin H, Yalcin S, Sahin YC, Coskun U. Nivolumab-induced sensory ganglionopathy. J Oncol Pharm Pract 2023; 29:1510-1515. [PMID: 37254496 DOI: 10.1177/10781552231177712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Nivolumab is s a human monoclonal antibody. Due to its widespread use in many cancers, including Merkel cell carcinoma, adverse reactions associated with nivolumab, such as neuropathies, endocrinopathies, gastrointestinal problems, and skin toxicities have been increasing. Sensory ganlionopathy is rarely observed in these patients. CASE DESCRIPTION We present a 63-year-old male with a medical history of Merkel cell carcinoma that recurred two times in the inguinal region. After undergoing surgery with adjuvant radiotherapy, a second surgery was performed. The patient suffered from tingling in all four limbs plus difficulty in walking after initiation of the third dose of nivolumab. MANAGEMENT AND OUTCOME After 1 month of 1 mg/kg/day methylprednisolone treatment, he showed significant improvement. Subsequently, the systemic corticosteroid regimen was tapered to 5 mg every other day. The treatment resulted in significant improvement in all extremities. DISCUSSION Sensory ganlionopathy can be seen as a side effect of an immune checkpoint inhibitor, even though it is very extraordinary. This is the case in the literature to develop sensory ganlionopathy due to nivolumab. We believe that patients using nivolumab may develop sensory ganlionopathy and management should be taken on this point.
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Affiliation(s)
- Ozlem Coskun
- Department of Neurology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Hasan Sahin
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selim Yalcin
- Department of Neurology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Yekta C Sahin
- Department of Nutrition and Dietetics, Ankara Medipol University School of Health Science, Ankara, Turkey
| | - Ugur Coskun
- Department of Neurology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
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Zhuang W, Xu J, Wu Y, Yang J, Lin X, Liao Y, Wan J, Weng L, Lin W. Post-marketing safety concerns with nirmatrelvir: A disproportionality analysis of spontaneous reports submitted to the FDA Adverse Event Reporting System. Br J Clin Pharmacol 2023; 89:2830-2842. [PMID: 37170890 DOI: 10.1111/bcp.15783] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/15/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023] Open
Abstract
AIMS Nirmatrelvir is an antiviral drug with a novel mechanism of action, targeting the 3-CL protease, and is used in the treatment of COVID-19. However, the potential side effects have not yet been fully studied. The aim of this study was to identify potential safety signals of nirmatrelvir by analysing post-marketing safety data based on the largest publicly available worldwide pharmacovigilance database. METHODS We analysed nirmatrelvir adverse events to identify and characterize relevant safety signals based on the FDA Adverse Event Reporting System database in 2022. The case/non-case approach was used to estimate the reporting odds ratio (ROR) and information component (IC) with relevant confidence intervals (95% CI) for adverse events (AEs) that numbered 4 or more. RESULTS A total of 26 846 cases were included. Disease recurrence (ROR [95% CI] = 413.2 [395.6-431.59]), dysgeusia (ROR [95% CI] = 110.84 [106.04-115.85]), anosmia (ROR [95% CI] = 15.21 [12.76-18.11]), ageusia (ROR [95% CI] = 9.80 [8.50-11.3]) and urticaria (ROR [95% CI] = 1.91 [1.69-2.17]) were the main safety signals. In addition, abdominal pain upper and skin toxicity were two specific safety signals of nirmatrelvir. In the pregnant population, there was a significant increased ROR for life-threatening conditions (ROR [95% CI] = 8.00 [1.77-36.20]). CONCLUSIONS Our study identified that the main and specific safety signals of nirmatrelvir were disease recurrence, dysgeusia, abdominal pain upper and skin toxicity. Clinicians and pharmacists should be vigilant of these AEs, although differentiating between COVID-19 symptoms and AEs can be challenging. Notably, a potential safety concern of nirmatrelvir should be a warning based on a small number of events in the pregnant population. However, the available data are insufficient, and further continued pharmacovigilance and surveillance is needed to fully understand this issue.
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Affiliation(s)
- Wei Zhuang
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jiabing Xu
- School of Pharmaceutical, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ye Wu
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jianhui Yang
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Xiuxian Lin
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Yufang Liao
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jun Wan
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Lizhu Weng
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Wanlong Lin
- Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
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Iguchi M, Takahashi T, Takeshita K. Effectiveness and Adherence Rate of S-flurbiprofen Plaster for the Pain Management of Patients With Moderate and End-Stage Knee Osteoarthritis. Cureus 2023; 15:e44556. [PMID: 37662513 PMCID: PMC10474442 DOI: 10.7759/cureus.44556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND S-flurbiprofen plaster (SFPP) is highly skin permeable and represents a new conservative treatment for knee osteoarthritis (KOA) that can attain considerably higher concentrations in the synovium than topical flurbiprofen. To date, no study has investigated the efficacy and adherence rate of SFPP in patients with end-stage KOA. This study aimed to compare the effectiveness and adherence rate of SFPP for pain management in patients with moderate and end-stage KOA. METHODS This retrospective study included a total of 118 patients with KOA (Kellgren-Lawrence classification grades II (n = 29), III (n = 32), and IV (n = 57)). The difference in SFPP use rate, adverse drug reactions rate, whether 50% pain relief occurred, and the percentage of patients who underwent surgical treatment were calculated. RESULTS The overall SFPP use rate at one year was 61.0% (88.1% at less than one month, 79.7% at three months, and 61.0% at six months), with no significant differences among Kellgren-Lawrence grade II, III, and IV groups (p = 0.538). Adverse drug reactions such as skin rash (n = 23), skin irritation (n = 8), and gastrointestinal disorders (n = 2) were observed. The one-year SFPP use rate was significantly lower in patients in whom these side effects occurred but did not decrease in patients in whom only a skin rash occurred. Overall, 19 patients underwent surgery after discontinuation of SFPP use. Surgery was statistically selected more by the "over 71 years of age" group (p = 0.038) and the "ineffective" group (p = 0.007). CONCLUSION SFPP exerts a comparable therapeutic effect even in end-stage KOA and may be an effective treatment option. Even if patients have end-stage KOA, there are cases in which the patient's background does not allow for surgery positively, such as high perioperative risk or desire for conservative treatment. In such cases, SFPP may be an effective treatment option worth trying.
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Affiliation(s)
- Masaki Iguchi
- Department of Orthopaedic Surgery, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, JPN
| | - Tsuneari Takahashi
- Department of Orthopaedic Surgery, Ishibashi General Hospital, Shimotsuke, JPN
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Tan Q, Zhang Y, Liu M, Tian D, Wu X, Zhou L, Fan W. Clinical characteristics and risk factors for tigecycline-induced pancreatitis in a tertiary hospital: A retrospective study. Br J Clin Pharmacol 2023; 89:2788-2797. [PMID: 37161703 DOI: 10.1111/bcp.15776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 05/11/2023] Open
Abstract
AIMS To analyse the clinical characteristics and risk factors for tigecycline-induced pancreatitis (TIP) and evaluate the safety and efficiency of tigecycline use in non-TIP. METHODS A retrospective case-control study was conducted on adult and juvenile patients administered tigecycline for >3 days. The adults were classified as TIP, non-TIP (pancreatitis with other causes) and non-pancreatitis. Univariate analyses were performed to compare TIP and non-pancreatitis, and multivariate analysis was used to identify risk factors for TIP. The clinical characteristics of TIP, and the safety and efficiency of tigecycline use in non-TIP were evaluated. RESULTS A total of 3910 patients (3823 adults and 87 juveniles) were enrolled. The adult patients comprised 21 TIP, 82 non-TIP and 3720 non-pancreatitis. The TIP prevalence was 0.56% in adults and 1.15% in juveniles. The mean time from tigecycline use to symptom onset was 7.2 days, and all cases were mild pancreatitis. The mean time from tigecycline withdrawal to symptom relief was 3.6 days. The multivariate analysis identified comorbid renal insufficiency as an independent risk factor for TIP (odds ratio = 3.032). Among the 82 non-TIP patients, 81.7% had severe pancreatitis and 47.6% had necrotizing pancreatitis. The modified computed tomography severity score after tigecycline use was similar to that before tigecycline use, but the pancreatic enzymes and infection indices were significantly decreased. CONCLUSIONS The prevalence of TIP was low. Comorbid renal insufficiency was as an independent risk factor for TIP. Tigecycline is safe and efficient for treatment of pancreatitis, especially necrotizing pancreatitis, with intra-abdominal infection.
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Affiliation(s)
- Qinghai Tan
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mei Liu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - De'an Tian
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaohui Wu
- Department of Internal Medicine, Dangyang Changbanpo Hospital, Yichang, Hubei, China
| | - Lei Zhou
- Department of Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenjuan Fan
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Key Laboratory of Hepato-Pancreato-Biliary Diseases, Wuhan, Hubei, China
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Yazdi ZS, Streeten EA, Whitlatch HB, Montasser ME, Beitelshees AL, Taylor SI. Vitamin D deficiency increases vulnerability to canagliflozin-induced adverse effects on 1,25-dihydroxyvitamin D and PTH. medRxiv 2023:2023.05.11.23289854. [PMID: 37214882 PMCID: PMC10197796 DOI: 10.1101/2023.05.11.23289854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Context. Canagliflozin has been reported to increase the risk of bone fracture - possibly mediated by decreasing 1,25-dihydroxyvitamin D [1,25(OH) 2 D] and increasing PTH. Objective. To investigate whether baseline vitamin D (VitD) deficiency renders individuals vulnerable to this adverse effect and whether VitD3 supplementation is protective. Design. This study had a paired design comparing individual participants before and after VitD3 supplementation. Setting. Community-based outpatient. Patients. 11 VitD deficient (25-hydroxyvitamin D [25(OH)D] ≤ 20 ng/mL) individuals recruited from the Amish population in Lancaster PA. Interventions. Participants underwent two canagliflozin challenge protocols (300 mg daily for five days): the first before and the second after VitD3 supplementation. In the VitD3 supplementation protocol, participants received VitD3 supplementation (50,000 IU once or twice a week depending on BMI for 4-6 weeks) to achieve 25(OH)D ≥ 30 ng/mL. Main Outcome Measures. Two co-primary endpoints were identified: effects of VitD3 supplementation on canagliflozin-induced changes in 1,25(OH) 2 D and PTH. Secondary endpoints included effects of VitD3 supplementation on baseline levels of VitD metabolites and PTH. Results. VitD3 supplementation increased mean 25(OH)D from 16.5±1.6 to 44.3±5.5 ng/mL (p=0.0006) and 24,25-dihydroxyvitamin D [24,25(OH) 2 D] from 1.0±0.1 to 4.3±0.6 ng/mL (p=0.0002). Mean 1,25(OH) 2 D and PTH were unchanged. VitD3 supplementation decreased the magnitude of canagliflozin-induced changes in 1,25(OH) 2 D (from -31.3%±4.7% to -9.3%±8.3%; p=0.04) and PTH (from +36.2%±6.2% to +9.7%±3.7%; p=0.005). Conclusions. VitD deficiency rendered individuals more vulnerable to adverse effects of canagliflozin on biomarkers associated with bone health. VitD3 supplementation was protective against canagliflozin's short-term adverse effects on 1,25(OH) 2 D and PTH.
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Affiliation(s)
- Zhinous Shahidzadeh Yazdi
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Elizabeth A Streeten
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hilary B Whitlatch
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - May E Montasser
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amber L Beitelshees
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Simeon I Taylor
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
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Hartmann K, Egberink H, Möstl K, Addie DD, Belák S, Boucraut-Baralon C, Frymus T, Lloret A, Hofmann-Lehmann R, Marsilio F, Pennisi MG, Tasker S, Thiry E, Truyen U, Hosie MJ. Feline Injection-Site Sarcoma and Other Adverse Reactions to Vaccination in Cats. Viruses 2023; 15:1708. [PMID: 37632050 PMCID: PMC10459272 DOI: 10.3390/v15081708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Vaccine-associated adverse events (VAAEs), including feline injection-site sarcomas (FISSs), occur only rarely but can be severe. Understanding potential VAAEs is an important part of informed owner consent for vaccination. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of feline medicine experts, presents the current knowledge on VAAEs in cats, summarizing the literature and filling the gaps where scientific studies are missing with expert opinion to assist veterinarians in adopting the best vaccination practice. VAAEs are caused by an aberrant innate or adaptive immune reaction, excessive local reactions at the inoculation site, an error in administration, or failure in the manufacturing process. FISS, the most severe VAAE, can develop after vaccinations or injection of other substances. Although the most widely accepted hypothesis is that chronic inflammation triggers malignant transformation, the pathogenesis of FISS is not yet fully understood. No injectable vaccine is risk-free, and therefore, vaccination should be performed as often as necessary, but as infrequently as possible. Vaccines should be brought to room temperature prior to administration and injected at sites in which FISS surgery would likely be curative; the interscapular region should be avoided. Post-vaccinal monitoring is essential.
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Affiliation(s)
- Katrin Hartmann
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, 80539 Munich, Germany
| | - Herman Egberink
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, University of Utrecht, 3584 CL Utrecht, The Netherlands;
| | - Karin Möstl
- Institute of Virology, Department for Pathobiology, University of Veterinary Medicine, 1210 Vienna, Austria;
| | | | - Sándor Belák
- Department of Biomedical Sciences and Veterinary Public Health (BVF), Swedish University of Agricultural Sciences (SLU), P.O. Box 7036, 750 07 Uppsala, Sweden;
| | | | - Tadeusz Frymus
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences—SGGW, 02-787 Warsaw, Poland;
| | - Albert Lloret
- Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain;
| | - Regina Hofmann-Lehmann
- Clinical Laboratory, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zuich, 8057 Zurich, Switzerland;
| | - Fulvio Marsilio
- Faculty of Veterinary Medicine, Università degli Studi di Teramo, 64100 Teramo, Italy;
| | - Maria Grazia Pennisi
- Dipartimento di Scienze Veterinarie, Università di Messina, 98168 Messina, Italy;
| | - Séverine Tasker
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK;
- Linnaeus Veterinary Ltd., Shirley, Solihull B90 4BN, UK
| | - Etienne Thiry
- Veterinary Virology and Animal Viral Diseases, Department of Infectious and Parasitic Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, B-4000 Liège, Belgium;
| | - Uwe Truyen
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, 04103 Leipzig, Germany;
| | - Margaret J. Hosie
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK;
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Elyasi F, Zarghami M, Fariborzifar A, Cheraghmakani H, Shirzad M, Kazempour F. The diagnostic dilemma in a patient with neuroleptic malignant syndrome during the COVID-19 pandemic: A significant increase in acute phase reactants. Clin Case Rep 2023; 11:e7734. [PMID: 37546158 PMCID: PMC10397481 DOI: 10.1002/ccr3.7734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/08/2023] Open
Abstract
Key Clinical Message In some patients, neuroleptic malignant syndrome is accompanied significant high levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Abstract Neuroleptic malignant syndrome (NMS) is an idiosyncratic life-threatening adverse reaction and usually triggered in response to antipsychotic drugs. In addition, leukocytosis and increased muscle enzymes levels (especially creatine phosphokinase) are observed in NMS. In addition, a transient increase in different types of acute phase reactants in NMS has been mentioned. This article describes a woman treated with haloperidol, perphenazine, escitalopram, and alprazolam because she developed catatonic symptoms after psychological stress. She suffered from NMS symptoms and had elevated CRP and ESR levels, among other signs and symptoms. Given the COVID-19 pandemic and reports of co-occurrence of catatonia and NMS and COVID-19 and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), this patient was a diagnostic dilemma. After consultation with the consultation-liaison psychiatry units, she was managed adequately with electroconvulsive therapy and lorazepam.
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Affiliation(s)
- Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research CenterAddiction Institute, Mazandaran University of Medical SciencesSariIran
- Department of Psychiatry, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Mehran Zarghami
- Department of Psychiatry, Faculty of MedicineMazandaran University of Medical SciencesSariIran
- Psychiatry and Behavioral Sciences Research CenterAddiction Institute, Mazandaran University of Medical SciencesSariIran
| | - Arghavan Fariborzifar
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of MedicineIran University of Medical SciencesTehranIran
| | - Hamed Cheraghmakani
- Neurology Department, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Mahboobeh Shirzad
- Department of internal Medicine, Faculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Feteme Kazempour
- Student Research Committee, Faculty of MedicineMazandaran University of Medical SciencesSariIran
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Finsterer J. Before blaming levodopa/carbidopa intestinal gel for demyelinating polyneuropathy, all differential aetiologies must be ruled out. Neurol Neurochir Pol 2023; 57:401-402. [PMID: 37466028 DOI: 10.5603/pjnns.a2023.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/11/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Josef Finsterer
- Neurology & Neurophysiology Centre, Vienna, Austria, Austria.
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Skouras PJ, Karanastasi E, Lycoskoufis I, Demopoulos V, Darras AI, Tsafouros A, Tsalgatidou PC, Margaritopoulos JT, Stathas GJ. Toxicity and Lethal Effect of Greenhouse Insecticides on Coccinella septempunctata (Coleoptera: Coccinellidae) as Biological Control Agent of Myzus persicae (Hemiptera: Aphididae). Toxics 2023; 11:584. [PMID: 37505550 PMCID: PMC10385029 DOI: 10.3390/toxics11070584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
Deltamethrin and imidacloprid are commonly used insecticides for controlling sub-sucking insects in greenhouses. However, their application may cause sublethal effects on the aphid coccinellid predator Coccinella septempunctata (Coleoptera: Coccinellidae). Here, we study (i) the toxicity and the effect of two sublethal doses (LD10 and LD30) of deltamethrin and imidacloprid on C. septempunctata in a laboratory microcosm and (ii) the residual toxicity of the two insecticides in a greenhouse. The results showed that both insecticides reduced fecundity, longevity, the intrinsic rate of increase, the finite rate of increase and the net reproductive rate. However, the developmental time of the fourth instar larvae was prolonged by both insecticides at LD10 and LD30. Deltamethrin residues were toxic 21 DAT (days after treatment) to C. septempunctata fourth instar larvae. In contrast, imidacloprid began in the slightly harmful category (75%) 1 DAT and declined to the harmless category (18.33%) 21 DAT. These results indicate that deltamethrin and imidacloprid have potential risks to C. septempunctata. This study provides information to guide the development of integrated pest management (IPM) strategies in greenhouses.
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Affiliation(s)
- Panagiotis J Skouras
- Laboratory of Agricultural Entomology and Zoology, Department of Agriculture, University of the Peloponnese, Kalamata Campus, 24100 Antikalamos, Greece
- Laboratory of Plant Protection, Department of Agriculture, University of the Peloponnese, Kalamata Campus, 24100 Antikalamos, Greece
| | - Eirini Karanastasi
- Plant Protection Laboratory, Department of Agriculture, University of Patras, Nea Ktiria, 30200 Mesolonghi, Greece
| | - Ioannis Lycoskoufis
- Department of Agriculture, University of the Peloponnese, 24100 Kalamata, Greece
| | - Vasilis Demopoulos
- Laboratory of Plant Protection, Department of Agriculture, University of the Peloponnese, Kalamata Campus, 24100 Antikalamos, Greece
| | - Anastasios I Darras
- Department of Agriculture, University of the Peloponnese, 24100 Kalamata, Greece
| | - Athanasios Tsafouros
- Department of Agriculture, University of the Peloponnese, 24100 Kalamata, Greece
| | - Polina C Tsalgatidou
- Department of Agriculture, University of the Peloponnese, 24100 Kalamata, Greece
| | - John T Margaritopoulos
- Department of Plant Protection, Institute of Industrial and Fodder Crops, Hellenic Agricultural Organization "DEMETER", 38334 Volos, Greece
| | - George J Stathas
- Laboratory of Agricultural Entomology and Zoology, Department of Agriculture, University of the Peloponnese, Kalamata Campus, 24100 Antikalamos, Greece
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Klib M, Ghandour M, Alazki O, Nabhan AI, Idres FA, Alolabi H, Khaddour MS, Zahlout J, Albakkar F, Hamoud HMM, Houri HNA, Alafandi BZ. Fears and misconceptions toward COVID-19 vaccination among Syrian population: A cross-sectional study. Health Sci Rep 2023; 6:e1426. [PMID: 37448732 PMCID: PMC10337013 DOI: 10.1002/hsr2.1426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/02/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023] Open
Abstract
Background and Aims Despite the significant milestone of vaccine discovery, the spread of misinformation and pseudoscientific claims has resulted in an increasing number of people refusing vaccination in Syria. In this study, we aimed to explore fears and misconceptions towards COVID-19 vaccines among the Syrian population. Methods We conducted a nationwide cross-sectional study between January and May 2022, using a convenience sample of 10,006 participants aged at least 18 years and living in Syria. We administered a validated online/paper questionnaire and conducted face-to-face interviews. We used SPSS software (version 26) for statistical analysis, assessing our data using frequency and χ 2 tests, with p < 0.05 considered statistically significant. Results The majority of the participants were female 6048 (60.4%), university degree holders 7304 (73%), and from urban areas 8015 (80.1%). Approximately half of the participants 5021 (50.2%) belonged to the medical sector (49% had concerns about the vaccine). Females, university degree holders, and participants with a history of symptomatic COVID-19 were more likely to have fears about the vaccines. The main concerns about the vaccines were the rapid development, fears of blood clots, and common side effects. The prevalence of some misconceptions was relatively high, such as the belief that the vaccine is an experiment or a secret plan to reduce the population. Reliable sources are crucial to fight misleading information on social media. Conclusion COVID-19 vaccine is key to controlling the spread, but acceptance rate is critical. High variability in vaccine acceptance and high vaccine hesitancy can affect the efforts to terminate the COVID-19 pandemic. Addressing the barriers associated with the acceptance of COVID-19 vaccination will be the cornerstone to achieving maximum vaccination coverage. It is important to consider the reasons for refusing the COVID-19 vaccine when interpreting the results of any study on vaccine attitudes among the Syrian population.
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Affiliation(s)
- Mohamad Klib
- Faculty of MedicineDamascus UniversityDamascusSyria
| | - Munir Ghandour
- Internal Medicine DepartmentDamascus UniversityDamascusSyria
| | - Osama Alazki
- Faculty of MedicineTishreen UniversityLatakiaSyria
| | - Ayman I. Nabhan
- Faculty of MedicineAl Andalus University for Medical SciencesTartusSyria
| | | | - Homam Alolabi
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Majd S. Khaddour
- Faculty of MedicineAl Andalus University for Medical SciencesTartusSyria
| | | | | | | | - Hasan N. Al Houri
- Internal Medicine DepartmentDamascus UniversityDamascusSyria
- Faculty of MedicineSyrian Private UniversityDamascusSyria
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Liu H, Lu M, Hu J, Fu G, Feng Q, Sun S, Chen C. Medications and Food Interfering with the Bioavailability of Levothyroxine: A Systematic Review. Ther Clin Risk Manag 2023; 19:503-523. [PMID: 37384019 PMCID: PMC10295503 DOI: 10.2147/tcrm.s414460] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023] Open
Abstract
Purpose Levothyroxine is a common prescribed drug. Many medications and food, however, can interfere with its bioavailability. The aim of this review was to summarize the medications, food and beverages that interact with levothyroxine and to assess their effects, mechanisms and treatments. Methods A systematic review on interfering substances that interact with levothyroxine was performed. Web of Science, Embase, PubMed, the Cochrane library, grey literature from other sources and the lists of references were searched for human studies comparing the levothyroxine efficacy with and without interfering substances. The patient characteristics, drug classes, effects and mechanism were extracted. The NHLBI study quality assessment tools and the JBI critical appraisal checklist were used to assess the quality of included studies. Results A total of 107 articles with 128 studies were included. Drugs interactions were revealed in calcium and iron supplements, proton pump inhibitors, bile acid sequestrants, phosphate binders, sex hormones, anticonvulsants and other drugs. Some food and beverage could also induce malabsorption. Proposed mechanisms included direct complexing, alkalization, alteration of serum thyroxine-binding globulin levels and acceleration of levothyroxine catabolism via deiodination. Dose adjustment, administration separation and discontinuation of interfering substances can eliminate the interactions. Liquid solutions and soft-gel capsules could eliminate the malabsorption due to chelation and alkalization. The qualities of most included studies were moderate. Conclusion Lots of medications and food can impair the bioavailability of levothyroxine. Clinicians, patients and pharmaceutical companies should be aware of the possible interactions. Further well-designed studies are needed to provide more solid evidence on treatment and mechanisms.
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Affiliation(s)
- Hanqing Liu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
| | - Man Lu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
| | - Jiawei Hu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
| | - Guangzhao Fu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
| | - Qinyu Feng
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Shengrong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China
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Wu SY, Ou CC, Lee ML, Hsin IL, Kang YT, Jan MS, Ko JL. Polysaccharide of Ganoderma lucidum Ameliorates Cachectic Myopathy Induced by the Combination Cisplatin plus Docetaxel in Mice. Microbiol Spectr 2023; 11:e0313022. [PMID: 37212664 PMCID: PMC10269453 DOI: 10.1128/spectrum.03130-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/05/2023] [Indexed: 05/23/2023] Open
Abstract
Cachexia is a lethal muscle-wasting syndrome associated with cancer and chemotherapy use. Mounting evidence suggests a correlation between cachexia and intestinal microbiota, but there is presently no effective treatment for cachexia. Whether the Ganoderma lucidum polysaccharide Liz-H exerts protective effects on cachexia and gut microbiota dysbiosis induced by the combination cisplatin plus docetaxel (cisplatin + docetaxel) was investigated. C57BL/6J mice were intraperitoneally injected with cisplatin + docetaxel, with or without oral administration of Liz-H. Body weight, food consumption, complete blood count, blood biochemistry, and muscle atrophy were measured. Next-generation sequencing was also performed to investigate changes to gut microbial ecology. Liz-H administration alleviated the cisplatin + docetaxel-induced weight loss, muscle atrophy, and neutropenia. Furthermore, upregulation of muscle protein degradation-related genes (MuRF-1 and Atrogin-1) and decline of myogenic factors (MyoD and myogenin) after treatment of cisplatin and docetaxel were prevented by Liz-H. Cisplatin and docetaxel treatment resulted in reducing comparative abundances of Ruminococcaceae and Bacteroides, but Liz-H treatment restored these to normal levels. This study indicates that Liz-H is a good chemoprotective reagent for cisplatin + docetaxel-induced cachexia. IMPORTANCE Cachexia is a multifactorial syndrome driven by metabolic dysregulation, anorexia, systemic inflammation, and insulin resistance. Approximately 80% of patients with advanced cancer have cachexia, and cachexia is the cause of death in 30% of cancer patients. Nutritional supplementation has not been shown to reverse cachexia progression. Thus, developing strategies to prevent and/or reverse cachexia is urgent. Polysaccharide is a major biologically active compound in the fungus Ganoderma lucidum. This study is the first to report that G. lucidum polysaccharides could alleviate chemotherapy-induced cachexia via reducing expression of genes that are known to drive muscle wasting, such as MuRF-1 and Atrogin-1. These results suggest that Liz-H is an effective treatment for cisplatin + docetaxel-induced cachexia.
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Affiliation(s)
- Sung-Yu Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chu-Chyn Ou
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
| | - Meng-Lin Lee
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - I-Lun Hsin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Ting Kang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Shiou Jan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Department of Health Industry Technology Management, Chung Shan Medical University, Taichung, Taiwan
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Skouras PJ, Karanastasi E, Demopoulos V, Mprokaki M, Stathas GJ, Margaritopoulos JT. Toxicity and Influence of Sublethal Exposure to Sulfoxaflor on the Aphidophagous Predator Hippodamia variegata (Coleoptera: Coccinellidae). Toxics 2023; 11:533. [PMID: 37368633 DOI: 10.3390/toxics11060533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Hippodamia variegata (Goeze), the variegated ladybug, is a predator of many insect pests, especially aphids. Sulfoxaflor is a chemical insecticide that can be used to control many sap-feeding insect pests, for instance, plant bugs and aphids, as an alternative to neonicotinoids in different crops. To improve the combination of the H. variegata and sulfoxaflor in an IPM (integrated pest management) program, we studied the ecological toxicity of the insecticide to the coccinellid predator at sublethal and lethal doses. We examined the influence of sulfoxaflor on larvae of H. variegata using exposure doses of 3, 6, 12, 24, 48 (maximum recommended field rate (MRFR)), and 96 ng a.i. per insect. In a 15-day toxicity test, we observed decreased adult emergence percentage and survival, as well as an increased hazard quotient. The LD50 (dose causing 50% mortality) of H. variegata due to sulfoxaflor decreased from 97.03 to 35.97 ng a.i. per insect. The total effect assessment indicated that sulfoxaflor could be grouped as slightly harmful for H. variegata. Additionally, most of the life table parameters were significantly decreased after exposure to sulfoxaflor. Overall, the results present a negative influence of sulfoxaflor on H. variegata when applied at the recommended field dose for controlling aphids in Greece, which demonstrates that this insecticide may only be employed with care when used in IPM programs.
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Affiliation(s)
- Panagiotis J Skouras
- Laboratory of Agricultural Entomology and Zoology, Department of Agriculture, Kalamata Campus, University of the Peloponnese, 24100 Antikalamos, Greece
- Laboratory of Plant Protection, Department of Agriculture, Kalamata Campus, University of the Peloponnese, 24100 Antikalamos, Greece
| | - Eirini Karanastasi
- Plant Protection Laboratory, Department of Agriculture, University of Patras, 30200 Messolonghi, Greece
| | - Vasilis Demopoulos
- Laboratory of Plant Protection, Department of Agriculture, Kalamata Campus, University of the Peloponnese, 24100 Antikalamos, Greece
| | - Marina Mprokaki
- Laboratory of Agricultural Entomology and Zoology, Department of Agriculture, Kalamata Campus, University of the Peloponnese, 24100 Antikalamos, Greece
| | - George J Stathas
- Laboratory of Agricultural Entomology and Zoology, Department of Agriculture, Kalamata Campus, University of the Peloponnese, 24100 Antikalamos, Greece
| | - John T Margaritopoulos
- Department of Plant Protection, Institute of Industrial and Fodder Crops, Hellenic Agricultural Organization "DEMETER", 38334 Volos, Greece
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Takahashi Y, Deshpande GA, Kanai Y, Seok Yan K, Naito T. RS3PE Syndrome with Subsequent PMR Caused by Long-Term DPP-4 Inhibitor Use. Eur J Case Rep Intern Med 2023; 10:003914. [PMID: 37455697 PMCID: PMC10348439 DOI: 10.12890/2023_003914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 05/23/2023] [Indexed: 07/18/2023] Open
Abstract
Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome has been reported in patients treated with dipeptidyl peptidase-4 inhibitors (DPP-4i). We experienced a case of RS3PE syndrome in a 73-year-old man with a history of type 2 diabetes, who developed RS3PE as a side effect of vildagliptin. Further to this, the patient developed polymyalgia rheumatica (PMR), the first such case associated with long-term DPP-4i use. LEARNING POINTS RS3PE syndrome and PMR are rare diseases that cause painful extremities in adults. We need to know if it occurs by DPP-4i.RS3PE syndrome and PMR can be complicated with malignancy or giant cell arteritis. However, we must rule out side effects of drugs at first from the standpoint of medical resources.
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Affiliation(s)
- Yuichi Takahashi
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Gautam A Deshpande
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshinori Kanai
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kwang Seok Yan
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
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