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2.
Medicine (Baltimore) ; 100(11): e24423, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725933

RESUMEN

ABSTRACT: The association between Glutathione S-transferase Pi 1(GSTP1) genetic polymorphism (rs1695, 313A>G) and cyclophosphamide-induced toxicities has been widely investigated in previous studies, however, the results were inconsistent. This study was performed to further elucidate the association.A comprehensive search was conducted in PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wan Fang database up to January 5, 2020. Risk ratios (RRs) and 95% confidence intervals (95% CIs) were used to estimate the association between GSTP1 rs1695 polymorphism and cyclophosphamide-induced hemotoxicity, gastrointestinal toxicity, infection, and neurotoxicity.A total of 13 studies were eventually included. Compared with the GSTP1 rs1695 AA genotype carriers, patients with AG and GG genotypes had an increased risk of cyclophosphamide-induced gastrointestinal toxicity (RR, 1.61; 95% CI, 1.18-2.19; P = .003) and infection (RR, 1.57; 95% CI, 1.00-2.48; P = .05) in the overall population. In the subgroup analyses, there were significant associations between GSTP1 rs1695 polymorphism and the risk of cyclophosphamide-induced myelosuppression (RR, 2.10; 95% CI, 1.60-2.76; P < .00001), gastrointestinal toxicity (RR, 1.77; 95%CI, 1.25-2.53; P = .001), and infection (RR, 2.01; 95% CI, 1.14-3.54; P = .02) in systemic lupus erythematosus (SLE) or lupus nephritis syndrome patients, but not in cancer patients.Our results confirmed an essential role for the GSTP1 rs1695 polymorphism in the prediction of cyclophosphamide-induced myelosuppression, gastrointestinal toxicity, and infection in SLE or lupus nephritis syndrome patients. More studies are necessary to validate our findings in the future.


Asunto(s)
Ciclofosfamida/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/genética , Predisposición Genética a la Enfermedad/genética , Gutatión-S-Transferasa pi/genética , Polimorfismo Genético , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/genética , Genotipo , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Nefritis Lúpica/tratamiento farmacológico , Estudios Observacionales como Asunto , Factores de Riesgo
4.
Dtsch Arztebl Int ; 118(1-2): 12-13, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33750532
7.
Vnitr Lek ; 67(1): 51-56, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33752392

RESUMEN

The COVID-19 pandemic represents a wide-ranging form of involvement from asymptomatic through mild respiratory form to bilateral bronchopneumonia with acute respiratory and multiorgan fatal failure. Patients with comorbidities (obesity, cardiovascular diseases, diabetes mellitus) are particularly at risk of a more severe course of infection. We present a 33-year old lean patient with a medical history of ulcerative colitis on immunosuppressive treatment with Azathioprine, after unsuccessful in vitro fertilization one week before the onset of symptoms, admitted to hospital for two-week-long cough with sore throat with fever ap to 40°C. CT confirmed bilateral bronchopneumonia without etiological detection of the infectious agent. Three PCR tests (two of nasopharyngeal swabs and one of bronchoalveolar lavage (BAL)) were negative for COVID-19, including antigen and antibody tests. Complex parenteral ATB treatment with high-flow nasal oxygen therapy was ineffective, and artificial lung ventilation was indicated for acute respiratory failure. After 4 days antifungal treatment of Fluconazole, condition of patient progressed to hepatic and multiorgan failure and the patient died on day 14 of hospitalization. Post-mortem histological examination revealed the presence of coronavirus in the cells of lung parenchyma. The case recalls that even young patients with immunosuppressive treatment are at risk for the critical course of COVID-19 disease. The negativity of the tests was due to the capture of the patient only after the second week of infection, at the time of the diagnostic window between the positive PCR test and the formation of antibodies. The persistent effect of immunosuppression was most likely the reason for the lack of antibody response.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Adulto , Femenino , Humanos , Inmunosupresión , Pandemias
9.
Zhongguo Zhong Yao Za Zhi ; 46(2): 306-311, 2021 Jan.
Artículo en Chino | MEDLINE | ID: mdl-33645116

RESUMEN

Liver is the main place of drug metabolism. Mitochondria of hepatocytes are important targets of drug-induced liver injury. Mitochondrial autophagy could maintain the healthy operation of mitochondria in cells and the stable proliferation of cells. Therefore, the use of mitochondrial autophagy to remove damaged mitochondria is an important strategy of anti-drug-induced liver injury. Active ingredients that could enhance mitochondrial autophagy are contained in many traditional Chinese medicines, which could regulate the mitochondrial autophagy to alleviate relevant diseases. However, there are only a few reports on how to accurately and efficiently identify and evaluate such components targeting mitochondria from traditional Chinese medicine. Liquid chromatography-mass spectro-metry(LC-MS) combined with serum pharmacology in vivo can be used to accurately and efficiently find active ingredients of traditional Chinese medicine acting on mitochondrial targets. This paper reviewed the research ideas and methods of traditional Chinese medicine ingredients for increasing the hepatotoxicity of mitochondrial autophagy, in order to provide new ideas and methods for the study of active ingredients of traditional Chinese medicine targeting mitochondria.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Medicamentos Herbarios Chinos , Medicamentos Herbarios Chinos/toxicidad , Humanos , Medicina China Tradicional , Mitocondrias
10.
Zhongguo Zhong Yao Za Zhi ; 46(3): 712-721, 2021 Feb.
Artículo en Chino | MEDLINE | ID: mdl-33645039

RESUMEN

This study aimed to comprehensively analyze and compare the differences of different clinical study types currently published in the safety evaluation of Xuebijing Injection. Six databases, namely the Cochrane Library, PubMed, EMbase, CNKI, VIP and Wanfang database, were electronically retrieved to collect all types of studies on the safety of Xuebijing Injection, including randomized controlled trials, case-controlled studies, cohort studies, systematic reviews, and centralized monitoring studies of clinical safety(hospital), in order to comprehensively and objectively evaluate the safety of Xuebijing Injection, and analyze the differences of different research results. A total of 211 literatures were included, involving a total of 46 384 patients treated with Xuebijing Injection, and 423 adverse reactions(ADRs) occurred. They included 191 randomized controlled trials, 3 cohort studies, 15 systematic reviews, and 2 centralized monitoring studies of clinical safety(hospital), and the incidence of adverse reactions was 2.54%(common), 2.31%(common), 0.95%(occasionally), and 0.50%(occasionally). More than half of the 423 cases of ADRs occurred in skin and adnexal system(151 cases) and gastrointestinal system(65 cases), including such manifestations as rash, skin itching, nausea and vomiting, diarrhea. The degree of ADRs was mild. Randomized controlled trials showed that the incidence of ADR was the highest when Xuebijing Injection was used for malignant tumor and multiple organ failure. And the systematic evaluation showed that the incidence of ADR was the highest when Xuebijing Injection was used for spontaneous peritonitis of liver cirrhosis. In conclusion, different study types could lead to significant differences in the results of drug safety evaluation. Sample size, study type, and quality control are the main factors for biased results. Due to large sample size and high-quality, centralized monitoring studies become the better clinical safety evaluation model of drugs at present, and full life cycle management could more objectively reflect drug safety and guide clinical rational drug use.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Medicamentos Herbarios Chinos , Estudios de Casos y Controles , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Medicamentos Herbarios Chinos/efectos adversos , Humanos , Inyecciones
11.
Database (Oxford) ; 20212021 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-33787872

RESUMEN

Understanding the underlying molecular and structural similarities between seemingly heterogeneous sets of drugs can aid in identifying drug repurposing opportunities and assist in the discovery of novel properties of preclinical small molecules. A wealth of information about drug and small molecule structure, targets, indications and side effects; induced gene expression signatures; and other attributes are publicly available through web-based tools, databases and repositories. By processing, abstracting and aggregating information from these resources into drug set libraries, knowledge about novel properties of drugs and small molecules can be systematically imputed with machine learning. In addition, drug set libraries can be used as the underlying database for drug set enrichment analysis. Here, we present Drugmonizome, a database with a search engine for querying annotated sets of drugs and small molecules for performing drug set enrichment analysis. Utilizing the data within Drugmonizome, we also developed Drugmonizome-ML. Drugmonizome-ML enables users to construct customized machine learning pipelines using the drug set libraries from Drugmonizome. To demonstrate the utility of Drugmonizome, drug sets from 12 independent SARS-CoV-2 in vitro screens were subjected to consensus enrichment analysis. Despite the low overlap among these 12 independent in vitro screens, we identified common biological processes critical for blocking viral replication. To demonstrate Drugmonizome-ML, we constructed a machine learning pipeline to predict whether approved and preclinical drugs may induce peripheral neuropathy as a potential side effect. Overall, the Drugmonizome and Drugmonizome-ML resources provide rich and diverse knowledge about drugs and small molecules for direct systems pharmacology applications. Database URL: https://maayanlab.cloud/drugmonizome/.


Asunto(s)
/tratamiento farmacológico , Bases de Datos Farmacéuticas , /efectos de los fármacos , Antivirales/química , Antivirales/farmacología , Descubrimiento de Drogas , Evaluación Preclínica de Medicamentos , Reposicionamiento de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Humanos , Técnicas In Vitro , Aprendizaje Automático , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Bibliotecas de Moléculas Pequeñas , Interfaz Usuario-Computador , Replicación Viral/efectos de los fármacos
12.
Arch. esp. urol. (Ed. impr.) ; 74(1): 71-79, ene.-feb. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-199438

RESUMEN

INTRODUCCIÓN: El cólico renoureteral (CRU) es la urgencia urológica más frecuente, con un amplio espectro de gravedad que genera una alta morbilidad y elevados costes sanitarios. Sin embargo, no existe un esquema homogéneo de tratamiento farmacológico en su fase aguda. OBJETIVOS: El objetivo principal de nuestro trabajo es evaluar la efectividad y perfil de seguridad de los distintos fármacos empleados en el tratamiento del CRU y proponer un esquema práctico de tratamiento. Los objetivos secundarios son evaluar el papel de la fluidoterapia en el CRU y el tratamiento del CRU en embarazadas. MATERIAL Y MÉTODOS: Hemos realizado una búsqueda bibliográfica en PubMed utilizando los términos MeSH "renal colic", "treatment", "anti-inflammatory-drugs", "antiemetic drugs", "fluid therapy" y "pregnant". Se revisaron ensayos clínicos, metaanálisis y revisiones sistemáticas de mayor relevancia, publicados desde el 1 de enero de 2005 hasta el 15 de septiembre de 2020, escritos en lengua española, inglesa y francesa. RESULTADOS: En los diferentes estudios revisados los antiinflamatorios no esteroideos (AINES) muestran un mejor control del dolor, con menores dosis de rescate y menos efectos secundarios que el tratamiento con opioides. Sin embargo, la fluidoterapia no ha logrado demostrar una repercusión en el tratamiento del CRU. CONCLUSIONES: El tratamiento de primera elección para el CRU son los AINES, reservando los opioides para sucesivas líneas de tratamiento. El control del cortejo vegetativo se puede realizar con ondansetrón como primera elección


INTRODUCTION: Renoureteral colic (CRU) is the most common urological emergency, with a wide spectrum of severity that generates high morbidity and high health costs. However, there is no homogeneous scheme of pharmacological treatment in its acute phase. AIMS: The main objective of our work is to evaluate the effectiveness and safety profile of the different drugs used in the treatment of CCR and to propose a practical treatment scheme. The secondary objectives are to evaluate the role of fluid therapy in CRU and the treatment of CRU in pregnant women. MATERIAL AND METHODS: We have carried out a literature search on PubMed using the MeSH terms "renal colic", "treatment", "anti-inflammatory drugs", "antiemetic drugs", "fluid therapy" and "pregnant". The most relevant clinical trials, meta-analyses and systematic reviews published from 1 January 2005 to 15 September 2020 in Spanish, English and French were reviewed. RESULTS: In the different studies reviewed, non-steroidal anti-inflammatory drugs (NSAIDs) show better pain control, with lower rescue doses and fewer side effects than treatment with opioids. However, fluid therapy has failed to demonstrate an impact on the treatment of CRU. CONCLUSIONS: The initial treatment for CRU is NSAIDs, reserving opioids for successive treatment lines. The control of vegetative cortex can be accomplished with Ondansetron as first choice


Asunto(s)
Humanos , Femenino , Embarazo , Cólico/tratamiento farmacológico , Cólico Renal/tratamiento farmacológico , Resultado del Tratamiento , Fluidoterapia , Antiinflamatorios no Esteroideos/uso terapéutico , Analgésicos Opioides , Dolor , Urolitiasis , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Manejo del Dolor , Complicaciones del Embarazo
14.
Am J Health Syst Pharm ; 78(7): 568-577, 2021 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-33537767

RESUMEN

KEY POINTS: In a multicenter point-prevalence study, we found that the rate of supportive care was high; among those receiving COVID-19 drug therapies, adverse reactions occurred in 12% of patients. PURPOSE: There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. METHODS: We conducted a noninterventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19-targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). RESULTS: A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19-directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). CONCLUSION: While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.


Asunto(s)
/tratamiento farmacológico , Quimioterapia Combinada/estadística & datos numéricos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antivirales/efectos adversos , Antivirales/uso terapéutico , Niño , Preescolar , Quimioterapia Combinada/efectos adversos , Femenino , Humanos , Hidroxicloroquina/efectos adversos , Hidroxicloroquina/uso terapéutico , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , Estudios Retrospectivos , Estados Unidos/epidemiología , Adulto Joven
15.
Emerg Infect Dis ; 27(4): 1220-1222, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33522478

RESUMEN

Coronavirus disease (COVID-19) symptoms can be mistaken for vaccine-related side effects during initial days after immunization. Among 4,081 vaccinated healthcare workers in Israel, 22 (0.54%) developed COVID-19 from 1-10 days (median 3.5 days) after immunization. Clinicians should not dismiss postvaccination symptoms as vaccine-related and should promptly test for COVID-19.


Asunto(s)
/efectos adversos , Personal de Salud/estadística & datos numéricos , Vacunación , Adulto , Rutas de Resultados Adversos , /epidemiología , /métodos , /administración & dosificación , Diagnóstico Diferencial , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/diagnóstico , Femenino , Humanos , Israel/epidemiología , Masculino , Vacunación/efectos adversos , Vacunación/métodos , Vacunación/estadística & datos numéricos
16.
Ecotoxicol Environ Saf ; 213: 112063, 2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33636465

RESUMEN

Evidence is still limited for the role of long-term PM2.5 exposure in cerebrovascular diseases among residents in high pollution regions. The study is aimed to investigate the long-term effects of PM2.5 exposure on stroke mortality, and further explore the effect modification of temperature variation on the PM2.5-mortality association in northern China. Based on a cohort data with an average follow-up of 9.8 years among 38,435 urban adults, high-resolution estimates of PM2.5 derived from a satellite-based model were assigned to each participant. A Cox regression model with time-varying exposures and strata of geographic regions was employed to assess the risks of stroke mortality associated with PM2.5, after adjusting for individual risk factors. The cross-product term of PM2.5 exposure and annual temperature range was further added into the regression model to test whether the long-term temperature variation would modify the association of PM2.5 with stroke mortality. Among the study participants, the annual mean level of PM2.5 concentration was 66.3 µg/m3 ranging from 39.0 µg/m3 to 100.6 µg/m3. For each 10 µg/m3 increment in PM2.5, the hazard ratio (HR) was 1.31 (95% CI: 1.04-1.65) for stroke mortality after multivariable adjustment. In addition, the HRs of PM2.5 decreased gradually as the increase of annual temperature range with the HRs of 1.95 (95% CI: 1.36-2.81), 1.53 (95% CI: 1.06-2.22), and 1.11 (95% CI: 0.75-1.63) in the low, middle, and high group of annual temperature range, respectively. The findings provided further evidence of long-term PM2.5 exposure on stroke mortality in high-exposure settings such as northern China, and also highlighted the view that assessing the adverse health effects of air pollution might not ignore the role of temperature variations in the context of climate change.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Material Particulado/toxicidad , Accidente Cerebrovascular/mortalidad , Adulto , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , China/epidemiología , Estudios de Cohortes , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Masculino , Material Particulado/análisis , Temperatura , Población Urbana
18.
Iran J Allergy Asthma Immunol ; 20(1): 11-23, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33639626

RESUMEN

The Coronavirus disease 2019 (COVID-19) virus spread from Wuhan, China, in 2019 and is spreading rapidly around the world. COVID-19 victims are almost associated with cardiovascular disease, high blood pressure, diabetes, and other underlying diseases. Concerning the high prevalence of these disorders, widespread mortality threatens global society, and its fatality rate may increase with increasing COVID-19 prevalence in countries with older populations. Therefore, evaluating patients' clinical status with severe COVID-19 infection and their medical history can help manage treatment. Currently, one of the considered treatments is angiotensin-converting enzyme 2 (ACE2) inhibition. This study investigated virus entry mechanisms through membrane receptors, their role in the pathogenesis of COVID-19 and underlying diseases, and treatment methods based on the viral entrance inhibition. According to existing studies, inhibition of ACE2 can increase oxidative stress, inflammation, fibrosis and ultimately exacerbate underlying diseases such as cardiovascular disease, kidney disease, diabetes, and hypertension in individuals with COVID-19. The ACE2 inhibition is not suitable for patients with COVID-19 with underlying diseases, but it seems that the recombinant ACE2 solution is more appropriate for inhibiting the virus in these patients if hypotension would be monitored.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antivirales/uso terapéutico , /virología , Internalización del Virus/efectos de los fármacos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Humanos , Hipotensión/etiología , Hipotensión/prevención & control , Monitoreo Fisiológico , Peptidil-Dipeptidasa A/metabolismo
20.
Rev Med Suisse ; 17(727): 383-388, 2021 Feb 24.
Artículo en Francés | MEDLINE | ID: mdl-33625803

RESUMEN

In the last few years, there has been a growing interest in the study of complement, fueleld mainly by the design of complement modulators, especially the C5-blocker eculizumab. The latter has significantly improved the prognosis of some nephropathies, such as the atypical hemolytic uremic syndrome. This breakthrough is a perfect example of fundamental translational research leading to clinical applications for patients. Currently, new molecules are being developed and some of them have already demonstrated clinical efficacy, such as avacopan (C5aR blocker) in ANCA vasculitis. As for kidney transplantation, complement modulators may lead to a new perspective in the treatment of some complications, such as humoral rejection. However, complement modulators carry the side effects, especially the infectious, and high costs.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Trasplante de Riñón , Vasculitis , Humanos , Riñón
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