Gastrointestinal treatment-related adverse events of combined immune checkpoint inhibitors: a meta-analysis.

Introduction: Combined immune checkpoint inhibitors can cause gastrointestinal adverse events. Methods: We performed a meta-analysis of pooled colonic, hepatic and pancreatic treatment-related adverse events of combined ICI. Results: 53 trials reporting treatment-related adverse events in 6581 patients. All grade diarrhea was the most common adverse event seen in 25.4% patients, followed by all grade hepatitis in nearly 13% patients and pancreatitis in nearly 7.5% patients. Conclusion: Our study provides pooled data of treatment-related adverse events from different combination immune checkpoint inhibitors use in solid tumors and demonstrates a high incidence of all grades and ≥3 grade gastrointestinal adverse events. Further studies are required to characterize these adverse events and assess their overall impact on treatment course and outcomes.

The article talks about a type of medicine called immune checkpoint inhibitors that are used to treat cancer. These medicines can sometimes cause problems in the stomach and liver when used in combination with other cancer treatments, which can lead to hospitalization or, rarely, death. We performed a study on 6581 people who took these medicines in combination with another treatment and determined exactly how often these side effects happened. We also looked at which combinations of medicines were safer. This information can help doctors identify the side effects early and treat them. It can also help scientists design more studies to learn more about these side effects and how to prevent them.

Pseudomonas mendocina Urinary Tract Infection: A Case Report and Literature Review.

Pseudomonas mendocina is a Gram-negative bacillus from the family Pseudomonadaceae. The first P. mendocina-related infection was reported in 1992. Although a rare cause of infections, P. mendocina has been known to cause severe infections that require intensive treatment. We present the first documented case of urinary tract infection caused by P. mendocina. An 83-year-old male with a past medical history of diabetes, hypertension, coronary artery disease, and prostate cancer with bone metastases, currently being treated with abiraterone and prednisone, presented with subjective fever, fatigue, altered mental status, dysuria, and hematuria of one-week duration. He was found to have a complicated urinary tract infection with an incidental asymptomatic COVID-19 infection on admission. The patient was empirically treated with ceftriaxone and switched to cefepime for broader coverage on day two of hospitalization. Urine culture reported the presence of P. mendocina with resistance only to fluoroquinolones. Ceftriaxone was reinstated. The patient was successfully treated with a seven-day course of ceftriaxone (days 1-3, days 6-7) and cefepime (days 4-5) but continued to remain inpatient for a later symptomatic COVID-19 pneumonia with discharge on day 15. The majority of P. mendocina infections present as skin and soft tissue infections, infective endocarditis, meningitis, and bacteremia. Ours is the first documented case of urinary tract infection caused by P. mendocina, particularly in an immunocompromised COVID-19 patient, and the second to report P. mendocina with resistance to fluoroquinolones. This report contributes to the growing literature regarding P. mendocina-related infections.

Hesitancy for Adult Vaccines Among Healthcare Providers and their Family Members in Delhi, India: A Cross-Sectional Study.

Objectives: Adult immunisation has recently emerged as an area of emphasis in research and policy. Increasing life expectancy, outbreaks like COVID-19, and the endemic nature of diseases like dengue, malaria have underscored its importance. Therefore, this study was carried out to assess hesitancy and the factors influencing the uptake of vaccines in adults. Methods: A descriptive cross-sectional study was conducted among the medical students and doctors affiliated to a medical college and tertiary care hospital in Delhi, India and their immediate family members in January 2021. Online data collection was done using the Google Form platforms. Data on awareness and perceptions regarding adult vaccination and immunisation status of participants was collected. The dataset was exported in the Microsoft Excel format and analysed with IBM SPSS Version 25 (Armonk, NY: IBM Corp). Results: A total of 461 adults responded to the survey. The most common reasons for vaccine hesitancy were fear of side effects (51.41%), lack of awareness of vaccines (49.46%), and the lack of national guidelines on adult vaccination (32.97%). Hesitancy for vaccines among those who were informed by healthcare workers of vaccine availability was highest for zoster vaccine (97.80%) and least for tetanus toxoid (57.62%). Significant hesitancy was also observed for pneumococcal, human papillomavirus, influenza and varicella vaccines. Conclusions: Reduced vaccine uptake due to vaccine hesitancy in adulthood is a major health concern. Framing national guidelines for adult vaccination in India and awareness generation to create a public demand for adult vaccination warrants prioritization.