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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 221-225, jan.-dez. 2020. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1048046

RESUMO

Objetivo: identificar os tipos de medicamentos mais utilizados por idosos hospitalizados e relacioná-los com o risco de desenvolvimento de lesão por pressão. Método: estudo descritivo e documental, realizado em um hospital de referência em traumas de Fortaleza, Ceará. A amostra constituiu-se por 48 prontuários e a coleta de dados ocorreu no período de agosto de 2015 a fevereiro de 2016. Resultados: ocorreu a análise dos 48 prontuários de pacientes idosos acamados que se encontravam internados na Unidade de Terapia Intensiva e enfermaria. A média de idade desses idosos foi de 75 anos com presença de 54,2% do sexo masculino e 45,8% do sexo feminino. Desse total, os fármacos que mais apareceram e tem relação com o desenvolvimento da lesão são: os anti-hipertensivos, analgésicos, diuréticos, drogas vasoativas e antibiótico. Conclusão: os tipos de medicamentos mais utilizados nos idosos deste estudo estavam diretamente relacionados às alterações no sistema circulatório do idoso


Objective: the study's main purpose has been to identify the types of medication most used by hospitalized-elderly people, while relating them to the risk of developing pressure injury. Method: it is a descriptive and documental study, which was performed in a trauma referral hospital from the Fortaleza city, Ceará State. The sample consisted of 48 medical records and the data collection took place from August 2015 to February 2016. Results: through the analysis of 48 medical records from elderly patients hospitalized in both Intensive Care Unit and ward, the following results were found: the average age of those elderly individuals was 75 years old, with 54.2% being males and 45.8% being females. Bearing in mind the total, the drugs that appeared the most and were also related to the development of pressure injury were as follows: antihypertensives, analgesics, diuretics, vasoactive drugs and antibiotics. Conclusion: the types of medication most used by the elderly patients addressed in this study were directly related to alterations in their circulatory system


Objetivo: identificar los tipos de medicamentos más utilizados por ancianos hospitalizados y relacionarlos con el riesgo de desarrollo de lesión por presión. Método: estudio descriptivo y documental, realizado en un hospital de referencia en traumas de Fortaleza, Ceará. La muestra se constituyó por 48 prontuarios y la recolección de datos ocurrió en el período de agosto de 2015 a febrero de 2016. Resultados: ocurrió el análisis de los 48 prontuarios de pacientes ancianos acamados que se encontraban internados en la Unidad de Terapia Intensiva y enfermería. El promedio de edad de estos ancianos fue de 75 años con presencia de 54,2% del sexo masculino y el 45,8% del sexo femenino. De ese total, los fármacos que más aparecieron y tienen relación con el desarrollo de la lesión son: los antihipertensivos, analgésicos, diuréticos, drogas vasoactivas y antibiótico. Conclusión: los tipos de medicamentos más utilizados en los ancianos de este estudio estaban directamente relacionados a las alteraciones en el sistema circulatorio del anciano


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Lesão por Pressão , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Pacientes Internados , Saúde do Idoso , Fatores de Risco
2.
Ann Ist Super Sanita ; 55(4): 319-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31850857

RESUMO

On the international scene, Multiple Chemical Sensitivity (MCS) is defined, by several experts, as a multisystem syndrome that develops following chronic exposures to low doses of common chemical contaminants. Its general characteristics are, however, the object of conflicting opinions and a source of debate and research aimed at the appropriate nosological and therapeutic frameworks. In the face of a potentially debilitating trend, both in the occupational and in the economical and social sphere, the scientific community has not so far found an agreement. This problem leads patients and their associations to periodically claim some requests. The syndrome is also taken into consideration at a political level, especially due to the close connection with the problems related to environmental pollution and to decision making in the field of control and prevention. For these reasons we believe that an appropriate widespread surveillance network for MCS should be set up in Italy, capable of intercepting possible cases, analyzing them at a multidisciplinary level, and following their evolution.


Assuntos
Saúde Ambiental , Sensibilidade Química Múltipla/etiologia , Saúde Pública , Ansiedade/complicações , Biomarcadores , Causalidade , Congressos como Assunto , Consenso , Citocinas/metabolismo , Suscetibilidade a Doenças , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Alimentos/efeitos adversos , Guias como Assunto , Humanos , Inflamação , Sistema Límbico/fisiopatologia , Sensibilidade Química Múltipla/diagnóstico , Sensibilidade Química Múltipla/genética , Sensibilidade Química Múltipla/psicologia , Personalidade , Polimorfismo Genético , Xenobióticos/efeitos adversos
3.
Br J Radiol ; 92(1104): 20190526, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31595778

RESUMO

OBJECTIVE: Unsuspected pulmonary embolism (UPE) has been increasingly diagnosed as an incidental finding on CT scans for routine staging in cancer patients. Previous studies suggest that obesity is an independent risk factor for venous thromboembolism in patients with malignant tumors. In this study, we aimed to investigate the association between abdominal adipose tissue, especially visceral adipose tissue (VAT) and the occurrence of UPE in hospitalized patients with gastrointestinal cancer. METHODS: Routine contrast-enhanced chest and abdominal CT scans of 1974 patients were retrospectively assessed for the presence of UPE, of which 58 patients were identified with UPE and 108 non-UPE patients were selected as the non-UPE control group based on several matching criteria. Abdominal adipose tissue was measured by volumes of VAT and subcutaneous adipose tissue (SAT) at the navel level. RESULTS: VAT, SAT, indwelling venous catheters, surgery, chemotherapy, and bed rest or immobilization were associated with the occurrence of UPE. Higher VAT volumes were associated with increased risk of UPE (odds ratio: 1.96; 95% confidence interval: 1.25, 3.06; p = 0.003) adjusting body mass index (BMI), bed rest or immobilization, surgery, chemotherapy and smoking, while SAT was not associated with UPE adjusting the same confounders (p = 0.117). No statistical association was found between BMI and UPE (p = 0.102). CONCLUSION: Higher VAT rather than SAT is associated with an increased risk of unsuspected pulmonary embolism on routine CT scans in hospitalized gastrointestinal cancer patients. ADVANCES IN KNOWLEDGE: Our findings indicate that VAT is a stronger risk factor for unsuspected pulmonary embolism than BMI and SAT in hospitalized patients with gastrointestinal cancer.


Assuntos
Embolia Gordurosa/etiologia , Gordura Intra-Abdominal/diagnóstico por imagem , Embolia Pulmonar/etiologia , Gordura Subcutânea Abdominal/diagnóstico por imagem , Idoso , Repouso em Cama/efeitos adversos , Índice de Massa Corporal , Estudos de Casos e Controles , Cateteres de Demora/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Embolia Gordurosa/diagnóstico por imagem , Feminino , Neoplasias Gastrointestinais , Humanos , Imobilização/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Embolia Pulmonar/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(6): 448-459, jul.-ago. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-185272

RESUMO

A pesar del avance que ha supuesto en la supervivencia de los pacientes oncológicos, la aparición de nuevos agentes quimioterápicos y nuevas combinaciones, estos han traído consigo numerosos efectos adversos que pueden llegar a comprometer el tratamiento y, por consiguiente, el pronóstico de la enfermedad. Entre otros efectos secundarios los citostáticos pueden causar toxicidad dermatológica. El efecto adverso más conocido de la quimioterapia es la alopecia que, aunque no es grave, altera la apariencia externa de los pacientes con cáncer. Otros efectos adversos que pueden observarse son las reacciones de hipersensibilidad y fotosensibilidad, el síndrome mano-pie, la necrólisis epidérmica, las reacciones de reactivación, las reacciones esclerodermiformes, el fenómeno de Raynaud, la siringometaplasia escamosa ecrina, la hidradenitis neutrofílica ecrina, las alteraciones ungueales, las alteraciones en la pigmentación y las lesiones por extravasación. La aparición de estos efectos adversos produce en muchas ocasiones una reducción de dosis y/o retraso del tratamiento, lo que puede afectar a la supervivencia y a la calidad de vida del paciente. Por ello, es importante prevenir su aparición e instaurar un tratamiento temprano, para lo que se hace imprescindible la colaboración entre oncólogos médicos y dermatólogos. En este artículo se revisa la toxicidad dermatológica asociada con la quimioterapia, así como su diagnóstico y abordaje terapéutico


Although the arrival of new chemotherapy drugs and combinations has brought progress in terms of cancer patient survival, they entail many adverse effects that can compromise treatment, and hence prognosis, of the disease. Cytostatic agents can cause dermatological toxicity, among other side effects. The most familiar adverse effect of chemotherapy is alopecia. Although not serious, this changes the outward appearance of cancer patients. Other adverse effects include hypersensitivity and photosensitivity reactions, hand-foot syndrome, epidermal necrolysis, recall reactions, scleroderma-like reactions, Raynaud's phenomenon, eccrine squamous syringometaplasia, neutrophilic eccrine hidradenitis, nail abnormalities, pigmentation changes and extravasation injuries. Onset of these adverse effects often causes dose reduction and/or delayed treatment, which can affect patient survival and quality of life. It is therefore important to prevent their occurrence and treat them promptly, which requires cooperation between medical oncologists and dermatologists. This article reviews chemotherapy-associated dermatological toxicity, along with its diagnosis and therapeutic management


Assuntos
Humanos , Conferências de Consenso como Assunto , Sociedades Médicas/normas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Prognóstico , Dermatopatias/induzido quimicamente , Antineoplásicos/efeitos adversos , Oncologia/normas , Espanha , Alopecia/induzido quimicamente , Hipersensibilidade a Drogas/complicações , Transtornos de Fotossensibilidade/induzido quimicamente , Hiperpigmentação/induzido quimicamente
5.
Environ Sci Pollut Res Int ; 26(25): 25491-25499, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31264151

RESUMO

Numerous studies have investigated the impacts of ambient fine particulate matter (PM2.5) on human health. In this study, we examined the association of daily PM2.5 concentrations with the number of deaths for the cerebrovascular disease on the same day, using the generalized additive model (GAM) controlling for temporal trend and meteorological variables. We used the data between 2012 and 2014 from Shanghai, China, where the adverse health effects of PM2.5 have been of particular concern. Three different approaches (principal component analysis, shrinkage smoothers, and the least absolute shrinkage and selection operator regularization) were used in GAM to handle multicollinear meteorological variables. Our results indicate that the average daily concentration of PM2.5 in Shanghai was high, 55 µg/m3, with an average daily death for cerebrovascular disease (CVD) of 62. There was 1.7% raised cerebrovascular disease deaths per 10 µg/m3 increase in PM2.5 concentration in the unadjusted model. However, PM2.5 concentration was no longer associated with CVD deaths after controlling for meteorological variables. The results were consistent in the three modelling techniques that we used. As a large number of people are exposed to air pollution, further investigation with longer time period including individual-level information is needed to examine the association.


Assuntos
Poluição do Ar/análise , Transtornos Cerebrovasculares/mortalidade , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Material Particulado/análise , China , Morte , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia , Humanos , Meteorologia , Material Particulado/efeitos adversos , Material Particulado/química , Análise de Componente Principal , Projetos de Pesquisa
6.
Obes Facts ; 12(4): 369-384, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31216558

RESUMO

BACKGROUND: Obesity has been associated with miscellaneous weight-inducing determinants. A comprehensive assessment of known obesity-related factors other than diet and physical activity within one cohort is currently lacking. OBJECTIVES: To assess the prevalence of potential contributors to obesity and self-reported triggers for marked weight gain in an adult population with obesity and between obesity classes. METHODS: In this observational cohort study, we assessed 408 persons with obesity (aged 41.3 ± 14.2 years, BMI 40.5 ± 6.2) visiting our obesity clinic. They were evaluated for use of weight-inducing drugs, hormonal abnormalities, menarcheal age, (high) birth weight, sleep deprivation, and obstructive sleep apnea syndrome (OSAS). We additionally assessed self-reported triggers for marked weight gain and performed genetic testing in patients suspected of genetic obesity. RESULTS: Nearly half of the patients were using a potentially weight-inducing drug, which was also the most reported trigger for marked weight gain. For the assessed hormonal conditions, a relatively high prevalence was found for hypothyroidism (14.1%), polycystic ovary syndrome (12.0%), and male hypogonadism (41.7%). A relatively low average menarcheal age (12.6 ± 1.8 years) was reported, whereas there was a high prevalence of a high birth weight (19.5%). Sleep deprivation and OSAS were reported in, respectively, 14.5 and 13.7% of the examined patients. Obesity class appeared to have no influence on the majority of the assessed factors. Of the genetically analyzed patients, a definitive genetic diagnosis was made in 3 patients (1.9%). CONCLUSIONS: A thorough evaluation of patients with obesity yields a relatively high prevalence of various potentially weight-inducing factors. Diagnostic screening of patients with obesity could therefore benefit these patients by potentially reducing the social stigma and improving the outcomes of obesity treatment programs by tackling, where possible, the weight-inducing factors in advance.


Assuntos
Obesidade/epidemiologia , Obesidade/etiologia , Ganho de Peso/fisiologia , Adolescente , Adulto , Índice de Massa Corporal , Causalidade , Estudos de Coortes , Dieta/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Doenças do Sistema Endócrino/complicações , Doenças do Sistema Endócrino/epidemiologia , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Anamnese/estatística & dados numéricos , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Fenótipo , Prevalência , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Adulto Jovem
8.
Turk J Med Sci ; 49(2): 624-634, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30997978

RESUMO

Background/aim: Erythema nodosum (EN) is an inflammatory disorder of subcutaneous tissue. Although etiopathogenesis of the disease is unknown, many predisposing factors such as infections, systemic disease, and drugs have been identified. Neutrophil to lymphocyte ratio (NLR) has been shown to be a novel inflammatory marker in many dermatological diseases. The aim of our study is to investigate NLR in EN patients and evaluate its relation to the underlying cause of the disease. Materials and methods: Between 2014 and 2018, clinical and laboratory data of 395 patients diagnosed with EN and 395 controls were extracted from patient files. EN patients were grouped as idiopathic EN and secondary EN (EN with an identified underlying cause). Clinical and laboratory characteristics of the two groups were compared Results: NLR was elevated in EN patients compared to controls (median of 2.38 vs. 1.55, P < 0.001). Among EN patients, NLR was also elevated in patients with secondary EN. In multivariate logistic regression model NLR (> 2.11), RDW-CV (> 13.65), and CRP (> 5.5) were identified as risk factors for secondary EN (relative risks were 17.16, 2.69, and 2, respectively). Conclusion: Elevated NLR (> 2.11) may be used as a parameter to discriminate secondary EN from idiopathic EN.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Eritema Nodoso/diagnóstico , Índices de Eritrócitos/fisiologia , Neoplasias/complicações , Neutrófilos/metabolismo , Adulto , Biomarcadores/metabolismo , Diagnóstico Diferencial , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Eritema Nodoso/etiologia , Eritema Nodoso/metabolismo , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neoplasias/metabolismo , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
9.
Rev. habanera cienc. méd ; 18(2): 254-269, mar.-abr. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1014167

RESUMO

RESUMEN • Introducción: Con el envejecimiento creciente de la población, la práctica estomatológica exige la utilización del conocimiento para identificar y tratar pacientes con enfermedades sistémicas cada vez más frecuentes, lo cual puede requerir el uso de medicamentos capaces de interactuar con el tratamiento farmacológico de su enfermedad de base. La literatura refleja esta relación de manera fragmentada y carente de un enfoque sistémico. Objetivo: Identificar en la literatura el uso de medicamentos en pacientes con riesgo quirúrgico y describir su repercusión durante el tratamiento estomatológico. Material y Métodos: Se realizó una revisión bibliográfica y se consultaron artículos científicos, tesis de titulación de especialistas, maestrías y doctorales entre otras referencias principalmente de los últimos 5 años mediante Google. Desarrollo: Se abordan las generalidades, manejo estomatológico y las interacciones medicamentosas de cada una de las enfermedades a estudiar (Diabetes Mellitus, hipertensión arterial y cardiopatía), así como las situaciones que requieren profilaxis antibiótica. Conclusiones: Los pacientes con riesgo quirúrgico utilizan medicamentos que producen interacciones importantes con fármacos como AINES, anestésicos locales y glucocorticoides que habitualmente se emplean en los tratamientos estomatológicos; existen además enfermedades sistémicas en las cuales hay que tener en cuenta la profilaxis antibiótica antes de realizar determinados procederes estomatológicos.


ABSTRACT • Introduction: With the growing of population aging, the dental practice requires the adequate knowledge to identify and treat patients with increasingly frequent systemic diseases, which may require the use of drugs capable of interacting with the pharmacological treatment of their underlying diseases. The literature reflects this relationship in a fragmented manner and lacking a systemic approach. Objective: To identify the drugs used in risk patients undergoing surgery and describe their repercussion during dental treatment. Material and Method: A bibliographic review was carried out. Scientific articles, specialists´ theses, Master´s and PhD degrees among other references were consulted, mainly the ones obtained from the search carried out in Google during the last 5 years. Results: The generalities, dental management and drug interactions between the diseases studied (diabetes mellitus, arterial hypertension and heart disease) were addressed, as well as the situations that require antibiotic prophylaxis. Conclusions: The surgical risk patients studied use drugs that produce important interactions with drugs such as NSAIDs, local anesthetics and glucocorticoids that are usually used in dental treatments. There are also systemic diseases in which antibiotic prophylaxis must be taken into account before performing certain dental procedures.


Assuntos
Humanos , Masculino , Feminino , Salas Cirúrgicas/métodos , Interações Medicamentosas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Doenças da Boca/cirurgia , Doenças da Boca/tratamento farmacológico , Odontólogos , Programas Nacionais de Saúde
11.
Nurs Womens Health ; 23(2): 172-176, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30836070

RESUMO

The U.S. Food and Drug Administration approved a new combination hormonal contraceptive in August 2018. Sold under the brand name Annovera, it is a combination of segesterone acetate and ethinyl estradiol, and it is the first multiuse vaginal contraceptive system that prevents ovulation for up to 13 menstrual cycles in a year. Although there are several combination hormonal contraceptives on the market, this is the first single system that can be repeatedly used for an entire year and does not require placement by a health care provider. This innovation gives women control over when to stop using the contraceptive, should they so desire. Annovera is stored at room temperature when not in use, allowing women living in uncontrolled-temperature climates to use one contraceptive method for an entire year.


Assuntos
Anticoncepção/instrumentação , Dispositivos Anticoncepcionais Femininos/normas , Anticoncepção/efeitos adversos , Anticoncepção/métodos , Dispositivos Anticoncepcionais Femininos/efeitos adversos , Dispositivos Anticoncepcionais Femininos/tendências , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Etinilestradiol/administração & dosagem , Etinilestradiol/efeitos adversos , Etinilestradiol/uso terapêutico , Humanos
12.
J Clin Psychiatry ; 80(1)2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865788

RESUMO

Despite the availability of effective treatments for MDD, many individuals have difficulty achieving remission. Residual symptoms can be difficult to differentiate from treatment side effects. Through 2 comic-based case presentations, this CME activity depicts common clinical scenarios and provides evidence-based strategies for effectively identifying and managing residual symptoms of MDD.


Assuntos
Antidepressivos/efeitos adversos , Distúrbios Induzidos Quimicamente/diagnóstico , Transtorno Depressivo Maior , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Adulto , Antidepressivos/uso terapêutico , Distúrbios Induzidos Quimicamente/etiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Humanos , Masculino
13.
J Investig Allergol Clin Immunol ; 29(2): 112-117, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29956666

RESUMO

BACKGROUND AND OBJECTIVE: Many patients with chronic spontaneous urticaria (CSU) report various drugs as triggers of their symptoms and often avoid medication unnecessarily. Objective: To estimate the clinical impact of the drugs patients most frequently suspect of inducing CSU exacerbations. METHODS: The prevalence of self-reported drug reactions was evaluated by questioning patients about their clinical history of urticaria and drug reactions and performing challenge tests with the suspect drugs. A group of healthy persons were included as controls to evaluate the prevalence of self-reported drug reactions. RESULTS: The study population comprised 245 patients with CSU and 127 healthy individuals. At least 1 adverse drug reaction was reported by 92 (37.5%) patients and 30 (23.6%) controls. Nonsteroidal anti-inflammatory drugs (NSAIDs) (27.7%) and ß-lactams (9.4%) were the most commonly reported drugs in the CSU group and the control group, respectively. Positive results in the challenge tests were less common than self-reports in the CSU group (13%) and the control group (0.7%). CONCLUSIONS: Self-reporting is generally not sufficient to confirm a drug reaction. Drug reactions to NSAIDs and ß-lactams are more frequent among patients who experience CSU than in those who do not. Drug challenge tests should be offered early during medical evaluation to avoid unnecessary restrictions.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Urticária/epidemiologia , Urticária/etiologia , Estudos de Casos e Controles , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Estudos Prospectivos , Autorrelato , Urticária/diagnóstico
14.
Medicine (Baltimore) ; 97(50): e13284, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30557974

RESUMO

RATIONALE: Dipeptidyl peptidase-4 inhibitors are commonly used drugs for the treatment of type 2 diabetes mellitus. While acute pancreatitis cases induced by saxagliptin, sitagliptin, and vildagliptin (all of which are members of the dipeptidyl peptidase-4 group) have been reported, there is no clear evidence suggesting that linagliptin may cause pancreatitis, and information in this regard is limited to a few studies. Moreover, no pancreatitis cases have been reported that were directly associated with linagliptin. PATIENT CONCERNS: We present a case of linagliptin-related pancreatitis in a 79-year-old male diabetic patient with biliary calculi. The patient, who was diagnosed with acute pancreatitis 4 months after initiating linagliptin 5 mg/d treatment, was admitted to our hospital. DIAGNOSES: The patient's pancreatic enzymes were high. Ultrasonography showed multiple biliary calculi, and abdominal computed tomography showed edematous pancreatitis. INTERVENTIONS: Linagliptin was discontinued and clinical improvement was achieved with standard acute pancreatitis treatment. OUTCOMES: This is the 1st case report suggesting that linagliptin might be associated with the risk of pancreatitis and could be an etiologic cause of pancreatitis, similar to the other members of its group. LESSONS: While the results of previous studies stated that there was no data to prove a causal relationship between dipeptidyl peptidase-4 inhibitors and pancreatitis, concerns regarding this subject have continued to arise. Therefore, new and comprehensive studies are needed to determine the long-term effects of dipeptidyl peptidase-4 inhibitors on type 2 diabetes mellitus patients and to shed light on the side effects of these medications.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Pancreatite/etiologia , Idoso , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Humanos , Linagliptina/efeitos adversos , Linagliptina/uso terapêutico , Masculino , Pancreatite/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos
15.
Medicine (Baltimore) ; 97(50): e13609, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30558037

RESUMO

RATIONALE: Heparin-induced thrombocytopenia (HIT) is a common antibody-mediated adverse reaction that occurs after heparin exposure. However, few case reports exist regarding nonantibody-mediated HIT. PATIENT CONCERNS AND DIAGNOSES: An 81-year-old female diagnosed with rapidly progressive glomerulonephritis (RPGN) presented with atypical presentation of non antibody-meditated HIT after using heparin during hemodialysis. INTERVENTIONS AND OUTCOMES: Patient was initiated on hemodialysis and presented with thrombocytopenia following administration of heparin during dialysis. After ruling out all other causes of thrombocytopenia, HIT was suspected to be the cause. Patient's 4Ts score was 6 points, and Naranjo adverse drug reaction probability scale was a score of 10. However, enzyme-linked immunoassay for platelet factor 4 (PF4)/heparin antibodies was negative, indicating non-antibody mediated HIT. Patient eventually continued hemodialysis without heparin. LESSONS: This patient case presented a rare presentation of HIT type I reaction due to heparin and demonstrated the importance of timely recognition of thrombocytopenia, appropriate diagnosis and management, and possible existence of a new atypical or subtype of HIT reaction.


Assuntos
Doenças Genéticas Ligadas ao Cromossomo X/etiologia , Glomerulonefrite/complicações , Heparina/efeitos adversos , Trombocitopenia/etiologia , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Glomerulonefrite/terapia , Heparina/uso terapêutico , Humanos , Diálise Renal/métodos , Trombocitopenia/diagnóstico
16.
J Natl Compr Canc Netw ; 16(12): 1481-1488, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30545995

RESUMO

Background: Current toxicity evaluation is primarily focused on high-grade adverse events (AEs) reported by clinicians. However, the cumulative effect of multiple lower-grade AEs may also impact patients' quality of life (QoL). Further, patient-reported toxicity may be more representative of patients' treatment experiences. This study aimed to determine whether cumulative toxicity comprising all-grade AEs is more associated with QoL than cumulative toxicity comprising high-grade AEs only, and whether patient-reported cumulative toxicity is more associated with QoL than clinician-reported cumulative toxicity. Methods: Patients with metastatic castration-naïve prostate cancer participating in the phase III GETUG-AFU 15 trial completed questionnaires on AEs (at 3 and 6 months) and QoL (at baseline and 3 and 6 months). Clinicians reported AEs during clinical visits. Cumulative toxicity scores were calculated for clinicians and patients in 3 ways: total number of high-grade AEs, total number of all-grade AEs, and total number of all AEs multiplied by their grade (severity score). Relationships between cumulative toxicity scores and QoL were studied using longitudinal regression analyses; unstandardized (B) and standardized regression coefficients (ß) are reported. Results: Of 385 patients, 184 with complete QoL and toxicity data were included. Clinician-reported all-grade AEs (B, -2.2; 95% CI, -3.3 to -1.1; P<.01) and severity score (B, -1.4; 95% CI, -2.2 to -0.7; P<.01) were associated with deteriorated physical QoL, whereas the total number of high-grade AEs was not. All patient-reported scores were significantly (P<.01 for all) associated with deteriorated physical and global QoL. Standardized regression coefficients indicated that patient-reported toxicity scores were more associated with QoL outcomes than clinician-reported scores, with the strongest association found for the all-grade AEs and severity cumulative toxicity scores. Conclusions: Patient- and clinician-based cumulative toxicity scores comprising all-grade AEs better reflect impact on patient QoL than toxicity scores comprising high-grade AEs only. To assess the effect of toxicity on QoL, patient-reported cumulative toxicity scores are preferred.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Medidas de Resultados Relatados pelo Paciente , Neoplasias da Próstata/tratamento farmacológico , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Antagonistas de Androgênios/efeitos adversos , Antineoplásicos Hormonais/efeitos adversos , Docetaxel/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Gosserrelina/efeitos adversos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Estudos Prospectivos , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Índice de Gravidade de Doença , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo
17.
BMC Neurol ; 18(1): 192, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30453901

RESUMO

BACKGROUND: There is limited data on the effects of medication-related adverse events occurring during inpatient stays for stroke. The objectives of our study were to characterize reasons for acute readmission after acute ischemic stroke (AIS) and determine if medication-related adverse events occuring during AIS hospitalization were associated with 30-day readmission. Secondary objectives examined whether demographic, clinical, and hospital characterisitcs were associated with post-AIS readmission. METHODS: We used the Nationwide Readmission Database to identify index AIS hospitalizations in the United States between January and November 2014. Inpatient records were screened for diagnostic and external causes of injury codes indicative of medication-related adverse events, including adverse effects of prescribed drugs, unintentional overdosing, and medication errors. Nationally representative estimates of AIS hospitalizations, medication-related adverse events, and acute non-elective readmissions were computed using survey weighting methods. Adjusted odds of readmission for medication-related adverse events and select characteristics were estimated using unconditional logistic regression. RESULTS: We identified 439,682 individuals who were hospitalized with AIS, 4.7% of whom experienced a medication-related adverse event. Overall, 10.7% of hospitalized individuals with AIS were readmitted within 30 days of discharge. Reasons for readmission were consistent with those observed among older adults. Inpatients who experienced medication-related adverse events had significantly greater odds of being readmitted within 30 days (adjusted odds ratio (AOR): 1.22; 95% CI: 1.14-1.30). Medication-related adverse events were associated with readmission for non-AIS conditions (AOR, 1.26; 95% CI: 1.17-1.35), but not with readmission for AIS (AOR, 0.91; 95% CI: 0.75-1.10). Several factors, including but not limited to being younger than 40 years (AOR, 1.12; 95% CI: 1.00-1.26), Medicare insurance coverage (AOR, 1.33; 95% CI: 1.26-1.40), length of stay greater than 1 week (AOR, 1.38; 95% CI: 1.33-1.42), having 7 or more comorbidites (AOR, 2.20; 95% CI: 2.08-2.34), and receiving care at a for-profit hospital (AOR, 1.20; 95% CI: 1.12-1.29), were identified as being associated with all-cause 30-day readmission. CONCLUSIONS: In this nationally representative sample of AIS hospitalizations, medication-related adverse events were positively associated with 30-day readmission for non-AIS causes. Future studies are necessary to determine whether medication-related adverse events and readmissions in AIS are avoidable.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Readmissão do Paciente/estatística & dados numéricos , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Bases de Dados Factuais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Acidente Vascular Cerebral/complicações , Estados Unidos
19.
Ugeskr Laeger ; 180(41)2018 Oct 08.
Artigo em Dinamarquês | MEDLINE | ID: mdl-30327081

RESUMO

Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is defined as an adverse reaction to continuous use of a culprit drug. The reaction resolves upon drug withdrawal. More than 50 drugs have been linked to DI-SCLE, and it is estimated, that around 20% of the SCLE cases are drug-induced. There are no diagnostic criteria, yet detection of anti-Ro/SSA antibodies combined with erosive/bullous or erythema multiforme/toxic epidermal necrolysis-like lesions, and widespread skin rash seem to be indicative of DI-SCLE. The most common drugs involved are proton pump inhibitors, terbinafine, thiazides and chemotherapeutics.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Lúpus Eritematoso Cutâneo/induzido quimicamente , Humanos , Lúpus Eritematoso Cutâneo/epidemiologia , Lúpus Eritematoso Cutâneo/patologia , Lúpus Eritematoso Cutâneo/terapia
20.
F1000Res ; 7: 677, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30271581

RESUMO

Background: Adverse drug reactions (ADRs) are a major cause of hospital admissions, prolonged hospital stays, morbidity, and drug-related mortality. In this study, we sought to identify the most frequently reported medications and associated side effects in adolescent-aged patients in an effort to prioritize clinical pharmacology consultation efforts for hospitals seeking to improve patient safety.   Methods: Quarterly reported data were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) from the third quarter of 2014 and ending in the third quarter of 2017. We then used the GeneCards database to map the pharmacogenomic biomarkers associated with the most reported FAERS drugs. Data homogenization and statistics analysis were all conducted in R for statistical programming. Results: We identified risperidone (10.64%) as the compound with the most reported ADRs from all reported cases. Males represented 90.1% of reported risperidone cases with gynecomastia being the most reported ADR. Ibuprofen OR=188 (95% CI, 105.0000 - 335.000) and quetiapine fumarate OR=116 (95% CI, 48.4000 - 278.000) were associated with the highest odds of completed suicide in teenagers. Ondansetron hydrochloride OR=7.12 (95% CI, 1.59 - 31.9) resulted in the highest odds of pneumothorax. Lastly, olanzapine (8.96%) represented the compound with the most reported drug-drug interactions cases, while valproic acid OR=221 (95% CI, 93.9000 - 522.000) was associated with the highest odds of drug-drug interactions. Conclusion: Despite any data limitations, physicians prescribing risperidone in males should be aware of the high rates of adverse drug events and an alternative psychotropic should be considered in male patients. Further, patients with a history of pneumothorax or genetically predisposed to pneumothorax should be considered for an alternative antiemetic to ondansetron hydrochloride, due to increased odds associated with the drug and adverse event.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Farmacologia Clínica/métodos , Adolescente , Biomarcadores , Pré-Escolar , Bases de Dados Factuais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Feminino , Ginecomastia/etiologia , Humanos , Masculino , Pneumotórax/etiologia , Estudos Retrospectivos , Risperidona/efeitos adversos , Resultado do Tratamento , Estados Unidos , United States Food and Drug Administration
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