Drug-induced Adverse Events

RTS,S/AS01<sub>E</sub> vaccine defaults in Ghana: a qualitative exploration of the perspectives of defaulters and frontline health service providers

Wed, 2023-09-06 06:00

Malar J. 2023 Sep 6;22(1):260. doi: 10.1186/s12936-023-04690-4.

ABSTRACT

BACKGROUND: While Ghana has a good track record in the Expanded Programme on Immunization, there are substantial challenges with regards to subsequent vaccinations, particularly after the first year of life of the child. Given that the last dose of the RTS, S/AS01E vaccine against malaria is administered at 24 months, there is a high likelihood of default. Hence, it is imperative to understand the dynamics and reasons for the defaults to enable the development of effective implementation strategies. This study explored why caregivers default on the RTS, S/AS01E vaccine from the perspective of health service providers and caregivers.

METHODS: This study employed an exploratory, descriptive approach. Using a purposive sampling technique, caregivers who defaulted and health service providers directly involved in the planning and delivery of the RTS, S/AS01E vaccine at the district level were recruited. A total of five health service providers and 30 mothers (six per FGD) participated in this study. Data analysis was done using NVivo-12 following Collaizi's thematic framework for qualitative analysis. The study relies on the Standards for Reporting Qualitative Research.

RESULTS: Reasons for defaulting included the overlap of timing of the last dose and the child starting school, disrespectful attitudes of some health service providers, concerns about adverse side effects and discomforts, travel out of the implementing district, the perception that the vaccines are too many, and lack of support from partners.

CONCLUSION: To reduce the occurrence of defaulting on the RTS, S/AS01E vaccine programme, stakeholders must reconsider the timing of the last dose of the vaccine. The schedule of the RTS, S/AS01E vaccine should be aligned with the established EPI schedule of Ghana. This will significantly limit the potential of defaults, particularly for the last dose. Also, the findings from this study underscore a need to encourage male partner involvement in the RTS, S/AS01E vaccine programme. Health promotion programmes could be implemented to raise caregivers' awareness of potential adverse reactions and discomforts-this is necessary to prepare the caregiver for the vaccine process psychologically.

PMID:37674197 | PMC:PMC10483715 | DOI:10.1186/s12936-023-04690-4

Categories: Literature Watch

Re-examination of therapeutic management of muscular dystrophies using a vascular smooth muscle-centered approach

Wed, 2023-09-06 06:00

J Smooth Muscle Res. 2023;59:67-80. doi: 10.1540/jsmr.59.67.

ABSTRACT

In contrast to the long-standing focus on the pathophysiology of skeletal muscles in the hunt for a cure for Duchenne muscular dystrophy (DMD), we opine that the malfunctioning of dystrophin produced by vascular smooth muscle is a major contributor to the pathology of the illness. We believe that a biological response modifier glucan (BRMG), which has been shown in clinical studies of DMD to boost the expression of vascular smooth muscle dystrophin and provide anti-fibrotic and anti-inflammatory effects, may play a key role in reducing the pathogenesis of DMD. According to the evaluation of biomarkers, this BRMG, which is safe and side-effect-free, reduces the pathogenesis of DMD. We describe the possible mechanisms of action by which this BRMG helps in alleviating the symptoms of DMD by targeting smooth muscle dystrophin, in addition to its advantages over other therapeutic modalities, as well as how it can serve as a valuable adjunct to existing therapies. We suggest that using BRMG adjuncts that target smooth muscle dystrophin would be a potential therapeutic approach that prolongs the lifespan and extends the duration of ambulation from the onset of DMD. Further studies are needed to validate this hypothesis.

PMID:37673649 | DOI:10.1540/jsmr.59.67

Categories: Literature Watch

Protecting the heart

Wed, 2023-09-06 06:00

Elife. 2023 Sep 6;12:e91831. doi: 10.7554/eLife.91831.

ABSTRACT

Blocking a protein known as EPAC1 may prevent the development of heart-related side effects caused by a chemotherapy drug.

PMID:37672034 | PMC:PMC10482425 | DOI:10.7554/eLife.91831

Categories: Literature Watch

Antibody-drug conjugates: the paradigm shifts in the targeted cancer therapy

Wed, 2023-09-06 06:00

Front Immunol. 2023 Aug 21;14:1203073. doi: 10.3389/fimmu.2023.1203073. eCollection 2023.

ABSTRACT

Cancer is one of the deadliest diseases, causing million of deaths each year globally. Conventional anti-cancer therapies are non-targeted and have systemic toxicities limiting their versatile applications in many cancers. So, there is an unmet need for more specific therapeutic options that will be effective as well as free from toxicities. Antibody-drug conjugates (ADCs) are suitable alternatives with the right potential and improved therapeutic index for cancer therapy. The ADCs are highly precise new class of biopharmaceutical products that covalently linked a monoclonal antibody (mAb) (binds explicitly to a tumor-associated surface antigen) with a customized cytotoxic drug (kills cancer cells) and tied via a chemical linker (releases the drug). Due to its precise design, it brings about the target cell killing sparing the normal counterpart and free from the toxicities of conventional chemotherapy. It has never been so easy to develop potential ADCs for successful therapeutic usage. With relentless efforts, it took almost a century for scientists to advance the formula and design ADCs for its current clinical applications. Until now, several ADCs have passed successfully through preclinical and clinical trials and because of proven efficacy, a few are approved by the FDA to treat various cancer types. Even though ADCs posed some shortcomings like adverse effects and resistance at various stages of development, with continuous efforts most of these limitations are addressed and overcome to improve their efficacy. In this review, the basics of ADCs, physical and chemical properties, the evolution of design, limitations, and future potentials are discussed.

PMID:37671162 | PMC:PMC10475555 | DOI:10.3389/fimmu.2023.1203073

Categories: Literature Watch

Pharmacological profile and clinical study results of darinaparsin (DARVIAS<sup>®</sup> injection 135 ‍mg), an organic arsenic product, for relapsed or refractory peripheral t-cell lymphoma

Wed, 2023-09-06 06:00

Nihon Yakurigaku Zasshi. 2023;158(5):408-418. doi: 10.1254/fpj.23047.

ABSTRACT

Darinaparsin, an active ingredient of DARVIAS® Injection 135 ‍mg, is a novel organic arsenical compound of dimethylated arsenic conjugated to glutathione. Darinaparsin is thought to induce apoptosis and cell-cycle arrest and suppress tumor growth by disrupting mitochondrial functions and increasing production of intracellular reactive oxygen species. Darinaparsin is processed at the cell surface by γ-glutamyltranspeptidase (γ-GT), leading to formation of dimethylarsino-cysteine, which is imported via a cystine transporter expressed on cell surface membranes. Numerous tumor cells express high levels of γ-GT and cystine transporter, to maintain high levels of glutathione as an intracellular antioxidant. Darinaparsin is a novel antineoplastic agent designed to exploit the characteristics of tumor cells and to be efficiently taken up by tumor cells to inhibit their growth. In a global phase 2 pivotal study of darinaparsin in Asian patients with relapsed or refractory peripheral T-cell lymphoma (r/r PTCL), the overall response rate was 19.3% (90% confidence interval: 11.2-29.9%) and grade ≥3 drug-related adverse events with an incidence rate ≥5% included neutropenia (9.2%, n = 6), anemia (6.2%, n = 4) and thrombocytopenia (6.2%, n = 4) in 65 patients receiving darinaparsin. Based on the results of this phase 2 trial, which demonstrated the anti-tumor activity and acceptable safety profile of darinaparsin in patients with r/r PTCL, Solasia pharma K.K. received approval for darinaparsin for the treatment of r/r PTCL in June 2022, and Nippon Kayaku Co., Ltd. launched this drug in August 2022. Darinaparsin is expected to contribute to the clinical practice of PTCL as a new treatment option for this disease.

PMID:37673618 | DOI:10.1254/fpj.23047

Categories: Literature Watch

Phase 1 Dose Escalation and Expansion Study of Golidocitinib, a Highly Selective JAK1 Inhibitor, in Relapsed or Refractory Peripheral T Cell Lymphomas

Wed, 2023-09-06 06:00

Ann Oncol. 2023 Sep 4:S0923-7534(23)00828-1. doi: 10.1016/j.annonc.2023.08.013. Online ahead of print.

ABSTRACT

BACKGROUND: Relapsed or refractory peripheral T cell lymphomas (r/r PTCLs) are a group of rare and aggressive diseases, which lack effective therapies. Constitutive activation of Janus kinase (JAK)/signal transducer and activation of transcription (STAT) pathway are reported to be associated with PTCLs. Golidocitinib is an oral, potent JAK1 selective inhibitor evaluated in a phase 1/2 multinational study in r/r PTCLs.

PATIENTS AND METHODS: Patients with r/r PTCLs were eligible. The primary objectives were to assess safety and tolerability of golidocitinib and to define its recommended phase 2 dose (RP2D). The secondary objectives were to evaluate its antitumor activity and pharmacokinetics (PK).

RESULTS: A total of 51 patients were enrolled and received golidocitinib treatment at 150 mg or 250 mg once daily (QD). The median prior lines of therapies were 2 (range: 1 - 8). Golidocitinib was tolerated at both doses tested while a higher incidence of serious adverse events (SAEs) and dose modifications at 250 mg were observed. The most common ≥ grade 3 drug-related treatment-emergent adverse events (TEAEs) included neutropenia (27.5%) and thrombocytopenia (11.8%). An objective response rate of 39.2% and a complete response rate of 21.6%were observed. With median follow-up time of 14.7 months and 15.9 months, respectively. The median duration of response (DoR) and progression-free survival (PFS) were 8.0 and 3.3 months, respectively. Based on the above data, 150 mg QD was defined as the RP2D. Golidocitinib demonstrated a favorite PK profile as an oral agent. Biomarker analysis suggested a potential correlation between JAK/STAT pathway aberrations and clinical activity of golidocitinib.

CONCLUSIONS: In this phase 1 study, golidocitinib demonstrated an acceptable safety profile and encouraging antitumor efficacy in heavily pre-treated patients with r/r PTCLs. These results support the initiation of the multinational pivotal study in patients with r/r PTCLs.

PMID:37673210 | DOI:10.1016/j.annonc.2023.08.013

Categories: Literature Watch

Interaction between drinking and dietary inflammatory index affects prostate specific antigen: a cross-sectional study

Tue, 2023-09-05 06:00

BMC Geriatr. 2023 Sep 5;23(1):537. doi: 10.1186/s12877-023-04151-2.

ABSTRACT

BACKGROUND: Numerous studies have shown that the dietary inflammatory index (DII) is associated with adverse health effects. However, the relationship between DII and prostate cancer (PCa) remains controversial. Although alcohol is included in DII as a dietary factor, the various adverse health effects of alcohol consumption are not only related to inflammation. On the other hand, it has been a long-standing debate whether alcohol consumption is linked to the risk of PCa. Therefore, to clarify whether drinking affects the relationship between DII and PCa, we evaluated the correlation between DII and prostate-specific antigen (PSA) based on the National Health and Nutrition Examination Survey (NHANES) database.

METHODS: We used data from the NHANES spanning from 2005 to 2010 to analyze the relationship between PCa and DII. Out of the 31,034 NHANES participants, we enrolled 4,120 individuals in our study, utilizing dietary intake data from a twenty-four-hour period to determine DII scores. Demographic data, physical and laboratory test results were collected to compare between low PSA and high PSA groups, and to calculate the odds ratio between both groups, we employed a logistic regression analysis.

RESULTS: In this cross-sectional investigation of PCa, drinkers and non-drinkers had different relationships between DII and PSA levels (OR: 1.2, 95% Cl: 1-1.44 vs. OR: 0.98, 95% Cl: 0.9-1.07), and DII and abstaining from alcohol were effective in reducing the incidence of PSA (p-value for significant interaction = 0.037).

CONCLUSION: The results of our study suggest that drinking may influence the relationship between DII and PSA levels. DII is likely to be a reliable indicator for estimating PSA levels among non-drinkers, who may limit their intake of pro-inflammatory ingredients to lower the incidence and death of PCa.

PMID:37670257 | PMC:PMC10478225 | DOI:10.1186/s12877-023-04151-2

Categories: Literature Watch

Performance of solar roof top panels with disparate particulate accumulation: Exergy analysis on an indoor lab study

Tue, 2023-09-05 06:00

PLoS One. 2023 Sep 5;18(9):e0291018. doi: 10.1371/journal.pone.0291018. eCollection 2023.

ABSTRACT

Deployment of solar photovoltaic panels are significantly rising to tackle adverse effects of climate change however, factors affecting output need to be categorized in addition to latitude angle and space. It is important to consider the atmospheric impact which can drastically change output power of solar panels. This study covers dust accumulation of soil, sand and ash at variable weights to foresee its effects on panel power output. Mixtures of these particles at multiple constituents were also analyzed. Experimental results indicated that clean panel gives maximum power output of 21.37W and exergy efficiency of 7.96% whereas ash accumulation showed worst results of 2.88W power output and 1.07% exergy efficiency at 700W/m2 and 50g dust accumulation. Other parameters like energy destruction, exergy losses and sustainability index were also analyzed. Trends have been illustrated in graphs along with the change in solar intensity and dust accumulations.

PMID:37669283 | PMC:PMC10479914 | DOI:10.1371/journal.pone.0291018

Categories: Literature Watch

A prospective, multicenter study on the clinical effectiveness of abiraterone in metastatic castration-resistant prostate cancer in Korea: Pre- vs. post-chemotherapy

Tue, 2023-09-05 06:00

Investig Clin Urol. 2023 Sep;64(5):466-473. doi: 10.4111/icu.20230128.

ABSTRACT

PURPOSE: The proper treatment sequence for administering abiraterone acetate plus prednisolone (AAP) and chemotherapeutic agents has not yet been elucidated for metastatic castration-resistant prostate cancer (mCRPC). Hence, this study evaluated the effectiveness and safety of AAP in pre- and post-chemotherapy settings using real-world data.

MATERIALS AND METHODS: This prospective, multicenter, open-label, observational study included 506 patients with mCRPC. Patients were classified according to the timing of chemotherapy into pre- and post-chemotherapy groups. The effectiveness and safety of AAP were compared between the groups; the prostate-specific antigen (PSA) response, PSA progression-free survival, and radiologic progression-free survival were assessed; and adverse drug reactions were recorded.

RESULTS: Among the included patients, 319 and 187 belonged to the pre- and post-chemotherapy groups, respectively. Risk classification was similar between the two groups. The PSA response was 61.8% in the pre-chemotherapy group and 39.0% in the post-chemotherapy group (p<0.001). The median time to PSA progression (5.00 vs. 2.93 mo, p=0.001) and radiologic progression-free survival (11.84 vs. 9.17 mo, p=0.002) were significantly longer in the pre-chemotherapy group. Chemotherapy status was associated with PSA (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.09-1.77) and radiologic progression (HR 1.66, 95% CI 1.18-2.33) during AAP treatment. Adverse drug reactions were reported at similar frequencies in both groups.

CONCLUSIONS: In this postmarketing surveillance, AAP benefited patients with mCRPC, especially in settings before chemotherapy was administered, resulting in a high PSA response and longer PSA and radiologic progression-free survival with tolerable adverse drug reactions.

PMID:37668202 | DOI:10.4111/icu.20230128

Categories: Literature Watch

Escitalopram-associated rhabdomyolysis

Tue, 2023-09-05 06:00

Tidsskr Nor Laegeforen. 2023 Aug 24;143(12). doi: 10.4045/tidsskr.23.0093. Print 2023 Sep 5.

ABSTRACT

This case history describes a case of rhabdomyolysis resulting from treatment with escitalopram as monotherapy at the recommended dose. This is a rare and little-known side effect of selective serotonin reuptake inhibitors.

PMID:37668131 | DOI:10.4045/tidsskr.23.0093

Categories: Literature Watch

Effects of different targeted therapies associated with adjuvant chemotherapy on clinical remission, survival and safety in patients with triple-negative breast cancer: a systematic review and meta-analysis

Tue, 2023-09-05 06:00

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7768-7780. doi: 10.26355/eurrev_202308_33431.

ABSTRACT

OBJECTIVE: The aim of this study was to systematically assess the effects of different targeted therapies associated with adjuvant chemotherapy on clinical remission, survival and safety of patients with triple-negative breast cancer (TNBC).

MATERIALS AND METHODS: This study searched for case-control trials of TNBC patients from January 2010 to May 2022. Two researchers independently extracted data. RevMan 5.3 statistical software was used for analysis.

RESULTS: This study included a total of 7 clinical controlled studies, containing 620 samples. The results showed that compared with the control group, the study group showed significant differences in objective response rate [OR = 2.44, 95% CI (1.69, 3.5), p < 0.00001], 1-year survival rate [OR = 3.59, 95% CI (2.01, 6.39), p < 0.0001], progression-free survival (PFS) [MD = 2.04, 95% CI (1.68, 2.41), p < 0.00001], with statistical significance (p < 0.05), while there are no significant differences in overall survival [MD = 6.33, 95% CI (-1.65, 14.30), p = 0.12] and incidence of adverse events [OR = 0.73, 95% CI (0.52, 1.02), p = 0.006] (p > 0.05).

CONCLUSIONS: Targeted therapy associated with adjuvant chemotherapy can remarkably enhance the outcome of patients with advanced TNBC, prolonging their progression-free survival (PFS) and overall survival (OS) without increasing adverse effects. The validity of this research, however, will require higher quality studies and longer follow-ups.

PMID:37667955 | DOI:10.26355/eurrev_202308_33431

Categories: Literature Watch

A PhD completed. General conclusions of doctoral research into regional mouth dryness

Tue, 2023-09-05 06:00

Ned Tijdschr Tandheelkd. 2023 Sep;130(9):373-375. doi: 10.5177/ntvt.2023.09.23034.

ABSTRACT

Dry mouth has a complex aetiology which makes proper diagnosis complicated. Until now, dry mouth diagnosis has mainly focused on the overall oral dryness, without taking into account regional differences within the mouth. This research showed, among other things, that there are unique patterns of oral dryness, each with its own cause. For example, patients suffering from Sjogren's syndrome mainly experienced dryness of the posterior of the palate. Patients with dry mouth due to the side effects of medication, in contrast, experienced the front part of the tongue as the driest. These findings suggest that mapping of intraoral dryness may be a useful diagnostic tool to differentiate between possible causes of dry mouth.

PMID:37667634 | DOI:10.5177/ntvt.2023.09.23034

Categories: Literature Watch

Emerging oral drug options for ulcerative colitis

Tue, 2023-09-05 06:00

Expert Opin Emerg Drugs. 2023 Sep 5. doi: 10.1080/14728214.2023.2254686. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the availability of a variety of therapeutic compounds and improved management strategies, one-third of UC patients with moderate-to-severe disease do not benefit from the existing treatments or experience drug-related side effects. This has boosted intensive research focusing on the development of new drugs for UC therapy. This article aims to summarize the available evidence on oral drugs, which are now being explored in clinical trials or are ready to enter the clinics.

AREAS COVERED: From 15 May to 11 June, we searched on PubMed using the keywords 'oral drugs ulcerative colitis,' 'ulcerative colitis clinical trials,' 'UC phase 2 and 3 trials' excluding case reports, case series, phase 1 and 4 studies, and studies about approved therapies.

EXPERT OPINION: The findings discussed in this article suggest that the future treatment of UC patients will be probably characterized by the possibility of using various small-molecule drugs. All these new compounds, even those belonging to the same class, differ in terms of efficacy and safety. Identification of predictors of response could help optimize the efficacy and safety of these treatments, thus improving resource allocation through a pre-treatment stratification of patients.

PMID:37668153 | DOI:10.1080/14728214.2023.2254686

Categories: Literature Watch

Efficacy and safety of olmesartan medoxomil-amlodipine besylate tablet in Chinese patients with essential hypertension: A prospective, single-arm, multi-center, real-world study

Tue, 2023-09-05 06:00

J Clin Hypertens (Greenwich). 2023 Sep 4. doi: 10.1111/jch.14700. Online ahead of print.

ABSTRACT

There lacks real-world study with a large sample size assessing olmesartan medoxomil-amlodipine besylate (OM-AML) tablet. Therefore, this study aimed to evaluate the efficacy and safety of OM-AML tablet in patients with essential hypertension. Totally, 1341 patients from 36 medical centers with essential hypertension who took OM-AML (20/5 mg) tablet were analyzed in the current prospective, single-arm, multi-center, real-world study (SVK study). Seated systolic blood pressure (SeSBP) and seated diastolic blood pressure (SeDBP) at baseline, week (W)4 and W8 were measured. The mean (±SE) change of SeSBP/SeDBP was -10.8 ± 0.4/-6.6 ± 0.3 mmHg at W4 and -12.7 ± 0.5/-7.6 ± 0.3 mmHg at W8, respectively. At W4, 78.8% and 29.0% patients achieved BP target by China and American Heart Association (AHA) criteria; at W8, 84.7% and 36.5% patients reached blood pressure (BP) target by China and AHA criteria, accordingly. Meanwhile, 80.2% and 86.4% patients achieved BP response at W4 and W8, respectively. Home-measured SeSBP and SeDBP decreased from W1 to W8 (both p < .001). Besides, patients' and physicians' satisfaction were elevated at W8 compared with W0 (both p < .001). The medication possession rate was 94.8% from baseline to W4 and 91.3% from baseline to W8. The most common drug-related adverse events were nervous system disorders (4.6%), vascular disorders (2.6%), and general disorders and administration site conditions (2.3%) by system organ class, which were generally mild and manageable. In conclusion, OM-AML tablet is one of the best antihypertensive agents in patients with essential hypertension.

PMID:37667532 | DOI:10.1111/jch.14700

Categories: Literature Watch

Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV

Mon, 2023-09-04 06:00

BMC Infect Dis. 2023 Sep 4;23(1):578. doi: 10.1186/s12879-023-08544-x.

ABSTRACT

HIV post- exposure prophylaxis (PEP) is a prevention tool for individuals with a recent potential exposure to HIV. Doravirine has been available since 2019 in combination with tenofovir disoproxil fumarate and lamivudine and has not been evaluated as a PEP. DOR/3TC/TDF is our department's most commonly prescribed PEP treatment since 2021. This study evaluates the completion rate of the DOR/3TC/TDF as compared to EVG/c/FTC/TAF for PEP, which was the regimen prescribed until 2020 in our hospital.This retrospective observational study was conducted between January 2020 and September 2021. The subjects included consecutively were adults who consulted for an HIV sexual exposure accident and for whom DOR/3TC/TDF in 2021 or EVG/c/FTC/TAF in 2020 was prescribed. The outcomes were the completion rate to the end of treatment (28 days), the seroconversion rate, and the description of side effects.During the study period, 311 people were included: 140 treated with DOR/3TC/TDF and 171 treated with EVGc/FTC/TAF. Considering subjects with a follow-up visit, the completion rate was 96.8% (90/93) in the DOR/3TC/TDF group, and 94.6% (123/130) in the EVG/c/FTC/TAF group (p-value: 0.53). The number of people lost to follow-up was nearly equivalent in both groups: 27.1% (38/140) in the DOR/3TC/TDF group and 23.4% (40/171) in the EVG/c/FTC/TAF group (p-value: 0.45). A side effect was described for 38% (36/94) in the DOR/3TC/TDF group, and 29.7% (38/128) in the EVG/c/FTC/TAF group. No cases of seroconversion were observed.DOR/3TC/TDF appears to have a similar safety profile to EVG/c/FTC/TAF. Due to its lower cost, it seems to be a treatment option for consideration in the context of HIV-exposure accidents.

PMID:37667182 | PMC:PMC10478445 | DOI:10.1186/s12879-023-08544-x

Categories: Literature Watch

Phrenic nerve block combined with stellate ganglion block for postoperative intractable hiccups: a case report

Mon, 2023-09-04 06:00

J Int Med Res. 2023 Aug;51(8):3000605231197069. doi: 10.1177/03000605231197069.

ABSTRACT

Postoperative intractable hiccups slow patient recovery and generate multiple adverse effects, highlighting the importance of investigating the pathogenesis and terminating the hiccups in a timely manner. At present, medical and physical therapies account for the main treatments. We encountered a case in which postoperative intractable hiccups after biliary T-tube drainage removal ceased with the application of an ultrasound-guided block of the unilateral phrenic nerve and stellate ganglion. No complications developed, and the therapeutic effect was remarkable. To our knowledge, this approach has not been reported to date. Simultaneously blocking the phrenic nerve and stellate ganglion may be a treatment option for intractable hiccups.

PMID:37666219 | PMC:PMC10478533 | DOI:10.1177/03000605231197069

Categories: Literature Watch

Dilemmas in rehabilitation and patient strategies in an intensive home intervention: a follow-up study

Mon, 2023-09-04 06:00

Int J Qual Stud Health Well-being. 2023 Dec;18(1):2253001. doi: 10.1080/17482631.2023.2253001.

ABSTRACT

BACKGROUND: The original project, where older persons received reablement performed by an interprofessional team showed success factors for IHR. However, since there is a lack of knowledge about why some persons do not recover despite receiving IHR, this study follows up patients' experiences of IHR.

AIM: To describe older persons' perceived dilemmas in the reablement process within the framework of IHR.

METHOD: 11 CIT interviews with participants who have previously received IHR, were analysed, interpreted and categorized according to CIT. The study was approved by the Swedish Ethical Review Authority.

RESULTS: The results showed disease-related dilemmas, fatigue or pain so that participants could not cope with the prescribed exercises. New diseases appeared, as well as medication side effects made exercising difficult, and painkillers became a prerequisite for coping with IHR. Low self-motivation and mistrust towards the staff emerged like lack of trust due to otherness such as sex, cultural background, or language also became critical.

CONCLUSIONS: Interventions that consider individual- and contextual dilemmas are very important. By recognizing critical situations, this study can work as a basis of evidence to further develop interventions for older people living in their own homes and to ensure them to stay there.

PMID:37665969 | PMC:PMC10478589 | DOI:10.1080/17482631.2023.2253001

Categories: Literature Watch

Extraordinary claims in the literature on high-intensity interval training (HIIT): III. Critical analysis of four foundational arguments from an interdisciplinary lens

Mon, 2023-09-04 06:00

Psychol Sport Exerc. 2023 May;66:102399. doi: 10.1016/j.psychsport.2023.102399. Epub 2023 Feb 1.

ABSTRACT

Kinesiology aspires to be an integrated, interdisciplinary field that studies human movement from multiple perspectives. However, the main societal deliverables of the field, namely exercise prescriptions and physical activity recommendations, still reflect fragmentation, placing more emphasis on physiological outcomes than on behavioral and other considerations. Recently, researchers have called for the introduction of High-Intensity Interval Training (HIIT) to the domain of public health, based on the argument that HIIT can maximize fitness and health benefits for a fraction of the time recommended by the prevailing model of physical activity in public-health guidelines. Here, we show that an unintended side-effect of arguments underpinning the implementation of HIIT in the domain of public health might have been the exacerbation of segmentation. To highlight the value of interdisciplinarity, four foundational claims in support of HIIT are critiqued by tapping into cognate literatures: (1) the primary reason people do not exercise is lack of time, (2) HIIT is relevant to public health, (3) HIIT is being proposed as merely another option, so there is no basis for controversy, and (4) HIIT is safe and well tolerated. These claims are contradicted by credible lines of evidence. To improve the accuracy and effectiveness of its public claims, kinesiology should remain committed to the ideals of integration and interdisciplinarity.

PMID:37665861 | DOI:10.1016/j.psychsport.2023.102399

Categories: Literature Watch

Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis

Mon, 2023-09-04 06:00

Pain Res Manag. 2023 Aug 23;2023:1523834. doi: 10.1155/2023/1523834. eCollection 2023.

ABSTRACT

The purpose of this systematic review and meta-analysis was to assess the short-, mid-, and long-term effectiveness of dry needling in improving pain and functional capacity of patients with chronic neck pain. Search strategy was performed on PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus biomedical databases. The risk of bias was assessed using the RoB2 tool. Randomised controlled clinical trials in which at least 1 of the groups received dry needling were included. 662 studies were found; 14 clinical trials were selected for qualitative analysis and 13 for quantitative analysis. The quality of most of the studies included was "high." All the studies reported improvements in cervical pain and/or disability, regardless of the protocol followed and the muscles targeted. No serious adverse effects were reported. Dry needling showed to be more effective when compared with other therapies in both women and men, without differences by sex. When the analysis was carried out by age, patients over 40 years old benefitted more than those below 40 years old. Our meta-analysis supports the use of dry needling to improve pain and functional capacity in patients with chronic neck pain at short- and mid-term intervals.

PMID:37664417 | PMC:PMC10469395 | DOI:10.1155/2023/1523834

Categories: Literature Watch

Analysis of Risk Factors for Infusion-Related Reactions Following Rituximab Administration in Patients with Desensitization before Renal Transplantation

Mon, 2023-09-04 06:00

Biol Pharm Bull. 2023;46(9):1332-1337. doi: 10.1248/bpb.b23-00157.

ABSTRACT

Infusion-related reactions (IRRs) are the major side effects of rituximab administration. Although several studies have reported predictive markers for IRRs in patients with malignancies, there are no such reports for patients without malignancies. Accordingly, we aimed to clarify the predictive markers for rituximab-induced IRRs in renal transplant recipients. This retrospective study included 116 inpatients aged ≥18 years who received an initial dose of 150 mg/m2 of rituximab for desensitization before renal transplantation with loxoprofen and diphenhydramine before rituximab infusion between June 2007 and February 2022. Overall, 45 patients were evaluated and 71 patients were excluded in this study. IRRs were observed in 12 (26.7%) patients. The proportion of men in the IRRs group was significantly higher than that in the non-IRRs group (p = 0.023). Additionally, body weight, body surface area (BSA), and body mass index (BMI) were significantly higher in the IRRs group than in the non-IRRs group (body weight, p = 0.0058; BSA, p = 0.0051; BMI, p = 0.017). Their cutoff values for predicting rituximab-induced IRRs, based on the receiver-operating characteristic curve, were 74.850 kg, 1.910 m2 and 24.164 kg/m2, respectively. In conclusion, the male sex, high actual body weight, BSA, and BMI may be new predictive markers for rituximab-induced IRRs in renal transplant recipients. Therefore, clinicians should carefully monitor patients who receive rituximab before renal transplantation and present with the predictive markers.

PMID:37661411 | DOI:10.1248/bpb.b23-00157

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