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https://www.readbyqxmd.com/read/28430767/are-steroids-effective-in-toxic-epidermal-necrolysis-and-stevens-johnson-syndrome
#1
Rodrigo Meza, Gabriel Rada, Pablo Varas
Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe adverse skin reactions to medications and infections. Steroids are described as a therapeutic alternative, but their use is still controversial. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified four systematic reviews including 11 primary studies answering the question of interest. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
April 5, 2017: Medwave
https://www.readbyqxmd.com/read/28426901/a-case-of-toxic-epidermal-necrolysis-and-vanishing-bile-duct-syndrome-requiring-liver-transplantation
#2
Sophie Momen, Carol Dangiosse, Emma Wedgeworth, Sarah Walsh, Daniel Creamer
A 52-year-old woman presented with a five-day history of headache, fevers and a diffuse, macular erythematous rash. Ten days prior she received cephalexin for a urinary-tract infection. She had a history of gastro-oesophageal reflux disorder and took omeprazole. This article is protected by copyright. All rights reserved.
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28423957/trends-in-culprit-drugs-and-clinical-entities-in-cutaneous-adverse-drug-reactions-a-retrospective-study
#3
Fang Wang, Yu-Kun Zhao, Minyi Li, Zhe Zhu, Xingqi Zhang
PURPOSE: Morbidity due to cutaneous adverse drug reactions (CADRs) is quite common. The specific culprit drugs change over time and clinicians must be kept informed with updated knowledge, thus preventing potential CADRs. This retrospective study is a survey of CADRs encountered in a hospital-based population in Southern China during three time intervals, from 1984 to 2015. MATERIALS AND METHODS: The clinical records were review of 306 patients with CADRs who were admitted to our hospital from 2011 to 2015...
April 19, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28419920/the-retention-and-distribution-of-parent-alkylated-and-n-o-s-containing-polycyclic-aromatic-hydrocarbons-on-the-epidermal-tissue-of-mangrove-seedlings
#4
Ruilong Li, Huadong Tan, Yaxian Zhu, Yong Zhang
The polycyclic aromatic hydrocarbons (PAHs) located on the epidermal tissues showed distinctive toxic effects to root, while the retention and distribution of PAHs on mangrove seedlings poorly understood. Our results confirmed that the partition coefficients (Kf) of the PAHs retained on the epidermal tissue of mangrove roots, such as Kandelia obovata, Avicennia marina and Aegiceras corniculatum, were much higher than the Poaceae plants roots, for example wheat and maize (Wild et al., 2005). Moreover, to the parent and alkyl PAHs, a well negative correlation was observed between the surface polarity of these three species of mangrove root and the Kf values (p < 0...
April 15, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28419328/efficacy-and-safety-of-osimertinib-in-a-japanese-compassionate-use-program
#5
Yutaka Fujiwara, Yasushi Goto, Shintaro Kanda, Hidehito Horinouchi, Noboru Yamamoto, Naomi Sakiyama, Reiko Ando Makihara, Yuichiro Ohe
Background: Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that targets the T790M mutation of EGFR. In 2016, AstraZeneca conducted a compassionate use program for osimertinib in Japan. Methods: Eighteen consecutive patients with histologically proven non-small-cell lung cancer (NSCLC) and harboring the T790M EGFR mutation participated in the compassionate use program between 1 April and 25 May 2016, at the National Cancer Center Hospital...
April 13, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28413662/phase-i-study-of-nanoparticle-albumin-bound-paclitaxel-carboplatin-and-trastuzumab-in-women-with-human-epidermal-growth-factor-receptor-2-overexpressing-breast-cancer
#6
Kenji Tezuka, Tsutomu Takashima, Shinichiro Kashiwagi, Hidemi Kawajiri, Shinya Tokunaga, Seika Tei, Shigehiko Nishimura, Shigehito Yamagata, Satoru Noda, Takeo Nishimori, Yoko Mizuyama, Takeshi Sunami, Katsumi Ikeda, Yoshinari Ogawa, Naoyoshi Onoda, Tetsuro Ishikawa, Shinzoh Kudoh, Minoru Takada, Kosei Hirakawa
Although the concurrent use of anthracycline-containing chemotherapy and taxane with trastuzumab are considered the treatment of choice for the primary systemic therapy of human epidermal growth factor receptor 2 (HER2)-overexpressing early breast cancer, non-anthracycline regimens, such as concurrent administration of docetaxel and carboplatin with trastuzumab, exhibited similar efficacies in a previous study. In addition, tri-weekly treatment with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) resulted in significantly higher response rates and a favorable safety profile compared with standard paclitaxel for metastatic breast cancer patients in another phase III study...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28413391/minocycline-induced-hyperpigmentation-in-a-patient-treated-with-erlotinib-for-non-small-cell-lung-adenocarcinoma
#7
Ann T Bell, John W Roman, Max L Gratrix, Christina E Brzezniak
INTRODUCTION: While epidermal growth factor receptor (EGFR) inhibitors have improved progression-free survival in patients with non-small cell lung cancer (NSCLC), one of the most common adverse effects is papulopustular skin eruption, which is frequently severe enough to be treated with oral minocycline or doxycycline. CASE: We present a case of an 87-year-old man who developed a severe papulopustular skin eruption secondary to erlotinib therapy for NSCLC. Control of the eruption with 100 mg of minocycline twice daily for 8 months eventually led to blue-gray skin hyperpigmentation...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28412864/cutaneous-allergic-drug-reactions-update-on-pathophysiology-diagnostic-procedures-and-differential-diagnostic
#8
Galina Balakirski, Hans F Merk
Important changes in the understanding and management of drug hypersensitivity reactions during the last years result from the increasing importance of biologics in medical practice, which differ in their spectrum of adverse drug reactions (ADRs) from the classical covalent drugs. With regard to covalent drugs, ampicillin and amoxicillin as well as clavulanic acid play an increasing role among ADRs to betalactam antibiotics. Fluoroquinolones are mainly the cause of anaphylactic and photosensitivity reactions...
April 17, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28411832/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-associations-outcomes-and-pathobiology-thirty-years-of-progress-but-still-much-to-be-done
#9
Robert S Stern, Sherrie J Divito
Although rare, Stevens-Johnson syndrome and toxic epidermal necrolysis remain among the most devastating of acute conditions involving the skin. In the past 30 years, tremendous progress has been made in understanding the causes and pathobiology of this often life-threatening condition. Su et al demonstrate associations between IL 15 serum levels and the outcome of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Their findings provide ideas for further investigations that may help us better understand the role of cytokines in this T-cell mediate disease and provides clues to possible new therapies...
May 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28403233/cost-effectiveness-of-cetuximab-and-panitumumab-for-chemotherapy-refractory-metastatic-colorectal-cancer
#10
Adriana Camargo Carvalho, Frederico Leal, Andre Deeke Sasse
BACKGROUND: Cetuximab and panitumumab are monoclonal antibodies targeting the epidermal growth factor receptor. Both drugs are active against RAS wild type metastatic colorectal cancer after chemotherapy failure, with similar efficacy and toxicity profiles. However, their cost and limited survival benefits may compromise incorporation in the Brazilian public healthcare system, the Unified Heath System (Sistema Único de Saúde) (SUS). METHODS: A cost-effectiveness analysis was conducted using a Markov model from the Brazilian Public health perspective and a lifetime horizon in patients with RAS -wt mCRC...
2017: PloS One
https://www.readbyqxmd.com/read/28403057/fever-in-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-pediatric-cases-laboratory-work-up-and-antibiotic-therapy
#11
Maren Paulmann, Maja Mockenhaupt
Fever is a symptom that often accompanies skin eruptions, especially in children. It can be a sign of an infectious condition presenting with exanthems or it may precede an exanthematous eruption. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe reactions affecting skin and mucosa with blisters and erosions. High fever occurs in these conditions, frequently before the skin and/or mucosa is affected.
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28401493/characterization-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-among-patients-admitted-to-kenyatta-national-hospital-a-retrospective-cross-sectional-study
#12
Kenneth Irungu, David Nyamu, Sylvia Opanga
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions. There is scant literature on the characteristics and causes of these conditions in Kenyatta National Hospital. OBJECTIVE: The aim of this study was to determine the prevalence, risk factors, and etiologies of SJS/TEN among patients admitted to Kenyatta National Hospital. METHODS: A retrospective cross-sectional study was done to find the characteristics and causes of severe cutaneous reactions among patients admitted to Kenyatta National Hospital...
April 11, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28400689/toxic-epidermal-necrolysis-and-acute-kidney-injury-due-to-glyphosate-ingestion
#13
J Indirakshi, A Sunnesh, M Aruna, M Hari Krishna Reddy, Anil C V Kumar, V Sarat Chandra, B Sangeetha, D T Katyarmal, R Ram, V Siva Kumar
The literature, particularly from India, is scarce on the renal effects of glyphosate poisoning. Glyphosate causes toxicity not only after its ingestion but also after dermal exposure by inhalation route and on eye exposure. We present a patient report of glyphosate consumption which resulted in toxic epidermal necrolysis - the first report after glyphosate consumption and acute kidney injury.
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28398652/brucella-abortus-activated-microglia-induce-neuronal-death-through-primary-phagocytosis
#14
Ana M Rodríguez, M Victoria Delpino, M Cruz Miraglia, Miriam M Costa Franco, Paula Barrionuevo, Vida A Dennis, Sergio C Oliveira, Guillermo H Giambartolomei
Inflammation has long been implicated as a contributor to pathogenesis in neurobrucellosis. Many of the associated neurocognitive symptoms of neurobrucellosis may be the result of neuronal dysfunction resulting from the inflammatory response induced by Brucella abortus infection in the central nervous system. In this manuscript, we describe an immune mechanism for inflammatory activation of microglia that leads to neuronal death upon B. abortus infection. B. abortus was unable to infect or harm primary cultures of mouse neurons...
April 11, 2017: Glia
https://www.readbyqxmd.com/read/28396847/patch-testing-and-cross-sensitivity-study-of-adverse-cutaneous-drug-reactions-due-to-anticonvulsants-a-preliminary-report
#15
T N Shiny, Vikram K Mahajan, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Rajni Sharma
AIM: To evaluate the utility of patch test and cross-sensitivity patterns in patients with adverse cutaneous drug reactions (ACDR) from common anticonvulsants. METHODS: Twenty-four (M:F = 13:11) patients aged 18-75 years with ACDR from anticonvulsants were patch tested 3-27 mo after complete recovery using carbamazepine, phenytoin, phenobarbitone, lamotrigine, and sodium valproate in 10%, 20% and 30% conc. in pet. after informed consent. Positive reactions persisting on D3 and D4 were considered significant...
March 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28395515/long-term-safety-experience-with-bendamustine-for-injection-in-a-real-world-setting
#16
Peter Martin, Paul M Barr, Leonard James, Ashutosh Pathak, Brad Kahl
BACKGROUND: Bendamustine hydrochloride (bendamustine) was approved for first-line treatment of patients with chronic lymphocytic leukemia (CLL) and relapsed indolent B-cell non-Hodgkin's lymphoma (NHL). Pharmacovigilance data have been collected since bendamustine's approval to enhance understanding of its long-term safety profile. Here we provide an overview of the pharmacovigilance data for bendamustine that have led to label updates related to safety and administration since its approval...
April 11, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28391354/low-plasma-concentration-of-gefitinib-in-patients-with-egfr-exon-21-l858r-point-mutations-shortens-progression-free-survival
#17
Yuji Okuda, Kazuhiro Sato, Kazuhisa Sudo, Yukiyasu Hasegawa, Mariko Asano, Hajime Miura, Masahide Takeda, Masaaki Sano, Hiroyuki Watanabe, Hiroyuki Kobayashi, Takenori Niioka, Masatomo Miura, Hiroshi Ito
PURPOSE: The relationship between the pharmacokinetics and effects of gefitinib in patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) is unknown. In this study, we examined the correlation between gefitinib plasma concentration and progression-free survival (PFS) in patients with two common types of EGFR mutations: a deletion in exon 19 and point mutations in exon 21 L858R. METHODS: The retrospective analysis examined 40 patients who were administered 250 mg of gefitinib daily...
April 8, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28388009/triplet-therapy-with-afatinib-cetuximab-and-bevacizumab-induces-deep-remission-in-lung-cancer-cells-harboring-egfr-t790m-in-vivo
#18
Kenichiro Kudo, Kadoaki Ohashi, Go Makimoto, Hisao Higo, Yuka Kato, Hiroe Kayatani, Yasuko Kurata, Yoichiro Takami, Daisuke Minami, Takashi Ninomiya, Toshio Kubo, Eiki Ichihara, Akiko Sato, Katsuyuki Hotta, Tadashi Yoshino, Mitsune Tanimoto, Katsuyuki Kiura
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have changed the treatment strategy for EGFR-mutant lung cancers; however, resistance usually occurs due to a secondary mutation, T790M, in EGFR. Combination therapy using afatinib and cetuximab has had good results in lung tumors harboring EGFR(T)(790M) mutations in clinical trials. The effect of bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, combined with EGFR-TKIs has also been investigated. We hypothesized that the dosage of afatinib and cetuximab could be reduced by combination with bevacizumab, and that the triplet therapy may result in better tumor inhibition with tolerable toxicity...
April 7, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28383863/-how-i-explore%C3%A2-hla-class-ii-by-ultrastructure-in-toxic-epidermal-necrolysis
#19
REVIEW
G E Piérard, A Dowlati, C Piérard-Franchimont, P Paquet, P Delvenne
Toxic epidermal necrolysis (TEN, Lyell syndrome) is a severe paroxystic drug reaction whose inductive mechanisms remain poorly understood. The HLA glycoproteins are possibly involved in the disease process. Such investigations rely on biomolecular methods, and suggest specific interactions between some drugs or their metabolites and some HLA groups according to ethnicity of the TEN patients. Electron microscopy following the immunogold method for revealing HLA-DR did not disclose any evidence for distinguishing distinct patterns on Langerhans cell membrane between the initial and the resolution phases of TEN...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28383851/-toxic-epidermal-necrolysis-lyell-syndrome-a-lifethreatening-emergency-of-introgenic-origin
#20
REVIEW
G E Piérard, S Jennes, C Piérard-Franchimont
Cutaneous drug eruptions are frequently encoun¬tered. Their putative diagnosis is based on a set of imputability arguments. The histopathological aspect is often suggestive of the dermatosis nature, and varies according to the type of drug reaction. Some drug eruptions follow a benign course, but others including the toxic epidermal necrolysis are severe and life-threatening. It corresponds to a dermatological emer¬gency to be managed in a specialized burn unit.
October 2016: Revue Médicale de Liège
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