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https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#1
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28720735/a-nonredundant-phosphopantetheinyl-transferase-ppta-is-a-novel-antifungal-target-that-directs-secondary-metabolite-siderophore-and-lysine-biosynthesis-in-aspergillus-fumigatus-and-is-critical-for-pathogenicity
#2
Anna Johns, Daniel H Scharf, Fabio Gsaller, Hella Schmidt, Thorsten Heinekamp, Maria Straßburger, Jason D Oliver, Mike Birch, Nicola Beckmann, Katharine S Dobb, Jane Gilsenan, Bharatkumar Rash, Elaine Bignell, Axel A Brakhage, Michael J Bromley
Secondary metabolites are key mediators of virulence for many pathogens. Aspergillus fumigatus produces a vast array of these bioactive molecules, the biosynthesis of which is catalyzed by nonribosomal peptide synthetases (NRPSs) or polyketide synthases (PKSs). Both NRPSs and PKSs harbor carrier domains that are primed for acceptance of secondary metabolic building blocks by a phosphopantetheinyl transferase (P-pant). The A. fumigatus P-pant PptA has been shown to prime the putative NRPS Pes1 in vitro and has an independent role in lysine biosynthesis; however, its role in global secondary metabolism and its impact on virulence has not been described...
July 18, 2017: MBio
https://www.readbyqxmd.com/read/28712930/disseminated-mycobacterium-kansasii-infection-with-cutaneous-lesions-in-an-immunocompetent-patient
#3
Miaomiao Zhang, Mei Feng, Jian-Qing He
We reported a case of disseminated Mycobacterium Kansasii (M. kansasii) infections involving skin tissue in a 57-year-old male farmer for recurrent fever, respiratory syndromes and skin lesions. Positive findings of syndromes, laboratory examinations and M. kansasii identified in the puncture fluid indicated the diagnosis of disseminated M. kansasii infections involving skin/soft tissue, pulmonary and mediastinal lymph nodes. After applying the standard HRE regime (isoniazid (300mg/d), rifampicin (600mg/d), and ethambutol (750mg/d)), the patient's temperature normalized and symptoms relieved gradually...
July 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28711984/clarithromycin-co-administration-does-not-increase-irinotecan-cpt-11-toxicity-in-colorectal-cancer-patients
#4
Katsuya Makihara, Sayaka Nakamura, Kazuyo Miyagi, Hiroyuki Ueno, Izumi Nakata
PURPOSE: Irinotecan (CPT-11) is used to treat advanced colorectal cancer. The drug is activated by carboxylesterases and rendered inactive by CYP3A4. Recently, the efficacy of combining CPT-11 and anti-epidermal growth factor receptor (EGFR) agents was confirmed in patients with KRAS wild-type metastatic colorectal cancer. Clarithromycin (CAM) is a strong CYP3A inhibitor often used to prevent rash associated with anti-EGFR therapy. The objective of this study was to evaluate the risk of increased neutropenia and diarrhea in combining CPT-11 and CAM...
July 15, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#5
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28704328/randomized-controlled-trial-of-dexamethasone-versus-dexamethasone-plus-hydrocortisone-as-prophylaxis-for-hypersensitivity-reactions-due-to-paclitaxel-treatment-for-gynecologic-cancer
#6
Dhammapoj Jeerakornpassawat, Prapaporn Suprasert
OBJECTIVE: The aim of this study was to assess intravenous hydrocortisone (HCT) added to standard dexamethasone (DXM) prophylaxis for paclitaxel-associated hypersensitivity reactions (HSRs). METHODS: Paclitaxel naives scheduled for 6 cycles of paclitaxel (plus platinum) were randomized to DXM alone (20 mg intravenously [IV]) versus DXM plus HCT (100 mg IV) as premedication including chlorpheniramine (10 mg IV), diphenhydramine (25 mg orally), and ranitidine (50 mg IV) 30 minutes before infusion...
July 12, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#7
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28686693/ivermectin-treatment-of-loa-loa-hyper-microfilaraemic-baboons-papio-anubis-assessment-of-microfilarial-loads-haematological-and-biochemical-parameters-and-histopathological-changes-following-treatment
#8
Samuel Wanji, Ebanga-Echi J Eyong, Nicholas Tendongfor, Che J Ngwa, Elive N Esuka, Arnaud J Kengne-Ouafo, Fabrice R Datchoua-Poutcheu, Peter Enyong, Dalen Agnew, Rob R Eversole, Adrian Hopkins, Charles D Mackenzie
BACKGROUND: Individuals with high intensity of Loa loa are at risk of developing serious adverse events (SAEs) post treatment with ivermectin. These SAEs have remained unclear and a programmatic impediment to the advancement of community directed treatment with ivermectin. The pathogenesis of these SAEs following ivermectin has never been investigated experimentally. The Loa/baboon (Papio anubis) model can be used to investigate the pathogenesis of Loa-associated encephalopathy following ivermectin treatment in humans...
July 7, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28684922/emerging-use-of-everolimus-in-the-treatment-of-neuroendocrine-tumors
#9
REVIEW
Pablo Gajate, Olga Martínez-Sáez, Teresa Alonso-Gordoa, Enrique Grande
Neuroendocrine tumors (NETs) consist of a diverse family of malignancies, which are derived from neuroendocrine cells, most commonly originating from the gastroenteropancreatic (GEP) tract or the bronchopulmonary system. In general, NETs are more indolent than epithelial tumors, with median survival rates of longer than 30 months. The upregulation of mTOR pathway has been shown to play a pivotal role in NET pathogenesis. Inhibition of mTOR protein with everolimus represents a progress in the treatment of advanced NETs...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28684647/hypersensitivity-to-antipyretics-pathogenesis-diagnosis-and-management
#10
REVIEW
Q U Lee
Antipyretics are commonly prescribed drugs and hypersensitivity occurs at rates of 0.01% to 0.3%. Hypersensitivity can be due to immune mechanisms that include type I to IV hypersensitivity. Type I hypersensitivity results from specific immunoglobulin E production following sensitisation on first exposure. Subsequent exposures elicit degranulation of mast cells, culminating an immediate reaction. Non-type I hypersensitivity is a delayed reaction that involves various effector cells, resulting in maculopapular rash, fixed drug eruptions, drug reaction with eosinophilia and systemic symptoms, and Stevens-Johnson syndrome/toxic epidermal necrolysis...
July 7, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28681394/amenamevir-a-novel-helicase-primase-inhibitor-for-treatment-of-herpes-zoster-a-randomized-double-blind-valaciclovir-controlled-phase-3-study
#11
Makoto Kawashima, Osamu Nemoto, Mariko Honda, Daisuke Watanabe, Juichiro Nakayama, Shinichi Imafuku, Toshiyuki Kato, Tsuneo Katsuramaki
Amenamevir is a potent helicase-primase inhibitor and a novel class of antiviral agent other than nucleoside compounds, such as aciclovir, valaciclovir and famciclovir. This study is the first randomized, double-blind, valaciclovir-controlled phase 3 study to evaluate the efficacy and safety of amenamevir in Japanese patients with herpes zoster when treated within 72 h after onset of rash. A total of 751 patients were randomly assigned to receive either amenamevir 400 mg or 200 mg p.o. once daily or valaciclovir 1000 mg three times daily (daily dose, 3000 mg) for 7 days...
July 5, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28681315/management-of-lyme-disease-in-european-children-a-review-for-practical-purpose
#12
REVIEW
Matteo D'Alessandro, Anna Loy, Elio Castagnola
PURPOSE OF REVIEW: Lyme disease is a tick-borne zoonosis transmitted through a bite of a tick carrying a spirochete belonging to Borrelia species. In the last 20 years, the reported incidence of Lyme disease is increased by three times in Europe. Clinically, the illness develops through a primary stage with a typical skin rash (erythema marginatum), then a secondary stage with possible neurologic or cardiac involvement. The last stage (chronic Lyme disease) is mainly represented by arthritis or late neurological complications but nowadays is rarely seen due to precocious antibiotic use...
July 5, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28680960/efficacy-and-safety-results-of-the-afatinib-expanded-access-program
#13
Edward S Kim, Balazs Halmos, Ingrid F Kohut, Taral Patel, Regan D Rostorfer, Alexander I Spira, Agnieszka Cseh, John McKay, Gudrun Wallenstein, Kathryn F Mileham
INTRODUCTION: Afatinib is an oral, irreversible ErbB family blocker approved for first-line treatment of metastatic epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC). The expanded access program (EAP) allowed early access to afatinib and provided additional data on its safety, tolerability, and efficacy. METHODS: The afatinib EAP was an open-label, multicenter, single-arm program in the United States that treated and followed patients with locally advanced or metastatic NSCLC harboring EGFR mutations...
2017: Oncology and Therapy
https://www.readbyqxmd.com/read/28678701/a-planning-and-guidance-platform-for-cardiac-resynchronization-therapy
#14
Peter Mountney, Jonathan M Behar, Daniel Toth, Maria Panayiotou, Sabrina Reiml, Marie-Pierre Jolly, Rashed Karim, Li Zhang, Alexander Brost, Christopher A Rinaldi, Kawal Rhode
Patients with drug-refractory heart failure can greatly benefit from cardiac resynchronization therapy (CRT). A CRT device can resynchronize the contractions of the left ventricle (LV) leading to reduced mortality. Unfortunately 30- 50% of patients do not respond to treatment when assessed by objective criteria such as cardiac remodeling. A significant contributing factor is suboptimal placement of the LV lead. It has been shown that placing this lead away from scar and at the point of latest mechanical activation can improve response rates...
June 27, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28676105/antipsychotic-associated-psoriatic-rash-a-case-report
#15
Camelia-Eugenia Bujor, Torkel Vang, Jimmi Nielsen, Ole Schjerning
BACKGROUND: Antipsychotics are a heterogeneous group of drugs. Although, antipsychotics have been used for years, unexpected side effects may still occur. With this case report we focus on a possible association between psoriasis and antipsychotics. Data on the patient's course of psychiatric disease, onset of psoriasis and its evolution were extracted from the patient's medical files. CASE PRESENTATION: We present a case of a 21-year-old female diagnosed with schizophrenia...
July 4, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28670109/controlled-release-of-optimized-electroporation-enhances-the-transdermal-efficiency-of-sinomenine-hydrochloride-for-treating-arthritis-in-vitro-and-in-clinic
#16
Shun Feng, Lijun Zhu, Zhisheng Huang, Haojia Wang, Hong Li, Hua Zhou, Linlin Lu, Ying Wang, Zhongqiu Liu, Liang Liu
Sinomenine hydrochloride (SH) is an ideal drug for the treatment of rheumatoid arthritis and osteoarthritis. However, high plasma concentration of systemically administered SH can release histamine, which can cause rash and gastrointestinal side effects. Topical delivery can increase SH concentration in the synovial fluid without high plasma level, thus minimizing systemic side effects. However, passive diffusion of SH was found to be inefficient because of the presence of the stratum corneum layer. Therefore, an effective method is required to compensate for the low efficiency of SH passive diffusion...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28661008/antiepileptic-drug-monotherapy-for-epilepsy-a-network-meta-analysis-of-individual-participant-data
#17
REVIEW
Sarah J Nevitt, Maria Sudell, Jennifer Weston, Catrin Tudur Smith, Anthony G Marson
BACKGROUND: Epilepsy is a common neurological condition with a worldwide prevalence of around 1%. Approximately 60% to 70% of people with epilepsy will achieve a longer-term remission from seizures, and most achieve that remission shortly after starting antiepileptic drug treatment. Most people with epilepsy are treated with a single antiepileptic drug (monotherapy) and current guidelines from the National Institute for Health and Care Excellence (NICE) in the United Kingdom for adults and children recommend carbamazepine or lamotrigine as first-line treatment for partial onset seizures and sodium valproate for generalised onset seizures; however a range of other antiepileptic drug (AED) treatments are available, and evidence is needed regarding their comparative effectiveness in order to inform treatment choices...
June 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28658503/delayed-type-hypersensitivity-reactions-induced-by-proton-pump-inhibitors-a-clinical-and-in-vitro-t-cell-reactivity-study
#18
Chien-Yio Lin, Chuang-Wei Wang, Chung-Yee Rosaline Hui, Ya-Ching Chang, Chih-Hsun Yang, Chi-Yuan Cheng, Wen-Wen Chen, Wei-Ming Ke, Wen-Hung Chung
BACKGROUND: Proton pump inhibitors (PPI) has been known to induce type I hypersensitivity reactions. However, severe delayed type hypersensitivity reactions (DHR) induced by PPI, such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or drug rash with eosinophilia and systemic symptoms (DRESS), are rarely reported. We conducted a study of a large series of PPI-related DHR, followed up their tolerability to alternative anti-ulcer agents, and investigated the T cell reactivity to PPI in PPI-related DHR patients...
June 28, 2017: Allergy
https://www.readbyqxmd.com/read/28652744/assessment-of-safety-and-efficacy-of-lamotrigine-over-the-course-of-1-year-observation-in-japanese-patients-with-bipolar-disorder-post-marketing-surveillance-study-report
#19
Takeshi Terao, Atsuko Ishida, Toshifumi Kimura, Mitsuhiro Yoshida, Terufumi Hara
BACKGROUND: A post-marketing surveillance (PMS) study was conducted with a 1-year observation period to assess the safety and efficacy of lamotrigine in routine clinical practice in patients with bipolar disorder (BD). PATIENTS AND METHODS: Central enrollment method was used to recruit patients diagnosed with BD who were being treated for the first time with lamotrigine to prevent the recurrence/relapse of BD mood episodes. Adverse drug reactions (ADRs) and recurrence/relapse were assessed...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28648978/the-thymus-and-activation-regulated-chemokine-tarc-level-in-serum-at-an-early-stage-of-a-drug-eruption-is-a-prognostic-biomarker-of-severity-of-systemic-inflammation
#20
Takayoshi Komatsu-Fujii, Yuko Chinuki, Hiroyuki Niihara, Kenji Hayashida, Masataka Ohta, Ryota Okazaki, Sakae Kaneko, Eishin Morita
BACKGROUND: In severe drug eruptions, precise evaluation of disease severity at an early stage is needed to start appropriate treatment. It is not always easy to diagnose these conditions at their early stage. In addition, there are no reported prognostic biomarkers of disease severity in drug eruptions. The aim of this study was to test whether the thymus and activation-regulated chemokine (TARC) level in serum at an early stage of a drug eruption can serve as a prognostic biomarker of systemic inflammation...
June 22, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
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