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Azzi R, Bordea G, Griffier R, Nikiema JN, Mougin F. Enriching the FIDEO ontology with food-drug interactions from online knowledge sources. J Biomed Semantics 2024; 15:1. [PMID: 38438913 PMCID: PMC10913206 DOI: 10.1186/s13326-024-00302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
The increasing number of articles on adverse interactions that may occur when specific foods are consumed with certain drugs makes it difficult to keep up with the latest findings. Conflicting information is available in the scientific literature and specialized knowledge bases because interactions are described in an unstructured or semi-structured format. The FIDEO ontology aims to integrate and represent information about food-drug interactions in a structured way. This article reports on the new version of this ontology in which more than 1700 interactions are integrated from two online resources: DrugBank and Hedrine. These food-drug interactions have been represented in FIDEO in the form of precompiled concepts, each of which specifies both the food and the drug involved. Additionally, competency questions that can be answered are reviewed, and avenues for further enrichment are discussed.
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Affiliation(s)
- Rabia Azzi
- Univ. Bordeaux, Inserm, BPH, U1219, F-33000, Bordeaux, France
- CHU de Bordeaux, Service d'information médicale, F-33000, Bordeaux, France
| | - Georgeta Bordea
- Univ. Bordeaux, Inserm, BPH, U1219, F-33000, Bordeaux, France
- Univ. La Rochelle, L3i, F-17000, La Rochelle, France
| | - Romain Griffier
- Univ. Bordeaux, Inserm, BPH, U1219, F-33000, Bordeaux, France
- CHU de Bordeaux, Service d'information médicale, F-33000, Bordeaux, France
| | - Jean Noël Nikiema
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Québec, Canada
| | - Fleur Mougin
- Univ. Bordeaux, Inserm, BPH, U1219, F-33000, Bordeaux, France.
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Mungmunpuntipantip R, Wiwanitkit V. COVID-19 Vaccine Associated with Cutaneous Involvement: Correspondence. Indian J Crit Care Med 2023; 27:599. [PMID: 37636846 PMCID: PMC10452765 DOI: 10.5005/jp-journals-10071-24499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
How to cite this article: Mungmunpuntipantip R, Wiwanitkit V. COVID-19 Vaccine Associated with Cutaneous Involvement: Correspondence. Indian J Crit Care Med 2023;27(8):599.
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Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Dental Sciences, Chandigarh University, Punjab, India
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3
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He B, Tavakoli H, Etminan M, Shokoohi S, Iovieno A, Yeung SN. Impact of the use of anti-glaucoma medications on the risk of herpetic keratitis recurrence. Int Ophthalmol 2022. [PMID: 36224301 DOI: 10.1007/s10792-022-02552-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Numerous case reports have associated anti-glaucoma medications with recurrence of herpes simplex virus (HSV) and herpes zoster virus (HZV) keratitis. The aim of our study was to determine whether different anti-glaucoma agents are associated with recurrence of herpetic keratitis. METHODS This was a retrospective cohort study using health databases from a Canadian province from January 2001 to December 2012. A new cohort of users on topical prostaglandins (PGs), beta blockers (BBs), alpha-2 agonists (AAs) and carbonic anhydrase inhibitors (CAIs) was created. The date of the third anti-glaucoma drug dispensation within 90 days was deemed the index date of the case. Herpetic keratitis events, as defined by an ICD-9/10 code for HSV or HZV keratitis, or the dispensation of an anti-viral medication by either an ophthalmologist or an optometrist, were examined prior to and following the index date. Risk ratios (RRs) were computed to compare the risk of HSV/HZV keratitis among the PG, BB, AA, and CAI groups individually and collectively while adjusting for age and sex. RESULTS Among 19,986 users of glaucoma medications identified, there were 684 cases of HSV/HZV keratitis. There was no increased risk of HSV/HZV keratitis recurrence for any of the four glaucoma medications classes individually or collectively when adjusted for age and sex. There was also no increased risk for redeveloping either HSV keratitis only or HZV keratitis only amongst all anti-glaucoma users. CONCLUSION There is no association between the use of topical ocular hypotensive therapies and HSV/HZV keratitis recurrence. Further studies are needed to confirm these findings.
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Meyer T, Steuer M. [Practical limitations of medical clarification and informed consent in the context of drug therapy]. Med Klin Intensivmed Notfmed 2022; 117:517-524. [PMID: 34468769 PMCID: PMC9553756 DOI: 10.1007/s00063-021-00856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/23/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
The efficacy of pharmacotherapy is limited by the occurrence of adverse drug reactions and the interactions between several drugs in polypharmacy, which are difficult to predict. Taking into account the complex mode of action of drugs, including their specific profiles of side effects, high demands are placed on the medical information with respect to a proper and complete clarification of the risks and alternative information under the precept of patient-oriented comprehensibility; however, these requirements can hardly ever be fulfilled in everyday medical practice. This article discusses the practical limitations of the information provided prior to the initiation and monitoring of drug therapy on the basis of selected current case law. In particular, the potential for conflict between the Patients' Rights Act and the so-called right to non-knowledge is highlighted.
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Affiliation(s)
- Thomas Meyer
- Klinik für Psychosomatische Medizin und Psychotherapie, Medizinische Fakultät, Georg-August-Universität Göttingen, Waldweg 33, 37073, Göttingen, Deutschland.
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Göttingen, Deutschland.
| | - Melanie Steuer
- Institut für Kriminalwissenschaften, Abteilung für strafrechtliches Medizin- und Biorecht, Juristische Fakultät, Georg-August-Universität Göttingen, Göttingen, Deutschland
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van Poelgeest EP, Seppala LJ, Lee JM, Bahat G, Ilhan B, Lavan AH, Mair A, van Marum RJ, Onder G, Ryg J, Fernandes MA, Garfinkel D, Guðmundsson A, Hartikainen S, Kotsani M, Montero-Errasquín B, Neumann-Podczaska A, Pazan F, Petrovic M, Soulis G, Vankova H, Wehling M, Wieczorowska-Tobis K, van der Velde N. Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey. Eur Geriatr Med 2022; 13:1455-1466. [PMID: 36319837 PMCID: PMC9722796 DOI: 10.1007/s41999-022-00702-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing. Responses to the survey questions and participant characteristics were quantified and differences evaluated between geriatricians and geriatricians-in-training and between European regions. RESULTS The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) were generally willing to deprescribe (98%) and felt confident about deprescribing (85%). Despite differences across European regions, the most commonly reported reasons for deprescribing were functional impairment and occurrence of adverse drug reactions. The most important barriers for deprescribing were patients' unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Perceived risk of adverse drug reactions was highest for psychotropic drugs, nonsteroidal anti-inflammatory drugs, cardiovascular drugs, and opioid analgesics. Only one in four respondents (23% of geriatricians and 37% of geriatricians-in-training) think education in medical school had sufficiently prepared them for deprescribing in clinical practice. They reported that their future deprescribing activities would probably increase with improved information sharing between various prescribers, deprescribing recommendations in guidelines, and increased education and training. Approximately 90% think that a paradigm shift is required for prescribers and patients, increasing focus on the possible benefits of deprescribing (potentially) inappropriate medications. CONCLUSIONS Based on the outcomes of this survey, we recommend investing in improved inter-professional communication, better education and evidence-based recommendations to improve future patient-centered deprescribing practices.
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Affiliation(s)
- Eveline P van Poelgeest
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands.
| | - Lotta J Seppala
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
| | - Jihoo M Lee
- Graduate School of Communication Science, University of Amsterdam, Amsterdam, The Netherlands
| | - Gülistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Birkan Ilhan
- Division of Geriatrics, Department of Internal Medicine, Sisli Hamidiye Etfal Training and Research Hospital, University of Medical Sciences, Istanbul, Turkey
| | - Amanda H Lavan
- Mercers Institute of Successful Ageing, St James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Alpana Mair
- Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, Scotland, UK
| | - Rob J van Marum
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
- Department of Elderly Care Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, Netherlands
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Deprescribing Initiative (ODIN), Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Marília Andreia Fernandes
- Department of Internal Medicine, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Doron Garfinkel
- Center for Appropriate Medication Use, Sheba Medical Center and Deputy Head, Homecare Hospice, Israel Cancer Association, 55 Ben Gurion Road, 5932210, Bat, Yam, Israel
| | - Aðalsteinn Guðmundsson
- Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Marina Kotsani
- Université de Lorraine, CHRU-Nancy, Pôle (Maladies du Vieillissement, Gérontologie et Soins Palliatifs), Nancy, France
| | | | | | - Farhad Pazan
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - George Soulis
- Outpatient Geriatric Assessment Unit, Henry Dunant Hospital Center, Athens, Greece
- Hellenic Open University, Patras, Greece
| | - Hana Vankova
- Cooperatio 34 - Internal Disciplines, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Wehling
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Nathalie van der Velde
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
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Tsutsumi T, Imai S, Kashiwagi H, Sato Y, Sugawara M, Takekuma Y. Investigation of the risk factors of vomiting during linezolid therapy: a retrospective observational study. Eur J Clin Pharmacol 2021; 78:279-286. [PMID: 34581841 DOI: 10.1007/s00228-021-03221-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/12/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Some clinical studies have reported the occurrence of nausea and vomiting with linezolid (LZD) administration. However, no studies have evaluated nausea and vomiting as primary endpoints. In a previous study, we noted a possible relationship between LZD and vomiting, but risk factors were not identified. Therefore, the aim of the present study was to identify them. METHODS Patients who received LZD 600 mg twice daily at Hokkaido University Hospital from September 2008 to April 2019 were enrolled in this retrospective observational study. Patient characteristics, concomitant medications, laboratory data, and the occurrence of vomiting were obtained from electronic medical records. Logistic regression analysis was performed to identify risk factors for vomiting, including age, sex, body weight, concomitant medications, and surgeries. RESULTS A total of 496 patients were included in this study, of which 90 experienced vomiting. By multivariate logistic regression analysis, female sex (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 1.62-4.47), ≥ 10 days of LZD administration (aOR, 2.57; CI, 1.46-4.50), and hyponatraemia (aOR, 2.96; CI, 1.72-5.10) were identified as independent risk factors for vomiting; administration of serotonergic agents (aOR, 0.23; CI, 0.07-0.82) was negatively associated. CONCLUSIONS This study is the first to successfully identify risk factors for LZD-induced vomiting. Careful monitoring of patients with these risk factors may lead to safer and sustainable LZD administration.
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Affiliation(s)
- Takezo Tsutsumi
- Graduate School of Life Science, Hokkaido University, Sapporo, Hokkaido, Japan.,Department of Pharmacy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Shungo Imai
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hitoshi Kashiwagi
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yuki Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mitsuru Sugawara
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.,Global Station for Biosurfaces and Drug Discovery, Hokkaido University, Kita 12-jo Nishi 6-chome, Kita-ku, Sapporo, 060-0812, Japan
| | - Yoh Takekuma
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
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Roohbakhsh A, Moshiri M, Salehi Kakhki A, Iranshahy M, Amin F, Etemad L. Thymoquinone abrogates methamphetamine-induced striatal neurotoxicity and hyperlocomotor activity in mice. Res Pharm Sci 2021; 16:391-399. [PMID: 34447447 PMCID: PMC8356713 DOI: 10.4103/1735-5362.319577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/25/2020] [Accepted: 06/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background and purpose: Methamphetamine (METH) abuse has devastating consequences on the nervous system. There are limited therapy choices in METH abuse with reduced effectiveness and elevated recurrence rates. Thymoquinone (TQ), the most bioactive constituent of Nigella sativa seeds exerts neuroprotective effects mainly via antioxidant properties. This study aimed to evaluate the effect of TQ against METH-induced striatal neurotoxicity and hyperlocomotor activity in mice. Experimental approach: Our groups of animals received METH (10 mg/kg) four times a day with 2 h intervals. Normal saline or TQ (5, 10, or 20 mg/kg) was injected intraperitoneally 30 min before METH administration. Control and sham groups received vehicle or TQ, respectively. The rectal temperature and behavioral tests including the open field for locomotor activity and rotarod for motor coordination were evaluated. The level of superoxide dismutase (SOD), as well as pathological changes, were also assessed in the striatum region. Findings/Results: No significant differences in rectal temperatures were observed among treated groups. Administration of METH increased locomotor activity and did not change motor coordination. TQ co-administration with METH significantly reduced the central and total locomotion and the mean latency to fall off the rotarod in a dose-dependent manner compared with the METH group. TQ also alleviated the METH-induced decrease in the activity of SOD.TQ, especially at the high dose, reduced the METH-induced reactive gliosis level. Conclusion and implications: In conclusion, TQ prevents the enhanced locomotor activity, antioxidant impairment, and morphological striatal damage caused by METH in mice. TQ may be a potential candidate for the treatment of specific METH-induced brain disorders or neurological diseases.
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Affiliation(s)
- Ali Roohbakhsh
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.,Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Azam Salehi Kakhki
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Milad Iranshahy
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Fatemeh Amin
- Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, I.R. Iran.,Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, I.R. Iran
| | - Leila Etemad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
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Milosevits G, Mészáros T, Őrfi E, Bakos T, Garami M, Kovács G, Dézsi L, Hamar P, Győrffy B, Szabó A, Szénási G, Szebeni J. Complement-mediated hypersensitivity reactions to an amphotericin B-containing lipid complex (Abelcet) in pediatric patients and anesthetized rats: Benefits of slow infusion. Nanomedicine 2021; 34:102366. [PMID: 33549818 DOI: 10.1016/j.nano.2021.102366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 11/26/2022]
Abstract
Intravenous administration of lipid-based nanodrugs can cause hypersensitivity, also known as infusion reactions (IRs), that can be attenuated by slow infusion in adult patients. We studied the role of infusion rate and complement (C) activation in IRs in pediatric patients treated with Abelcet, and also in anesthetized rats. IRs were observed in 6 out of 10 (60%) patients who received Abelcet infusion in 4 h or less, while no patients who received the infusion in 6 h showed C activation or IRs. The rat model indicated an inverse relationship between infusion speed and Abelcet-induced hypotension, taken as an experimental endpoint of IRs, while the rise of C3a in blood, an index of C activation, directly correlated with hypotension. The results suggest that pediatric patients are more prone to produce IRs, and that the optimal infusion time of Abelcet may be much longer than the presently recommended 2 h.
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Affiliation(s)
- Gergely Milosevits
- Second Department of Paediatrics, Semmelweis University, Budapest, Hungary; Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Tamás Mészáros
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary; SeroScience LCC, Budapest, Hungary.
| | - Erik Őrfi
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Tamás Bakos
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Miklós Garami
- Second Department of Paediatrics, Semmelweis University, Budapest, Hungary.
| | - Gábor Kovács
- Second Department of Paediatrics, Semmelweis University, Budapest, Hungary.
| | - László Dézsi
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Péter Hamar
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Balázs Győrffy
- Second Department of Paediatrics, Semmelweis University, Budapest, Hungary; Cancer Biomarker Research Group, Institute of Enzymology, Research Center for Natural Sciences, Budapest, Hungary.
| | - András Szabó
- Second Department of Paediatrics, Semmelweis University, Budapest, Hungary.
| | - Gábor Szénási
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - János Szebeni
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary; SeroScience LCC, Budapest, Hungary; Cancer Biomarker Research Group, Institute of Enzymology, Research Center for Natural Sciences, Budapest, Hungary; Department of Nanobiotechnology and Regenerative Medicine, Faculty of Health, Miskolc University, Miskolc, Hungary.
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9
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Rehfeld JF, Knop FK, Asmar M. Gastrin secretion in normal subjects and diabetes patients is inhibited by glucagon-like peptide 1: a role in the gastric side effects of GLP-1-derived drugs? Scand J Gastroenterol 2019; 54:1448-1451. [PMID: 31725337 DOI: 10.1080/00365521.2019.1690673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Randomized and controlled trials of glucagon-like peptide-1 (GLP-1) derived drugs have shown that the most frequent adverse symptoms are gastrointestinal. Some of the side effects such as dyspepsia, nausea and upper abdominal pain may well be of gastric origin. Since the antral hormone gastrin regulates gastric secretion of acid and enzymes and contributes to the regulation of gastric motility, we examined the effect of GLP-1 on the secretion of gastrin in normal subjects and diabetes patients.Method: Plasma was sampled from ten healthy subjects and ten patients with diabetes mellitus type 1 with glucose clamped between 6 and 9 mM. GLP-1 or saline were infused for 4 h during and after a meal. Plasma concentrations of gastrin and GLP-1 were measured using specific radioimmunoassays.Results: Basal plasma concentrations of gastrin were similar in controls and patients. After the meal, the gastrin concentrations rose significantly during saline infusion, whereas the GLP-1 infusion suppressed the secretion of gastrin significantly, most pronounced in the diabetes patients.Conclusions: The results show that GLP-1 infusion suppresses the postprandial secretion of gastrin in normal subjects and even more so in the diabetes patients. The results may therefore shed further light on the upper gastrointestinal side effects of GLP-1-derived drugs in diabetic patients.
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Affiliation(s)
- Jens F Rehfeld
- Department of Clinical Biochemistry, University of Copenhagen, Rigshospitalet, Denmark
| | - Filip K Knop
- Center for Clinical Metabolic Research, Gentofte Hospital; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen; and Steno Diabetes Center Copenhagen, Hellerup, Denmark
| | - Meena Asmar
- Department of Clinical Physiology, Bispebjerg Hospital, Steno Diabetes Center, Odense University Hospital, Denmark, Copenhagen, Denmark
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Rosen LE, Olea-Popelka F, Deem SL, Isaza R, Schmitt D, Miller M. SURVEY OF ANTITUBERCULOSIS DRUG ADMINISTRATION AND ADVERSE EFFECTS IN ELEPHANTS IN NORTH AMERICA. J Zoo Wildl Med 2019; 50:23-32. [PMID: 31120659 DOI: 10.1638/2018-0028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Tuberculosis, caused by Mycobacterium tuberculosis, is a disease causing morbidity and mortality in captive elephants (Elephas maximus and Loxodonta africana) as well as free-ranging individuals. Elephants in North America diagnosed with tuberculosis are often treated with antituberculosis drugs, unlike livestock species, which has necessitated the development of treatment guidelines adapted from recommendations for humans. There are few published reports describing empirical treatment, which may be complicated by poor patient compliance, interruptions in drug administration, and adverse effects. A survey of elephants in North America was conducted to compile information on treatment protocols, including drugs, dosages, routes of administration, serum drug concentrations, and adverse effects of antituberculosis treatment. Responses were received regarding 182 elephants, 12 of which were treated prophylactically or therapeutically with antituberculosis drugs. Treatment protocols varied among elephants, and included various combinations of isoniazid, rifampin, pyrazinamide, ethambutol, enrofloxacin, levofloxacin, and ethionamide. Serum drug concentrations also varied considerably among and within individuals. Facility staff reported 5 elephants (out of 7 treated elephants with responses) that exhibited clinical signs that may have been associated with antituberculosis drugs or treatment procedures. Anorexia, decreased water intake, constipation, depression, ataxia, limb paresis, and tremors were among the signs observed. Most adverse effects were reported to be moderate or severe, resulting in interruption of the treatment. The results from this survey provide veterinarians and elephant managers with valuable historical data to make informed clinical management decisions regarding antituberculosis therapy in elephants.
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Wagner JL, Mueller M, Kellermann T, Griffin M, Smith G, Soliven M, Guilfoyle SM, Junger KF, Mucci G, Huszti H, Barrett L, Zupanc M, Modi AC. Vulnerabilities to antiepileptic drug (AED) side effects in youth with epilepsy. Epilepsy Behav 2019; 97:22-28. [PMID: 31181425 DOI: 10.1016/j.yebeh.2019.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/26/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective of the study was to investigate the relationship between sociodemographic, seizure-related, behavioral health, and antiepileptic drug (AED) adverse effect variables. The aim of this study was to examine whether there were significant differences on AED adverse effects between youth with normative and subclinical/clinical depressive and/or anxiety symptoms. METHODS As part of a larger multisite validation study, 231 youth age 5 to 18 years diagnosed with epilepsy and their caregivers were recruited to participate for the current study. Youth ages 8 and older and caregivers of all youth completed the Behavior Assessment System for Children-2 (BASC-2). Caregivers also completed the Pediatric Epilepsy Side Effects Questionnaire (PESQ) and a Background Questionnaire. Medical chart review provided information regarding epilepsy diagnosis and treatment. RESULTS No differences were observed in the mean scores on AED adverse effects between the group with subclinical/clinical BASC-2 Depressive symptoms and those with average/low depressive symptoms. In contrast, the proportion of youth with subclinical/clinical versus average/low depressive symptoms via caregiver report was significantly different for the cognitive, behavioral, general neurological, and total scale of the PESQ. There was also a larger proportion of youth with self-reported subclinical/clinical depressive symptoms who experienced general neurological adverse effects compared with youth with average/low depressive symptoms who experienced general neurological adverse effects. Findings were consistent for anxiety symptoms. SIGNIFICANCE Identifying potentially modifiable behavioral health symptoms that exacerbate the expression of AED adverse effects could provide alternative solutions for improved AED tolerability to achieve optimum treatment outcomes.
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Affiliation(s)
| | | | | | - Millie Griffin
- Medical University of South Carolina, Charleston, SC, USA
| | - Gigi Smith
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Shanna M Guilfoyle
- Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Katherine F Junger
- Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Grace Mucci
- Children's Hospital of Orange County, Orange, CA, USA
| | | | | | - Mary Zupanc
- Children's Hospital of Orange County, Orange, CA, USA
| | - Avani C Modi
- Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
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Fernández Regueiro R, Estrada Menéndez C, Morís de la Tassa J. Impact of an intervention program to improve potentially inappropriate prescription in hospitalized elderly patients. Rev Clin Esp 2019; 219:375-385. [PMID: 31030886 DOI: 10.1016/j.rce.2018.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/11/2018] [Accepted: 12/16/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND OBJECTIVES Potentially inappropriate prescription (PIP) is common in elderly people. It has become a global public health problem due to its association with adverse drug effects (ADE), increased morbidity and mortality, emergency care visits and resource use. The main aim of this study was to determine whether the use of a notification program of PIP in elderly patients admitted in the hospital led to a reduction of their prescription. METHOD A quasi-experimental before-after study was conducted. PIP were identified by using Beers (2012 update) and STOPP-START criteria (2008 version). An individualized report on PPI was prepared and the effect of this intervention was evaluated. RESULTS 174 patients were included who presented 284 PIP. 54% (153) of the recommendations were accepted. Barthel index was the only variable that proved to contribute to the presence of PIP modifications. The patients whose PIP drugs were modified were significantly more dependent (p=0.005), presented cognitive impairment (p=0.001) and were more institutionalized (p=0.039) than those without any modifications. There were fewer readmissions, emergency care visits and mortality within six months after intervention comparing patients with and without PIP modifications, but without significant differences. 32 ADE were detected, 29 related with PIP drugs. Adverse events were significantly associated with PIP drugs, versus other medications (p<0.001), odds ratio 242.5 (CI95%: 56.9-1023.6). CONCLUSIONS Review of medication in elderly patients, along with the use of tools that help in the identification of dangerous drugs, entail a reduction of inadequate prescription and significantly contribute to the continuous improvement of chronic medication in elders.
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Affiliation(s)
- R Fernández Regueiro
- Servicio de Medicina Interna, Hospital Universtario de Cabueñes, Gijón, Asturias, España.
| | | | - J Morís de la Tassa
- Servicio de Medicina Interna, Hospital Universtario de Cabueñes, Gijón, Asturias, España; Facultad de Medicina y Ciencias de la Salud. Universidad de Oviedo, Oviedo, Asturias, España
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13
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Thompson P, Daikou S, Ueno K, Batista-Navarro R, Tsujii J, Ananiadou S. Annotation and detection of drug effects in text for pharmacovigilance. J Cheminform 2018; 10:37. [PMID: 30105604 PMCID: PMC6089860 DOI: 10.1186/s13321-018-0290-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/20/2018] [Indexed: 02/02/2023] Open
Abstract
Pharmacovigilance (PV) databases record the benefits and risks of different drugs, as a means to ensure their safe and effective use. Creating and maintaining such resources can be complex, since a particular medication may have divergent effects in different individuals, due to specific patient characteristics and/or interactions with other drugs being administered. Textual information from various sources can provide important evidence to curators of PV databases about the usage and effects of drug targets in different medical subjects. However, the efficient identification of relevant evidence can be challenging, due to the increasing volume of textual data. Text mining (TM) techniques can support curators by automatically detecting complex information, such as interactions between drugs, diseases and adverse effects. This semantic information supports the quick identification of documents containing information of interest (e.g., the different types of patients in which a given adverse drug reaction has been observed to occur). TM tools are typically adapted to different domains by applying machine learning methods to corpora that are manually labelled by domain experts using annotation guidelines to ensure consistency. We present a semantically annotated corpus of 597 MEDLINE abstracts, PHAEDRA, encoding rich information on drug effects and their interactions, whose quality is assured through the use of detailed annotation guidelines and the demonstration of high levels of inter-annotator agreement (e.g., 92.6% F-Score for identifying named entities and 78.4% F-Score for identifying complex events, when relaxed matching criteria are applied). To our knowledge, the corpus is unique in the domain of PV, according to the level of detail of its annotations. To illustrate the utility of the corpus, we have trained TM tools based on its rich labels to recognise drug effects in text automatically. The corpus and annotation guidelines are available at: http://www.nactem.ac.uk/PHAEDRA/ .
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Affiliation(s)
- Paul Thompson
- National Centre for Text Mining, School of Computer Science, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
| | - Sophia Daikou
- National Centre for Text Mining, School of Computer Science, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
| | - Kenju Ueno
- Artificial Intelligence Research Center, National Research and Development Agency (AIST), Tokyo Waterfront 2-3-2 Aomi, Koto-ku, Tokyo, 135-0064 Japan
| | - Riza Batista-Navarro
- National Centre for Text Mining, School of Computer Science, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
| | - Jun’ichi Tsujii
- National Centre for Text Mining, School of Computer Science, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
- Artificial Intelligence Research Center, National Research and Development Agency (AIST), Tokyo Waterfront 2-3-2 Aomi, Koto-ku, Tokyo, 135-0064 Japan
| | - Sophia Ananiadou
- National Centre for Text Mining, School of Computer Science, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
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Vallabh H, Hahn B, Bryan C, Hogg J, Kupec JT. Small bowel angioedema from angiotensin-converting enzyme: Changes on computed tomography. Radiol Case Rep 2018; 13:55-7. [PMID: 29552243 DOI: 10.1016/j.radcr.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 11/20/2022] Open
Abstract
Intestinal angioedema is a rare side effect of angiotensin-converting enzyme inhibitors. We present a 41-year-old woman with sporadic right lower quadrant abdominal pain and diarrhea with multiple computed tomography scans demonstrating enteritis. Suspicion turned to angiotensin-converting enzyme inhibitor use as the cause for the patient's illness after an extensive negative evaluation including labs, stool studies, endoscopies, and capsule endoscopy. Weeks after stopping the medication, the patient's symptoms improved and repeat computed tomography showed a resolution of the previously seen findings of enteritis. This case illustrates the importance of a good medication review to make appropriate clinical decisions and diagnoses.
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Abstract
Cannabis, commonly called marijuana, is often used during pregnancy, likely due to the perception that it is a "safe" drug. Changes in legislation in many countries have lead to the increased availability of this drug and to its increasing use during pregnancy, often with other concomitant exposures such as alcohol, tobacco, and other drugs. Herein, we review the medical literature regarding effects of marijuana on the fetus and newborn. Possible effects of in utero exposure to marijuana focus on fetal growth, increase in the rates of stillbirth and preterm delivery, congenital malformations, and neurodevelopmental effects on the child. Published studies for all these outcomes are inconsistent. Fetal weight growth may be somewhat decreased, but the magnitude of this decrease is no greater than 100 g. There is insufficient evidence to conclude on any effect on the stillbirth rate. Although there are some reports of a slight increase in the rate of prematurity, most reports do not support this effect. Marijuana does not appear to be a major teratogen; however, a small increased risk for some congenital birth defects may be associated with early pregnancy use. Neurodevelopmental effects have been associated with marijuana use, but it is difficult to control for the effect of confounders. Despite the lack of conclusive evidence, it is important to remember that marijuana has not been shown to be a harmless drug during pregnancy and may affect the long-term neurodevelopment of the newborn infant.
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Affiliation(s)
- Paul Merlob
- Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel and Beilinson Teratology Information Service, Rabin Medical Center, Petah Tikva, Israel, the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bracha Stahl
- Beilinson Teratology Information Service, Rabin Medical Center, Petah Tikva, Israel
| | - Gil Klinger
- Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel and Beilinson Teratology Information Service, Rabin Medical Center, Petah Tikva, Israel, the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
BACKGROUND The effectiveness of a national post-marketing surveillance program depends directly on the active participation of all health professionals. There is no current comprehensive and active pharmacovigilance program available in Lebanon. OBJECTIVES To assess the knowledge, attitudes, and practices (KAP) among community pharmacists in Lebanon with respect to potential pharmacovigilance and adverse-drug-reaction reporting in Lebanon. METHODS A cross-sectional descriptive study, using a self-administered KAP questionnaire and conducted between March and July 2016, included 1857 pharmacists practicing in community settings. Statistical analysis included χ2 test for dichotomous or multinomial qualitative variables, and Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution. RESULTS The majority of responders had good knowledge concerning the concept and purpose of pharmacovigilance as well as adverse drug reactions (how to report these/the importance of reporting adverse events/the definition of an adverse event and pharmacovigilance). Concerning community pharmacists' attitudes and practice towards pharmacovigilance, the majority described having a positive attitude towards their role in adverse drug reaction reporting and this activity was even seen as one of their core duties. The questionnaire revealed a lack of practice and training regarding pharmacovigilance. Nonetheless, the pharmacists agreed on the Order of Pharmacists in Lebanon and the Ministry of Health's role in promoting this practice and helping them be more involved in reporting adverse drug reactions (ADRs). The pharmacists thought that they are well positioned regarding patient-safety practice in their pharmacies and the results were not statistically different between pharmacy employers and employees. CONCLUSION Lebanese pharmacists have the required knowledge and positive attitude to start reporting ADRs, were aware of ADRs occurring with various medicines post-marketing, yet were currently not able to disseminate this information widely or to record it centrally, emphasizing the importance of establishing a national ADR reporting system.
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Affiliation(s)
- Aline Hajj
- a Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des médicaments, Pôle Technologie- Santé (PTS), Faculty of Pharmacy , Saint-Joseph University , Beirut , Lebanon
| | - Souheil Hallit
- b Saint-Joseph University , School of Pharmacy , Beirut , Lebanon
- c Lebanese University , School of Pharmacy , Beirut , Lebanon
- d Universite Saint-Esprit Kaslik , Faculty of Medicine , Kaslik , Lebanon
- e Psychiatric Hospital of the Cross , Jal Eddib , Lebanon
| | - Elsy Ramia
- f Lebanese American University , School of Pharmacy , Byblos , Lebanon
| | - Pascale Salameh
- c Lebanese University , School of Pharmacy , Beirut , Lebanon
- g Lebanese University , Faculty of Medicine , Beirut , Lebanon
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Enders D, Kollhorst B, Engel S, Linder R, Verheyen F, Pigeot I. Comparative risk for cardiovascular diseases of dipeptidyl peptidase-4 inhibitors vs. sulfonylureas in combination with metformin: Results of a two-phase study. J Diabetes Complications 2016; 30:1339-46. [PMID: 27245402 DOI: 10.1016/j.jdiacomp.2016.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/07/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022]
Abstract
AIMS The aim was to assess whether the use of additional data from the Disease Management Program (DMP) diabetes mellitus type 2 to minimize the potential for residual confounding will alter the estimated risk of either myocardial infarction, ischemic stroke or heart failure in patients with type 2 diabetes using sulfonylureas compared to dipeptidyl peptidase-4 (DPP-4) inhibitors in addition to metformin based on routine health care data. METHODS We conducted a nested two-phase case-control study using claims data of one German health insurance from 2004 to 2013 (phase 1) and data of the DMP from 2010 to 2013 (phase 2). Adjusted odds ratios (ORs) for the combined cardiovascular event myocardial infarction, ischemic stroke or heart failure were calculated using a two-phase logistic regression. RESULTS Phase 1 comprised 3179 patients (289 cases; 2890 controls) and phase 2 comprised 1968 patients (168 cases; 1800 controls). We observed an adjusted OR of 0.83 for the combined cardiovascular event (95% CI: 0.61-1.13). CONCLUSIONS We observed a non-significantly reduced risk for cardiovascular diseases in patients using DPP-4 inhibitors compared to sulfonylureas in addition to metformin. This finding was not altered by the inclusion of additional information of the DMP in the analysis. However, due to the low power of this study, further studies are needed to reproduce our findings.
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Affiliation(s)
- Dirk Enders
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Bianca Kollhorst
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Susanne Engel
- Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany
| | - Roland Linder
- Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany
| | - Frank Verheyen
- Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
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Löscher W. Fit for purpose application of currently existing animal models in the discovery of novel epilepsy therapies. Epilepsy Res 2016; 126:157-84. [PMID: 27505294 DOI: 10.1016/j.eplepsyres.2016.05.016] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/06/2016] [Accepted: 05/30/2016] [Indexed: 01/10/2023]
Abstract
Animal seizure and epilepsy models continue to play an important role in the early discovery of new therapies for the symptomatic treatment of epilepsy. Since 1937, with the discovery of phenytoin, almost all anti-seizure drugs (ASDs) have been identified by their effects in animal models, and millions of patients world-wide have benefited from the successful translation of animal data into the clinic. However, several unmet clinical needs remain, including resistance to ASDs in about 30% of patients with epilepsy, adverse effects of ASDs that can reduce quality of life, and the lack of treatments that can prevent development of epilepsy in patients at risk following brain injury. The aim of this review is to critically discuss the translational value of currently used animal models of seizures and epilepsy, particularly what animal models can tell us about epilepsy therapies in patients and which limitations exist. Principles of translational medicine will be used for this discussion. An essential requirement for translational medicine to improve success in drug development is the availability of animal models with high predictive validity for a therapeutic drug response. For this requirement, the model, by definition, does not need to be a perfect replication of the clinical condition, but it is important that the validation provided for a given model is fit for purpose. The present review should guide researchers in both academia and industry what can and cannot be expected from animal models in preclinical development of epilepsy therapies, which models are best suited for which purpose, and for which aspects suitable models are as yet not available. Overall further development is needed to improve and validate animal models for the diverse areas in epilepsy research where suitable fit for purpose models are urgently needed in the search for more effective treatments.
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Hristovski D, Kastrin A, Dinevski D, Burgun A, Žiberna L, Rindflesch TC. Using Literature-Based Discovery to Explain Adverse Drug Effects. J Med Syst 2016; 40:185. [PMID: 27318993 DOI: 10.1007/s10916-016-0544-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/09/2016] [Indexed: 01/29/2023]
Abstract
We report on our research in using literature-based discovery (LBD) to provide pharmacological and/or pharmacogenomic explanations for reported adverse drug effects. The goal of LBD is to generate novel and potentially useful hypotheses by analyzing the scientific literature and optionally some additional resources. Our assumption is that drugs have effects on some genes or proteins and that these genes or proteins are associated with the observed adverse effects. Therefore, by using LBD we try to find genes or proteins that link the drugs with the reported adverse effects. These genes or proteins can be used to provide insight into the processes causing the adverse effects. Initial results show that our method has the potential to assist in explaining reported adverse drug effects.
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Affiliation(s)
- Dimitar Hristovski
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Andrej Kastrin
- Faculty of Information Studies, Novo mesto, Ljubljana, Slovenia
| | - Dejan Dinevski
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Anita Burgun
- INSERM UMRS 1138 Eq 22, Paris Descartes University, Georges Pompidou European Hospital, APHP, Paris, France
| | - Lovro Žiberna
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Abstract
Statins are widely used in secondary and primary prevention of atherosclerotic cardiovascular disease. They reduce cardiovascular events and mortality, and have an excellent safety record. Recent case reports suggest a possible association between statins and adverse effects on cognition. This article reviews recent literature related to statins and cognition and provides recommendations to clinicians. Cognitive considerations should not play a role in decision making for most patients for whom statins are indicated. Future trials of statin, or any novel antilipemic agent should include systematic assessment of cognition.
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Affiliation(s)
- Carlos Rojas-Fernandez
- Schlegel-UW Research Institute for Ageing & School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; Michael G. DeGroote School of Medicine, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Zain Hudani
- University of Waterloo School of Pharmacy, 10 Victoria St S, Kitchener, Ontario N2G 1C5, Canada
| | - Vera Bittner
- Division of Cardiovascular Disease, University of Alabama at Birmingham, LHRB 310, 701 19th Street South, Birmingham, AL 35294, USA
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Bileck A, Kreutz D, Muqaku B, Slany A, Gerner C. Comprehensive assessment of proteins regulated by dexamethasone reveals novel effects in primary human peripheral blood mononuclear cells. J Proteome Res 2014; 13:5989-6000. [PMID: 25347463 DOI: 10.1021/pr5008625] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Inflammation is a physiological process involved in many diseases. Monitoring proteins involved in regulatory effects may help to improve our understanding of inflammation. We have analyzed proteome alterations induced in peripheral blood mononuclear cells (PBMCs) upon inflammatory activation in great detail using high-resolution mass spectrometry. Moreover, the activated cells were treated with dexamethasone to investigate their response to this antiphlogistic drug. From a total of 6886 identified proteins, 469 proteins were significantly regulated upon inflammatory activation. Data are available via ProteomeXchange with identifiers PXD001415-23. Most of these proteins were counter-regulated by dexamethasone, with some exceptions concerning members of the interferon-induced protein family. To confirm some of these results, we performed targeted MRM analyses of selected peptides. The inflammation-induced upregulation of proteins such as IL-1β, IL-6, CXCL2, and GROα was confirmed, however, with strong quantitative interindividual differences. Furthermore, the inability of dexamethasone to downregulate inflammation-induced proteins such as PTX3 and TSG6 was clearly demonstrated. In conclusion, the relation of cell function as well as drug-induced modulation thereof was successfully mapped to proteomes, suggesting targeted analysis as a novel and powerful drug evaluation method. Although most consequences of dexamethasone were found to be compatible with the expected mode of action, some unexpected but significant observations may be related to adverse effects.
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Affiliation(s)
- Andrea Bileck
- Institute of Analytical Chemistry, Faculty of Chemistry, University of Vienna , Vienna 1090, Austria
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Bucher C, Tapernoux D, Diethelm M, Büscher C, Noser A, Fehr T, Henz S. Influence of weather conditions, drugs and comorbidities on serum Na and Cl in 13000 hospital admissions: evidence for a subpopulation susceptible for SIADH. Clin Biochem 2014; 47:618-24. [PMID: 24389078 DOI: 10.1016/j.clinbiochem.2013.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 12/06/2013] [Accepted: 12/17/2013] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Considerable variation in serum sodium (Na) and chloride (Cl) is found in patients at hospital admission. Our goal was to quantify the respective impact of drugs, comorbidities, demographic factors and weather conditions on serum Na and Cl. DESIGN AND METHODS For 13277 consecutive patients without terminal kidney disease admitted to the Department of Internal Medicine of the Kantonsspital St. Gallen drug history on admission, age, sex, body weight, ICD-10 diagnoses, and laboratory data were extracted from electronic medical records. Weather parameters prior to hospital admission were also integrated in a multivariate regression analysis. RESULTS Both serum Na and Cl showed an asymmetric left-tailed distribution. Median (interquartile range) Na was 138 (136/140) and Cl 104 (101/106). The distribution of sodium in patients with one or more risk factors for SIADH was best explained by the presence of two populations: one population with a similar distribution as the unexposed patients and a smaller population (about 25%) shifted to lower sodium levels. Lower weight, lower blood pressure, kidney dysfunction, fever, and diabetes were associated with both lower Na and Cl. Higher ambient temperature and higher air humidity preceding admission were associated with both higher Na and Cl values. CONCLUSIONS Na and Cl at hospital admission are highly influenced by ambient weather conditions, comorbidities and medication. The bimodal distribution of Na and Cl in persons exposed to risk factors for SIADH suggests that SIADH may only affect a genetically distinct vulnerable subpopulation.
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Affiliation(s)
- Christian Bucher
- Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland
| | - Daniel Tapernoux
- Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland
| | - Markus Diethelm
- Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland
| | - Christine Büscher
- Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland
| | - Anja Noser
- University of Applied Sciences, St. Gallen, Switzerland
| | - Thomas Fehr
- Division of Nephrology, University Hospital, Zürich, Switzerland
| | - Samuel Henz
- Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland.
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Abstract
Long QT syndrome (LQTS) is a cardiac conduction disorder that predisposes patients at potentially fatal cardiac events. Inherited conditions and acquired factors contribute to LQTS. A number of frequently prescribed CNS-active drugs prolong the QT interval. The clinical neurologist may encounter LQTS when initiating a pharmacotherapy or when increasing the dosage of drugs. The clinical neurologist may also encounter LQTS during the diagnostic work-up of patients with unexplained loss of consciousness, because LQTS may present as convulsive syncope. Some studies report an association of LQTS and stroke. Awareness of LQTS may help to recognize and prevent potentially fatal cardiac events associated with LQTS. This concise article highlights the clinically most relevant aspects of LQTS in the field of neurology.
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Anderson C, Roy T. Patient experiences of taking antidepressants for depression: a secondary qualitative analysis. Res Social Adm Pharm 2013; 9:884-902. [PMID: 23219056 DOI: 10.1016/j.sapharm.2012.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 11/06/2012] [Accepted: 11/08/2012] [Indexed: 11/20/2022]
Abstract
BACKGROUND Depression is one of the most commonly encountered mental health problems leading to significant morbidity and mortality and high medical and societal costs. Antidepressant prescribing in the UK has more than doubled in the last decade. There are a variety of factors that have been shown to affect a patient's experience of taking antidepressants The aim of this research was to explore patient narratives interviews about depression and its treatment in order to improve patient and health professional understanding of what it is like to use antidepressants. METHODS This study involved a supplementary secondary qualitative analysis of 80 in-depth narrative interviews from Healthtalkonline. Patients' experiences of using medicines for depression were explored in the context of their social, occupational and emotional impact, to identify any additional issues and to clarify what type of information people want to find after being prescribed a medicine. The interviews were conducted by the University of Oxford and had received ethical approval and been consented and copyrighted for this purpose. Data were analyzed thematically. RESULTS The most prominent theme was the coexistence of several conflicting issues around the use of medicines and participants were mostly influenced by the reality of their experiences, beliefs, attitudes and interaction with health care. Antidepressants appear to occupy a central place in many people' lives. Many people described how their medicines had helped them and how this served as a reinforcement to continue taking them in order to maintain a "normal life." Those who had stopped taking their antidepressants were likely to have experienced adverse reactions and had unsatisfactory interactions with health care professionals. A lack of information about antidepressants was a major cause of dissatisfaction often shaping attitudes to antidepressants'. CONCLUSIONS People's experiences with antidepressant use have a major impact on treatment continuation and hence treatment outcomes. Further studies are needed on depressed patients' beliefs about their depression and treatment and how they relate to different stages of illness, their interactions with health care and their adherence to antidepressants.
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Schott E, Paul F, Wuerfel JT, Zipp F, Rudolph B, Wiedenmann B, Baumgart DC. Development of ulcerative colitis in a patient with multiple sclerosis following treatment with interferonβ 1a. World J Gastroenterol 2007; 13:3638-40. [PMID: 17659718 PMCID: PMC4146807 DOI: 10.3748/wjg.v13.i26.3638] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To alert clinicians to a potential novel adverse drug effect of interferonβ 1a, we herein report a patient with relapsing-remitting multiple sclerosis who developed ulcerative colitis following treatment with interferonβ 1a. Ulcerative colitis persisted despite discontinuation of interferonβ 1a treatment and switching the patient to glatiramer acetate. Tacrolimus (FK506), 6-mercaptopurine, and prednisolone were required to induce remission. Both ulcerative colitis and multiple sclerosis were eventually well controlled using this regimen. Our report underscores that caution should be exercised when prescribing immunostimulatory agents in patients with inflammatory bowel disease (IBD) and challenges current efforts to stimulate innate immunity as a novel therapeutic concept for IBD.
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Affiliation(s)
- Eckart Schott
- Division of Gastroenterology and Hepatology, Department of Medicine, Charité Medical School, Humboldt-University of Berlin, Berlin, Germany
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Omoti AE, Omoti CE. Ocular toxicity of systemic anticancer chemotherapy. Pharm Pract (Granada) 2006; 4:55-9. [PMID: 25247000 PMCID: PMC4166144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The increased use of chemotherapeutic agents has resulted in longer cancer patient survival. Consequently the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Ocular toxicity induced by cancer chemotherapy includes a broad spectrum of disorders, reflecting the unique anatomical, physiological and biochemical features of the eye. Understanding the ocular side effects will assist the ophthalmologist and oncologist to recognize them early and intervene before blindness occurs. Anticipation of various treatment-related toxicities may also provide the opportunity for pharmacists to develop intervention strategies that could minimize or eliminate an expected side effect. The ophthalmologist should examine patients on anticancer therapy at baseline and three monthly thereafter. The various ocular side effects of anticancer chemotherapeutic agents, tamoxifen, and interferon on the adnexia, anterior segment, posterior segment and neuro-ophthalmic structures were reviewed.
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