Adverse Events and Complications with Intragastric Balloons: a Narrative Review (with Video)

2021 ◽  
Author(s):  
Igor Braga Ribeiro ◽  
Ana Paula Samy Tanaka Kotinda ◽  
Sergio A. Sánchez-Luna ◽  
Diogo Turiani Hourneaux de Moura ◽  
Fabio Catache Mancini ◽  
...  
Keyword(s):  
Adverse Events ◽  
Narrative Review ◽  
Intragastric Balloons

scholarly journals Neurocognitive effects associated with proprotein convertase subtilisin-kexin type 9 inhibitor use: a narrative review

2021 ◽  
Vol 12 ◽  
pp. 204209862095927
Author(s):  
Wei C. Yuet ◽  
Didi Ebert ◽  
Michael Jann
Keyword(s):  
Cognitive Impairment ◽  
Adverse Events ◽  
The United States ◽  
Narrative Review ◽  
Lipid Lowering ◽  
Patient Specific ◽  
Proprotein Convertase ◽  
Pcsk9 Inhibitors ◽  
Pcsk9 Inhibitor ◽  
Receptor Modulation

Neurocognitive adverse events have been observed with the widespread use of 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors or “statins,” which reduce low-density lipoprotein cholesterol (LDL-C) levels and subsequently cardiovascular risk. The United States Food and Drug Association directed manufacturers of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors to monitor for neurocognitive adverse events due to their potent effects on LDL-C reduction, which is a proposed mechanism for neuronal cell dysfunction. Other proposed mechanisms for PCSK9 inhibitor-associated neurocognitive adverse events include N-methyl-d-aspartate receptor modulation, dysregulation of lipid and glucose metabolism, and patient-specific risk factors for cognitive impairment. The purpose of this narrative review article is to describe the proposed mechanisms, incidence of neurocognitive adverse events from phase II and III trials for PCSK9 inhibitors, neurocognitive assessments utilized in clinical trials, and clinical implications. Given the increasing prevalence of PCSK9 inhibitor use and the neurocognitive adverse events observed with prior lipid-lowering therapies, clinicians should be aware of the risks associated with PCSK9 inhibitors, especially when therapy is indicated for patients at high risk for cardiovascular events. Overall, the incidence of PCSK9 inhibitor-associated neurocognitive appears to be uncommon. However, additional prospective studies evaluating cognitive impairment may be beneficial to determine the long-term safety of these agents.

Managing adverse events after endoscopic ultrasound‐guided (EUS) drainage of the biliary tract and pancreatic fluid collections: a narrative review (with video)

2021 ◽  
Author(s):  
Mateus Pereira Funari ◽  
Igor Braga Ribeiro ◽  
Marcos Eduardo Lera dos Santos ◽  
Sergio Eiji Matuguma ◽  
Eduardo Guimarães Hourneaux de Moura
Keyword(s):  
Adverse Events ◽  
Biliary Tract ◽  
Endoscopic Ultrasound ◽  
Narrative Review ◽  
Ultrasound Guided ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections

scholarly journals SGLT2 inhibitors: a narrative review of efficacy and safety

2021 ◽  
Vol 121 (2) ◽  
pp. 229-239
Author(s):  
Donald S. Nelinson ◽  
Jose M. Sosa ◽  
Robert J. Chilton
Keyword(s):  
Adverse Events ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Narrative Review ◽  
Atherosclerotic Cardiovascular Disease ◽  
Comorbid Conditions ◽  
Postprandial Plasma Glucose ◽  
Renal Outcomes ◽  
Glucose Levels ◽  
Wide Range

Abstract Type 2 diabetes mellitus (T2DM) is a cardio-renal-metabolic condition that is frequently associated with multiple comorbidities, including atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD). The sodium-glucose co-transporter-2 (SGLT2) inhibitors, which lower glycated hemoglobin, fasting and postprandial plasma glucose levels, body weight, and blood pressure, as well as reduce the risk of a range of cardiovascular and renal outcomes without increasing hypoglycaemic risk, have heralded a paradigm shift in the management of T2DM. These drugs are compatible with most other glucose-lowering agents and can be used in patients with a wide range of comorbid conditions, including ASCVD, HF, and CKD, and in those with estimated glomerular filtration rates as low as 30 mL/min/1.73 m2. However, there are misunderstandings surrounding the clinical implications of SGLT2 inhibitors’ mechanism of action and concerns about the key adverse events with which this class of drugs has been associated. This narrative review summarizes the data that support the efficacy of SGLT2 inhibitors in reducing the risks of cardiovascular and renal outcomes in patients with T2DM and comorbid conditions and clarifies information relating to SGLT2 inhibitor-related adverse events.

scholarly journals Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review

2017 ◽  
Vol 11 (12) ◽  
pp. 419-24
Author(s):  
Janie Allaire ◽  
Tal Ben-Zvi ◽  
Benoît Lamarche ◽  
Karine Robitaille ◽  
Yves Fradet ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Adverse Events ◽  
Nutritional Status ◽  
Radical Cystectomy ◽  
Mortality Risk ◽  
Prospective Studies ◽  
Intervention Studies ◽  
Narrative Review ◽  
Nutritional Factors ◽  
The Impact

Only a few nutritional factors have been identified to predict the risk of developing complications after radical cystectomy (RC). This narrative review delineates the current known effects of preoperative nutritional status factors in this context. The report highlights the heterogeneity between study methods and results. We determined that low albuminemia values increase mortality risk and overall complications. In addition, obesity tends to increase the risk of developing venous thromboembolism and adverse events. Additional prospective studies, using standardized methods to both define and report complications, should be conducted to strengthen the connections between preoperative nutritional status factors and post-RC complications. Furthermore, intervention studies testing the impact of strategies to improve nutritional status on the risk of complications after RC are also needed.

scholarly journals Quality and Safety Improvement in Spine Surgery

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 17S-28S
Author(s):  
Fan Jiang ◽  
Jamie R. F. Wilson ◽  
Jetan H. Badhiwala ◽  
Carlo Santaguida ◽  
Michael H. Weber ◽  
...  
Keyword(s):  
Adverse Events ◽  
Spine Surgery ◽  
Practice Guidelines ◽  
Prediction Models ◽  
Narrative Review ◽  
Quality And Safety ◽  
Ovid Medline ◽  
Modern Health Care ◽  
Safety Improvement ◽  
Modern Era

Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

Rheumatological Immune-related Adverse Events of Checkpoints Inhibitors: a Narrative Review for the Latin American Rheumatologist

2021 ◽  
Author(s):  
Lilian Guadalupe Cano-Cruz ◽  
Ana Barrera-Vargas ◽  
Abigail Mateos-Soria ◽  
Enrique Soto-Perez-de-Celis ◽  
Javier Merayo-Chalico
Keyword(s):  
Adverse Events ◽  
Latin American ◽  
Narrative Review

scholarly journals Review of the Safety of Bipolar Radiofrequency Ablation in Patients with Chronic Pain with Implantable Cardiac Rhythm Management Devices

2021 ◽  
pp. E169-E176
Keyword(s):  
Chronic Pain ◽  
Radiofrequency Ablation ◽  
Pain Management ◽  
Adverse Events ◽  
Persistent Pain ◽  
Narrative Review ◽  
Cardiac Conduction ◽  
Systematic Assessment ◽  
Bipolar Radiofrequency ◽  
Cardiac Devices

BACKGROUND: Chronic pain, especially low back pain and hip pain, has been a growing public health concern that affects over 100 million Americans annually. Radiofrequency ablation (RFA) has distinct advantages over other chronic pain management modalities and its use has been increasing over the past decade. Among the growing population with comorbid conduction disorders and persistent pain, RFA and its potential interference with implantable cardiac devices is of concern. RFA is becoming a foundational element of persistent pain management and has been shown to be effective in a multitude of chronic pain syndromes. Cardiac implantable electronic devices (CIED), such as cardiac pacemakers or implantable cardioverter defibrillators, have been used in the treatment of cardiac conduction diseases for a number of decades. With our aging population, these diseases have increased in both incidence and prevalence. Chronic pain and cardiac conduction diseases are both common in our increasingly aging population. OBJECTIVES: This study aims to determine if the literature supports the hypothesis that patients with CIEDs can safely use RFA with minimal to no interaction. STUDY DESIGN: Systematic assessment of literature with a modified approach with bipolar RFA. METHODS: A narrative review with systematic assessment of the literature was carried out. In this review, we included randomized controlled trials (RCTs), open non-randomized control studies, prospective studies, retrospective studies, case series, and case reports. All types of radiofrequency utilized for pain management including pulsed and conventional were included. Outcome measures included interactions between the cardiovascular implantable electronic device (CIED) and radiofrequency ablation (RFA), adverse events, RFA efficacy in treating the pain using pain scores, and other complications. RESULTS: Our search criteria yielded 4 studies for inclusion, with inclusion of 33 patients and 71 bipolar radiofrequency for treatments. No adverse events or interactions occurred between the bipolar radiofrequency device and the implanted cardiac devices in any of these patients. Bipolar radiofrequency was utilized in all patients (n = 33). Overall there were no complications or malfunctions. LIMITATIONS: Small sample size, narrative review. CONCLUSIONS: This study provides evidence that bipolar RFA can be safely used in patients with CIEDs for chronic pain provided that proper precautions are employed. Considerations for safe use are provided. KEY WORDS: Chronic pain, CIED, radiofrequency ablation

scholarly journals Treatment-Emergent Adverse Events in Gene Therapy Trials for Inherited Retinal Diseases: A Narrative Review

2020 ◽  
Vol 9 (4) ◽  
pp. 709-724 ◽  
Author(s):  
Yan Nuzbrokh ◽  
Alexis S. Kassotis ◽  
Sara D. Ragi ◽  
Ruben Jauregui ◽  
Stephen H. Tsang
Keyword(s):  
Gene Therapy ◽  
Adverse Events ◽  
Narrative Review ◽  
Retinal Diseases

scholarly journals Smooth Extubation and Smooth Emergence Techniques: A Narrative Review

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Tiffany H. Wong ◽  
Garret Weber ◽  
Apolonia E. Abramowicz
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Review Paper ◽  
Significant Risk ◽  
Extubation Failure ◽  
Narrative Review ◽  
Infection Transmission ◽  
Aerosol Generation ◽  
Definition Of

There is a paucity of literature on extubation technique and a lack of consensus regarding the definition of smooth extubation. This narrative review paper defines an ideal extubation, otherwise known as a “smooth extubation,” reviews perioperative criteria for extubation and risks and adverse events related to extubation, and explores various perioperative techniques that can be used to achieve a smooth extubation while caring for an uncomplicated patient without significant risk factors for extubation failure. In light of the evolving practice during the SARS CoV2 (COVID-19) pandemic to minimize aerosol generation and infection transmission, smooth extubation is particularly important.

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