Severe adverse events associated with hemoglobin based oxygen carriers: Role of resuscitative fluids and liquid preserved RBC

Abstract Background Status epilepticus (SE) is an emergency condition for which rapid and secured cessation is important. Phenytoin and fosphenytoin, the prodrug of phenytoin with less severe adverse effects, have been recommended as second-line treatments. However, fosphenytoin causes severe adverse events, such as hypotension and arrhythmia. Levetiracetam reportedly has similar efficacy and higher safety for SE; however, evidence to support its use for adult SE is lacking. In the present study, a non-inferiority designed multicenter randomized controlled trial (RCT) is being conducted to compare levetiracetam with fosphenytoin after diazepam as a second-line treatment for SE. Methods This multicenter, prospective, and open-label RCT is conducted in emergency departments. Between December 23, 2019, and March 31, 2023, 176 patients with convulsive SE transported to an emergency room will be randomized into a fosphenytoin group and levetiracetam group at a ratio of 1:1. The definition of SE is “continuous seizures longer than 5 min or discrete seizures longer than 2 min with intervening consciousness disturbance.” In both groups, diazepam is initially administered at 1–20 mg, followed by intravenous fosphenytoin at 22.5 mg/kg or intravenous levetiracetam at 1000–3000 mg. The primary outcome is the seizure cessation rate within 30 min. Seizure recurrence within 24 h, severe adverse events, and intubation rate within 24 h are secondary outcomes. Discussion The present study was approved and conducted as an initiative study of the Japanese Association for Acute Medicine. If non-inferiority is identified, the society will pursue an application for the national health insurance coverage of levetiracetam for SE via a public knowledge-based application. Trial registration Japan Registry of Clinical Trials jRCTs031190160. Registered on December 13, 2019

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Oral corticosteroid bursts and severe adverse events: a critical appraisal

British Journal of Dermatology ◽

10.1111/bjd.20071 ◽

2021 ◽

Author(s):

S.‐C. Shao ◽

L.‐T. Kuo ◽

E. C.‐C. Lai ◽

C.‐C. Chi

Keyword(s):

Adverse Events ◽

Critical Appraisal ◽

Oral Corticosteroid ◽

Severe Adverse Events

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Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

The Journal of Rheumatology ◽

10.3899/jrheum.151252 ◽

2016 ◽

Vol 43 (8) ◽

pp. 1547-1552 ◽

Cited By ~ 33

Author(s):

Alexis Régent ◽

Serge Redeker ◽

Alban Deroux ◽

Pierre Kieffer ◽

Kim Heang Ly ◽

...

Keyword(s):

Retrospective Study ◽

Side Effects ◽

Adverse Events ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Multicenter Study ◽

Efficacy And Safety ◽

Severe Adverse Events ◽

Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

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Pain therapy to reduce perioperative complications

Innovative Surgical Sciences ◽

10.1515/iss-2019-0008 ◽

2019 ◽

Vol 4 (4) ◽

pp. 158-166

Author(s):

Stephan M. Freys ◽

Esther Pogatzki-Zahn

Keyword(s):

Postoperative Pain ◽

Postoperative Complications ◽

Adverse Events ◽

Acute Pain ◽

Surgical Procedure ◽

Pain Therapy ◽

Recovery Period ◽

Acute Pain Therapy

AbstractThe incidence rates of adverse events secondary to any operation are a well-known problem in any surgical field. One outstanding example of such adverse events is postoperative pain. Thus, the incidence of acute postoperative pain following any surgical procedure and its treatment are central issues for every surgeon. In the times of Enhanced Recovery After Surgery (ERAS) programs, acute pain therapy became an increasingly well investigated and accepted aspect in almost all surgical subspecialties. However, if it comes to the reduction of postoperative complications, in the actual context of postoperative pain, surgeons tend to focus on the operative process rather than on the perioperative procedures. Undoubtedly, postoperative pain became an important factor with regard to the quality of surgical care: both, the extent and the quality of the surgical procedure and the extent and the quality of the analgesic technique are decisive issues for a successful pain management. There is growing evidence that supports the role of acute pain therapy in reducing postoperative morbidity, and it has been demonstrated that high pain scores postoperatively may contribute to a complicated postoperative course. This overview comprises the current knowledge on the role of acute pain therapy with regard to the occurrence of postoperative complications. Most of the knowledge is derived from studies that primarily focus on the type and quality of postoperative pain therapy in relation to specific surgical procedures and only secondary on complications. As far as existent, data that report on the recovery period after surgery, on the rehabilitation status, on perioperative morbidity, on the development of chronic pain after surgery, and on possible solutions of the latter problem with the institution of transitional pain services will be presented.

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