scholarly journals Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents

Dermatology ◽  
2020 ◽  
Vol 236 (5) ◽  
pp. 477-480 ◽  
Author(s):  
Steven Madsen ◽  
Kyla N. Price ◽  
Vivian Y. Shi ◽  
Peter A. Lio
Keyword(s):  
Adverse Effect ◽  
Therapeutic Option ◽  
Topical Steroid ◽  
Test Area ◽  
Application Site ◽  
Inflammatory Dermatoses ◽  
Small Test ◽  
The Common ◽  
Site Pain ◽  
Steroid Sparing

Background: Topical steroid-sparing agents (SSA), such as tacrolimus, pimecrolimus, and crisaborole, represent an important therapeutic option in the treatment of inflammatory dermatoses such as atopic dermatitis. While these agents lack the common side effects associated with topical corticosteroids, they all share application site pain as an important adverse effect. Summary: Based on the available evidence and our experience, we suggest the following 7 practical strategies for decreasing the pain associated with SSA use. (1) Use a topical corticosteroid for a few days to reduce inflammation before starting the SSA treatment. (2) Use SSAs strategically. (3) Apply moisturizer before applying SSAs. (4) Store moisturizers in the refrigerator. (5) Ask the patient to apply the SSA on a small test area before broader application. (6) Apply the SSA on dry rather than on damp skin. (7) Consider using aspirin when appropriate for the patient.

scholarly journals PSPC1 is a new contextual determinant of aberrant subcellular translocation of oncogenes in tumor progression

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Yaw-Dong Lang ◽  
Yuh-Shan Jou
Keyword(s):  
Nuclear Export ◽  
Synergistic Effects ◽  
Therapeutic Option ◽  
Nucleocytoplasmic Shuttling ◽  
Innovative Strategy ◽  
Fda Approval ◽  
Cargo Proteins ◽  
The Common ◽  
Contextual Determinants ◽  
Nuclear Export Receptor

AbstractDysregulation of nucleocytoplasmic shuttling is commonly observed in cancers and emerging as a cancer hallmark for the development of anticancer therapeutic strategies. Despite its severe adverse effects, selinexor, a selective first-in-class inhibitor of the common nuclear export receptor XPO1, was developed to target nucleocytoplasmic protein shuttling and received accelerated FDA approval in 2019 in combination with dexamethasone as a fifth-line therapeutic option for adults with relapsed refractory multiple myeloma (RRMM). To explore innovative targets in nucleocytoplasmic shuttling, we propose that the aberrant contextual determinants of nucleocytoplasmic shuttling, such as PSPC1 (Paraspeckle component 1), TGIF1 (TGF-β Induced Factor Homeobox 1), NPM1 (Nucleophosmin), Mortalin and EBP50, that modulate shuttling (or cargo) proteins with opposite tumorigenic functions in different subcellular locations could be theranostic targets for developing anticancer strategies. For instance, PSPC1 was recently shown to be the contextual determinant of the TGF-β prometastatic switch and PTK6/β-catenin reciprocal oncogenic nucleocytoplasmic shuttling during hepatocellular carcinoma (HCC) progression. The innovative nucleocytoplasmic shuttling inhibitor PSPC1 C-terminal 131 polypeptide (PSPC1-CT131), which was developed to target both the shuttling determinant PSPC1 and the shuttling protein PTK6, maintained their tumor-suppressive characteristics and exhibited synergistic effects on tumor suppression in HCC cells and mouse models. In summary, targeting the contextual determinants of nucleocytoplasmic shuttling with cargo proteins having opposite tumorigenic functions in different subcellular locations could be an innovative strategy for developing new therapeutic biomarkers and agents to improve cancer therapy.

scholarly journals Wrong Biochemistry Results: Two Case Reports and Observational Study in 5310 Patients on Potentially Misleading Thyroid-stimulating Hormone and Gonadotropin Immunoassay Results

2002 ◽  
Vol 48 (11) ◽  
pp. 2023-2029 ◽  
Author(s):  
Adel AA Ismail ◽  
Paul L Walker ◽  
Julian H Barth ◽  
Kryzsztof C Lewandowski ◽  
Rick Jones ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Observational Study ◽  
Early Identification ◽  
Prospective Observational Study ◽  
Case Reports ◽  
Clinical Care ◽  
Thyroid Stimulating Hormone ◽  
The Common ◽  
Almost All ◽  
Stimulating Hormone

Abstract Background: Immunoassays are used in almost all medical and surgical specialties, but they suffer from interference from proteins such as antibodies in some patients’ sera. Such interferences are usually reported in the literature only as case reports after the introduction of a new assay. Methods: We undertook a prospective observational study on 5310 patients for whom the common immunoassay tests for thyroid-stimulating hormone (TSH) and/or gonadotropins were requested. All TSH and gonadotropin results were critically assessed for a mismatch between the clinical details and analytical results to identify samples suspected of analytical unreliability. These were tested further by three approaches to screen for interference. Results: From the 5310 sets of results, 59 patients’ samples were identified as suspect and were tested further. Analytically incorrect results were found in 28 (0.53% of the total studied). The magnitude of interference varied, but in 23 of 28 patients (82%), it was considered large enough to have a potentially adverse effect on cost and/or the clinical care of these patients. Two cases, described in detail, illustrate the adverse effect of error on patient care and cost, and the second highlights the difficulties and limitations of current approaches for identifying interference and inaccuracy in immunoassays. Conclusions: Because millions of TSH/gonadotropin tests are carried out in UK hospital laboratories alone, our data suggest that thousands of patients could be adversely affected by errors from interferences. Early identification of interference in cases with unusual results could be valuable.

Safety of Single-Dose Oral Cefixime, Intramuscular Ceftriaxone, or Intramuscular Gentamicin for the Treatment of Gonorrhea: A Systematic Review and Meta-analysis

2020 ◽  
pp. 106002802096633
Author(s):  
Jacob Dresser ◽  
Kyle John Wilby
Keyword(s):  
Adverse Effect ◽  
Single Dose ◽  
Adverse Effects ◽  
Injection Site ◽  
Randomized Controlled Trials ◽  
Keyword Search ◽  
Controlled Trials ◽  
Injection Site Pain ◽  
Randomized Controlled ◽  
Site Pain

Objective: To compare the incidence and types of adverse effects between 3 recommended treatment options for gonorrhea and to compare the incidence of injection site pain between single-dose intramuscular ceftriaxone and gentamicin. Data Sources: A keyword search of MEDLINE (1966 to September 2020), EMBASE (1947 to September 2020), and International Pharmaceutical Abstracts (1970 to September 2020) was conducted. The electronic search was supplemented with manual screening of references. Study Selection and Data Extraction: Comparator studies reporting adverse effect outcomes of treatment with cefixime, ceftriaxone, or gentamicin for gonorrhea in humans were included. Data extracted included study year, authors, aim, setting, population, dosing protocols, and outcome results. Data Synthesis: A total of 298 articles were identified, of which 6 met inclusion criteria. Two randomized controlled trials compared ceftriaxone and gentamicin. Four randomized controlled trials compared cefixime and ceftriaxone. No differences were noted for the occurrence of at least 1 adverse effect between gentamicin and ceftriaxone (odds ratio [OR] = 0.81; 95% CI = 0.56-1.18) or between cefixime and ceftriaxone (OR = 1.11; 95% CI = 0.21-5.93). Injection site pain (ceftriaxone and gentamicin) and other adverse effects (all drugs) were common but occurred at similar rates between groups. Relevance to Patient Care and Clinical Practice: Results of this review show a lack of signal for safety concerns with gentamicin-based regimens for the treatment of gonorrhea. Future research should investigate patient acceptability, especially for intramuscular injections. Conclusions: The use of single-dose cefixime, ceftriaxone, and gentamicin-based regimens for treatment of gonorrhea appears to be safe and acceptable for use in practice.

scholarly journals Staphylococcus aureus Infection and Persistence in Chronic Rhinosinusitis: Focus on Leukocidin ED

Toxins ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 678 ◽  
Author(s):  
Dimitri Poddighe ◽  
Luca Vangelista
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Neutralizing Antibodies ◽  
Therapeutic Option ◽  
Aureus Infection ◽  
Ccr5 Antagonists ◽  
Direct Targeting ◽  
The Common ◽  
Hiv 1 ◽  
Ccr5 Blockade

Chronic rhinosinusitis (CRS) is thought to be a multifactorial disease that includes a direct involvement of bacteria that trigger inflammation and contribute to CRS pathogenesis. Staphylococcus aureus infection and persistence is associated with chronic rhinosinusitis (CRS), and it may be particularly relevant in the form with nasal polyps (CRSwNP). The large array of exotoxins deployed by S. aureus is instrumental for the bacterium to warrant its infection and dissemination in different human body districts. Here, we analyze the common Th2 environment in CRSwNP and prospect a possible dynamic role played by S. aureus leukocidins in promoting this chronic inflammation, considering leukocidin ED (LukED) as a strong prototype candidate worth of therapeutic investigation. CCR5 is an essential target for LukED to exert its cytotoxicity towards T cells, macrophages and dendritic cells. Therefore, CCR5 blockade might be an interesting therapeutic option for CRS and, more specifically, persistent and relapsing CRSwNP. In this perspective, the arsenal of CCR5 antagonists being developed to inhibit HIV-1 entry (CCR5 being the major HIV-1 co-receptor) could be easily repurposed for CRS therapeutic investigation. Finally, direct targeting of LukED by neutralizing antibodies could represent an important additional solution to S. aureus infection.

scholarly journals Treatment of allergic rhinoconjunctivitis: a review of the role of topical levocabastine

1995 ◽  
Vol 4 (7) ◽  
pp. S31-S38 ◽  
Author(s):  
R. Gerth van Wijk
Keyword(s):  
Adverse Effect ◽  
Sodium Cromoglycate ◽  
Nasal Spray ◽  
Allergic Rhinoconjunctivitis ◽  
Application Site ◽  
Eye Drops ◽  
Clinical Effects ◽  
Therapeutic Approaches ◽  
First Line ◽  
Duration Of Action

Lcocabastine is an extremely potent and highly selective H1-receptor antagonist which has been specifically developed as eye drops and nasal spray for the treatment of allergic rhinoconjunctivitis. Clinical experience to date suggests that this topical antihistamine is at least as effective as other current first-line therapeutic approaches for the treatment of this condition, including oral H1-receptor antagonists and sodium cromoglycate. Onset of action is rapid, with clinical effects apparent within minutes of instillation. Moreover, duration of action is sufficiently long to permit a convenient twice-daily dosing regimen. Topical levocabastine is well tolerated with an adverse-effect profile comparable with that of placebo and sodium cromoglycate. As might be expected from the route of drug administration, application site reactions are the most frequent adverse effect associated with levocabastine eye drops and nasal spray with an incidence comparable with that seen in placebotreated controls. The availability of effective and well-tolerated topical antihistamines, such as levocabastine, is an important advance which broadens the range of therapeutic approaches available for the clinical management of allergic rhinoconjunctivitis. Levocabastine appears to be an attractive alternative to oral antihistamines as a first-line therapeutic option for the treatment of this atopic condition.

scholarly journals Steroid-sparing effect of mepolizumab in children with severe eosinophilic nonallergic asthma

2021 ◽  
Vol 49 (5) ◽  
pp. 113-116
Author(s):  
Maria Angela Tosca ◽  
Donata Girosi ◽  
Oliviero Sacco ◽  
Roberto Bernardini ◽  
Giorgio Ciprandi
Keyword(s):  
Lung Function ◽  
Therapeutic Option ◽  
Clinical Findings ◽  
Peripheral Eosinophilia ◽  
Interleukin 5 ◽  
Asthma Exacerbations ◽  
Effective Therapeutic Option ◽  
Sparing Effect ◽  
Steroid Sparing

Background: Asthma is characterized by a chronic airway inflammation, usually sustained by type 2 immunity. Bronchial and peripheral eosinophilia are biomarkers for type 2 asthma. Biologicals are the most effective treatment for severe asthma at present. Mepolizumab is an antagonist of interleukin-5 (IL-5), the most relevant cytokine involved in eosinophilia.Objective: This case report evaluated the effectiveness of mepolizumab in two girls with severe eosinophilic non-allergic asthma.Materials and methods: Two female children with severe eosinophilic nonallergic asthma were treated with mepolizumab for two years. Clinical findings, lung function, peripheral eosinophils, asthma control, and bronchial endoscopy were performed.Results: Biologicals reduced the eosinophilia, asthma exacerbations, and improved lung function in both patients. The treatment was also safe and well-tolerated.Conclusion: Mepolizumab represents an effective therapeutic option in the management of severe pediatric asthma.  

scholarly journals Preventive Effects of Multi-Lamellar Emulsion on Low Potency Topical Steroid Induced Local Adverse Effect

2013 ◽  
Vol 25 (1) ◽  
pp. 5 ◽  
Author(s):  
Geun Dong Sul ◽  
Hyun Jung Park ◽  
Jong Hwan Bae ◽  
Keum Duck Hong ◽  
Byeong Deog Park ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Topical Steroid ◽  
Local Adverse Effect ◽  
Preventive Effects

A case of palmar hypopigmentation induced by capecitabine in a gastrointestinal cancer patient

2021 ◽  
pp. 107815522110279
Author(s):  
Julian Gratiaux ◽  
Chloé Gossery ◽  
Chirine Rezzag-Mahcene ◽  
Damien Botsen ◽  
Laetitia Visseaux ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Drug Reaction ◽  
Case Reports ◽  
Antineoplastic Agent ◽  
Skin Lesions ◽  
Severe Adverse Effect ◽  
Gastrointestinal Cancers ◽  
History Of ◽  
The Common ◽  
Cutaneous Adverse Drug Reaction

Introduction Capecitabine is an antimetabolite antineoplastic agent widely used in the treatment gastrointestinal cancers. The common frequently reported cutaneous adverse drug reaction associated with capecitabin are a palmar-plantar erythrodysesthesia syndrome, rash and hyperpigmentation. This case reports a capecitabine-induced palmar hypopigmentation. Case report We report the case of a 74-years old patient with jejunum adenocarcinoma treated by capecitabine. The patient developed a pseudo-vitiligo after 2 cycles capecitabine and without history of cutaneous disorders. The skin lesions were characterized with skin hypopigmentation on both hands. Management and outcome: The hypopigmentation slowly recovered after capecitabine discontinuation. Conclusion This is the first described case of pseudo-vitiligo induced by capecitabine. This impressive but non-severe adverse effect should be known by oncologists and oncology pharmacists to reassure the patients in particular about the possible recovery after discontinuation of capecitabine.

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