Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy

2021 ◽  
pp. 107815522110039
Author(s):  
Christine Barrett ◽  
Seon Jo Park ◽  
Lindsay Edmondson ◽  
Dulabh Monga

Objective This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. Methods This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. Results Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. Conclusion In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.

Author(s):  
Lili Saar ◽  
Maria Unbeck ◽  
Stefanie Bachnick ◽  
Beatrice Gehri ◽  
Michael Simon

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Amyna Husain ◽  
M. Douglas Baker ◽  
Mark C. Bisanzo ◽  
Martha W. Stevens

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE−) was 14% (P=0.22). The FTE+ study group, and FTE− comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE− infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE− infants.


2018 ◽  
Vol 36 (07) ◽  
pp. 765-772 ◽  
Author(s):  
Meredith L. Dorr ◽  
Rebecca C. Pierson ◽  
Joanne Daggy ◽  
Sara K. Quinney ◽  
David M. Haas

Objective To compare the efficacy of similar buccal and vaginal misoprostol doses for induction of labor. Study Design Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery and other labor outcomes (e.g., vaginal delivery less than 24 hours) were compared between women receiving buccal and vaginal misoprostol. Results There was no significant difference in time to delivery for women receiving buccal (median 18.2 hour, 95% confidence interval [CI] = [14.9, 21.5]) versus vaginal (median 18.3 hour, 95% CI = [15.0, 20.4]) misoprostol (p = 0.428); even after adjusting for covariates (p = 0.381). Women who presented with premature rupture of membranes were more likely to receive buccal misoprostol (92.7% received buccal vs. 7.3% received vaginal, p < 0.001). A similar number of women delivered vaginally in the buccal group (88.2%) and vaginal misoprostol group (86.8%, p = 0.835). The proportion of women who experienced uterine tachysystole or chorioamnionitis did not significantly differ by route of administration. Conclusion We found no significant differences in time to delivery or other labor outcomes between buccal or vaginal dosing of misoprostol in women undergoing labor induction at term.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa L. Somers ◽  
Ed Peterson ◽  
Saurabh Sharma ◽  
Kathleen Yaremchuk

Objective. To determine predictors of patient adherence to CPAP. Design. A retrospective chart review identified patients with AHI values greater than 15 who were recommended to receive CPAP. Compliance was measured at a 1-to 4-month interval and at 1 year. Results. There were 106 of 368 (29%) patients who received CPAP therapy that were compliant with CPAP use at 1 to 4 months. Forty-six patients (12%) were using CPAP at one year. For the male group at one year, the model demonstrated the AHI value (P  value=.026) as a predictor of compliance if greater than 27.3 and a significant two-way interaction between age and AHI (P=.023). Increased length of time from the initial visit and receiving the CPAP machine was associated with poorer compliance (P=.002). Those living in areas with higher incomes and with a higher percentage of non-high-school graduates were more likely to be compliant (P=.01 and P=.044). Conclusion. Older male patients with higher AHI values were noted to be more adherent to CPAP. Efforts should be made to try to minimize the length of time between the initial visit and the time to receive CPAP to improve compliance.


2021 ◽  
Author(s):  
Min Hyong Koh ◽  
Sheng-Che Yen ◽  
Lester Y. Leung ◽  
Sarah Gans ◽  
Keri Sullivan ◽  
...  

Abstract Background: Manual treadmill training is used for rehabilitating locomotor impairments but can be physically demanding for trainers. This has been addressed by enlisting robots, but in doing so, the ability of trainers to use their experience and judgment to modulate locomotor assistance on the fly has been lost. This paper explores the feasibility of a telerobotics approach that allows patients to receive physical assistance from robotically augmented trainers.Methods: In the approach, a trainer holds onto a small robotic manipulandum that shadows the motion of a large robotic arm, which is magnetically attached to the leg of a locomoting patient. When the trainer deflects the manipulandum, the robotic arm applies a proportional force to the patient. After an initial evaluation of the telerobotic system’s ability to follow the leg during unassisted locomotion with unimpaired participants, a small feasibility study was performed with six patients with prior strokes. Over six days, the patients interacted with two robotically augmented trainers (separately), who assisted in altering a targeted gait feature: an increase in the affected leg’s swing length. Results: During unassisted walking, unwanted robot interaction forces averaged 3−4 N (swing−stance) for unimpaired individuals and 2−3 N for the patients who survived strokes. Transients averaging about 10 N were sometimes present at heel-strike/toe-off. For five of six patients, these forces increased with treadmill speed during stance (R2 = .99; p < .001) and increased with patient height (R2 = .71; p = .073) during swing. During assisted walking, the trainers applied 3.0 ± 2.8 N (mean ± standard deviation across patients) and 14.1 ± 3.4 N of force anteriorly and upwards, respectively. The patients exhibited a 20 ± 21% increase in unassisted swing length between Days 1−6 (p = .058). Conclusions: The results support the feasibility of locomotor assistance with a telerobotics approach. Simultaneous measurement of trainer manipulative actions, patient motor responses, and the forces associated with these interactions may prove useful for testing sensorimotor rehabilitation hypotheses. Further research with clinicians as operators and randomized controlled trials with more comprehensive outcome measures are needed before conclusions regarding efficacy can be reached.


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