Isotretinoin Use in Acne: Prospective Evaluation of Adverse Events

Background: Isotretinoin is an effective treatment for severe acne. Although the spectrum of side effects has been well documented, the changing incidence of such side effects over the course of treatment has not been studied in detail. Objectives: The purpose of our study was to examine a group of patients monthly over their course of treatment and prospectively document the side effects experienced. Methods: Over the period between January 1991 and July 1996, 124 courses of treatment with isotretinoin for severe acne were followed. The patients were treated for 4 months at a dose of 1 mg per kg body weight. A questionnaire was administered monthly, inquiring specifically about side effects known to be associated with isotretinoin. Any additional side effects were also noted. Results: The majority of patients experienced persistent dryness of lips. Dry eyes affected 40% of patients; this continued throughout treatment in 25%. Contact lens wearers were more likely to develop conjunctivitis. Lower back pain was reported early in about 30% of patients and fewer than 10% of patients would develop it later in the course of treatment. Arthralgia was noted in 16.5% of patients at the first visit and there was little change with ongoing treatment. Hair loss was experienced in a small percentage but was rarely noted on more than one occasion. Headaches occurred in less than 10% and were occasionally severe, but most often intermittent and recorded at a single visit. Depression occurred in 4% of patients and tended to persist throughout the treatment. All these patients completed the full course of treatment. Conclusion: This prospective analysis has shown that patients treated with isotretinoin experienced a predictable series of side effects. Some occurred fleetingly, but several persisted for the duration of treatment.

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Post Hoc Analyses of Data from a 90-Day Clinical Trial Evaluating the Tolerability and Efficacy of Tapentadol Immediate Release and Oxycodone Immediate Release for the Relief of Moderate to Severe Pain in Elderly and Nonelderly Patients

Pain Research and Management ◽

10.1155/2011/323985 ◽

2011 ◽

Vol 16 (4) ◽

pp. 245-251 ◽

Cited By ~ 19

Author(s):

Gary Vorsanger ◽

Jim Xiang ◽

David Biondi ◽

David Upmalis ◽

Jacqueline Delfgaauw ◽

...

Keyword(s):

Back Pain ◽

Pain Relief ◽

Adverse Events ◽

Elderly Patients ◽

Lower Back Pain ◽

Severe Pain ◽

Immediate Release ◽

Osteoarthritis Pain ◽

Lower Back ◽

Post Hoc

OBJECTIVE: To evaluate the tolerability and efficacy of tapentadol immediate release (IR) and oxycodone IR for relief of moderate to severe pain in elderly and nonelderly patients.METHODS: Post hoc data analyses were conducted on a 90-day randomized, phase 3, double-blind, flexible-dose study (ClinicalTrials.gov: NCT00364546) of adults with moderate to severe lower back pain or osteoarthritis pain who received tapentadol IR 50 mg or 100 mg, or oxycodone HCl IR 10 mg or 15 mg every 4 h to 6 h as needed for pain relief. Treatment-emergent adverse events and study discontinuations were recorded.RESULTS: Data from 849 patients randomly assigned (4:1 ratio) to treatment with a study drug (tapentadol IR [n=679] or oxycodone IR [n=170]) were analyzed according to age (younger than 65 years of age [nonelderly], or 65 years of age or older [elderly]) and treatment group. Among elderly patients, incidences of constipation (19.0% versus 35.6%) and nausea or vomiting (30.4% versus 51.1%) were significantly lower with tapentadol IR versus oxycodone IR (all P<0.05). Initial onsets of nausea and constipation occurred significantly later with tapentadol IR versus oxycodone IR (both P≤0.031). Tapentadol IR-treated elderly patients had a lower percentage of days with constipation than oxycodone IR-treated patients (P=0.020). For tapentadol IR- and oxycodone IR-treated elderly patients, respectively, incidences of study discontinuation due to gastrointestinal treatment-emergent adverse events were 15.8% and 24.4% (P=0.190). Tapentadol IR and oxycodone IR provided similar pain relief, with no overall age-dependent efficacy differences (mean pain scores [11-point numerical rating scale] decreased from 7.0 and 7.2 at baseline, to 4.9 and 5.2 at end point, respectively).CONCLUSIONS: Tapentadol IR was safe and effective for the relief of lower back pain and osteoarthritis pain in elderly patients, and was associated with a better gastrointestinal tolerability profile than oxycodone IR.

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Psychosocial effects of unrelated bone marrow donation: experiences of the National Marrow Donor Program

Blood ◽

10.1182/blood.v81.7.1947.bloodjournal8171947 ◽

1993 ◽

Vol 81 (7) ◽

pp. 1947-1959 ◽

Cited By ~ 1

Author(s):

VA Butterworth ◽

RG Simmons ◽

G Bartsch ◽

B Randall ◽

M Schimmel ◽

...

Keyword(s):

Bone Marrow ◽

Back Pain ◽

Side Effects ◽

Lower Back Pain ◽

Multivariate Analyses ◽

Psychosocial Effects ◽

Lower Back ◽

Bone Marrow Donation ◽

Survey Questionnaires ◽

Difficulty Walking

In this study, we investigated the psychosocial effects of unrelated marrow donation. Survey questionnaires were administered pre-donation, shortly post-donation, and 1 year post-donation to all donors through the National Marrow Donor Program over a 3-year period. Univariate, bivariate, and multivariate analyses were then performed. Donors were generally quite positive about the donation 1 year post-donation: 87% felt it was “very worthwhile” and 91% would be willing to donate again in the future. Marrow donors were more likely than kidney donors to feel better about themselves as a result of the donation (P < .001). Donors with longer collection times, in general, had less positive psychosocial outcomes from the donation. Donors who experienced lower back pain or difficulty walking as a result of the donation were more likely to experience the donation as more stressful and painful than expected, but no more likely to experience it as less positive emotionally than donors who did not experience these side effects.

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The Role of Body Weight and Growing in Body Height to Nonspecific Musculoskeletal Pain in a Cohort of Bosnia and Herzegovina Schoolchildren

10.20944/preprints201811.0207.v1 ◽

2018 ◽

Author(s):

Nurka Pranjic ◽

Selma Azabagic

Keyword(s):

Body Weight ◽

Back Pain ◽

Musculoskeletal Pain ◽

Lower Back Pain ◽

School Children ◽

Body Height ◽

Overweight And Obesity ◽

Physical Growth ◽

Lower Back ◽

Musculosceletal Pain

Background Children often suffer the nonspecific musculosceletal pain as reported in literature. Aim To determine relationship between body weights with development of musculoskeletal pain and to determine whether growing in body height is associated with musculoskeletal pain in schoolchildren. Subjects/ Methods A prospective longitudinal study included 1315 school children aged 7-14 years (652 boys and 663 girls) and was performed in 13 elementary schools in B&H. Child body height and body weight were measured. The survey of perception of musculoskeletal pain in different body regions of subjects was conducted by adjusted Nordic Musculosceletal Questionnaire (NMQ). Results The highest prevalence of an overweight and obesity in the 10th year 35.7% and the lowest frequency 17.8% in the 14th year was. In the age 14th obesity was’nt found. Boys have more prevalence of overweight. Using logistic regression model, we found that school children with normal BMI were protected with increased body height of acute lower back pain (β= -0.089, 95%CI, -9.730- -0.023, P< 0.049), and increased body height was protector of obese school children of acute upper back pain (β= -0.356, 95%CI, -14.077- -3.878, P< 0.001) and chronic lower back pain (β= -0.356, 95%CI, -14.077- -3.878, P< 0.001). Conclusion Schoolchildren with normal weight more often have had musculosceletal pain than those with overweight or obesity. This can be associated with intense physical growth period in height, especially. The assumption is that the increase in height changes the relationship between excessive BMI and musculoskeletal pain in children of school age.

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Pain and other symptoms in patients with hepatocellular carcinoma (HCC): A qualitative analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15187 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15187-e15187 ◽

Cited By ~ 2

Author(s):

Zeeshan Butt ◽

Rajiv Mallick ◽

Mary Frances Mulcahy ◽

Al B. Benson ◽

David Cella ◽

...

Keyword(s):

Quality Of Life ◽

Back Pain ◽

Side Effects ◽

Systemic Therapy ◽

Liver Diseases ◽

Lower Back ◽

Ongoing Pain ◽

Pain Symptoms ◽

Loss Of Appetite

e15187 Background: HCC is the second leading cause of cancer related deaths worldwide and incidence is increasing. Most HCC patients are diagnosed late-stage and with pain. Understanding the nature of pain experienced by HCC patients is complicated by co-morbid (including other liver) diseases and treatment related pain. The purpose of this study was to identify pain symptoms that are important and relevant to HCC patients who have received systemic therapy. Methods: We conducted semi-structured thematic interviews with 10 HCC patients who were currently on or previously had received oral systemic therapy (e.g., sorafenib) and had not received local or loco-regional therapy (e.g., surgery, radiation or chemo-embolization) within 4 weeks of the interview. Interviews included open elicitation of key symptoms, side effects and concerns. Patients also completed selected pain items from the FACT-Hep; items had previously been validated for patients with hepatobiliary cancers. Results: Mean age was 58 years (range 33-77); 2 patients had co-morbid cirrhosis, 1 had co-morbid hepatitis, and 4 patients had cirrhosis and hepatitis. When asked to describe the symptoms, side-effects or other issues that most significantly impact their quality of life, patients most often mentioned fatigue (n=5), diarrhea (n=5), skin toxicities (n=5), and loss of appetite (n=4). Nine patients reported experiencing pain over their HCC treatment course. Abdomen (N=7) and lower back (N=3) were the most common sites of pain; 2 patients reported only experiencing temporary pain from prior chemoembolization. The other 7 patients experienced ongoing pain, partly attributed to systemic therapy, ascites, or metastases. Ongoing abdominal and back pain were frequently not attributed to a specific cause. All patients indicated that FACT-Hep items adequately assessed their pain. Conclusions: Although pain was not a major driver of quality of life and for a few HCC patients it was transient and treatment-related, the majority of patients experienced some persistent pain. Abdominal pain and back pain were the most common pain sites for HCC patients. These results support the relevance of pain symptoms that have been previously identified as important in HCC.

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A prospective evaluation of both outcome and psychological status in 100 patients with mechanical lower back pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-1997-9112 ◽

1997 ◽

Vol 9 (1) ◽

pp. 39-41

Author(s):

N.J. Harris ◽

M.J. Robson ◽

S. Simpson ◽

B.H. Mehta

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Psychological Status ◽

Prospective Evaluation ◽

Lower Back

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AB0872 EFFICACY AND SAFETY OF THE COMBINATION OF APOCYNIN AND PAEONOL (APPA) IN PATIENTS WITH OSTEOARTHRITIS: AN UNCONTROLLED PATIENT CASE SERIES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1221 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1742.1-1742

Author(s):

N. Larkins

Keyword(s):

Adverse Events ◽

Meniscal Tear ◽

Case Series ◽

Duration Of Treatment ◽

R And D ◽

Lower Back ◽

Asian Medicine ◽

End Stage ◽

Age Range

Background:Apocynin and paeonol are secondary metabolites of plants used in traditional Asian medicine for centuries. The combination of synthetic versions of these two molecules (APPA) was developed initially for the treatment of osteoarthritis (OA) in animals where it has been found at least as effective as meloxicam. Human clinical trials are currently ongoing.Objectives:To report the outcomes from a case series of patients treated with APPA.Methods:Subjects with a diagnosis of OA, who had tried unsuccessfully a number of standard therapies, requested treatment with APPA from the author (NL), often following successful treatment of their animals with the combination or via networking. The usual daily dose was 1240 mg paeonol and 352 mg of apocynin taken as two 400mg capsules twice daily.Results:Twenty-three subjects with a diagnosis of OA of whom 7 were scheduled for surgery have been treated with APPA. There were 10 female and 13 males with an age range from 40 to 81 years. Nine patients had OA of the knees, 5 of whom had bilateral involvement, 7 had hip OA, 5 bilaterally and 2 with end stage bone on bone disease. Four patients had hand OA, one of whom also had disease of the hip, lower back and feet. In 3 patients the joints involved was not recorded. In 19 patients treatment was reported as effective. In 4 patients the treatment was ineffective, all of who were scheduled or had been recommended for surgery. In 2 of these cases cases this was bone on bone The duration of treatment for OA at the last recorded follow-up was reported for 16 patients in whom treatment was deemed effective and ranged from 9 to 120 months (median 24 months). In a further 3 patients the treatment the duration was not reported. In the 4 patients where no benefit was reported APPA was discontinued within a few weeks. In no case was there a report of APPA being discontinued due to adverse events. In 13 patients it was specifically stated that there had been no adverse events whereas for the remaining 10 patients it was not documented whether adverse events had occurred or not.Conclusion:Treatment with APPA was reported as effective by 82.6% of patients. In all patients in which the combination was ineffective the disease was severe with joint replacement recommended or scheduled; in two patients this was bone on bone. This would suggest that APPA is not a simple analgesic, a conclusion supported by effects seen in the rat meniscal tear model where possible disease modifying effects have been reported (1).References:[1]Glasson, S., Bendele, A. and Larkins, N. (2012). APPA provides disease modification in preclinical osteoarthritis. Osteoarthritis and Cartilage20: S72 -S73 Abstract 132.Disclosure of Interests:Nicholas Larkins Shareholder of: AKL R and D Ltd, Employee of: AKL R and D Ltd

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Psychosocial effects of unrelated bone marrow donation: experiences of the National Marrow Donor Program

Blood ◽

10.1182/blood.v81.7.1947.1947 ◽

1993 ◽

Vol 81 (7) ◽

pp. 1947-1959 ◽

Cited By ~ 36

Author(s):

VA Butterworth ◽

RG Simmons ◽

G Bartsch ◽

B Randall ◽

M Schimmel ◽

...

Keyword(s):

Bone Marrow ◽

Back Pain ◽

Side Effects ◽

Lower Back Pain ◽

Multivariate Analyses ◽

Psychosocial Effects ◽

Lower Back ◽

Bone Marrow Donation ◽

Survey Questionnaires ◽

Difficulty Walking

Abstract In this study, we investigated the psychosocial effects of unrelated marrow donation. Survey questionnaires were administered pre-donation, shortly post-donation, and 1 year post-donation to all donors through the National Marrow Donor Program over a 3-year period. Univariate, bivariate, and multivariate analyses were then performed. Donors were generally quite positive about the donation 1 year post-donation: 87% felt it was “very worthwhile” and 91% would be willing to donate again in the future. Marrow donors were more likely than kidney donors to feel better about themselves as a result of the donation (P < .001). Donors with longer collection times, in general, had less positive psychosocial outcomes from the donation. Donors who experienced lower back pain or difficulty walking as a result of the donation were more likely to experience the donation as more stressful and painful than expected, but no more likely to experience it as less positive emotionally than donors who did not experience these side effects.

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