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Use of Fixed-dose Combination Therapy with Remogliflozin and Vildagliptin as an Add-on Drug in Improving the Glycemic Control of Type 2 Diabetes Mellitus: An Observational Study 使用瑞格列净和维格列汀作为附加药物的固定剂量联合治疗改善2型糖尿病的血糖控制:一项观察性研究
IF 0.2 Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1177/0976500X231175219
Velammal Petchiappan, E. Mathew, Josna Jose, Mohamed Fardan, Y. Chidambaram, S. Thangavelu
Objective To evaluate whether a fixed dose combination (FDC) with remogliflozin and vildagliptin as an add-on therapy can improve the glycemic control in the management of type 2 diabetes mellitus and also the non-glycemic effects on physical profile, blood pressure, lipids, and insulin resistance. Materials and Methods An observational study that included 50 poorly controlled diabetics from April 2021 to September 2021. Patients were divided into two groups – those who were prescribed this FDC by their treating physician as an add-on drug were formed as group 1 (n = 28). Comparison group was age-matched patients who received other standard anti-diabetic medications, categorized as group 2 (n = 22). Fasting and postprandial sugars were done at baseline, the third and sixth month; glycated hemoglobin, body mass index, blood pressure, and lipids were done at baseline and the sixth month. Changes in blood sugar levels and glycated hemoglobin (HbA1C) at the third and sixth month from the baseline were compared using the Mann-Whitney U test. P-value less than 5% was considered statistically significant. Results A statistically significant reduction in mean HbA1c was noted in group 1 [–1.80 (−3.20, −0.15)] when compared to group 2 [0.50 (0.05, 0.80)] at the end of the third month. At the end of the sixth month, a significant reduction in the HbA1c level was noted in group 1 [(7.83 ± 0.87 %) when compared to baseline (10.3 ± 1.75%)]. Change in PPBS value at the third month from baseline was also statistically significant between groups 1 and 2 (−62.0 mg%, 19.0, P = 0.003). With respect to the body mass index and blood pressure, we did not find any significant difference. Conclusion The fixed drug combination improves glycemic control by significantly reducing mean HbA1c at the third and sixth month from baseline and there was no significant effect on body mass index, blood pressure, and lipids.
目的评价固定剂量联合应用瑞格列嗪和维达格利汀作为辅助治疗是否能改善2型糖尿病的血糖控制,以及对身体状况、血压、血脂和胰岛素抵抗的非血糖影响。材料和方法一项观察性研究,包括2021年4月至2021年9月期间50名控制不佳的糖尿病患者。患者被分为两组——治疗医生给他们开这种FDC作为附加药物的患者被列为第1组(n=28)。对照组为接受其他标准抗糖尿病药物治疗的年龄匹配的患者,分为第2组(n=22)。禁食和餐后血糖在基线、第三个月和第六个月进行;糖化血红蛋白、体重指数、血压和血脂在基线和第6个月进行测定。使用Mann-Whitney U检验比较基线后第三个月和第六个月血糖水平和糖化血红蛋白(HbA1C)的变化。P值小于5%被认为具有统计学意义。结果第3个月底,与第2组[0.50(0.05,0.80)]相比,第1组的平均HbA1c在统计学上显著降低[-1.80(−3.20,−0.15)]。第6个月底,第1组的HbA1c水平显著下降[(7.83±0.87%),与基线(10.3±1.75%)相比]。第1组和第2组在第3个月的PPBS值与基线相比的变化也具有统计学意义(−62.0 mg%,19.0,P=0.003)。就体重指数和血压而言,我们没有发现任何显著差异。结论固定药物组合在基线第3个月和第6个月显著降低平均HbA1c,改善血糖控制,对体重指数、血压和血脂没有显著影响。
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引用次数: 0
Influence of miR-142-3p on Pulmonary Fibrosis Through Regulation of p53/NF-κB miR-142-3p通过调控p53/NF-κB对肺纤维化的影响
IF 0.2 Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1177/0976500X231175222
Ye Shen, Hengjie Li, Ke Zhang, Shengqin Li, Ying-Ge Xu
Objectives To investigate the role of miR-142-3p in the bleomycin-induced idiopathic pulmonary fibrosis (IPF) mouse model and elucidate its targets. Methods In vitro model: Alveolar epithelial cells (AECs) were isolated and treated with bleomycin (50 µg/mL) or PBS for 12 h. In vivo model: Bleomycin (5 mg/kg) was injected into the trachea under anesthesia and aseptic conditions, and controls were treated with equal saline. After the completion of modeling, proteins and RNA were extracted. p53/NF-κB signaling factors were evaluated by western blot or immunohistochemistry. IL-1β and MMP-9 levels were measured by ELISA. The lentiviral transfection technique was used to overexpress miR-142-3p. Results In IPF, miR-142-3p was identified to play a negative regulatory role in lung epithelial cell senescence. Bleomycin treatment significantly reduced miR-142-3p expression in a concentration-dependent manner in vitro. miR-142-3p overexpression inhibited bleomycin-induced cellular senescence in vivo. In particular, miR-142-3p negatively regulated collagen deposition in pulmonary fibrosis by regulating p53/NF-κB expression. Conclusion MiR-142-3p plays an important role in the development of IPF by negatively regulating the p53/NF-κB network.
目的研究miR-142-3p在博来霉素诱导的特发性肺纤维化(IPF)小鼠模型中的作用,并阐明其靶点。方法体外模型:分离肺泡上皮细胞(AECs),用博来霉素(50µg/mL)或PBS处理12h。体内模型:在麻醉和无菌条件下将博来菌素(5mg/kg)注入气管,对照组用等量生理盐水处理。建模完成后,提取蛋白质和RNA。κB信号因子的表达。β和MMP-9水平。慢病毒转染技术用于过表达miR-142-3p。结果在IPF中,miR-142-3p在肺上皮细胞衰老中起负调控作用。博莱霉素治疗在体外以浓度依赖性方式显著降低miR-142-3p的表达。miR-142-3p过表达抑制了博来霉素诱导的体内细胞衰老。特别是,miR-142-3p通过调节p53/NF-κB的表达,负调控肺纤维化中的胶原沉积。结论MiR-142-3p通过负调控p53/NF-κB网络在IPF的发生发展中发挥重要作用。
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引用次数: 0
Critical Evaluation of Drug Promotional Literature Using WHO Ethical Criteria and Perception of Clinicians at a Tertiary Care Hospital 使用世界卫生组织伦理标准和三级护理医院临床医生的认知对药物宣传文献的批判性评价
IF 0.2 Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1177/0976500X231164812
A. Kaur, Shweta Singla, Mandeep Kaur, Jasninder Singh
Objective To evaluate the rationality of drug promotional literature (DPL) using World Health Organization (WHO) ethical criteria and to evaluate the perception of clinicians regarding DPLs using prevalidated criteria. Methods The promotional material was collected at a tertiary care teaching hospital over a period of 3 months. The perception of different prescribers has been changed. The data were analyzed using descriptive analysis. Results 191 DPLs were collected from various outpatient departments at a tertiary care hospital. The information regarding brand name, generic name, and active ingredients was mentioned in 100% of the collected material. Therapeutic uses of the promotional agents were mentioned in only 60.20%; references were cited in only 15.18%. The adverse effects were listed in only 17.80% of the DPLs. The perception regarding DPLs was gathered from 27 physicians at the same institute. The percentage of clinicians who were aware of the WHO criteria used for analyzing DPL was only 37.03%. All healthcare workers have agreed on the necessity of including critical appraisal of the DPLs in the undergraduate curriculum.
目的采用世界卫生组织(WHO)伦理标准评价药品宣传文献(DPL)的合理性,并采用预验证标准评价临床医生对DPL的认知。方法在某三级教学医院收集宣传品,为期3个月。不同开处方者的看法已经改变。采用描述性分析对数据进行分析。结果在某三级医院门诊共收集住院病人191例。关于品牌名称、通用名称和有效成分的信息在收集的材料中100%被提及。只有60.20%的人提到了促销剂的治疗用途;文献引用率仅为15.18%。不良反应仅在17.80%的dpl中列出。对dpl的看法收集了来自同一研究所的27名医生。了解用于DPL分析的who标准的临床医生比例仅为37.03%。所有医护人员都同意在本科课程中对dpl进行批判性评估的必要性。
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引用次数: 0
Food-derived Bioactive Peptides with Angiotensin-Converting Enzyme Inhibiting Effect: A Systematic Review 具有血管紧张素转换酶抑制作用的食源性生物活性肽:系统综述
IF 0.2 Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1177/0976500X231175217
Belén Daza-Rodríguez, Angie Rodríguez Martínez, Albeiro Marrugo Padilla, Johana Márquez Lázaro
Objective To describe the current scientific evidence of food-derived bioactive peptides and their angiotensin-converting enzyme inhibiting effect. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. We searched MEDLINE (through PubMed) and Science Direct databases to identify studies assessing food-derived bioactive peptides and angiotensin-converting enzyme-inhibiting effects. The evidence was organized and presented using tables and narrative synthesis. Results We identified 11 peptides with the best antihypertensive potential: RDGGYCC, LRLESF, FHAPWK, and LVLPG from plants; LSGYGP, ITT, VISDEDGVTH, ATT, and LWHTH from animals; and ALGRV and SPQW from fungi, which demonstrated their antihypertensive potential in vitro and in vivo. Conclusion Overall, food-derived bioactive peptides with hypertensive activity were identified, which shows a promising field as a therapeutic alternative to conventional pharmacological treatments.
目的介绍食源性生物活性肽及其抑制血管紧张素转换酶作用的最新科学证据。方法采用系统评价和荟萃分析首选报告项目(PRISMA)。我们检索了MEDLINE(通过PubMed)和Science Direct数据库,以确定评估食物来源的生物活性肽和血管紧张素转换酶抑制作用的研究。证据是用表格和叙事综合来组织和呈现的。结果从植物中鉴定出11种具有最佳降压潜能的肽:RDGGYCC、LRLESF、FHAPWK和LVLPG;来自动物的LSGYGP、ITT、VISDEDGVTH、ATT和LWHTH;真菌中的ALGRV和SPQW,在体外和体内均显示出抗高血压的潜力。结论食品源性生物活性肽具有一定的降压活性,有望作为常规药物治疗的替代药物。
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引用次数: 0
Challenges in Anesthetic Management of Succinylcholine-induced Masseter Muscle Rigidity in Difficult Airway Patient: A Case Report 琥珀酰胆碱诱导气道困难患者Masseter肌强直的麻醉管理挑战:一例报告
IF 0.2 Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1177/0976500X231169104
Monika Sharma, A. Chandak, Priyanka Dev, Aditi Prafulshatalwar
The difficult airway is already a challenging situation for anesthesiologists, in that scenario Succinylcholine (SCh) use, because of its rapid onset and short duration of action makes it a neuromuscular blockage drug of choice. Development of masseter muscular rigidity is thought to be an early indicator of the occurrence of the dreaded consequence, malignant hyperthermia. Consequently, it is essential to understand the potential side effects of this widely used drug in order to successfully treat the airway. Resulting is the use of videolaryngoscopic intubation along with propofol use and the procedure was completed successfully with no intraoperative or postoperative problems. Here, we described a case report of a 33-year-old male patient with a difficult airway posted for open reduction internal fixation of bilateral Lefort’s III fracture, developed masseter muscle rigidity (MMR) following administration of a standard dose of SCh.
气道困难对麻醉师来说已经是一个具有挑战性的情况,在这种情况下,琥珀酰胆碱(SCh)的使用,因为其起效快,作用时间短,使其成为神经肌肉阻断药物的首选。咬肌强直的发展被认为是恶性高热这一可怕后果发生的早期指标。因此,为了成功治疗气道,了解这种广泛使用的药物的潜在副作用至关重要。结果是使用了视频喉镜插管和丙泊酚,手术成功完成,没有术中或术后问题。在此,我们描述了一例33岁的男性患者的病例报告,该患者在接受双侧Lefort's III骨折切开复位内固定术时气道困难,在给予标准剂量的SCh后出现咬肌强直(MMR)。
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引用次数: 0
Rituximab, a Safer Option for Rheumatoid Arthritis: A Comparison of the Reported Adverse Events of Approved Monoclonal Antibodies 利妥昔单抗是治疗类风湿性关节炎的一种更安全的选择:获批单克隆抗体不良事件报告的比较
IF 0.2 Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1177/0976500X231154743
Sweety Sharma, Somnath Basu, Ramesh K. Goyal, Parbhat K. Sahoo, R. Mathur
Monoclonal antibodies (mAbs), which are commonly used to treat rheumatoid arthritis (RA), have been linked to a variety of adverse events (AEs). The objective of the study was to compare the safety profiles of six FDA approved mAbs (sarilumab, tocilizumab, adalimumab, golimumab, infliximab, and rituximab) marketed for the treatment of RA. A systematic review of the literature was conducted using the databases PubMed, Cochrane Library, and Science Direct. The manuscript comprised a total of 23 clinical studies. The percentage of patients who had AEs was calculated and presented using box-whisker and forest plots. Infections and infestations were found to be the most common AEs in RA patients treated with mAbs. Raised alanine aminotransferase (ALT), aspartate aminotransferase (AST), upper respiratory tract infection (URTI), and nasopharyngitis were frequently reported. The most common AEs were reported with adalimumab. The highest percentage of patients reporting AEs was associated with golimumab (52%), while rituximab had the fewest AEs (4.9%). In conclusion, rituximab appears to be a safer treatment option for RA as it is found to be associated with a lower risk of AEs, particularly respiratory infections.
单克隆抗体(mab)通常用于治疗类风湿性关节炎(RA),与各种不良事件(ae)有关。该研究的目的是比较6种FDA批准的单抗(sarilumab, tocilizumab, adalimumab, golimumab,英夫利昔单抗和利妥昔单抗)用于治疗RA的安全性。使用PubMed、Cochrane图书馆和Science Direct数据库对文献进行系统综述。该手稿共包括23项临床研究。使用盒须图和森林图计算并呈现ae患者的百分比。在单克隆抗体治疗的RA患者中,感染和感染是最常见的ae。谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)升高、上呼吸道感染(URTI)、鼻咽炎常被报道。最常见的ae是阿达木单抗。报告不良事件的患者比例最高的是戈利单抗(52%),而利妥昔单抗的不良事件最少(4.9%)。总之,利妥昔单抗似乎是一种更安全的治疗RA的选择,因为它被发现与较低的ae风险相关,特别是呼吸道感染。
{"title":"Rituximab, a Safer Option for Rheumatoid Arthritis: A Comparison of the Reported Adverse Events of Approved Monoclonal Antibodies","authors":"Sweety Sharma, Somnath Basu, Ramesh K. Goyal, Parbhat K. Sahoo, R. Mathur","doi":"10.1177/0976500X231154743","DOIUrl":"https://doi.org/10.1177/0976500X231154743","url":null,"abstract":"Monoclonal antibodies (mAbs), which are commonly used to treat rheumatoid arthritis (RA), have been linked to a variety of adverse events (AEs). The objective of the study was to compare the safety profiles of six FDA approved mAbs (sarilumab, tocilizumab, adalimumab, golimumab, infliximab, and rituximab) marketed for the treatment of RA. A systematic review of the literature was conducted using the databases PubMed, Cochrane Library, and Science Direct. The manuscript comprised a total of 23 clinical studies. The percentage of patients who had AEs was calculated and presented using box-whisker and forest plots. Infections and infestations were found to be the most common AEs in RA patients treated with mAbs. Raised alanine aminotransferase (ALT), aspartate aminotransferase (AST), upper respiratory tract infection (URTI), and nasopharyngitis were frequently reported. The most common AEs were reported with adalimumab. The highest percentage of patients reporting AEs was associated with golimumab (52%), while rituximab had the fewest AEs (4.9%). In conclusion, rituximab appears to be a safer treatment option for RA as it is found to be associated with a lower risk of AEs, particularly respiratory infections.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48757489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patterns of Medication Use and Their Determinants in Pregnancy among Women Admitted to the Obstetrics Wards of a Tertiary Care Hospital: A Cross-Sectional Study: Patterns of Medication Use and Their Determinants in Pregnancy 三级医院产科病房住院妇女妊娠期用药模式及其决定因素:一项横断面研究:妊娠期用药模式及其决定因素
IF 0.2 Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1177/0976500X221147803
Boney Rajan, E. Pasangha, P. Devi, S. George
Objective To assess the patterns and factors affecting medication use during antenatal and perinatal periods and to examine maternal and fetal outcomes among pregnant women admitted to a tertiary care hospital in a developing country. Methods A cross-sectional study was conducted in the obstetrics wards from 2017 to 2019. Data on patient demographics, co-existent medical conditions, medications, and patient outcomes were collected. Descriptive statistics were used to analyze baseline data, chi-square test was used for categorical variables, and multivariate logistic regression was used for factors influencing drug prescription. Results Out of 442 pregnant women, 56% were primigravida with a mean age of 24.7 ± 3.9 years. Approximately 32% experienced at least one disease condition during pregnancy; hypothyroidism (9.7%) was the commonest. The mean number of medications was 2.7 and 38.9% received drugs for a disease condition. Antimicrobials (24.5%) were the commonest drug class. Maternal age of over 25 [(OR (CI): 1.508 (1.191–2.716) (p = .005)] and maternal illness [OR (CI) 2.934 (1.8–4.7) (p = .00)] were identified as factors affecting drug prescription. Approximately 39.8% of deliveries were cesarean. Of the newborns, 12.6% had low birth weight, 9.2% were admitted to the newborn intensive care unit, and 14.9% were premature. Conclusions Most patients were primigravida and under 25 years. Antimicrobials were the most prescribed drug class. Maternal age over 25 years and maternal illness were identified as the factors affecting medication use. The prevalence of cesareans and prematurity was similar to previous studies.
目的评估影响产前和围产期用药的模式和因素,并检查在发展中国家某三级医院住院的孕妇的母婴结局。方法对2017 - 2019年产科病房进行横断面研究。收集了患者人口统计、共存医疗条件、药物和患者结果的数据。基线资料采用描述性统计分析,分类变量采用卡方检验,药物处方影响因素采用多因素logistic回归分析。结果442例孕妇中,初产妇占56%,平均年龄24.7±3.9岁。大约32%的人在怀孕期间至少经历过一种疾病;甲状腺功能减退(9.7%)最为常见。平均服药次数为2.7次,38.9%的人接受了治疗疾病的药物。抗微生物药物(24.5%)是最常见的药物类别。25岁以上的产妇年龄[OR (CI): 1.508 (1.191 ~ 2.716) (p = 0.005)]和产妇疾病[OR (CI): 2.934 (1.8 ~ 4.7) (p = 0.005)]是影响药物处方的因素。约39.8%的分娩为剖宫产。12.6%的新生儿出生体重过低,9.2%的新生儿住进新生儿重症监护病房,14.9%的新生儿早产。结论患者多为初迁女性,年龄在25岁以下。抗菌药物是处方最多的药物类别。母亲年龄超过25岁和母亲疾病被确定为影响用药的因素。剖宫产和早产的发生率与以往的研究相似。
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引用次数: 0
Comparative Study Between Intravenous Clonidine and Preservative Free Intravenous Lignocaine in Attenuation of Pressor Response to Laryngoscopy and Endotracheal Intubation 可乐定与不含防腐剂的利多卡因静脉滴注对喉镜和气管插管压力反应的比较研究
IF 0.2 Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1177/0976500X221148539
S. T. Vazhakalayil, Shahbaz Haroon
Objectives To compare the attenuation of pressor responses by intravenous clonidine and preservative-free lignocaine to laryngoscopy and endotracheal intubation. Materials and Methods A randomized, prospective, comparative, double-blinded study was conducted in 80 adult patients who were randomized into two groups of 40 each, group clonidine (Group C) and group lignocaine (Group L). Group C patients were given 2 µg/kg clonidine in 20 ml of normal saline as a slow infusion over 10 min prior to intubation. Group L patients were given 1.5 mg/kg of preservative-free 2% lignocaine in 20 ml of normal saline as a single-dose infusion over 3 min prior to intubation. Baseline vital and hemodynamic parameters were monitored during the perioperative period at 1-, 5-, and 10-min post-intubation. Results The attenuation of heart rate (HR) after intubation was much better with clonidine than lignocaine as there is statistically significant difference in the mean HR between the two groups at 1, 5, and 10 min after intubation with the HR significantly lesser in the Group C than the Group L at all times after intubation. Both clonidine and lignocaine were effective in attenuating systolic blood pressure response after intubation, but clonidine was more effective than lignocaine as systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the Group C remained much lower than the Group L and the difference between the two groups was statistically significant at all times after intubation. Conclusion Premedicating with a single slow infusion of 2 µg/kg i.v. clonidine has been proven to be effective in maintaining perioperative hemodynamic stability at 1, 5, and 10 min post-intubation than lignocaine.
目的比较静脉注射可乐定和不含防腐剂的利多卡因对喉镜和气管插管压迫反应的衰减。材料和方法对80名成年患者进行随机、前瞻性、对比、双盲研究,他们被随机分为两组,每组40人,可乐定组(C组)和利多卡因组(L组)。C组患者在插管前10分钟内缓慢输注20 ml生理盐水中的2µg/kg可乐定。L组患者在插管前3分钟内接受1.5mg/kg不含防腐剂的2%利多卡因在20ml生理盐水中的单剂量输注。在插管后1、5和10分钟的围手术期监测基线生命和血液动力学参数。结果可乐定对插管后心率(HR)的衰减比利多卡因好得多,因为在插管后1、5和10分钟,两组之间的平均HR存在统计学显著差异,C组在插管后所有时间的HR均显著低于L组。可乐定和利多卡因均能有效减轻插管后的收缩压反应,但可乐定在收缩压(SBP)、舒张压(DBP),C组的平均动脉压(MAP)仍远低于L组,并且两组之间在插管后的所有时间的差异具有统计学意义。结论与利多卡因相比,单次缓慢输注2µg/kg静脉注射可乐定在插管后1、5和10分钟的围手术期血液动力学稳定性方面是有效的。
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引用次数: 0
Delayed Extensive Local Reaction to the mRNA-1273 Vaccine against SARS-CoV-2: A Case Report 严重急性呼吸系统综合征冠状病毒2型mRNA-1273疫苗延迟的广泛局部反应:一例报告
IF 0.2 Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1177/0976500x221147748
Renato Ferreira-da-Silva, I. Ribeiro-Vaz, A. Silva, Fernando Nunes, M. Morato, J. Polónia, P. Guedes
In response to the COVID-19 pandemic, two mRNA vaccines (Comirnaty and Spikevax) received emergency use authorization from the European Medicines Agency. This case report aimed to report a delayed adverse reaction to the mRNA-1273 vaccine against COVID-19 from a Portuguese vaccination center. A case report was performed with medical observation and reported to the Portuguese Pharmacovigilance System, then investigated based on the WHO-UMC Causality Categories. A 66-year-old female patient with a clinical history of dyslipidemia, essential arterial hypertension, obesity, multinodular goitre and cholecystectomy, who presented delayed large cutaneous hypersensitivity reaction following Spikevax COVID-19 mRNA (mRNA-1273) vaccine administration. Our clinical findings (time and clinical appearance), along with evidence of previously reported histological findings, are strongly suggestive of T-cell-mediated hypersensitivity. There is no contraindication to the inoculation of subsequent doses in patients developing these clinical conditions, and vaccination should continue to be strongly encouraged.
为了应对新冠肺炎大流行,两种mRNA疫苗(Comirnaty和Spikevax)获得了欧洲药品管理局的紧急使用授权。本病例报告旨在报告葡萄牙疫苗接种中心对新冠肺炎mRNA-1273疫苗的延迟不良反应。对病例报告进行医学观察,并报告给葡萄牙药物警戒系统,然后根据WHO-UMC因果关系类别进行调查。一名66岁女性患者,有血脂异常、原发性动脉高压、肥胖、多结节性甲状腺肿和胆囊切除术的临床病史,在接种Spikevax新冠肺炎mRNA(mRNA-1273)疫苗后出现迟发性大面积皮肤超敏反应。我们的临床发现(时间和临床表现),以及先前报道的组织学发现的证据,强烈提示T细胞介导的超敏反应。出现这些临床症状的患者没有接种后续剂量疫苗的禁忌症,应继续大力鼓励接种。
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引用次数: 0
Targeting TLR-4 Signaling to Treat COVID-19-induced Acute Kidney Injury 靶向TLR-4信号治疗COVID-19诱导的急性肾损伤
IF 0.2 Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1177/0976500X221147798
Meaad A. Almazmomi, M. Alsieni
The newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has turned into a potentially fatal pandemic illness. Numerous acute kidney injury (AKI) cases have been reported, although diffuse alveolar destruction and acute respiratory failure are the major symptoms of SARS-CoV-2 infection. The AKI, often known as a sudden loss of kidney function, carries a greater risk of mortality and morbidity. AKI was the second most frequent cause of death after acute respiratory distress syndrome (ARDS) in critically ill patients with coronavirus disease 2019 (COVID-19). While most patients with COVID-19 have moderate symptoms, some have severe symptoms, such as septic shock and ARDS. Also, it has been proven that some patients have severe symptoms, such as the failure of several organs. The kidneys are often affected either directly or indirectly. The major signs of kidney involvement are proteinuria and AKI. It is hypothesized that multiple mechanisms contribute to kidney injury in COVID-19. Direct infection of podocytes and proximal tubular cells in the kidneys may lead to acute tubular necrosis and collapsing glomerulopathy. SARS-CoV2 may also trigger a cascade of immunological responses that lead to AKI, including cytokine storm (CS), macrophage activation syndrome, and Toll-like receptor type-4 activation (TLR-4). Other proposed processes of AKI include interactions between organs, endothelial failure, hypercoagulability, rhabdomyolysis, and sepsis. Furthermore, ischemic damage to the kidney might result from the decreased oxygen supply. This article focuses on kidney injury’s epidemiology, etiology, and pathophysiological processes. Specifically, it focuses on the CS and the role of TLR-4 in this process. To effectively manage and treat acute kidney damage and AKI in COVID-19, it is crucial to understand the underlying molecular pathways and pathophysiology.
新发现的严重急性呼吸系统综合征冠状病毒2型(SARS-CoV2)已成为一种潜在的致命流行病。尽管弥漫性肺泡破坏和急性呼吸衰竭是严重急性呼吸系统综合征冠状病毒2型感染的主要症状,但已经报道了许多急性肾损伤(AKI)病例。AKI,通常被称为肾功能的突然丧失,具有更大的死亡和发病风险。AKI是2019冠状病毒病(新冠肺炎)危重患者中仅次于急性呼吸窘迫综合征(ARDS)的第二常见死亡原因。虽然大多数新冠肺炎患者症状中等,但有些患者症状严重,如感染性休克和ARDS。此外,已经证明一些患者有严重的症状,例如几个器官的衰竭。肾脏经常受到直接或间接的影响。肾脏受累的主要症状是蛋白尿和AKI。假设多种机制导致新冠肺炎的肾损伤。肾脏中足细胞和近端肾小管细胞的直接感染可能导致急性肾小管坏死和肾小球塌陷。严重急性呼吸系统综合征冠状病毒2型也可能引发一系列导致AKI的免疫反应,包括细胞因子风暴(CS)、巨噬细胞活化综合征和Toll样受体4型活化(TLR-4)。AKI的其他拟议过程包括器官之间的相互作用、内皮衰竭、高凝状态、横纹肌溶解症和败血症。此外,肾脏的缺血性损伤可能是由氧气供应减少引起的。本文着重介绍肾损伤的流行病学、病因和病理生理过程。具体而言,它侧重于CS和TLR-4在这一过程中的作用。为了有效管理和治疗新冠肺炎的急性肾损伤和AKI,了解潜在的分子途径和病理生理学至关重要。
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引用次数: 1
期刊
Journal of Pharmacology & Pharmacotherapeutics
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