Adverse effects

不利影响
  • 文章类型: Case Reports
    关于2019年冠状病毒病(COVID-19)疫苗的不良反应有许多研究,但COVID-19疫苗接种后的尿失禁很少见。这里,我们报告了一个8岁的男孩去门诊部,泰国平医学院医院,泰语Binh,越南在过去2周内抱怨尿失禁,在第一剂信使RNA疫苗之后。他在临床和实验室检查中没有其他异常。这种临床情况表明疫苗有副作用。在没有厕所和膀胱训练的情况下,诊断后没有给予特异性治疗。随后的监测显示症状在2个月内逐渐减轻,从症状开始的第14周完全康复,不需要任何医疗干预。该案例强调需要对疫苗接种后的潜在不良反应进行全面评估和评估。包括不常见的介绍。
    There have been many studies on the adverse effects of coronavirus disease 2019 (COVID-19) vaccines but the urinary incontinence after COVID-19 vaccination is rare. Here, we report an 8-year-old boy presented to outpatient department, Thai Binh University of Medicine Hospital, Thai Binh, Vietnam with complaints of urinary incontinence for the past 2 weeks, following the first dose of the messenger RNA vaccine. He had no other abnormalities in clinical and laboratory exams. This clinical situation suggested vaccine side effects. No specific treatment was administered upon diagnosis without toilet and bladder training. Subsequent monitoring revealed a gradual reduction in symptoms over 2 months, with complete recovery achieved at the 14th week from the onset of symptoms, without necessitating any medical intervention. This case highlights the need for thorough evaluation and assessment of potential adverse effects following vaccination, including uncommon presentations.
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  • 文章类型: Case Reports
    错位是与外周中心静脉导管(PICC)相关的相对罕见的并发症,特别是在股浅静脉(SFV)导管插入的情况下。据我们所知,我们是第一个报告这种罕见的情况下,在对侧肾静脉SFVPICC错位。
    一名82岁的妇女在超声引导下接受了用于PICC的SFV床边插管。随后的射线照相检查发现了意外的错位,导管尖端朝向对侧肾静脉。根据X射线检查结果拔出导管后,观察到导管保留了其功能。
    虽然罕见,在SFVPICC放置时应考虑尖端错位。迅速校正尖端位置对于防止导管故障和进一步的灾难性后果至关重要。对于接受床边SFVPICC插入的危重患者,术后X射线对提高安全性至关重要.
    UNASSIGNED: Malposition is a relatively rare complication associated with peripherally inserted central catheters (PICCs), particularly in cases of superficial femoral vein (SFV) catheterization. To the best of our knowledge, we are the first to report this rare case of SFV PICC malposition in the contralateral renal vein.
    UNASSIGNED: An 82-year-old woman underwent bedside cannulation of the SFV for PICC under ultrasound guidance. Subsequent radiographic examination revealed an unexpected misplacement, with the catheter tip positioned toward the contralateral renal vein. After pulling out the catheter on the basis of the X-ray result, it was observed that the catheter retained its function.
    UNASSIGNED: Although rare, tip misplacement should be considered in SFV PICC placement. Prompt correction of the tip position is crucial to prevent catheter malfunction and further catastrophic consequences. For critical patients receiving bedside SFV PICC insertion, postoperational X-ray is crucial for enhancing safety.
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  • 文章类型: Case Reports
    急性胰腺炎被认为是钠-葡萄糖协同转运蛋白-2抑制剂(SGLT-2is)的一种罕见的潜在不良反应,最近批准的一类新药物可作为辅助治疗,用于治疗控制不佳的2型糖尿病患者以及心力衰竭(HF)和慢性肾病(CKD)患者.SGLT-2i可有效降低心血管死亡率和肾功能恶化。只有少数已发表的与SGLT-2i给药有关的急性胰腺炎病例。我们的病例描述了一名58岁的男性,他到急诊科就诊,临床表现为急性胰腺炎,没有已知的危险因素,他最近开始接受达格列净治疗。经过全面的临床和实验室测试,胰腺炎的诊断与达格列净有关.出院时,dapagliflozin停药,上腹痛没有进一步复发.
    Acute pancreatitis has been considered a rare potential adverse effect of sodium-glucose co-transporter-2 inhibitors (SGLT-2is), a new class of medications recently approved for use as an add-on therapy in patients with poorly controlled type 2 diabetes mellitus as well as in individuals with heart failure (HF) and chronic kidney disease (CKD). SGLT-2i can effectively reduce cardiovascular mortality and the deterioration of renal function. There are only a few published cases of acute pancreatitis linked to SGLT-2i administration. Our case describes a 58-year-old male who presented to the emergency department with a clinical presentation of acute pancreatitis, with no known risk factors, who was recently started on therapy with dapagliflozin. Following thorough clinical and laboratory testing, the diagnosis of pancreatitis was associated with dapagliflozin. Upon discharge, dapagliflozin was discontinued with no further recurrence of epigastric pain.
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    文章类型: Case Reports
    皮肤利什曼病在伊朗流行。
    我们试图研究皮肤利什曼病患者的治疗结果和治疗并发症。
    本病例系列纳入了2018年至2019年在伊朗访问我们中心的经涂片证实的皮肤利什曼病患者。
    总共,36例患者接受了皮损内的葡甲胺治疗,肌内锑酸葡甲胺,葡萄糖酸钠,和两性霉素B。这种治疗对81.8%的患者有效。6.1%和12.1%的患者出现复发和治疗失败,分别。病灶内治疗,肌内锑酸葡甲胺,葡萄糖酸钠,两性霉素B的清除率为80.8%,92.3%,75%,85.7%,分别。清除与病灶内注射锑酸葡甲胺之间较短的时间间隔相关(p=0.006),复发与注射之间较长的时间间隔相关(p=0.018)。每个患者的平均副作用数量,葡萄糖酸钠,肌内锑酸葡甲胺,两性霉素B分别为0.62,1.4,1.6和2.8.最常见的副作用,肌内锑酸葡甲胺,两性霉素B是局部疼痛,关节痛,和低钾血症,分别。
    低样本量是本研究的局限性。
    肌内注射锑酸葡甲胺的治愈率高于两性霉素B,高于葡萄糖酸钠的治愈率。在病灶内治疗的患者中,缩短注射间隔时间增加了清除率,降低了复发率.
    UNASSIGNED: Cutaneous leishmaniasis is endemic in Iran.
    UNASSIGNED: We sought to investigate the therapeutic outcomes and complications of treatment in patients with cutaneous leishmaniasis.
    UNASSIGNED: This case series enrolled patients with smear-proven cutaneous leishmaniasis who visited our center in Iran from 2018 to 2019.
    UNASSIGNED: In total, 36 patients were treated with intralesional meglumine antimoniate, intramuscular meglumine antimoniate, sodium stibogluconate, and amphotericin B. Overall, this treatment was effective in 81.8 percent of patients. Relapse and treatment failure occurred in 6.1 percent and 12.1 percent of patients, respectively. Treatment with intralesional meglumine antimoniate, intramuscular meglumine antimoniate, sodium stibogluconate, and amphotericin B yielded a clearance rate of 80.8 percent, 92.3 percent, 75 percent, and 85.7 percent, respectively. Clearance was associated with a shorter time interval between injections of intralesional meglumine antimoniate (p=0.006) and relapse was associated with a longer time interval between injections (p=0.018). The average number of side effects per patient for intralesional meglumine antimoniate, sodium stibogluconate, intramuscular meglumine antimoniate, and amphotericin B was 0.62, 1.4, 1.6, and 2.8, respectively. The most common side effect of intralesional meglumine antimoniate, intramuscular meglumine antimoniate, and amphotericin B was local pain, arthralgia, and hypokalemia, respectively.
    UNASSIGNED: Low sample size was the limitation of this study.
    UNASSIGNED: The cure rate of intramuscular meglumine antimoniate was higher than amphotericin B, which was higher than the cure rate of sodium stibogluconate. In patients treated with intralesional meglumine antimoniate, reducing the time interval between injections increased the clearance rate and decreased the rate of relapse.
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  • 文章类型: Case Reports
    达托霉素(DAP)是一种环状脂肽抗生素,对革兰氏阳性菌具有杀菌活性。最常见的不良反应是以横纹肌溶解为特征的肌毒性。其他报告的不良反应包括胃肠道症状,皮肤损伤,出血,和肺部受累。神经毒性是罕见的,其机制仍部分阐明。我们报告了一例与DAP诱导的神经毒性一致的混乱病例。一名73岁的肥胖男子接受DAP9mg/kg的治疗,以治疗与足部骨炎和颈后部前突关节炎相关的耐甲氧西林金黄色葡萄球菌(MRSA)菌血症。在治疗的第五天,他发展了空间迷失方向,血清DAP浓度很高。提示DAP诱导的神经毒性。停止治疗后,他的神经状态恢复正常。该观察结果描述了肥胖所偏爱的混乱与DAP之间的关系。临床医生应警惕与DAP相关的神经系统疾病。减少肥胖患者的剂量是谨慎的。
    Daptomycin (DAP) is a cyclic lipopeptide antibiotic with bactericidal activity against gram-positive bacteria. The most common adverse reaction is myotoxicity characterized by rhabdomyolysis. Other reported adverse reactions include gastrointestinal symptoms, skin lesions, bleeding, and pulmonary involvement. Neurotoxicity is rare and its mechanism remains partially elucidated. We report a case of confusion consistent with DAP-induced neurotoxicity. A 73-year-old obese man was treated with DAP 9 mg/kg for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia associated with foot osteitis and cervical posterior inter-apophyseal arthritis. On the fifth day of treatment, he developed spatial disorientation, and serum DAP concentrations were very high. DAP-induced neurotoxicity was suggested. His neurological status returned to normal after treatment was stopped. This observation describes a relationship between confusion and DAP that is favored by obesity. Clinicians should be alert for neurologic disorders associated with DAP. It is prudent to reduce doses in obese patients.
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  • 文章类型: Case Reports
    黄色瘤(XD)是一种罕见的,非朗格汉斯细胞组织细胞增生症。虽然治疗是出了名的困难,2-氯脱氧腺苷(克拉屈滨)最近已成为潜在的有效治疗选择。这里,我们描述了一例65岁男性XD患者在接受克拉屈滨治疗后皮肤明显改善.根据报告的不良反应(AE),我们还提供了有关XD患者使用克拉屈滨的最新文献综述。虽然克拉屈滨在XD中的疗效是明确的,对于治疗持续时间和AE管理尚无共识.因此,在这些病例中,我们强烈鼓励涉及皮肤病学和肿瘤学的跨学科讨论。
    Xanthoma disseminatum (XD) is a rare, non-Langerhans cell histiocytosis. While treatment is notoriously difficult, 2-chlorodeoxyadenosine (cladribine) has recently emerged as a potential effective therapeutic option. Here, we describe the case of a 65-year-old male with XD who experienced significant cutaneous improvement after cladribine treatment. We also provide an updated literature review on cladribine use in patients with XD in light of reported adverse effects (AEs). While the efficacy of cladribine in XD is clear, no consensus exists for treatment duration and AE management. Hence, we strongly encourage interdisciplinary discourse involving dermatology and oncology in these cases.
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  • 文章类型: Case Reports
    奥马珠单抗是一种针对过敏性疾病的既定疗法,然而,与其他生物制剂相比,其神经作用仍未得到充分开发。
    一名45岁男性哮喘患者在接受第一剂奥马珠单抗治疗一周后出现急性四肢瘫痪。电生理研究表明,多条神经的部分运动传导阻滞,具有降低的CMAP振幅和缺乏F波。CSF显示细胞-白蛋白解离。诊断为格林-巴利综合征。尽管静脉注射免疫球蛋白(IVIG)治疗,患者出现持续性神经性症状.
    患者出现急性四肢轻瘫,没有感觉或颅神经受累,提示一种称为急性运动传导阻滞神经病(AMCBN)的格林-巴利综合征(GBS)变体。电生理研究表明无脱髓鞘的传导阻滞,涉及轴突变性。尽管常见病因的阴性结果,奥马珠单抗给药和症状发作之间的时间关联表明存在潜在的联系,由药物引起的疾病标准支持。关于奥马珠单抗的神经效应存在矛盾的证据,提出的机制包括自身免疫反应和肥大细胞功能障碍。与TNF-α拮抗剂的比较突出了相似的神经病变模式,表明需要进一步研究以阐明奥马珠单抗的神经毒性。
    总而言之,虽然奥马珠单抗对过敏疾病有希望,包括慢性荨麻疹,其对周围神经的潜在影响需要临床医生保持警惕.进一步的研究对于确定奥马珠单抗治疗相关的神经系统并发症的风险-收益概况和阐明潜在的机制和风险因素是必要的。
    UNASSIGNED: Omalizumab is an established therapy for allergic conditions, yet its neurological effects remain underexplored compared to other biological agents.
    UNASSIGNED: A 45-year-old male with asthma developed acute quadriparesis one week after receiving the first dose of omalizumab. Electrophysiological studies have shown partial motor conduction block in multiple nerves, with reduced CMAP amplitudes and absent F-waves in others. CSF showed cyto-albuminous dissociation. The diagnosis was a variant of Guillain-Barré syndrome. Despite intravenous immunoglobulin (IVIG) therapy, the patient experienced persistent neuropathic symptoms.
    UNASSIGNED: The patient presented with acute quadriparesis devoid of sensory or cranial nerve involvement, suggestive of a variant of Guillain-Barré syndrome (GBS) known as acute motor conduction block neuropathy (AMCBN). Electrophysiological studies have indicated conduction block without demyelination, implicating axonal degeneration. Despite negative findings for common etiologies, the temporal association between omalizumab administration and symptom onset suggests a potential link, supported by criteria for drug-induced illness. Conflicting evidence exists regarding omalizumab\'s neurological effects, with proposed mechanisms including autoimmune reactions and mast cell dysfunction. Comparisons to TNF-α antagonists highlight similar neuropathy patterns, indicating a need for further research to clarify omalizumab\'s neurotoxicity.
    UNASSIGNED: In conclusion, while omalizumab holds promise for allergic conditions, including chronic urticaria, its potential impact on peripheral nerves necessitates vigilance among clinicians. Further studies are imperative to ascertain the risk-benefit profile and elucidate underlying mechanisms and risk factors of neurological complications associated with omalizumab therapy.
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  • 文章类型: Journal Article
    在马来西亚,在广泛接种COVID-19疫苗后,吉隆坡医院报告免疫接种后皮肤反应增加。为了理解这一点,我们启动了一项病例对照研究,以确定潜在的危险因素.
    此基于注册表的,无与伦比的病例对照研究涵盖了与COVID-19疫苗相关的免疫接种(AEFI)报告后的所有不良事件,吉隆坡医院药剂科通过马来西亚药品不良反应咨询委员会(MADRAC)AEFI报告表格收到。评估了24个潜在的危险因素,包括人口统计信息,病史,食物过敏,COVID-19疫苗接种史和SARS-CoV-2感染史,使用MADRACAEFI报告表进行评估。使用单变量和多变量逻辑回归估计具有95%置信区间(CI)的比值比(OR)。
    皮肤反应在中年女性中更为常见,特别是在第一剂COVID-19疫苗接种后。这些反应,主要是温和和普遍的,包括瘙痒和荨麻疹。值得注意的是,52%为延迟反应(疫苗接种后4小时以上)。与COVID-19免疫接种后皮肤反应风险增加相关的因素包括海鲜和贝类过敏史(调整比值比[adjOR]:2.11;95%CI:1.12,3.96;P=0.020),疫苗过敏史(adjOR:4.07;95%CI:1.44,11.54;P=0.008),过去的皮肤病(调整:5.48;95%CI:2.03,14.78;P=0.001),和既往药物过敏(adjOR:2.12;95%CI:1.36,3.31;P=0.001)。
    自我报告的疫苗过敏史,发现食物或药物会增加COVID-19疫苗接种后皮肤反应的可能性。这些反应,主要是温和的,不妨碍第二次疫苗剂量的给药。大多数反应发生在第一次给药后,表现为广泛性瘙痒和荨麻疹。他们有效地管理与口服抗组胺药和低剂量的皮质类固醇,从而避免了住院治疗的需要。
    UNASSIGNED: In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors.
    UNASSIGNED: This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression.
    UNASSIGNED: Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001).
    UNASSIGNED: Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.
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  • 文章类型: Case Reports
    博来霉素是一种具有出色抗肿瘤作用的糖肽抗生素。博来霉素的主要不良反应是肺纤维化。然而,白内障作为严重不良反应的发展尚未有报道。
    这里,我们描述了1例22岁男性睾丸癌患者通过博莱霉素治疗诱发白内障的病例.在手术干预和BEP方案的五个连续化疗周期后,包括博来霉素,依托泊苷和顺铂,患者报告视力逐渐无痛丧失,随着视觉能力的大幅下降,尤其是右眼。在全面的眼科检查之后,诊断为白内障。最终,患者接受了白内障超声乳化术和人工晶状体置换.
    博来霉素可引起白内障,这导致了视力的显著丧失。因此,临床医生应观察早期症状,适当调整治疗方法,防止症状加重。
    UNASSIGNED: Bleomycin is a glycopeptide antibiotic with outstanding anti-tumor effects. A major adverse effect of bleomycin is lung fibrosis. However, the development of cataracts as a severe adverse effect has not been reported.
    UNASSIGNED: Herein, we describe the first case of cataract induced by bleomycin therapy in a 22-year-old male with testicular cancer. After surgical intervention and following five successive chemotherapy cycles of the BEP regimen, including bleomycin, etoposide and cisplatin, the patient reported a gradual painless loss of vision, with substantial decline in visual ability, especially in the right eye. Following comprehensive eye examinations, a cataract was diagnosed. Eventually, the patient underwent phacoemulsification and received replacement of the intraocular lenses.
    UNASSIGNED: Bleomycin can cause cataracts, which induces a significant loss of vision. Therefore, clinicians should observe early symptoms and properly adjust treatment to prevent aggravation of symptoms.
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  • 文章类型: Case Reports
    背景:大剂量维生素C治疗(HVCT)可以减少化疗的不良反应并增强抗肿瘤治疗的效果,这被认为是最安全的替代疗法之一。然而,其不良反应的严重程度可能被低估了。最严重的不良反应是溶血,这可能导致急性肾损伤或死亡。尽管葡萄糖-6-磷酸脱氢酶(G6PD)缺乏被认为是主要原因,概率和病理机制还没有完全理解,导致缺乏有效和规范的治疗方法。
    方法:两名大肠癌患者在使用1g/kgHVCT后出现溶血性贫血。与以前的案例相比,这两例患者的最低血红蛋白水平<50g/L,低于以前的报道。这可能是因为病例1患有慢性乙型肝炎多年,导致肝脏储备功能异常,病例2有II级骨髓抑制。两名患者均在血液替代疗法后好转并出院。我们的病例溶血程度最严重,但预后最好,提示我们的治疗可能有助于挽救药物引起的溶血。这是对HVCT引起的溶血的文献的首次回顾,我们发现所有G6PD缺乏症患者在HVCT后出现溶血。
    结论:G6PD缺乏症应被视为HVCT的禁忌症,不建议骨髓抑制患者使用,中度至重度贫血,造血异常,或肝肾功能异常。早期血液净化和类固醇治疗可以避免HVCT相关溶血性贫血引起的急性肾损伤或死亡。
    BACKGROUND: High-dose vitamin C treatment (HVCT) can reduce the adverse effect of chemotherapy and enhance the effect of antitumor therapy, which has been considered one of the safest alternative treatments. However, the severity of its adverse effects may have been underestimated. The most serious adverse effect is hemolysis, which may result in acute kidney injury or death. Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is considered to be the main cause, the probability and pathological mechanism are not completely understood, leading to a lack of effective and standardized treatment methods.
    METHODS: Two patients with colorectal cancer developed hemolytic anemia after using 1 g/kg HVCT. In contrast to previous cases, the lowest hemoglobin level in the two cases was < 50 g/L, which was lower than previously reported. This may be because Case 1 had chronic hepatitis B for many years, which caused abnormal liver reserve function, and Case 2 had grade II bone marrow suppression. Both patients improved and were discharged after blood replacement therapy. Our cases had the most severe degree of hemolysis but the best prognosis, suggesting that our treatment may be helpful for rescue of drug-induced hemolysis. This is the first review of the literature on hemolysis caused by HVCT, and we found that all patients with G6PD deficiency developed hemolysis after HVCT.
    CONCLUSIONS: G6PD deficiency should be considered as a contraindication to HVCT, and it is not recommended for patients with bone marrow suppression, moderate-to-severe anemia, hematopoietic abnormalities, or abnormal liver and kidney function. Early blood purification and steroid therapy may avoid acute kidney injury or death caused by HVCT-related hemolytic anemia.
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