case reports

病例报告
  • 文章类型: Journal Article
    大多数关于依库珠单抗的安全性数据来自临床试验,而其在现实世界中的安全信息仍然有限。
    收集并分析了依库珠单抗在FDA不良事件报告系统(FAERS)数据库中的数据(从2007年第一季度到2023年第一季度)。PubMed中与依库珠单抗相关的药物不良反应(ADR)的病例报告,对2023年5月之前的Embase和WebofScience进行了系统审查。
    在FAERS数据库中确定了总共464例依库珠单抗的ADR。比例报告比率(PRR)最高的前五名ADR是总补体活性下降,血管外溶血,血红蛋白尿症,总补体活性增加和突破性溶血。从44篇出版物中发现51例与依库珠单抗相关的ADR。观察到病例报告中依库珠单抗相关淋病奈瑟菌感染病例数与脑膜炎奈瑟菌感染病例数相当。
    临床医生必须密切关注接受eculizumab的患者的感染风险,包括严重的脑膜炎奈瑟氏球菌感染和其他可能致命的感染,如淋病奈瑟氏球菌感染。此外,临床用药时应警惕可能出现的新的ADR。
    UNASSIGNED: Most of the safety data regarding eculizumab came from clinical trials, while its safety information in the real world is still limited.
    UNASSIGNED: The data of eculizumab in the FDA Adverse Event Reporting System (FAERS) database (from the first quarter of 2007 to the first quarter of 2023) was collected and analyzed. The case reports of adverse drug reactions (ADRs) related to eculizumab in PubMed, Embase and Web of Science before May 2023 were systematically reviewed.
    UNASSIGNED: A total of 464 ADRs of eculizumab were identified in the FAERS database. The top five ADRs with the highest proportional reporting ratio (PRR) are total complement activity decreased, extravascular hemolysis, hemoglobinuria, total complement activity increased and breakthrough hemolysis. Fifty-one cases of ADR related to eculizumab were identified from 44 publications. The number of reported cases of eculizumab associated Neisseria gonorrhoeae infection in case reports was observed to be comparable to the number of cases of Neisseria meningitidi infection.
    UNASSIGNED: Clinicians must pay close attention to the risk of infections in patients receiving eculizumab, including severe N. meningitidis infection and other potentially fatal infections such as N. gonorrhoeae infection. In addition, The possible emergence of new ADRs should be vigilant during clinical medication.
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  • 文章类型: Case Reports
    肺鳞状细胞癌(LUSC)的特点是转移和复发率高,导致患者预后不良。LUSC肠转移是临床罕见的发生。LUSC肠转移患者的治疗选择有限,并且没有管理这些病例的标准治疗指南。在这次审查中,我们讨论临床特征,诊断,并治疗LUSC肠转移患者,目前罕见的LUSC肠转移病例。我们描述了一名患有严重咳嗽和胸痛并被诊断患有LUSC和骨肿瘤的患者。最初,原发性LUSC和骨肿瘤通过标准治疗得到控制.然而,原发性LUSC在治疗后不久复发,这次是肠道转移,缺乏有效的治疗方法。我们从该病例的观察表明,LUSC转移到肠道与预后较差有关。
    Lung squamous cell carcinoma (LUSC) is characterized by a high rate of metastasis and recurrence, leading to a poor prognosis for affected patients. Intestinal metastasis of LUSC is a rare clinical occurrence. Treatment options for LUSC patients with intestinal metastasis are limited, and no standard therapy guidelines exist for managing these cases. In this review, we discuss the clinical features, diagnosis, and treatment of LUSC patients with intestinal metastasis and present a rare case of LUSC with intestinal metastasis. We describe a patient who presented with a severe cough and chest pain and diagnosed with LUSC and bone tumor. Initially, the primary LUSC and bone tumor were controlled with standard treatments. However, the primary LUSC reoccurred shortly after treatment, this time with intestinal metastasis, for which effective treatments are lacking. Our observation from the case suggests that LUSC metastasizing to intestinal tract is associated with a poorer prognosis.
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  • 文章类型: Journal Article
    Chlorfenapyr is a kind of insecticide widely used in agriculture. Acute chlorfenapyr poisoning has a high mortality rate and there is no effective treatment at present. Poisoning caused by oral chlorfenapyr can lead to multiple organs damage such as heart, brain, muscle and retina. Clinical treatment should remove toxicants from the body early to improve the prognosis. In this paper, the death data of 3 patients with chlorfenapyr poisoning were reported and literature search was conducted to discuss the mechanism and treatment of chlorfenapyr poisoning.
    虫螨腈是广泛应用于农业的一种杀虫剂,急性虫螨腈中毒患者死亡率高,目前尚无有效治疗方法。口服虫螨腈中毒可导致心脏、脑、肌肉、视网膜等多器官损害,临床治疗应早期清除体内毒物,以改善预后。本文报道3例虫螨腈中毒患者死亡资料并检索文献,探讨虫螨腈中毒的机制及治疗方法。.
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  • 文章类型: Case Reports
    背景:史蒂文斯-约翰逊综合征-中毒性表皮坏死松解症(SJS-TNE)重叠是一种罕见的以红斑为特征的皮肤病,水泡,广泛的剥脱,表皮脱离,多个粘膜受累,和积极的Nikolsky\的标志。SJS-TEN的死亡率很高。我们的病例涉及罕见的药物诱发的Stevens-Johnson综合征-毒性表皮坏死松解症重叠,在喹硫平和法莫替丁治疗的情况下延迟发作。
    方法:一名82岁的台湾女性因尿量减少入院,全身性水肿,和多个皮肤水泡和褥疮。随着病变的进一步扩散,多个破裂的大疱,脸上有浅的侵蚀,树干,四肢和粘膜受累影响了全身表面积的20%。Nikolsky的信号是积极的。高度怀疑史蒂文-约翰逊综合征的诊断。一个月前,她开始使用法莫替丁和喹硫平。开始静脉注射甲基强的松龙治疗,3天后改善皮肤病变。然而,甲基强的松龙逐渐减少仅1天后出现新的病变。患者入院后12天死亡。
    结论:Stevens-Johnson综合征-中毒性表皮坏死松解症是一种罕见的皮肤病。虽然它主要是急性的,死亡率很高,延迟发作仍然可能发生。喹硫平和法莫替丁通常安全有效地治疗老年病和胃肠道疾病,但罕见的药物超敏反应会导致衰弱的后果。因此,提高临床意识和开始支持治疗势在必行.仍然缺乏最佳的管理指南,需要通过随机对照试验确认制定的指南.有必要为更好的管理策略进行合作。
    BACKGROUND: Stevens-Johnson syndrome-toxic epidermal necrolysis (SJS-TNE) overlap is a rare skin disorder characterized by erythema, blisters, extensive exfoliation, epidermal detachment, the involvement of multiple mucosae, and positive Nikolsky\'s sign. SJS-TEN has a high mortality rate. Our case involves a rare occurrence of drug-induced Stevens-Johnson syndrome-toxic epidermal necrolysis overlap with a delayed onset in the setting of quetiapine and famotidine therapy.
    METHODS: An 82-year-old Taiwanese female was admitted to our hospital for decreased urine output, generalized edema, and multiple skin blisters and bedsores. With further spread of the lesions, multiple ruptured bullae with shallow erosions on the face, trunk, and limbs and mucosal involvement affected 20% of the total body surface area. Nikolsky\'s sign was positive. A diagnosis of Steven-Johnson syndrome was highly suspected. One month prior, she had started famotidine and quetiapine. Intravenous methylprednisolone treatment was initiated, which ameliorated the skin lesions after 3 days. However, new lesions developed after only 1 day of methylprednisolone tapering. The patient died 12 days after admission.
    CONCLUSIONS: Stevens-Johnson syndrome-toxic epidermal necrolysis is a rare skin disorder. Although it is mainly acute and has a high mortality rate, delayed onset can still occur. Quetiapine and famotidine are generally safe and effective for treating geriatric and gastrointestinal problems, but rare drug hypersensitivity reactions can lead to debilitating consequences. Therefore, increased clinical awareness and the initiation of supportive care are imperative. Optimal management guidelines are still lacking, and confirmation of developed guidelines through randomized controlled trials is needed. Collaboration for better management strategies is warranted.
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  • 文章类型: Case Reports
    本病例报告描述了儿童肘关节罕见异位骨化的发生,创伤后不适当的运动引起的。报告中描述了成功的去除异位骨化的手术,结果令人满意。
    一名7岁男孩在意外跌倒后肱骨髁上骨折,用石膏固定后,运动不当导致肘关节异位骨化,严重影响关节功能。手术切除异位骨化,随访18个月后完全恢复。术后18个月随访,异位骨化成功,肘关节功能良好,无复发。
    本报告的目的是显示手术治疗儿童肘关节异位骨化的良好效果,当保守治疗不起作用时。
    UNASSIGNED: This case report describes the occurrence of a rare heterotopic ossification of the elbow joint in a child, caused by inappropriate movement after trauma. A successful operation to remove heterotopic ossification was described in the report with satisfactory results.
    UNASSIGNED: A 7-year-old boy suffered a supracondylar fracture of the humerus after an accidental fall, and after immobilization with a cast, improper movement resulted in heterotopic ossification of the elbow joint, which severely affected joint function. The heterotopic ossification was surgically removed and a complete recovery was demonstrated at 18 months follow-up. The heterotopic ossification was successfully removed with good elbow function and no recurrence at 18 months follow-up.
    UNASSIGNED: The purpose of this report is to show the good results with surgical treatment of heterotopic ossification of the elbow joint in children,when conservative treatment does not work.
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  • 文章类型: Journal Article
    食管小细胞癌(SCCE)是一种罕见且高度恶性的食管癌,没有标准的治疗方法。面临着对传统疗法的抵抗的挑战。这项研究介绍了一名接受化学免疫疗法治疗的广泛阶段和两名有限阶段SCCE患者的病例。两名有限阶段的患者在治疗后接受了手术,并经历了显着且持久的积极反应。这代表了新辅助化学免疫疗法在局限期SCCE患者中的首次应用。此外,对病例患者进行综合免疫组织化学分析和全外显子组测序。研究结果表明,SCCE肿瘤中CD8T细胞的浸润和PD-L1的表达是接受化学免疫疗法的SCCE患者反应良好的关键因素。
    Small cell carcinoma of the esophagus (SCCE) is a rare and highly malignant type of esophageal cancer with no standard treatment, facing challenges of resistance to conventional therapies. This study presents the cases of one extensive-stage and two limited-stage SCCE patients treated with chemoimmunotherapy. The two limited-stage patients underwent surgery post-treatment and experienced notable and enduring positive responses. This represents the first documented application of neoadjuvant chemoimmunotherapy in limited-stage SCCE patients. Additionally, comprehensive immunohistochemical analysis and whole exome sequencing were performed on the case patients. The findings revealed that infiltration of CD8+ T cells and PD-L1 expression in the SCCE tumor were key factors for favorable responses in SCCE patients receiving chemoimmunotherapy.
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  • 文章类型: Journal Article
    该研究旨在获得8岁以下儿童四环素类药物的真实世界安全性概况,并为临床药物应用提供参考。
    我们通过OpenVigil2对FDA不良事件报告系统(FAERS)数据库进行了不成比例的分析,并对8岁以下儿童四环素类药物不良反应(ADR)的病例报告进行了审查。
    FAERS分析确定了8岁以下儿童的32种四环素类药物不良反应。呼吸,在所有系统器官类别(SOC)中,胸部和纵隔疾病的ADR最为常见.比例报告比(PRR)最高的前3位阳性信号为喉部损伤,霍纳综合征和高铁血红蛋白血症。文献中发现了16例8岁以下儿童四环素相关病例,集中在三个SOC中。胃肠道疾病是最常见的病例(n=12)。
    在我们的研究中,仅在8岁以下的儿童中新报告了几种不良反应,包括霍纳综合征和高铁血红蛋白血症。我们建议临床从业人员应在说明书和标签之外注意ADR。密切照顾孩子,并在治疗不可避免时及时进行干预。
    UNASSIGNED: The study aims to obtain the real-world safety profile of tetracyclines in children younger than 8 years old and provide reference for clinical drug applications.
    UNASSIGNED: We made a disproportionality analysis of the FDA Adverse Event Reporting System (FAERS) database through OpenVigil 2 and conducted a review of case reports regarding adverse drug reactions (ADRs) of tetracyclines in children younger than 8-year-old.
    UNASSIGNED: FAERS analysis identified 32 ADRs of tetracyclines in children younger than 8-year-old. Respiratory, thoracic, and mediastinal disorders contained the most frequent ADRs among all system organ classes (SOCs). The top three positive signals with the highest proportional reporting ratio (PRR) were laryngeal injury, Horner\'s syndrome and methaemoglobinaemia. Sixteen published tetracyclines-associated cases in children younger than 8-year-old were identified in the literature, concentrating in three SOCs. Gastrointestinal disorders were the most commonly reported cases (n = 12).
    UNASSIGNED: Several ADRs were newly reported only in children younger than 8-year-old in our research, including Horner\'s syndrome and methemoglobinemia. We recommended that the clinical practitioners should pay attention to the ADRs both in instruction and beyond the label. Take close care of children and timely intervene when the treatment is inevitable.
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  • 文章类型: Case Reports
    斑秃(AA)是一种自身免疫相关疾病,其特征是儿童无疤痕脱发。我们报告了一例儿童在第五剂狂犬病疫苗后感染AA的病例,并总结了疫苗接种诱导AA的各种潜在机制。这种情况表明狂犬病疫苗可能通过引起免疫失调而成为AA的易感性。
    Alopecia areata (AA) is an autoimmune-related disorder characterized by non-scarring hair loss in children. We report the case of a child who had AA after the fifth dose of rabies vaccine and summarized various potential mechanisms of vaccination induced AA. This case indicates that rabies vaccine might be a predisposition of AA by causing immune dysregulation.
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  • 文章类型: Case Reports
    华法林是一种抗凝剂,需要基于INR的剂量调整。根据有限的文献,抗坏血酸可能会损害华法林的有效性。我们报告了一例罕见的病例,一名63岁的女性有主动脉瓣置换史,在乳腺癌手术后服用抗坏血酸治疗贫血后出现华法林耐药性。尽管华法林的剂量从每天6毫克增加到10毫克,她的INR仍低于治疗范围。在排除了华法林抵抗的其他原因之后,我们停用了抗坏血酸,观察到INR迅速增加至目标值.在这种情况下,时间关系和其他混杂因素的缺乏证实了抗坏血酸的因果关系。我们建议同时服用维生素C和华法林的患者应密切监测其INR值,如果出现华法林耐药迹象,应尽快停用抗坏血酸。
    Warfarin is an anticoagulant that requires INR-based dosage adjustment. Ascorbic acid may impair warfarin effectiveness according to limited literature. We report a rare case of a 63-year-old woman with an aortic valve replacement history who developed warfarin resistance after taking ascorbic acid for anemia following breast cancer surgery. Despite increasing the warfarin dose from 6 mg to 10 mg daily, her INR remained below the therapeutic range. After ruling out other causes of warfarin resistance, we discontinued ascorbic acid and observed a rapid increase in INR to target values. The temporal relationship and the absence of other confounding factors confirmed the causality of ascorbic acid in this case. We recommend that patients concomitantly taking vitamin C and warfarin should monitor their INR values closely and discontinue ascorbic acid as soon as possible if they exhibit signs of warfarin resistance.
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  • 文章类型: Journal Article
    真皮填充剂可注射性是医学美容专业人员采用商业产品和成功的临床施用的关键因素。我们先前已经报道了(体外和离体)基于交联透明质酸(HA)的真皮填充剂在手动和自动可注射性要求方面的基准。为了进一步增强面向功能的产品表征工作流程和真皮填充剂可注射性评估的临床相关性,本研究的目的是进行体内评估.因此,MaiLi®产品系列(OxiFree™技术)的几种变体在体外和体内的可注射性属性方面进行了表征,重点是水凝胶系统的均匀性和易于注射。首先,在SimSkin®皮肤等效物中进行标准化的体外测定,随着临床注射器的变化,注射部位,注射技术。然后,在质地分析装置中比较地进行了SimSkin®皮肤等效物中的自动注射,以获得细粒度注射力曲线结果.最后,招募了五名女性参与者参与研究的体内研究(病例报告),随着临床注射器的变化,注射部位,注射技术。一般来说,从平移的角度对获得的定量力值和注射力曲线进行了严格评估,基于围绕OxiFree™制造技术的讨论和使用中的专业临床医生反馈。总的来说,本研究概述了MaiLi®产品系列在可注射性属性方面的显著同质性,以及医疗美容临床医生一贯高度的管理。
    Dermal filler injectability is a critical factor for commercial product adoption by medical aesthetic professionals and for successful clinical administration. We have previously reported (in vitro and ex vivo) cross-linked hyaluronic acid (HA)-based dermal filler benchmarking in terms of manual and automated injectability requirements. To further enhance the function-oriented product characterization workflows and the clinical relevance of dermal filler injectability assessments, the aim of this study was to perform in vivo evaluations. Therefore, several variants of the MaiLi® product range (OxiFree™ technology) were characterized in vitro and in vivo in terms of injectability attributes, with a focus on hydrogel system homogeneity and ease of injection. Firstly, standardized in vitro assays were performed in SimSkin® cutaneous equivalents, with variations of the clinical injector, injection site, and injection technique. Then, automated injections in SimSkin® cutaneous equivalents were comparatively performed in a texture analysis setup to obtain fine-granulometry injection force profile results. Finally, five female participants were recruited for the in vivo arm of the study (case reports), with variations of the clinical injector, injection site, and injection technique. Generally, the obtained quantitative force values and injection force profiles were critically appraised from a translational viewpoint, based on discussions around the OxiFree™ manufacturing technology and on in-use specialized clinician feedback. Overall, the present study outlined a notable level of homogeneity across the MaiLi® product range in terms of injectability attributes, as well as consistently high ease of administration by medical aesthetic clinicians.
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