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Therapeutics and Clinical Risk Management

Shi Zhou, Samrat Khanal, Haijun Zhang
Purpose: The aim of this study was to evaluate the risk of immune-related adverse events (irAEs) among cancer patients receiving nivolumab-plus-ipilimumab therapy and nivolumab monotherapy. Patients and methods: PubMed and Web of Science were searched for related studies from inception to June 2018. Eligible studies included randomized controlled trials comparing nivolumab-plus-ipilimumab with nivolumab alone in cancer patients reporting on all-grade (grade 1-4) and high-grade (grade 3/4) irAEs...
2019: Therapeutics and Clinical Risk Management
Nurul 'Izzah Ibrahim, Mohd Sharkawi Ahmad, Mohamed S Zulfarina, Sharifah Nurul Aqilah Sayed Mohd Zaris, Zainal Abidin Nor Azlin, Isa Naina Mohamed, Norazlina Mohamed, Sabarul Afian Mokhtar, Ahmad Nazrun Shuid
Background and purpose: Physical function assessment can be performed to assess functional mobility among older adults, especially after a traumatic incident such as lower body fracture (LBF). The objective of this study was to evaluate physical function of older patients with LBF after 3 months of discharge from the hospital. Patients and methods: A total of 89 patients were followed up at the discharge phase. Four independent variables were tested: age, sex, type of fracture, and use of a walking aid before fracture...
2019: Therapeutics and Clinical Risk Management
Shan Tian, Ruixue Li, Yingyun Guo, Xuemei Jia, Weiguo Dong
Objective: Variceal hemorrhage is the primary driver of mortality in patients with portal hypertension. Recent guidelines recommended that patients with esophageal varices should receive endoscopic band ligation (EBL) or carvedilol as prophylaxis of variceal bleeding. Several clinical trials have compared carvedilol use with EBL intervention, yielding controversial results. The present study aimed to perform a meta-analysis of randomized controlled trials (RCTs) evaluating the benefits and harms of carvedilol vs EBL for the prevention of variceal bleeding...
2019: Therapeutics and Clinical Risk Management
Massimiliano Pelli, Luigi Maggi, Monica Rocco
No abstract text is available yet for this article.
2019: Therapeutics and Clinical Risk Management
Zhongyu Liu, Shuang Tian, Zhifeng Yan, Xiurong Yu, Xiuli Li, Ye Tao
Objective: To report the first case series of robotic single-site (RSS) surgery via the da Vinci Si Surgical System for mature cyst teratoma cystectomy in China. Materials and methods: The study was devised as a retrospective study in a single medical center. Five patients with mature cyst teratomas requested a minimally invasive surgical treatment. These patients were treated with RSS surgery for mature cyst teratoma between January 2014 and January 2015. RSS mature cyst teratoma cystectomies were performed with the da Vinci single-site platform in the Hainan branch of PLA General Hospital...
2019: Therapeutics and Clinical Risk Management
Manuela Farris, Carlo Bastianelli, Elena Rosato, Ivo Brosens, Giuseppe Benagiano
Uterine fibroids are the most common gynecological disorder, classically requiring surgery when symptomatic. Although attempts at finding a nonsurgical cure date back to centuries, it is only around the middle of the last century that serious attempts at a medical treatment were carried out. Initially, both progestins and estrogen-progestin combinations have been utilized, although proof of their usefulness is lacking. A major step forward was achieved when peptide analogs of the GnRH were introduced, first those with superagonist properties and subsequently those acting as antagonists...
2019: Therapeutics and Clinical Risk Management
Filip Machaj, Elżbieta Dembowska, Jakub Rosik, Bartosz Szostak, Małgorzata Mazurek-Mochol, Andrzej Pawlik
Despite continuous efforts to prevent cardiovascular diseases (CVDs), heart failure prevails as the number one cause of death in developed countries. To properly treat CVDs, scientists had to take a closer look at the factors that contribute to their pathogenesis and either modernize current pharmaceuticals or develop brand new treatments. Enhancement of current drugs, such as tolvaptan and omecamtiv mecarbil, sheds new light on already-known therapies. Tolvaptan, a vasopressin antagonist, could be adopted in heart failure therapy as it reduces pre- and afterload by decreasing systolic blood pressure and blood volume...
2019: Therapeutics and Clinical Risk Management
Mohamed Hassan Elnaem, Mohamad Haniki Nik Mohamed, Hasniza Zaman Huri, Azarisman Shah Mohd Shah
Background: Cardiovascular diseases (CVDs) are the main complication leading to morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). There is a large amount of evidence to support the use of lipid-lowering therapy (LLT) for the prevention of CVD. This study aimed to assess the effectiveness and prescription quality of LLT among T2DM patients and to identify its associated factors. Methods: A multicenter cross-sectional study included 816 T2DM patients from four different primary care centers in Pahang, Malaysia...
2019: Therapeutics and Clinical Risk Management
Hsin-Hsien Yu, Yutaka Yonemura, Mao-Chih Hsieh, Chang-Yun Lu, Szu-Yuan Wu, Yan-Shen Shan
Objectives: The prognosis of ovarian teratoma with malignant transformation and peritoneal dissemination (PD) is poor. This condition is rare but associated with a high recurrence rate even after aggressive debulking surgery and adjuvant chemotherapy. In the present paper, we describe our experience of using cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for this condition. Methods: The data of ten female patients having ovarian teratoma with malignant transformation and PD between June 2007 and June 2017 were collected and reviewed retrospectively...
2019: Therapeutics and Clinical Risk Management
Mingxing Lei, Jun Yu, Shiju Yan, Xiao An, Yaosheng Liu
Purpose: The aim of this study was to investigate the clinical results of surgery for cervical spine metastasis and identify clinical risk factors affecting postoperative survival and neurological outcome. Patients and methods: A retrospective analysis of medical records was performed on 19 patients who had undergone decompressive surgery and spine stabilization due to metastatic spinal cord compression in the cervical spine. All patients had severe pain before surgery...
2019: Therapeutics and Clinical Risk Management
Fu-Chao Liu, Shih-Jyun Shen, Jr-Rung Lin, Huang-Ping Yu
Background: Benign prostate hyperplasia, a common disease in elderly men, can be surgically treated with transurethral resection of the prostate (TURP). Postoperative sexual dysfunction is a major issue and is influenced by many factors. The present study aimed to assess whether the intraoperative resected prostate weight influences the probability of postoperative sexual dysfunction. Methods: This population-based study included 41,574 patients from the Nation Health Insurance Research Database who had undergone TURP once between 1997 and 2013...
2019: Therapeutics and Clinical Risk Management
Ching-Hui Huang, Ya-Yun Lai, Yu-Jui Kuo, Su-Ching Yang, Yu-Jun Chang, Kuo-Kuan Chang, Wen-Kang Chen
Background: Liver cirrhosis is an uncommon but not rare side effect of amiodarone-induced hepatotoxicity. Patients with hepatitis B virus and hepatitis C virus infections are at a high risk for developing liver cirrhosis. However, the relationship between this treatment and risk of liver cirrhosis in high-risk chronic hepatitis B and chronic hepatitis C patients is unknown. Patients and methods: The present study identified amiodarone users (N=8,081) from the Taiwan National Health Insurance Research Database from 1997 through 2013...
2019: Therapeutics and Clinical Risk Management
Pan Liu, Huapeng Lin, Yuanyuan Chen, Yu-Shen Wu, Maocai Tang, Liang Lai
Aim: To compare endoscopic papillary large balloon dilation (EPLBD) alone with EPLBD following endoscopic sphincterotomy (EST) in patients with large and/or multiple common bile duct stones. Methods: We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library database to identify relevant available articles until July 19, 2018. Complete common bile duct stone (CBDS) removal rate, frequency of mechanical lithotripsy (ML) usage, total procedure time and intra- and postoperative adverse events were analyzed...
2019: Therapeutics and Clinical Risk Management
Jian Qiu, Yunfeng Fu, Jiewei Xu, Xiaohong Huang, Guorong Yao, Weiguo Lu
Purpose: The purpose of this study was to investigate the efficiency, complications, and subsequent fertility outcomes of two methods in treating patients with cesarean scar pregnancy (CSP) after receiving uterine artery embolization (UAE) treatment. Patients and methods: A total of 62 CSP patients who visited our hospital and underwent UAE from January 2013 to January 2018 were retrospectively analyzed. Patients were either treated by dilation and curettage (D&C) guided by ultrasonography or hysteroscopy...
2019: Therapeutics and Clinical Risk Management
Teng Moua, Jay H Ryu
Idiopathic pulmonary fibrosis is a progressive and fatal fibrotic lung disease which has seen new opportunity for drug treatment in the last several years with the approval of nintedanib and pirfenidone, two antifibrotic agents aimed at slowing decline in lung function as defined by FVC on pulmonary function testing. Despite these promising effects, delays in drug initiation have been reported undermining the premise that earlier drug initiation may sustain lung function and prolong survival. This review explores obstacles to earlier treatment, inclusive of defining so-called early idiopathic pulmonary fibrosis, difficulties in achieving a confident diagnosis in that setting, and uncertainties regarding drug-related benefits among specific patient subgroups such as those with no symptoms or advanced disease at presentation...
2019: Therapeutics and Clinical Risk Management
Zhiyong Chen, Bin Hu, Yajuan Feng, Zongming Wang, Xiaobing Jiang, Yunjiu Cheng, Dongsheng He, Dimin Zhu, Zheng Xiao, Haijun Wang, Zhigang Mao
Purpose: To investigate the incidence and risk factors for early repolarization (ER) in patients with growth hormone (GH)-secreting pituitary adenomas. Methods: From August 2014 to August 2016, patients with GH-secreting pituitary adenomas and non-functioning pituitary adenomas admitted to the First Affiliated Hospital, Sun Yat-sen University, were prospectively enrolled. Logistic regression analysis was used to investigate risk factors for ER development. Results: A total of 118 patients with GH-secreting pituitary adenomas (41 with concomitant ER) and 103 patients with non-functioning pituitary adenomas were included...
2019: Therapeutics and Clinical Risk Management
Ayaka Inada, Keiko Hosohata, Saki Oyama, Iku Niinomi, Yasuhiro Mori, Yuki Yamaguchi, Mayako Uchida, Kazunori Iwanaga
Background: Bisphosphonates (BPs) and denosumab are widely used to treat osteoporosis and complications associated with bone metastases. However, medication-related osteonecrosis of the jaw (MRONJ) is a serious problem. Objective: The objective of this study was to evaluate the frequency, outcome, and characteristics of patients with drug-induced MRONJ. Methods: Retrospective pharmacovigilance disproportionality analysis was conducted using the Japanese Adverse Drug Event Report (JADER) database from the Pharmaceuticals and Medical Devices Agency...
2019: Therapeutics and Clinical Risk Management
Zhen-Gang Wei, Feng-Xian Wei, Zi-Wei Shao, Guo-Hong Su, Xue-Ping Qi, You-Cheng Zhang
Objective: Carvedilol is nonselective beta-blocker with a mild anti-alpha-1-adrenergic effect. Several studies proposed improved hemodynamic effects of carvedilol compared with propanolol. Our study was to perform a systematic review and meta-analysis of randomized control trials comparing carvedilol with variceal banding ligation (VBL). Methods: Studies were searched on online databases MEDLINE, EMBASE(Ovid), the Cochrane Library, Chinese Wanfang Database, and China National Knowledge Infrastructure between January 2000 and May 2018...
2019: Therapeutics and Clinical Risk Management
Jian Lu, Changjun Sun, Jiangbo Bai, Siyu Tian, Bing Zhang, Dehu Tian, Lingde Kong
Background: This study was conducted to determine whether sagittal lordotic alignment and clinical outcomes could be improved by the correction of segmental kyphosis after single-level anterior cervical discectomy and fusion (ACDF) surgery. Patients and methods: We retrospectively reviewed patients who underwent single-level ACDF surgery in our hospital between January 2014 and February 2017. Basic characteristics of patients included age at surgery, gender, diagnosis, duration of symptoms, and location of target level...
2019: Therapeutics and Clinical Risk Management
Cong Geng, Yapeng Lin, Qin Tang, Yifang Tang, Xiaoqing Wang, Jun-Shan Zhou, Jie Yang, Danni Zheng, Ying-Dong Zhang
Background: Data concerning sex differences in clinical characteristics and outcomes of young ischemic stroke (IS) patients in Eastern China are scarce. Understanding sex differences in clinical characteristics and long-term outcomes of young IS patients might provide valuable evidence for designing preventative measures and therapeutic interventions. Methods: The study included 228 acute IS patients aged up to 50 years recruited in the prospective Nanjing First Hospital Stroke Registry over a 5-year period...
2019: Therapeutics and Clinical Risk Management
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