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Minerva Surgery Jun 2024
Topics: Humans; Cyclopropanes; Sulfides; Quinolines; Acetates; Rhinitis, Allergic; Drugs, Chinese Herbal; Leukotriene Antagonists; Female; Male; Adult; Capsules; Drug Therapy, Combination; Treatment Outcome
PubMed: 37851008
DOI: 10.23736/S2724-5691.23.10038-4 -
Cureus Aug 2023Eosinophilic enteritis is a rare subset of eosinophilic gastrointestinal disorders. It typically presents with chronic symptoms of abdominal pain, nausea, vomiting,...
Eosinophilic enteritis is a rare subset of eosinophilic gastrointestinal disorders. It typically presents with chronic symptoms of abdominal pain, nausea, vomiting, diarrhea, and ascites. However, the clinical presentation can vary due to acute flare-ups. Here, we present a case of eosinophilic enteritis in a young female patient with intractable vomiting and diarrhea, mimicking acute gastroenteritis in the absence of other gastrointestinal symptoms. This case illustrates the challenge of diagnosing acute and diverse presentations of eosinophilic enteritis. It also highlights the importance of promptly treating and confirming the diagnosis through urgent tissue histopathology in adolescents with unexplained vomiting and diarrhea.
PubMed: 37767271
DOI: 10.7759/cureus.44199 -
Antioxidants (Basel, Switzerland) Sep 2023Overweight and obesity prevalence has increased worldwide. Apart from conventional approaches, people also resort to botanical supplements for reducing body weight,...
Overweight and obesity prevalence has increased worldwide. Apart from conventional approaches, people also resort to botanical supplements for reducing body weight, although several adverse events have been associated with these products. In this context, the present study aimed at evaluating the toxicity of -based products and shedding light on the mechanisms involved. The suspected hepatotoxic reactions related to -containing products collected within the Italian Phytovigilance System (IPS) were examined. Then, an in vitro study was performed to evaluate the possible mechanisms responsible for the liver toxicity, focusing on the modulation of oxidative stress and Nrf2 expression. From March 2002 to March 2022, the IPS collected eight reports of hepatic adverse reactions related to , which exclusively involved women and were mostly severe. The causality assessment was probable in three cases, while it was possible in five. In the in vitro experiments, a low cytotoxicity of was observed. However, its combination with montelukast greatly reduced cell viability, increased the intracellular ROS levels, and affected the cytoplasmic Nrf2 expression, thus suggesting an impairment of the antioxidant and cytoprotective defenses. Overall, our results support the safety concerns about -containing supplements and shed light on the possible mechanisms underpinning its hepatotoxicity.
PubMed: 37760074
DOI: 10.3390/antiox12091771 -
European Respiratory Review : An... Sep 2023The United States Food and Drug Administration issued a black box warning on the mental health adverse effects of montelukast in 2020. Age-related effects on the risk of... (Review)
Review
BACKGROUND
The United States Food and Drug Administration issued a black box warning on the mental health adverse effects of montelukast in 2020. Age-related effects on the risk of developing specific neuropsychiatric events in montelukast users remain largely unknown.
OBJECTIVE
To describe the risk of neuropsychiatric events associated with montelukast in adults and children with asthma.
METHODS
A systematic search of all studies investigating neuropsychiatric events in montelukast users was performed in PubMed, the Cochrane Library and Embase from inception to 7 September 2022. Animal studies and conference abstracts were excluded.
RESULTS
59 studies (21 pharmacovigilance studies, four reviews from 172 randomised controlled trials, 20 observational studies, 10 case reports and four case series) evaluating neuropsychiatric events in patients with asthma on montelukast were reviewed. No significant association was shown between montelukast and suicide-related events in six of the observational studies. No association was found for depression as defined by the International Classification of Diseases 10 revision codes in three observational studies and a review of randomised clinical trials. However, findings from four studies using antidepressant prescriptions as the outcome identified significant associations. Consistent with nine pharmacovigilance studies, two large-scale observational studies revealed possible associations of montelukast with anxiety and sleeping disorders in adult patients with asthma, respectively. However, the results were not replicated in two observational studies on children.
CONCLUSION
Montelukast is not associated with suicide- and depression-related events in asthma patients. Older adults may be particularly susceptible to anxiety and sleeping disorders.
Topics: Child; Animals; Humans; Aged; Asthma; Acetates; Quinolines; Cyclopropanes; Anti-Asthmatic Agents
PubMed: 37758273
DOI: 10.1183/16000617.0079-2023 -
Targeted Oncology Nov 2023Daratumumab, an anti-CD38 monoclonal antibody, is used for treatment of multiple myeloma (MM) and light chain amyloidosis at an intravenous dosage of 16 mg/kg or at a...
BACKGROUND
Daratumumab, an anti-CD38 monoclonal antibody, is used for treatment of multiple myeloma (MM) and light chain amyloidosis at an intravenous dosage of 16 mg/kg or at a subcutaneous fixed dose of 1800 mg. However, the subcutaneous formulation has only recently been approved in Europe, and real-life data on its safety are still few.
OBJECTIVE
In this multicenter retrospective real-life experience, we provided evidence for the safety of subcutaneous daratumumab in plasma cell disorders.
PATIENTS AND METHODS
A total of 189 patients diagnosed with MM or light chain amyloidosis were included in this retrospective study, and all subjects were daratumumab-naïve. Primary endpoint was safety of subcutaneous daratumumab, especially for infusion-related reaction (IRR) incidence and severity. All patients received premedication with dexamethasone, paracetamol, and antihistamine, with montelukast usage in 85% of cases.
RESULTS
Eight patients (4%) experienced IRRs, mainly of grade I-II, and other frequent toxicities were: hematological (thrombocytopenia, 4%; neutropenia, 5%; lymphopenia, 6%) and non-hematological (pneumonia, 4%; diarrhea, 2%; and cytomegalovirus reactivation, 0.5%). In our multicenter retrospective real-life experience, subcutaneous daratumumab was well-tolerated with an excellent safety profile with a very low (4%) IRR incidence, even in frailer MM patients with severe renal impairment or increased body weight.
CONCLUSIONS
Subcutaneous daratumumab was safe in a real-life setting including patients with severe renal failure and advanced disease. However, further studies on larger and prospective cohorts are required to confirm our real-life observations.
Topics: Humans; Retrospective Studies; Plasma Cells; Prospective Studies; Antineoplastic Agents; Multiple Myeloma; Antibodies, Monoclonal; Amyloidosis; Antineoplastic Combined Chemotherapy Protocols
PubMed: 37747623
DOI: 10.1007/s11523-023-01001-4 -
Pakistan Journal of Medical Sciences 2023To observe the efficacy of Montelukast combined with sublingual immunotherapy (SLIT) in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS)...
Efficacy of Montelukast combined with Sublingual Immunotherapy in the treatment of children with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with allergic rhinitis.
OBJECTIVE
To observe the efficacy of Montelukast combined with sublingual immunotherapy (SLIT) in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with allergic rhinitis (AR).
METHODS
This is a prospective study. A total of 102 children with OSAHS complicated with allergic rhinitis admitted to Hunan Children's Hospital from April 2020 to April 2021 were selected and randomly divided into two groups: sublingual group and two-drug combination group. Children in the sublingual group were treated with standardized dust mite drops Nos. 1-4 for SLIT, while those in the two-drug combination group were treated with Montelukast on top of the sublingual group. Statistical analysis and comparison were made between the two groups of children in terms of Sleep apnea hypopnea index (AHI), Hypoxic saturation (Lsao), interleukin-4, Il-4), interleukin-17 (IL-17), OSA-18 Snoring Symptom Scale for Children (OSA-18), allergic rhinitis symptom scale (TNSS), efficacy, occurrence of adverse reactions, etc.
RESULTS
After treatment, the AHI index of the two-drug combination group was significantly decreased, and the Lsao index was significantly increased compared with the sublingual group (P<0.05). Compared with the sublingual group, the levels of IL-4 and IL-17 in the two-drug combination group were significantly decreased (P<0.05), the OSA-18 score and TNSS score were significantly lower (P<0.05). Moreover, compared with the sublingual group, the efficacy of the two-drug combination group was significantly increased (P<0.05), the incidence of adverse reactions was significantly lower (P<0.05).
CONCLUSION
Montelukast combined with sublingual immunotherapy offers many advantages, such as effectively controlling nasal allergy symptoms in children with OSAHS complicated with allergic rhinitis and improving OSAHS symptoms.
PubMed: 37680839
DOI: 10.12669/pjms.39.5.6985 -
Cureus Sep 2023Progesterone hypersensitivity (PH) is a rare hypersensitivity reaction to either endogenous or exogenous progesterone. There are around 200 reported cases of...
Progesterone hypersensitivity (PH) is a rare hypersensitivity reaction to either endogenous or exogenous progesterone. There are around 200 reported cases of progesterone hypersensitivity in the medical literature. We present the case of a 31-year-old female who presented with cyclical urticaria and angioedema after exogenous progesterone exposure. Her symptoms would begin a few days before her menstrual cycle began and resolve after menstruation. She only had partial recovery of her symptoms with antihistamines, steroids, montelukast, and omalizumab. She needed treatment with oral contraceptives and had a resolution of symptoms, but subsequently developed a recurrence again. Given the rarity of this condition, the diagnosis is often delayed. This diagnosis should be considered for women of reproductive age who present with cyclic hypersensitivity or allergic symptoms.
PubMed: 37680259
DOI: 10.7759/cureus.44776 -
Cureus Aug 2023To investigate the color stability of light-cured (LC) restorative material in different pediatric drug formulations.
AIM
To investigate the color stability of light-cured (LC) restorative material in different pediatric drug formulations.
METHOD
Two distinct restorative materials, specifically LC resin and LC glass ionomer cement (GIC), were employed to create 88 disc-shaped specimens. These comprised 44 specimens fabricated from each material. Each specimen had a diameter of 5 mm and a height of 3 mm. To conduct the experiment, specimens were randomly allocated into four experimental groups, each containing 11 specimens made of each material. This division was accomplished through the use of a stratified random sampling method. The five experimental groups and their respective liquid medications were as follows: Group 1 - montelukast sodium and levocetirizine dihydrochloride syrup, Group 2 - cefixime, Group 3 - sodium valproate, and Group 4 - metronidazole. To ensure thorough exposure to the medications, all samples underwent a two-minute agitation cycle, which was repeated every 12 h over the course of one week. Following the immersion period, the color stability of all specimens was assessed using a spectrophotometer. The data obtained from the color stability measurements were subjected to statistical analysis using one-way analysis of variance (ANOVA), followed by a post hoc test. The aim was to determine whether significant differences in color stability were observed among the groups studied.
RESULTS
The mean values and standard deviations of ΔE were calculated. The highest values of ΔE were observed in Group 3 (4.70 ± 1.89), followed by Group 4 (4.04 ± 2.10). Conversely, the lowest ΔE values were observed in Group 2 (3.23 ± 2.02) and Group 1 (3.24 ± 2.31). The calculated p-value was 0.298, and the F-value was 1.269.
CONCLUSION
This study concludes that both restorative materials, LC composite and LC GIC, are susceptible to discoloration. Sodium valproate exhibited the greatest staining effect on both materials. Conversely, cefixime had the least impact on the color of the LC composite, whereas montelukast had the least effect on the color of LC GIC.
PubMed: 37674954
DOI: 10.7759/cureus.42953 -
Proceedings (Baylor University. Medical... 2023Patients with chronic kidney disease (CKD) are at increased risk for adverse drug events due to medication dosing errors. We studied the awareness and knowledge among...
BACKGROUND
Patients with chronic kidney disease (CKD) are at increased risk for adverse drug events due to medication dosing errors. We studied the awareness and knowledge among internal medicine housestaff (IMHS) of proper dose adjustment of commonly used rheumatology and allergy/immunology medications for patients with CKD.
METHODS
We surveyed 353 IMHS to evaluate their awareness of the need for medication dose adjustments for patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate for common rheumatology and allergy/immunology medications.
RESULTS
There was lack of awareness and knowledge for both rheumatology and allergy/immunology medications. Incorrect awareness and knowledge were as follows: allopurinol, 21.2%, 73.4%; colchicine, 19.0%, 75.9%; diphenhydramine, 34.0%, 34.0%; loratadine, 82.2%, 93.2%; and montelukast, 34.0%, 34.0%, respectively. Exploratory logistic regression analyses showed that PGY1 residents had higher odds for lack of awareness for allopurinol (odds ratio [OR] 24.57, 95% CI [confidence interval] 4.69, 99.13, < 0.001), colchicine (OR 3.98, 95% CI 1.50, 10.51, < 0.01), diphenhydramine (OR 2.24, 95% CI 1.10, 4.54, < 0.04), and montelukast (OR 2.45, 95% CI 1.20, 5.00, < 0.05) than PGY3 residents. A nephrology rotation in medical school was associated with lower odds for incorrect knowledge for allopurinol (OR 0.46, 95% CI 0.25, 0.87, < 0.05) and montelukast (OR 0.50, 95% CI 0.27, 0.92, < 0.05).
CONCLUSION
Overall, awareness and knowledge were poor among IMHS for dose adjustments of rheumatology and allergy/immunology medications in patients with CKD. Proper education and exposure to nephrology during training may improve quality and safety of care for patients with CKD.
PubMed: 37663380
DOI: 10.1080/08998280.2023.2228172 -
Journal of Pharmacy & Bioallied Sciences Jul 2023Opioid may cause undue risk after surgical procedures like orthognathic surgeries. The present study was aimed to determine how the preoperative administration of oral...
INTRODUCTION
Opioid may cause undue risk after surgical procedures like orthognathic surgeries. The present study was aimed to determine how the preoperative administration of oral montelukast affected the degree of postoperative discomfort following bimaxillary orthognathic surgery (BOS).
METHODOLOGY
This study included all skeletal class III subjects scheduled for BOS. The participants were split into placebo and montelukast groups at random. Every patient received a 10-mL serving of apple juice an hour prior to the surgery; however, for the intervention group, a montelukast 10 mg pill was dissolved in the juice. The same surgical team and general anesthetic guidelines were used for all procedures. The visual analog scale (VAS) was used to calculate postoperative pain at designated intervals. The significance level for the statistical analysis was determined using the Statistical Package for the Social Sciences (SPSS) version 23.
RESULTS
The control subjects had a higher level of pain at all the intervals than the intended drug test group. Also, the control group needed more analgesics than the test group. There was one observation made that the length of the surgery had an impact on the postoperative pain.
CONCLUSION
Preoperative montelukast medication may be useful in minimizing postoperative discomfort following bimaxillary orthognathic surgery. More research is required for greater relevance.
PubMed: 37654356
DOI: 10.4103/jpbs.jpbs_432_22