Flushes In Patients Research Articles

ОЦЕНКА ИНТЕРЛЕЙКИНОВОГО ПРОФИЛЯ В НАЗАЛЬНЫХ СМЫВАХ У ДЕТЕЙ С АЛЛЕРГИЧЕСКИМ РИНИТОМ

Allergic rhinitis is one of the most urgent problems of allergology and immunology, since, despite the improvement of therapeutic and diagnostic approaches, the number of patients remains very significant. Allergic pathologies of various types occur in 25-30% of children. Allergic rhinitis is based on a multifactorial chronic inflammatory process of the nasal mucosa, which causes the presence of constant persistent inflammation and the progression of the disease, especially in childhood. Biological inflammatory mediators in nasal flushes help to determine the pathophysiological phenotypes of allergic rhinitis, which is of undoubted interest. The work carried out the determination of the level of cytokines: IL 1b, IL 4, IL 6, IL 10 and interferon gamma in nasal flushes in patients with allergic rhinitis, depending on the presence or absence of changes in the nasal mucosa based on rhinoscopy during diagnosis verification. Changes in the nasal mucosa directly depend on the production of cytokines, which form individual phenotypes of the disease. According to the results of the analysis, the data obtained are associated with the presence of persistent allergic inflammation, neurohumoral and anti-infectious, which make a significant contribution to the clinical manifestations of the disease. The study of the role and significance of the proliferation of major cytokines in the nasal secretion will help the practitioner in determining treatment tactics, duration of therapeutic and preventive measures and further marching of the patient.

Evaluation of IL-1β and TNF-α level in endometrial flush in patients with recurrent implantation failure

Infertility is defined as the inability to conceive within a year of regular unprotected intercourse affecting one in six couples. The most common causes of infertility are ovulatory dysfunction, male factor infertility, and tubal disease [1]. Unexplained Infertility (UI) and Recurrent Implantation Failure (RIF) are diagnoses based on failed pregnancy attempts with current infertility treatment options. UI is diagnosed when testing is inconclusive and RIF is diagnosed after three failed In Vitro Fertilization (IVF) cycles. UI is the absence of conception despite 12 months of unprotected intercourse, not explained by anovulation, poor sperm quality, tubal pathology or other known cause of infertility. RIF is defined by three failed IVF cycles in which one or two high-quality embryos are transferred in each cycle or by two failures in oocyte donor recipients after the transfer of good quality embryos [1]. UI is a common cause of infertility affecting 10-30% of infertile couples [2], while RIF is present in around 10% of in vitro fertilization (IVF) cycles [3].

PACAP38 Induced Headache, Migraine and Flushing in Patients With Migraine

PACAP38 Induced Headache, Migraine and Flushing in Patients With Migraine

Patient-Reported Symptom Control of Diarrhea and Flushing in Patients with Neuroendocrine Tumors Treated with Lanreotide Depot/Autogel: Results from a Randomized, Placebo-Controlled, Double-Blind and 32-Week Open-Label Study.

In the double-blind (DB) ELECT study, lanreotide depot/autogel significantly reduced versus placebo the need for short-acting octreotide for symptomatic carcinoid syndrome (CS) control in neuroendocrine tumor (NET) patients. Here we present patient-reported symptom data during DB and initial open-label (IOL) treatment. Adults with NETs and CS history, with/without prior somatostatin analog use, were randomized to 16 weeks' DB lanreotide 120 mg subcutaneous or placebo every 4 weeks, followed by 32 weeks' IOL lanreotide. Patients recorded diarrhea and/or flushing frequency and severity daily by Interactive Voice (Web) Response System for 1 month prior to randomization and throughout the study. Of 115 patients randomized (n = 59 lanreotide, n = 56 placebo), 56 lanreotide and 45 placebo patients enrolled in the IOL phase. During DB treatment, least square (LS) mean percentages of days with moderate/severe diarrhea and/or flushing were significantly lower for lanreotide (23.4%) versus placebo (35.8%; LS mean difference [95% confidence interval]: -12.4 [-20.73 to -4.07]; p = .004). For DB lanreotide patients, average daily composite (frequency × severity) diarrhea scores improved significantly between DB and IOL treatment (mean difference: -0.71 [-1.20 to -0.22]; p = .005), and remained stable for diarrhea and/or flushing. For DB placebo patients, composite scores for diarrhea, flushing, and diarrhea and/or flushing improved significantly between DB and IOL treatment (mean differences: -1.07 [-1.65 to -0.49]; -1.06 [-1.93 to -0.19]; and -2.13 [-3.35 to -0.91]; all p ≤ .018). Improved diarrhea and flushing control in CS patients during 16-week lanreotide treatment was sustained during maintenance of lanreotide treatment for the 32-week IOL phase (48 weeks total). This study prospectively collected daily patient-reported data on diarrhea and flushing from the ELECT trial to evaluate the direct impact of lanreotide depot on patients' relief of carcinoid syndrome symptoms. Treatment with lanreotide depot was associated with significant reductions in the percentages of days patients reported symptoms of diarrhea and flushing, as well as reductions in the frequency and severity of daily symptoms compared with placebo during 16 weeks of double-blind treatment. These improvements were sustained for 32 additional weeks of open-label lanreotide treatment (i.e., through week 48 of treatment), resulting in clinically meaningful, long-term symptom reduction.

Safety of every 90 days portacath heparin maintenance flush in patients with cancer.

e20654 Background: Totally implanted venous access devices, portacath, are widely used and improve the quality of life of patients in long term chemotherapy. It is recommended that they should be f...

Preliminary assessment of the use of hypnosis in the management of drug induced hot flushes in patients with breast cancer

Preliminary assessment of the use of hypnosis in the management of drug induced hot flushes in patients with breast cancer

Acetylsalicylic Acid Reduces Niacin Extended-Release-Induced Flushing in Patients with Dyslipidemia

Niacin extended-release (NER) is safe and effective for treatment of dyslipidemia. However, some patients discontinue NER treatment because of flushing, the most common adverse event associated with niacin therapy. To evaluate the effect of daily oral acetylsalicylic acid (ASA) on NER-induced flushing in patients with dyslipidemia. A randomized, double-blind, placebo-controlled, multicenter, 5-week study was conducted (ClinicalTrials.gov identifier: NCT00626392). Patients (n = 277) were randomly assigned to one of six treatment arms and received a 1-week run-in with ASA 325 mg or placebo followed by 4 weeks of ASA 325 mg or placebo 30 minutes before NER at a starting dose of 500 mg or 1000 mg; all patients were titrated to NER 2000 mg at week 3. The primary endpoint was the maximum severity of flushing events during week 1. In week 1, ASA run-in, ASA pretreatment, and a lower starting dosage of NER (500 mg/day) resulted in reductions in mean maximum severity of flushing; 48% fewer patients who received ASA experienced flushing episodes of moderate or greater intensity relative to placebo (absolute rates 15% vs 29%; p = 0.01). Over 4 weeks, ASA reduced the number of flushing episodes/patient/week by 42% relative to placebo. The discontinuation rate due to flushing was lower in the ASA group compared with placebo (1.8% vs 9.4%; p = 0.007). Overall safety was not different between groups. These data suggest that a clinically meaningful reduction in the severity and incidence of NER-induced flushing may be achieved with ASA use.

Acupuncture for treating hot flushes in men with prostate cancer: a systematic review

The goal of the study was to assess the effects of acupuncture as a treatment for hot flushes in prostate cancer (PC) patients. The literature was searched using 14 databases with dates ranging from their inceptions to December 2008 and without language restrictions. All clinical studies of any type of acupuncture in PC patients were included. Their main outcome measures had to be vasomotor symptoms. Their methodological quality was assessed using the modified Jadad score. Six studies met all the inclusion criteria. One randomised clinical trial compared the effects of manual acupuncture with acupuncture plus electro-acupuncture. The other five studies were uncontrolled observational studies and therefore had limitations. The evidence is not convincing to suggest acupuncture is an effective treatment for hot flush in patients with PC. Further research is required to investigate whether acupuncture has hot-flush-specific effects.

Tachykinins in endocrine tumors and the carcinoid syndrome

A new antibody, active against the common tachykinin (TK) C-terminal, was used to study TK expression in patients with endocrine tumors and a possible association between plasma-TK levels and symptoms of diarrhea and flush in patients with metastasizing ileocecal serotonin-producing carcinoid tumors (MSPCs). TK, serotonin and chromogranin A (CgA) immunoreactivity (IR) was studied by immunohistochemistry in tissue samples from 33 midgut carcinoids and 72 other endocrine tumors. Circulating TK (P-TK) and urinary-5 hydroxyindoleacetic acid (U-5HIAA) concentrations were measured in 42 patients with MSPCs before treatment and related to symptoms in patients with the carcinoid syndrome. Circulating CgA concentrations were also measured in 39 out of the 42 patients. All MSPCs displayed serotonin and strong TK expression. TK-IR was also seen in all serotonin-producing lung and appendix carcinoids. None of the other tumors examined contained TK-IR cells. Concentrations of P-TK, P-CgA, and U-5HIAA were elevated in patients experiencing daily episodes of either flush or diarrhea, when compared with patients experiencing occasional or none of these symptoms. In a Spearman partial rank test, the correlation of P-TK with daily diarrhea was independent of both U-5HIAA and CgA levels. We found that TK synthesis occurs in serotonin-IR tumors and that P-TK levels are significantly correlated with symptoms of flush and diarrhea in patients with MSPCs. This is, to our knowledge, the first report demonstrating an independent correlation of P-TKs with carcinoid diarrhea, a symptom that is customarily regarded as serotonin mediated. Further investigations may present opportunities for new therapeutic possibilities.

Effects of Laropiprant on Nicotinic Acid-Induced Flushing in Patients With Dyslipidemia

Niacin (nicotinic acid) is not optimally used mainly because of flushing, a process mediated primarily by prostaglandin D(2), which leads to poor patient compliance and suboptimal dosing. This phase II dose-ranging study was designed to assess whether the prostaglandin D(2) receptor 1 antagonist laropiprant (LRPT; MK-0524) would (1) reduce extended-release niacin (ERN)-induced flushing in dyslipidemic patients and (2) support a novel accelerated ERN dosing paradigm: initiating ERN at 1 g and advancing rapidly to 2 g. In part A of the study, 154 dyslipidemic patients were randomized to LRPT 150 mg/day or placebo in a 9-week, 2-period crossover study. Patients who completed part A (n = 122) entered part B (after a 2-week washout), together with additional patients who entered part B directly (n = 290). Part B patients were randomized to placebo, ERN 1 g (Niaspan, no previous titration), or ERN 1 g coadministered with LRPT 18.75, 37.5, 75, or 150 mg for 4 weeks, with doubling of the respective doses for the remaining 4 weeks. Patients treated with LRPT plus ERN experienced significantly less ERN-induced flushing than those treated with ERN alone during the initiation of treatment (ERN 1 g, week 1) and the maintenance treatment (ERN 1 to 2 g, weeks 2 to 8). All doses of LRPT were maximally effective in inhibiting niacin-induced flushing. LRPT did not alter the beneficial lipid effects of ERN. LRPT plus ERN was well tolerated. In conclusion, the significant reduction in ERN-induced flushing provided by LRPT plus ERN supports an accelerated ERN dose-advancement paradigm to achieve rapidly a 2-g dose in dyslipidemic patients.

POS-03.58: Prevalence and distress due to hot flushes in patients receiving endocrine therapy for prostate cancer and therapeutic efficacy of Japanese herbal medicine

POS-03.58: Prevalence and distress due to hot flushes in patients receiving endocrine therapy for prostate cancer and therapeutic efficacy of Japanese herbal medicine

Venlafaxine reduces the frequency of hot flushes in patients with breast cancer more than clonidine,

Venlafaxine reduces the frequency of hot flushes in patients with breast cancer more than clonidine,

Hot flashes: behavioral treatments, mechanisms, and relation to sleep

Hot flashes are the most common symptom of the climacteric and occur in about 75% of perimenopausal and postmenopausal women in Western societies. Although hot flashes accompany the withdrawal of estrogen at menopause, the decline in estrogen levels is not sufficient to explain their occurrence. Elevated sympathetic activation acting through central alpha(2)-adrenergic receptors contributes to the initiation of hot flashes, possibly by narrowing the thermoneutral zone in symptomatic women. Hot flashes are then triggered by small elevations in core body temperature acting within this narrowed zone. A relaxation-based method, paced respiration, has been shown in 3 controlled investigations to significantly reduce objectively measured hot flash occurrence by about 50% with no adverse effects. In 6 studies of physical exercise, however, investigators did not find positive effects on hot flashes, possibly because exercise raises core body temperature, thereby triggering hot flashes. Although many epidemiologic studies have found increased reports of sleep disturbance during the menopausal transition, recent laboratory investigations have not found this effect, nor have they found that hot flashes produce disturbed sleep. Therefore, sleep complaints in women at midlife should not routinely be attributed to hot flashes or to menopause.

Alcohol Intolerance and Facial Flushing in Patients Treated With Topical Tacrolimus

Alcohol Intolerance and Facial Flushing in Patients Treated With Topical Tacrolimus

Objectively Recorded Hot Flushes in Patients with Pituitary Insufficiency*

A study was conducted of 2 young adult women with pituitary insufficiency and complaints of hot flushes. Both underwent continuous recordings of skin temperature of the finger and skin resistance over the sternum as objective indices of flushing episodes. Frequent blood samples were also obtained during the recordings for the measurement of serum LH and FSH levels. During the 10 h of recording, 12 subjective hot flushes occurred and each was associated with a rise of finger temperature of greater than 1 C. Eighty-five percent of the temperature rises were associated with measurable decreases in skin resistance. The mean interval between flushes, the magnitude of the skin temperature and resistance changes, and the relationship of these changes to the onset of subjective flushes were identical to those observed in symptomatic postmenopausal women. Circulating gonadotropin levels were in the low to low normal range in comparison to values observed in premenopausal women and showed minimal pulsatile release. There were no significant correlations between finger temperature changes and LH levels in either subject. These results suggest that the previously described association of pulsatile LH release and the occurrence of hot flushes in postmenopausal women cannot be attributed to augmented LH secretion per se and, therefore, may be due to hypothalamic factors responsible for pulsatile LH release.

Changes of fibrinolysis during flush in patients with carcinoid syndrome

Changes of fibrinolysis during flush in patients with carcinoid syndrome