Short-term Side Effects Research Articles

Steroid pulse therapy in idiopathic nephrotic syndrome in the era of modern immunosuppressive treatment-still up to date?

Intravenous steroid pulses (SP) are successfully used for the treatment of patients with idiopathic nephrotic syndrome (INS) resistant to oral prednisone. We performed a retrospective analysis of all patients in the three pediatric nephrology centers of the Paris region from 2002 to 2022 who were resistant to a 30-day course of oral prednisone and who received SP for their first INS flare and analyzed their disease course over 4years. Forty-seven patients (17 girls), median age 3.4years, were analyzed. Of them, 68% reached remission within 7days of SP. No significant short-term side effects were noted. Half of the patients started immunosuppressive treatment immediately after their first remission and 62% of them relapsed at least once, whereas all the patients who did not receive immunosuppressive treatment since their first remission relapsed. Among the SP-sensitive patients, 75% needed calcineurin inhibitor (CNI) or B-cell depletion during their disease course to achieve stable remission. Forty-two percent of the whole cohort received B-cell-depleting agents. Among the 15 SP-resistant patients, all received CNI. Twelve/fifteen patients reached remission. After 4years, 68% among the SP-sensitive patients and 87% of SP-resistant patients still had an active disease. SP are helpful to obtain rapid remission in pediatric INS patients resistant to oral steroids. However, as most SP-sensitive patients need immunosuppressive drugs, mainly CNI and B-cell-depleting agents it could be interesting to discuss the possibility to start CNI directly after the 30-day course of prednisone instead of SP.

Short-term effectiveness and side effects of ketogenic diet for drug-resistant epilepsy in children with genetic epilepsy syndromes.

Drug-resistant epilepsy (DRE) impacts a significant portion, one-third, of individuals diagnosed with epilepsy. In such cases, exploring non-pharmacological interventions are crucial, with the ketogenic diet (KD) standing out as a valuable option. KD, a high-fat and low-carb dietary approach with roots dating back to the 1920s for managing DRE, triggers the formation of ketone bodies and modifies biochemistry to aid in seizure control. Recent studies have increasingly supported the efficacy of KD in addressing DRE, showcasing positive outcomes. Furthermore, while more research is needed, limited data suggests that KD May also be beneficial for specific genetic epilepsy syndromes (GESs). This study aimed to assess the short-term efficacy of KD among pediatric patients diagnosed with GESs. This is a multi-center retrospective analysis of pediatric patients with GESs diagnosed using next-generation sequencing. The enrolled patients followed the keto-clinic protocol, and the KD efficacy was evaluated at 3, 6, and 12-month intervals based on seizure control and compliance. The collection instrument included demographic, baseline, and prognostic data. The collected data was coded and analyzed promptly. We enrolled a cohort of 77 patients with a mean current age of 7.94 ± 3.83 years. The mean age of seizure onset was 15.5 months. Notably, patients experienced seizures at a younger age tended to have less positive response to diet. Overall, 55 patients responded favorably to the diet (71.4%) while 22 patients (28.6%) showed no improvement. Patients with genetic etiology showed a significantly more favorable responses to the dietary intervention. Patients with Lennox-Gastaut syndrome showed the most significant improvement (14/15) followed by patients with Dravet syndrome (6/8), and West syndrome (3/4). The number of used anti-seizure medications also played a significant role in determining their response to the diet. While some patients experienced mild adverse events, the most common being constipation, these occurrences were not serious enough to necessitate discontinuation of the diet. The study revealed a high improvement rate in seizure control, especially among younger patients and those with later seizure onset. The success of dietary treatment hinges greatly on early intervention and the patient's age. Certain genetic mutations responded favorably to the KD, while efficacy varied among various genetic profiles.

Practically implementing an LLM-supported collaborative vulnerability remediation process: A team-based approach

Incorporating LLM into cybersecurity operations, a typical real-world high-stakes task, is critical but non-trivial in practice. Using cybersecurity as the study context, we conduct a three-step mix-method study to incorporate LLM into the vulnerability remediation process effectively. Specifically, we deconstruct the deficiencies in user satisfaction within the existing process (Study 1). This inspires us to design, implement, and empirically validate an LLM-supported collaborative vulnerability remediation process through a field study (Study 2). Given LLM’s diverse contributions, we further investigate LLM’s double-edge roles through the analysis of remediation reports and follow-up interviews (Study 3). In essence, our contribution lies in promoting an efficient LLM-supported collaborative vulnerability remediation process. These first-hand, real-world pieces of evidence suggest that when incorporating LLMs into practical processes, facilitating the collaborations among all associated stakeholders, reshaping LLMs’ roles according to task complexity, as well as approaching the short-term side effects of improved user engagement facilitated by LLMs with a rational mindset.

Intracavitary cisplatin-fibrin followed by irradiation improved tumor control compared to the single treatments in a mesothelioma rat model

ObjectiveTo test the safety and efficacy of combination treatment for pleural mesothelioma (PM) with intracavitary cisplatin-fibrin (cis-fib) plus hemithoracic irradiation (IR) applied after lung-sparing surgery in an orthotopic immunocompetent rat model. MethodsWe randomized male F344 rats into 5 groups: cis-fib (n = 9), 10 Gy IR (n = 6), 20 Gy IR (n = 9), cis-fib+10 Gy IR (n = 6), and cis-fib+20 Gy IR (n = 9). Subpleural tumor implantation was performed on day 0 with 1 million syngeneic rat mesothelioma cells (IL45-luciferase). Tumors were resected on day 9, followed by treatment with intracavitary cis-fib or vehicle control (NaCl-fib). On day 12, computed tomography–guided local irradiation in a single high dose of the former tumor region was applied. ResultsWe observed only short-term side effects related to 20 Gy radiotherapy. Compared to 20 Gy, 10 Gy IR did not show an impact on tumor growth. At 3 days after treatment with 20 Gy IR (day 15 of the experiment), we detected significantly smaller tumors in the cis-fib+IR group compared to IR alone (mean tumor growth, 252% vs 539%; P = .04). On day 21, there was a significant difference in tumor growth between cis-fib–treated and cis-fib+IR– treated tumors (mean tumor growth, 2295% vs 660%; P = .01). ConclusionsLocalized treatment after tumor resection in PM aims to improve local tumor control. Irradiation applied in combination with intracavitary cis-fib in rats is safe up to a dosage of 20 Gy and shows an additive effect on tumor growth delay compared to the single treatments.

Chronic Cocaine Use and Parkinson's Disease: An Interpretative Model.

Over the years, the growing "epidemic" spread of cocaine use represents a crucial public health and social problem worldwide. According to the 2023 World Drug Report, 0.4% of the world's population aged 15 to 64 report using cocaine; this number corresponds to approximately 24.6 million cocaine users worldwide and approximately 1 million subjects with cocaine use disorder (CUD). While we specifically know the short-term side effects induced by cocaine, unfortunately, we currently do not have exhaustive information about the medium/long-term side effects of the substance on the body. The scientific literature progressively highlights that the chronic use of cocaine is related to an increase in cardio- and cerebrovascular risk and probably to a greater incidence of psychomotor symptoms and neurodegenerative processes. Several studies have highlighted an increased risk of antipsychotic-induced extrapyramidal symptoms (EPSs) in patients with psychotic spectrum disorders comorbid with psychostimulant abuse. EPSs include movement dysfunction such as dystonia, akathisia, tardive dyskinesia, and characteristic symptoms of Parkinsonism such as rigidity, bradykinesia, and tremor. In the present paper, we propose a model of interpretation of the neurobiological mechanisms underlying the hypothesized increased vulnerability in chronic cocaine abusers to neurodegenerative disorders with psychomotor symptoms. Specifically, we supposed that the chronic administration of cocaine produces significant neurobiological changes, causing a complex dysregulation of various neurotransmitter systems, mainly affecting subcortical structures and the dopaminergic pathways. We believe that a better understanding of these cellular and molecular mechanisms involved in cocaine-induced neuropsychotoxicity may have helpful clinical implications and provide targets for therapeutic intervention.

Navigating non-medical androgen use: Towards a harm reduction paradigm

Non-medical androgen use is on the rise, with short-term side effects being well-documented whereas long-term consequences remain less understood but are likely to entail cardiovascular illness and permanent endocrine disruptions. Current educational initiatives are falling short in curbing this significant increase, signaling the need for a different approach. In this context, harm reduction emerges as a promising secondary prevention strategy. The key principles of the harm reduction approach outlined in this article emphasize educating individuals about side effects, limiting androgen use, and monitoring health closely. Successful implementation of this strategy hinges upon healthcare providers possessing expertise in the field, fostering non-judgmental interpersonal relationships, and securing cooperation of the athlete. The efficacy of this strategy will be rigorously evaluated in the HARNAS trial, comparing its outcomes with those of a historical control group. The findings from this trial are anticipated to be published in the coming years, shedding light on the effectiveness of this pioneering approach.

A large-scale observational comparison of antidepressants and their effects

BackgroundSelective Serotonin Reuptake Inhibitors (SSRIs) represent a diverse class of medications widely prescribed for depression and anxiety. Despite their common use, there is an absence of large-scale, real-world evidence capturing the heterogeneity in their effects on individuals. This study addresses this gap by utilizing naturalistic search data to explore the varied impact of six different SSRIs on user behavior. MethodsThe study sample included ∼508 thousand Bing users with searches for one of six SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) from April–December 2022, comprising 510 million queries. Cox proportional hazard models were employed to examine 30 topics (e.g., shopping, tourism, health) and 195 health symptoms (e.g., anxiety, weight gain, impotence), using each SSRI as a reference. We assessed the relative hazard ratios between drugs and, where feasible, ranked the SSRIs based on their observed effects. We used Cox proportional hazard models in order to account for both the likelihood of users searching for a particular topic or symptom and the associated time to that search. The temporal aspect aided in distinguishing between potential symptoms of the disorder, short-term medication side effects, and later appearing side effects. ResultsDifferences were found in search behaviors associated with each SSRI. E.g., fluvoxamine was associated with a significantly higher likelihood of searching weight gain compared to all other SSRIs (HRs 1.85–2.93). Searches following citalopram were associated with significantly higher rates of later impotence queries compared to all other SSRIs (HRs 5.11–7.76), except fluvoxamine. Fluvoxamine was associated with a significantly higher rate of health related searches than all other SSRIs (HRs 2.11–2.36). ConclusionsOur study reveals new insights into the varying SSRI impacts, suggesting distinct symptom profiles. This novel use of large-scale, naturalistic search data contributes to pharmacovigilance efforts, enhancing our understanding of intra-class variation among SSRIs, potentially uncovering previously unidentified drug effects.

Microneedling with Topical Insulin versus Microneedling with Topical Saline in Treatment of Striae Alba

Abstract Background Striae distensae, an extremely common condition, are a challenging cosmetic problem and pose a significant psychological burden for patients. Various treatment modalities have been applied with low satisfaction rate. Objectives To evaluate the clinical response, efficacy, safety and adverse effect of combined microneedling with topical insulin compared to microneedling alone in the treatment of striae alba. Patients and Methods This randomized prospective controlled comparative study included 20 patients suffering from stria albae on both sides of the abdomen. The diagnosis was made via clinical diagnosis of dermatological findings. All patients were consecutively selected from the dermatology outpatient clinic, Ain-Shams University Hospitals in the period from November 2021 till April 2022. Results The result The study showed that there was significant improvement in striea alba indentation index after treatment in both the insulin sides and placebo sides, the insulin sides being superior. In comparing both methods, there was no statistically significant difference between them as regards Erythema and hyperpigmentation. The current study showed nearly equal patient satisfaction scores in both groups. Conclusion Both microneedling alone and microneedling with topical insulin were effective and safe methods in treating patients with striae alba. Using topical insulin had better result than microneedling alone. Both methods are tolerated regarding Microneedling with insulin had no short term side effects.

COVID-19 Vaccine Side Effects and Long-Term Neutralizing Antibody Response : A Prospective Cohort Study.

Concern about side effects is a common reason for SARS-CoV-2 vaccine hesitancy. To determine whether short-term side effects of SARS-CoV-2 messenger RNA (mRNA) vaccination are associated with subsequent neutralizing antibody (nAB) response. Prospective cohort study. San Francisco Bay Area. Adults who had not been vaccinated against or exposed to SARS-CoV-2, who then received 2 doses of either BNT162b2 or mRNA-1273. Serum nAB titer at 1 month and 6 months after the second vaccine dose. Daily symptom surveys and objective biometric measurements at each dose. 363 participants were included in symptom-related analyses (65.6% female; mean age, 52.4 years [SD, 11.9]), and 147 were included in biometric-related analyses (66.0% female; mean age, 58.8 years [SD, 5.3]). Chills, tiredness, feeling unwell, and headache after the second dose were each associated with 1.4 to 1.6 fold higher nAB at 1 and 6 months after vaccination. Symptom count and vaccination-induced change in skin temperature and heart rate were all positively associated with nAB across both follow-up time points. Each 1 °C increase in skin temperature after dose 2 was associated with 1.8 fold higher nAB 1 month later and 3.1 fold higher nAB 6 months later. The study was conducted in 2021 in people receiving the primary vaccine series, making generalizability to people with prior SARS-CoV-2 vaccination or exposure unclear. Whether the observed associations would also apply for neutralizing activity against non-ancestral SARS-CoV-2 strains is also unknown. Convergent self-report and objective biometric findings indicate that short-term systemic side effects of SARS-CoV-2 mRNA vaccination are associated with greater long-lasting nAB responses. This may be relevant in addressing negative attitudes toward vaccine side effects, which are a barrier to vaccine uptake. National Institute on Aging.

CAR T-cell therapies: Measuring the growing need for increasing long-term safety protocols.

e23047 Background: The CAR T-Cell market has grown significantly over the last five years with six products in the U.S. market covering a range of cancer types (DLBCL, FL, MCL, MM, ALL). The number of transplant centers certified for CAR T-Cell administration has also grown from 142 centers in Q4 2020 to 200 in Q4 2023. The FDA is currently investigating the safety of CAR T-Cell therapies due to the threat of secondary malignancies. CAR T-Cell patients are treated at advanced treatment centers but after they have completed therapy, they are often referred back to their original specialist for long-term monitoring. The purpose of this research is to measure if referring Oncologists have the information required to safely manage CAR T-Cell patients. Methods: This study followed market research best practices. The study was based on a survey of the BrandImpact panel of Oncologists who refer patients and a CAR T-Cell Panel of Oncologists who administer CAR T-Cell therapies. Results: The majority of referring Oncologists (61%) report they could use more information about CAR T-Cell therapies. When asked on an unaided basis what type of information they require, the most common request was for additional safety information (57%). At the same time, one-third of Oncologists treating CAR T-Cell patients at the advanced centers feel that there needs to be improved knowledge of the long-term safety aspects of CAR T-Cell therapies. When they resume monitoring CAR T-Cell patients, they would like to better understand the relevant long-term side effects and how they differ from the short-term side effects. Conclusions: Oncologists who refer CAR T-Cell patients report that they need more information; mainly around safety/side-effects. Of the Oncologists administering CAR T-Cell therapies, one-third feel there needs to be improved knowledge of the long-term safety issues. Consideration should be given to improving the level of educational information provided on this topic to improve CAR T-Cell patient outcomes. [Table: see text]

Patient-reported provider communication skills and adherence to recommended treatment in breast cancer.

537 Background: Effective communication is essential to build trust and improve patient understanding of cancer diagnosis and treatment. Little is known about patient comprehension of provider explanations and whether better communication influences adherence to recommended treatment especially in breast cancer (BC) which may require years of adjuvant treatment. Methods: Between 7/2023-8/2023, active patients and survivors were recruited from Breastcancer.org and consented to participate in an anonymous online survey in English or Spanish. Eligibility included: US resident, age ≥18, and diagnosed with BC within the past 10 years. Survey assessed patient-reported overall communication, side effect communication, and treatment adherence. Multivariate analysis (MVA) assessed relationship of patient-reported understanding and treatment adherence after controlling for gender, age, stage, race, ethnicity, and education. Results: Of 1266 screened, 997 met eligibility and participated. 98.2% identified as women, 81.2% White, 4.8% Black, and 4.2% Hispanic. Median age was 62 (interquartile range IQR 53-69) and median time since diagnosis 2.1 years (IQR 1-5.1). 6.5% had metastatic disease. 77.3% had a college degree. 93.4% participants reported their doctors “usually” or “always” explained things in a way they could understand. On MVA, there was a trend for minoritized groups (Black, Hispanic, Indigenous patients) to report their doctors were less likely to explain things well (OR 0.57, 95%CI 0.30-1.06, p=0.08) but there were no significant differences. Most felt their doctors “definitely” (45.8%) or “to some extent” (10.3%) explained possible short-term side effects. One-third (35.2%) stated their doctors explained “to some extent” and that they also did their own research to fully understand short-term side effects; 6.1% stated that their own research was the only thing that helped them understand as their doctors did not explain. Less than one-third (27.9%) felt their doctors “definitely” explained possible long-term side effects. 7.7% participants took less medication that their doctors prescribed due to treatment side effects, 15.1% stopped taking a medication or treatment altogether. Patients who reported that their doctors were “sometimes” or “never” understandable were more likely to reduce or stop their treatment (44.4% vs 21.3%, p<0.001). This held true on MVA: patients reporting poor communication were less likely to adhere to recommended treatment (OR 0.36, 95%CI 0.21-0.62, p<0.001). Conclusions: Surveyed patients with BC report good provider communication skills overall but note that side effect profiles are not always well-explained, especially for long-term side effects. More than 1 in 5 did not follow some aspect of BC treatment as recommended, and those who reported poor communication with their providers were 64% less likely to be adherent to recommended care.

Serial testing to assess cognitive function in patients with cancer being treated with immunotherapy.

TPS1644 Background: The advent of immunotherapy (IT) has revolutionized lung cancer treatment, becoming a primary modality from Stages Ib to IV. While the short-term side effects of IT are well documented, its long-term impact on cognitive function are under explored. This is a crucial area of investigation given the significant impact of cognitive health on the quality of life in cancer survivors. Preclinical investigations suggest neurocognitive alterations in IT-treated patients, evidenced by increased microglial activation and cytokine release, contributing to observed cognitive deficits such as impaired cued fear memory and object recognition. This study leverages the Montreal Cognitive Assessment (MoCA) to investigate these potential cognitive changes in a clinical setting, aiming to provide crucial insights into the long-term effects of IT. Methods: This single-center, open-label pilot study enrolls patients with various cancer types and stages undergoing IT. Exclusion criteria include prior history of underlying cognitive dysfunction, dementia, depression or psychiatric illness, history of brain metastasis or radiation. The study compromises three cohorts: those receiving IT alone, those undergoing chemo-immunotherapy, and a control group with no active treatment (in remission with prior history of cancer and have received IT in the past). Each of the IT and chemo-immunotherapy groups will include 72 patients, while the control group will consist of 40 participants. Baseline cognitive function is assessed using the MoCA scale, with follow-up assessments at 3 and 6 months from baseline. Patient enrollment commenced in April 2022, with 4 patients enrolled in the IT group, 16 in the chemo-IT group, and 32 in the control group. The primary objective is to assess the Cognitive function change in each individual group of patients. The secondary objective is to assess change of MoCA scores after 3 months and 6 months in patients receiving immunotherapy alone in lung cancer patients. The changes in MoCA scores will be plotted and summarized with mean change, standard deviation of change and standard errors of mean change. MoCA scores at baseline and at 6 months will be compared using paired t-tests. The study will analyze the rate of change in MoCA scores over time, comparing outcomes across the treatment cohorts. Clinical trial information: NCT06160700 .

Analgesia for the treatment of acute pancreatitis: a protocol for a systematic review and network meta-analysis

IntroductionGastrointestinal hospitalisations in the USA cause over US$130 billion in expenditures, and acute pancreatitis is a leading cause of these hospitalisations. Adequate pain control is one of the primary treatment...

Abstract PO5-26-06: Understanding patient experiences to inform future studies to reduce treatment burden in breast cancer

Abstract Background Most patients with early breast cancer receive multimodality therapy, including surgery, chemotherapy, radiotherapy and endocrine therapy. Currently, not all patients benefit from the treatments they receive but many experience significant morbidities that substantially impact their quality of life. Personalised approaches to treatment offer the opportunity for patients to avoid treatments that do not offer oncological benefit without compromising breast cancer outcomes. Further studies are needed to evaluate these approaches; it is vital that future research is designed to optimise treatment benefit while remaining acceptable to patients. This survey aimed to understand experiences of patients who have received treatment for early breast cancer to inform future risk-adapted studies. Methods An online survey was co-developed with patient advocates to explore respondents’ experiences of treatments. Questions included simple demographics, treatments received and views about omitting therapies if it was safe to do so. Free-text boxes were provided for respondents to explain their decision. The survey was circulated via social media platforms from April-July 2023. Responses were summarised using simple descriptive statistics and free text was analysed thematically. Results 112 responses were received. Respondents were mostly aged 40-60 (n=88, 72.7%) and diagnosed with breast cancer between 1995 - 2023 (median 2017). Treatments received included surgery (n=107, 95.5%), radiotherapy (n=85, 75.9%), chemotherapy (n=69, 61.6%) and endocrine therapy (n=82, 73.2%). Of the 106 (94.6%) respondents who expressed a preference, 38 (35.8%) would omit chemotherapy; 34 (32.1%) would choose not to have endocrine therapy; 19 (17.9%) would prefer to avoid surgery and 11 (10.4%) would omit radiotherapy if safe to do so. Respondents opting to avoid chemotherapy highlighted the ‘brutal’ short-term side effects and their profound impact on their ability to continue with their daily lives. Hair loss was a common concern and chemotherapy was considered ‘very visible’, making them a ‘cancer patient’ in the eyes of others. Long-term effects of treatment such as peripheral neuropathy had lasting effects on respondents’ activities of daily living. Almost all respondents who would omit endocrine therapy cited the profound impact of side effects including joint/muscle pains, fatigue, hair loss, sleep disturbance and loss of libido on quality of life. Some respondents commented that the treatment itself was a daily reminder of their diagnosis. Surgery was identified as having long-term impacts on respondents’ physical and psychological well-being. Many expressed a desire to avoid ‘disfiguring’ procedures which had affected their relationships and quality of life. Respondents highlighted specific procedures they would choose to avoid including mastectomy due to the ‘trauma’ of losing a breast and axillary node clearance due to complications such as lymphoedema. Fewer women chose to avoid radiotherapy. Reasons to do so included both short and long-term side effects of treatment including chronic pain, difficulties travelling and attending for treatment over 5 weeks. Although there was generally a positive response to the concept of reducing unnecessary treatments, safety was a key concern. Several respondents commented that they would have any treatments considered necessary as survival was their ‘absolute priority’. Respondents felt that patients would need to be reassured that any reduction in treatment would not impact long-term outcomes. Conclusions This survey suggests patients would support studies aiming to reduce the burden of breast cancer treatment, and that different patients may wish to de-escalate different components of therapy. Studies developing an evidence base to allow treatment personalisation with a particular emphasis on reducing chemotherapy and endocrine therapy are research priorities. Citation Format: Shelley Potter, Mhairi MacTier, Katherine Fairhurst, Jacqui Gath, Hilary Stobart, Stuart McIntosh. Understanding patient experiences to inform future studies to reduce treatment burden in breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-26-06.

Revealing the therapeutic potential of teriparatide: a review

Teriparatide is an FDA-approved medication for osteoporosis that presents promising results in treating various musculoskeletal conditions. It helps in improving the bone mineral density and preventing fractures in individuals with osteoporosis. Its effectiveness in treating non-union and delayed union fractures, atypical femoral fractures, and spinal fusion procedures makes it valuable in improving bone healing and reducing complications. Teriparatide also improves bone density and strength in individuals with osteogenesis imperfecta, helps prevent and treat hypocalcaemia post-thyroidectomy, and helps in the management of hypoparathyroidism. In MRONJ, teriparatide improves lesion resolution and reduces bony defects. Furthermore, it potentially prevents bone metastasis in cancer patients without stimulating tumour growth. Nevertheless, teriparatide may cause short-term side effects like nausea and long-term concerns pertaining to the risk of osteosarcoma. Recent European alliance of associations for rheumatology guidelines have highlighted teriparatide's superior effectiveness in achieving bone mineral density thresholds and reducing fracture risks. Further clinical trials are necessary to determine optimal dosages and treatment durations of teriparatide. The off-label use of teriparatide should be considered only under the guidance of a healthcare professional when standard options are unavailable or inadequate.

Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study.

Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.

Pulsed shortwave electromagnetic field therapy increases quality of life in canines with symptoms of osteoarthritics.

Joint stiffness, lameness and reduced activity levels are common inflammatory responses observed in canines and have significant impact on quality of life (QOL). The symptoms are often ascribed to osteoarthritis (OA), for which the standard treatment is systemic anti-inflammatories, but pharmacologic intervention can have significant short-term and long-term side effects. Test the efficacy of a Food and Drug Administration (FDA)-cleared pulsed shortwave therapy (PSWT) device as a means to modulate vagus nerve activity and initiate a systemic anti-inflammatory response to determine its ability to improve functionality and the QOL of canines with inflammatory symptoms commonly associated with OA. A randomized, double-blinded, placebo-controlled 14-day study of 60 dogs with a presumptive prior diagnosis of OA in at least one limb joint. Two outcomes assessing changes in the dog's QOL and functionality were measured: subjectively determined changes in eight behaviours associated with discomfort and objectively determined changes in passive range of motion (PROM). The device was secured near the cervico-thoracic region of the dog's spine. PROM measures were taken at baseline and at the end of study. Behavioural measures were taken daily. Forty-nine animals completed the study. No negative side effects were reported. Average subjective discomfort scores for the treatment group (N=26) were reduced from 3.74 to 2.10 (44%), compared to no improvement in the placebo group (N=23) over the study period (p=0.0001). Average PROM scores increased by 5.51 (4.59-6.23) degrees relative to the placebo group (p<0.01). Ninety-six per cent of the treatment group showed either increased PROM or improved behavioural changes or both, compared to 4% for the placebo group (p<0.01). Most changes occurred within the first 8 days of treatment. PSWT applied at the level of the cervico-thoracic spine to target the vagus nerve may have the potential to improve QOL in dogs manifesting behaviours commonly associated with OA.

Short-term side effects of COVID-19 vaccines among healthcare workers: a multicenter study in Iran

Since the initiation of the COVID-19 vaccination effort, there has been widespread concern regarding vaccine efficacy and potential side effects. This study aimed to explore the short-term side effects of four available COVID-19 vaccines (Sputnik V, Sinopharm, Oxford–AstraZeneca, and Covaxin) among healthcare workers (HCWs) in Iran. The multicenter study involved 1575 HCWs, with the majority received Sputnik V (74.1%), followed by Covaxin (15.6%), Sinopharm (6.4%), and Oxford-AstraZeneca (3.8%). The prevalence of at least one side effect after the first and second dose COVID-19 vaccine was 84.6% and 72.9%, respectively. The common side effects (presented in > 50% of the study participants) after the first dose of the vaccine were injection site pain (61.7%), myalgia (51.8%), and muscle pain (50.9%). The most reported side effects after the second dose of the vaccine were injection site pain (26.8%), myalgia (15.8%), fever (10.3%), headache (9.9%), and chills (9.2%). In conclusion, according to the COVID-19 vaccine type, different side effects might occur following the first and second doses of vaccination. These findings assist in addressing the ongoing problems of vaccination hesitancy which has been driven by widespread worries about the vaccine safety profile.

Micellar solution of [223Ra]RaCl2: Reaching renal excretion, potent efficacy in osteoblastic osteosarcoma in PDX model, biochemistry alterations and pharmacokinetics

Despite the successful use of the radiopharmaceutical radium-223 dichloride ([223Ra]RaCl2) for targeted alpha therapy of castration-resistant prostate cancer patients with bone metastases, some short-term side effects, such as diarrhea and vomiting, have been documented, causing patient discomfort. Hence, we prepared a nanosized micellar solution of [223Ra]RaCl2 and evaluated its biodistribution, pharmacokinetics, and induced biochemical changes in healthy mice up to 96 h after intraperitoneal administration as an alternative to overcome the previous limitations. In addition, we evaluated the bone specificity of micellar [223Ra]RaCl2 in patient-derived xenografts in the osteosarcoma model. The biodistribution studies revealed the high bone-targeting properties of the micellar [223Ra]RaCl2. Interestingly, the liver uptake remained significantly low (%ID/g = 0.1–0.02) from 24 to 96 h after administration. In addition, the micellar [223Ra]RaCl2 exhibited a significantly higher uptake in left (%ID/g = 0.85–0.23) and right (%ID/g = 0.76–0.24) kidneys than in small (%ID/g = 0.43–0.06) and large intestines (%ID/g = 0.24–0.09) over time, suggesting its excretion pathway is primarily through the kidneys into the urine, in contrast to the non-micellar [223Ra]RaCl2. The micellar [223Ra]RaCl2 also had low distribution volume (0.055 ± 0.003 L) and longer elimination half-life (28 ± 12 days). This nanosystem was unable to change the enzymatic activities of alanine aminotransferase, aspartate aminotransferase, gamma GT, glucose, and liquiform lipase in the treated mice. Finally, microscopic examination of the animals' osteosarcoma tumors treated with micellar [223Ra]RaCl2 indicated regression of the tumor, with large areas of necrosis. In contrast, in the control group, we observed tumor cellularity and cell anaplasia, mitotic figures and formation of neoplastic extracellular bone matrix, which are typical features of osteosarcoma. Therefore, our findings demonstrated the efficiency and safety of nanosized micellar formulations to minimize the gastrointestinal excretion pathway of the clinical radiopharmaceutical [223Ra]RaCl2, in addition to promoting regression of the osteosarcoma. Further studies must be performed to assess dose–response outcomes and organ/tissue dosimetry for clinical translation.

Chemotherapy-related adverse effects with anthracycline and taxane-containing regimens in patients with localized Breast cancer: a descriptive study

BackgroundAlthough the side effects of chemotherapy are frequently described in research studies, there is little evidence on how common they are in everyday clinical care. This study’s goal was to assess the most prevalent short-term side effects experienced by patients with localized breast cancer, undergoing chemotherapy based on anthracyclines and taxane-containing treatments, at the medical oncology department of the Mohammed VI University Hospital of Marrakech, Morocco.MethodsThis was a descriptive study. We conducted a listening session at the outpatient department of the hospital with the help of a structured questionnaire. The session engaged 122 women who had undergone cycles of chemotherapy. A chi-square test was used to compare the incidence and relative risk of short side effects with both anthracycline and taxane-containing regimens.ResultsThe average age of participants was 49.1 years. In both regimens, the findings highlighted the frequency and relative risk of the following adverse effects: systemic symptoms (fever, asthenia and sleep disorder), gastrointestinal toxicity (Vomiting, nausea, diarrhoea, constipation, mucositis and loss of appetite), dermatological toxicity (Skin reactions on hands/feet, nail toxicity, allergies, alopecia and peripheral edema), neurological toxicity (neuropathy), arthromyalgia and ocular toxicity.ConclusionsIn conclusion, it is crucial for healthcare professionals to be conscious of the significance of these adverse effects. They must also know how to manage them. Likewise, the listening approach highlights its importance in the daily follow-up and monitoring of patients.