476,727 results match your criteria patient dose


Reduced-dose intravenous thrombolysis for acute intermediate high-risk pulmonary embolism: Rationale and design of the PEITHO-3 trial.

Thromb Haemost 2021 Sep 24. Epub 2021 Sep 24.

Hopital Europeen Georges Pompidou, Paris, France.

Intermediate high-risk pulmonary embolism (PE) is characterised by right ventricular (RV) dysfunction and elevated circulating cardiac troponin levels despite apparent haemodynamic stability at presentation. In these patients, full-dose systemic thrombolysis reduced the risk of haemodynamic decompensation or death but increased the risk of life-threatening bleeding. Reduced-dose thrombolysis may be capable of improving safety while maintaining reperfusion efficacy. Read More

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September 2021

Improving quality of PrEP counseling for adolescent girls and young women in Kenya with standardized patient actors: a dose-response analysis.

J Acquir Immune Defic Syndr 2021 Sep 23. Epub 2021 Sep 23.

Department of Global Health, University of Washington, Seattle, WA, USA Department of Epidemiology, University of Washington, Seattle, WA, USA Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya Policy Development & Evaluation Unit, Public Health Seattle/King County, Seattle, WA, USA Howard University, Washington, DC, USA Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA Department of Biostatistics, University of Washington, Seattle, WA, USA Department of Medicine, University of Washington, Seattle, WA, USA Department of Pediatrics, University of Washington, Seattle, WA, USA Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA.

Background: Health care worker (HCW) training using standardized patient actors (SPs) is an evidence-based approach for improving patient-provider interactions. We evaluated whether SP training among HCWs in Western Kenya improved quality of PrEP counseling for adolescent girls and young women (AGYW).

Methods: We conducted a 2-day SP training intervention among HCWs providing PrEP counseling for AGYW. Read More

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September 2021

Effects of hypertonic saline on intracranial pressure and cerebral autoregulation in pediatric traumatic brain injury.

J Neurosurg Pediatr 2021 Sep 24:1-7. Epub 2021 Sep 24.

2Pediatric Intensive Care Unit, University Children's Hospital of Tuebingen, Tuebingen; and.

Objective: Hypertonic saline (HTS) is commonly used in children to lower intracranial pressure (ICP) after severe traumatic brain injury (sTBI). While ICP and cerebral perfusion pressure (CPP) correlate moderately to TBI outcome, indices of cerebrovascular autoregulation enhance the correlation of neuromonitoring data to neurological outcome. In this study, the authors sought to investigate the effect of HTS administration on ICP, CPP, and autoregulation in pediatric patients with sTBI. Read More

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September 2021

Radiomic modeling to predict risk of vertebral compression fracture after stereotactic body radiation therapy for spinal metastases.

J Neurosurg Spine 2021 Sep 24:1-9. Epub 2021 Sep 24.

1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore.

Objective: In the treatment of spinal metastases with stereotactic body radiation therapy (SBRT), vertebral compression fracture (VCF) is a common and potentially morbid complication. Better methods to identify patients at high risk of radiation-induced VCF are needed to evaluate prophylactic measures. Radiomic features from pretreatment imaging may be employed to more accurately predict VCF. Read More

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September 2021

Dose to neuroanatomical structures surrounding pituitary adenomas and the effect of stereotactic radiosurgery on neuroendocrine function: an international multicenter study.

J Neurosurg 2021 Sep 24:1-9. Epub 2021 Sep 24.

20Centro Gamma Knife Dominicano and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.

Objective: Stereotactic radiosurgery (SRS) provides a safe and effective therapeutic modality for patients with pituitary adenomas. The mechanism of delayed endocrine deficits based on targeted radiation to the hypothalamic-pituitary axis remains unclear. Radiation to normal neuroendocrine structures likely plays a role in delayed hypopituitarism after SRS. Read More

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September 2021

Interactions of noradrenergic, glucocorticoid and endocannabinoid systems intensify and generalize fear memory traces.

Neuroscience 2021 Sep 21. Epub 2021 Sep 21.

Departamento de Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil. Electronic address:

Systemic administration of drugs that activate the noradrenergic or glucocorticoid system potentiates aversive memory consolidation and reconsolidation. The opposite happens with the stimulation of endocannabinoid signaling under certain conditions. An unbalance of these interacting neurotransmitters can lead to the formation and maintenance of traumatic memories, whose strength and specificity attributes are often maladaptive. Read More

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September 2021

Correlations between bone marrow radiation dose and hematologic toxicity in locally advanced cervical cancer patients receiving chemoradiation with cisplatin: a systematic review.

Radiother Oncol 2021 Sep 21. Epub 2021 Sep 21.

Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. Electronic address:

Patients with locally advanced cervical cancer (LACC) treated with chemoradiation often experience hematologic toxicity (HT), as chemoradiation can induce bone marrow (BM) suppression. Studies on the relationship between BM dosimetric parameters and clinically significant HT might provide relevant indices for developing BM-sparing (BMS) radiotherapy techniques. This systematic review studied the relationship between bone marrow dose and HT in LACC-patients treated with primary cisplatin-based chemoradiation. Read More

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September 2021

Combination treatment with rituximab, low-dose cyclophosphamide and plasma exchange for severe antineutrophil cytoplasmic antibody-associated vasculitis.

Kidney Int 2021 Sep 21. Epub 2021 Sep 21.

Vasculitis Clinic, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London UK; Centre for Inflammatory Disease, Imperial College London, London UK. Electronic address:

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis can present with life-threatening lung-kidney syndromes. However, many controlled treatment trials excluded patients with diffuse alveolar hemorrhage or severely impaired glomerular filtration rates, and so the optimum treatment in these cases is unclear. In this retrospective cohort study, we report the outcomes of 64 patients with life-threatening disease treated with a combination regimen of rituximab, low-dose intravenous cyclophosphamide, oral glucocorticoids, and plasma exchange. Read More

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September 2021

Efficacy of a single dose of esmolol to prevent extubation-related complications during emergence from anesthesia: a randomized, double-blind, placebo-controlled trial.

Braz J Anesthesiol 2021 Sep 21. Epub 2021 Sep 21.

Hospital de Base do Distrito Federal, Centro de Ensino e Treinamento em Anestesiologia (CET), Brasília, DF, Brasil.

Background: Few trials have examined the efficacy of esmolol to attenuate hemodynamic and respiratory responses during extubation. However, the most appropriate dose of esmolol and an optimal protocol for administering this beta-blocker are uncertain.

Methods: Ninety patients ASA physical status I, II and III (18-60 years) scheduled to procedures with general anesthesia and tracheal extubation were selected. Read More

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September 2021

Role of melatonin in attenuation of hemodynamic response to intubation and anesthetic requirements: a randomized controlled double blind study.

Braz J Anesthesiol 2021 Sep 21. Epub 2021 Sep 21.

Dr. S.N. Medical College, Department of Orthopedics, Jodhpur, India.

Background: Melatonin has been studied to have anxiolytic, sedative, and analgesic effects. However, there is limited data on the effect of melatonin in the attenuation of hemodynamic response to intubation. We aimed to study whether preanesthetic oral melatonin attenuates hemodynamic responses to intubation and anesthetic requirements. Read More

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September 2021

Efficacy and safety of PXL770, a direct AMP kinase activator, for the treatment of non-alcoholic fatty liver disease (STAMP-NAFLD): a randomised, double-blind, placebo-controlled, phase 2a study.

Lancet Gastroenterol Hepatol 2021 Sep 21. Epub 2021 Sep 21.

Institute for Cardiometabolism and Nutrition, Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, France.

Background: AMP kinase (AMPK) is an energy sensor implicated in regulation of lipid metabolism, inflammation, and insulin sensitivity. We aimed to assess efficacy and safety of PXL770, a novel direct AMPK activator, in patients with non-alcoholic fatty liver disease (NAFLD).

Methods: STAMP-NAFLD, a randomised, double-blind, placebo-controlled phase 2a study, was done across 15 US clinical sites. Read More

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September 2021

All-trans retinoic acid plus high-dose dexamethasone as first-line treatment for patients with newly diagnosed immune thrombocytopenia: a multicentre, open-label, randomised, controlled, phase 2 trial.

Lancet Haematol 2021 Oct;8(10):e688-e699

Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China; National Clinical Research Center for Hematologic Disease, Beijing, China; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Collaborative Innovation Center of Hematology, Peking University, Beijing, China. Electronic address:

Background: High-dose dexamethasone is the standard initial treatment for patients with immune thrombocytopenia, but many patients still relapse and require further treatments. All-trans retinoic acid has been shown to exert immunomodulatory effects and promote thrombopoiesis, and so we aimed to assess the activity and safety of all-trans retinoic acid plus high-dose dexamethasone as a first-line treatment for newly diagnosed patients with immune thrombocytopenia.

Methods: This multicentre, open-label, randomised, controlled, phase 2 trial was done at six different tertiary medical centres in China. Read More

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October 2021

A single-center, open-label, randomized cross-over study to evaluate the pharmacokinetics and bioavailability of once-daily prolonged-release formulations of tacrolimus in de novo liver transplant recipients.

Immun Inflamm Dis 2021 Sep 24. Epub 2021 Sep 24.

Department of Visceral Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: The narrow therapeutic window of tacrolimus (Tac) requires intense drug monitoring to achieve adequate efficacy while minimizing dose-related toxicities. Once-daily formulations of Tac (LCP-Tac and PR-Tac) have been recently designed for higher bioavailability and a more consistent exposure over time, as opposed to the twice-daily, administered immediate-release formulation of Tac (IR-Tac).

Methods: This single-center, open-label, randomized cross-over pharmacokinetic (PK) study compares extended-release LCP-Tac with the prolonged-release formulation of tacrolimus (PR-Tac) in adult de novo liver transplant recipients. Read More

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September 2021

A phase I/II study of ixazomib, pomalidomide and dexamethasone for lenalidomide and proteasome inhibitor refractory multiple myeloma. (Alliance A061202).

Am J Hematol 2021 Sep 24. Epub 2021 Sep 24.

Division of Hematology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.

Preclinical studies demonstrated activity of the oral proteasome inhibitor (PI) ixazomib (IXA) in bortezomib-resistant multiple myeloma (MM) and synergy with immunomodulatory drugs. We therefore conducted a phase I/II study to establish the safety and preliminary efficacy of IXA with pomalidomide (POM) and dexamethasone (DEX) in lenalidomide (LEN)/PI-refractory MM. Dose escalation established a 4 mg dose of POM and IXA and 20/40 mg dose of DEX as the maximum tolerated dose. Read More

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September 2021

Effects of Curcuma longa L., Eucommia ulmoides Oliv. and Gynostemma pentaphyllum (Thunb.) Makino on Cytokine Production in Stimulated Peripheral Blood Mononuclear Cells in Patients with Tuberculosis.

Altern Ther Health Med 2021 Sep 24. Epub 2021 Sep 24.

Background: Tuberculosis (TB) infection triggers the innate and adaptive immune responses. Eucommia ulmoides Oliv., Gynostemma pentaphyllum (Thunb. Read More

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September 2021

Clinical Importance of Plasma Drug Concentration of Oral Molecular Targeted Drugs for Renal Cell Carcinoma.

J Pharm Pharm Sci 2021 ;24:127-136

Department of Pharmaceutical Sciences, Tohoku University Hospital, Miyagi.

Purpose: Therapeutic drug monitoring (TDM) is widely used in clinical practice to maximize drug efficacy and minimize toxicities. Currently, it is also practiced in the use of oral molecular targeted drugs. The objective of this study was to assess the clinical importance of measuring the systemic concentration of oral molecular targeted drugs used to treat renal cell carcinoma (RCC). Read More

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January 2021

Evolution of Radioembolization in Treatment of Hepatocellular Carcinoma: A Pictorial Review.

Radiographics 2021 Sep 24:210014. Epub 2021 Sep 24.

From the Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 800, Chicago, IL 60611.

Transarterial radioembolization (TARE) with yttrium 90 has increasingly been performed to treat hepatocellular carcinoma (HCC). TARE was historically used as a palliative lobar therapy for patients with advanced HCC beyond surgical options, ablation, or transarterial chemoembolization, but recent advancements have led to its application across the Barcelona Clinic Liver Cancer staging paradigm. Newer techniques, termed and , are being performed before liver resection to facilitate hypertrophy of the future liver remnant, before liver transplant to bridge or downstage to transplant, or as a definite curative treatment. Read More

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September 2021

Encouraging long-term survival following autophagy inhibition using neoadjuvant hydroxychloroquine and gemcitabine for high-risk patients with resectable pancreatic carcinoma.

Cancer Med 2021 Sep 24. Epub 2021 Sep 24.

Department of Internal Medicine, University of Pittsburgh, PA, USA.

Introduction: Preoperative autophagy inhibition with hydroxychloroquine (HCQ) in combination with gemcitabine in pancreatic adenocarcinoma (PDAC) has been shown to be safe and effective in inducing a serum biomarker response and increase resection rates in a previous phase I/II clinical trial. We aimed to analyze the long-term outcomes of preoperative HCQ with gemcitabine for this cohort.

Methods: A review of patients enrolled between July 2010 and February 2013 in the completed phase I/II single arm (two doses of fixed-dose gemcitabine (1500 mg/m ) in combination with oral hydroxychloroquine administered for 31 consecutive days until the day of surgery for high-risk pancreatic cancer) was undertaken. Read More

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September 2021

Do High Dose Corticosteroids Improve Outcomes in Hospitalized COVID-19 Patients?

J Med Virol 2021 Sep 24. Epub 2021 Sep 24.

Associate Professor, Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, GA, 30909.

Problem: COVID-19 is characterized by dysregulated hyperimmune response and steroids have been shown to decrease mortality. However, whether higher dosing of steroids results in better outcomes have been debated.

Methods: This was a retrospective observational of COVID-19 admissions between March 1 2020 and March 10 2021. Read More

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September 2021

Loss of response to anti-TNFα agents depends on treatment duration in patients with inflammatory bowel disease.

Aliment Pharmacol Ther 2021 Sep 24. Epub 2021 Sep 24.

Division of Internal Medicine and Dermatology, Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Background: Inflammatory bowel disease (IBD) is often managed with anti-tumour necrosis factor-α therapy (anti-TNFα), but treatment efficacy is compromised by high annual rates of loss of response (13%-21% per patient-year).

Aims: To assess whether the incidence of loss of response decreases with longer treatment duration METHODS: This was a multicentre, retrospective cohort study of patients with ulcerative colitis (UC) or Crohn's disease (CD) who received anti-TNFα for at least 4 months between 2011 and 2019. We studied the incidence of loss of response as a function of treatment duration, employing parametric survival modelling. Read More

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September 2021

Post-Tonsillectomy Ibuprofen: Is There a Dose-Dependent Bleeding Risk?

Laryngoscope 2021 Sep 24. Epub 2021 Sep 24.

Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.

Objectives/hypothesis: Post-tonsillectomy hemorrhage (PTH) is a potentially life-threatening complication. A recent meta-analysis suggests that ibuprofen may increase the risk of PTH. The aims of this study were to 1) re-evaluate the effect of ibuprofen on PTH given additional recent evidence and 2) to evaluate a potential dose effect of ibuprofen. Read More

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September 2021

A Phase 1b Trial of Prexasertib in Combination with Standard-of-Care Agents in Advanced or Metastatic Cancer.

Target Oncol 2021 Sep 24. Epub 2021 Sep 24.

Sarah Cannon Research Institute, Nashville, TN, USA.

Background: The checkpoint kinase 1 (CHK1) inhibitor prexasertib exhibited modest monotherapy antitumor activity in prior trials, suggesting that combination with chemotherapy or other targeted agents may be needed to maximize efficacy.

Objectives: The aim of this study was to determine the recommended phase II dose and schedule of prexasertib in combination with either cisplatin, cetuximab, pemetrexed, or 5-fluorouracil in patients with advanced and/or metastatic cancer, and to summarize preliminary antitumor activity of these combinations.

Patients And Methods: This phase Ib, nonrandomized, open-label study comprised dose-escalation phase(s) with multiple sub-arms evaluating different prexasertib-drug combinations: Part A, prexasertib + cisplatin (n = 63); Part B, prexasertib + cetuximab (n = 41); Part C, prexasertib + pemetrexed (n = 3); Part D, prexasertib + 5-fluorouracil (n =8). Read More

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September 2021

Supportive care for the prevention of nausea, vomiting and anorexia in a phase 1B study of selinexor in advanced cancer patients: an exploratory study.

Invest New Drugs 2021 Sep 24. Epub 2021 Sep 24.

Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, USA.

Introduction: Clinical observations of cancer patients treated with selinexor have reported high incidence of nausea and anorexia. The study objective was to investigate the adoption of prophylactic olanzapine for the prevention of nausea, vomiting and anorexia in cancer patients receiving selinexor and standard chemotherapy.

Methods: We retrospectively reviewed supportive care interventions in patients receiving selinexor and recorded frequency of adverse events (NCI-CTAE). Read More

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September 2021

Narcolepsy genetic marker HLA DQB1*06:02 and excessive daytime sleepiness in Parkinson disease patients treated with dopaminergic agents.

J Neurol 2021 Sep 24. Epub 2021 Sep 24.

Parkinson Disease and Movement Disorders Center, Albany Medical College, 47 New Scotland Ave, Albany, NY, 12208, USA.

Objective: To determine whether narcolepsy Human Leukocyte Antigen (HLA) risk allele DQB1*0602 is associated with excessive daytime sleepiness (EDS) and inappropriate sleep in patients with Parkinson disease (PD).

Background: EDS is a common and disabling non-motor manifestation of PD, affecting quality of life and driving performance. DQB1*0602 is an HLA risk allele for narcolepsy. Read More

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September 2021

Effect of the Histone Deacetylase Inhibitor FRM-0334 on Progranulin Levels in Patients With Progranulin Gene Haploinsufficiency: A Randomized Clinical Trial.

JAMA Netw Open 2021 Sep 1;4(9):e2125584. Epub 2021 Sep 1.

FORUM Pharmaceuticals Incorporated, Waltham, Massachusetts.

Importance: Histone deacetylase inhibitors have been repeatedly shown to elevate progranulin levels in preclinical models. This report describes the first randomized clinical trial of a histone deacetylase inhibitor in frontotemporal dementia (FTD) resulting from progranulin (GRN) gene variations.

Objective: To characterize the safety, tolerability, plasma pharmacokinetics, and pharmacodynamic effects of oral FRM-0334 on plasma progranulin and other exploratory biomarkers, including fluorodeoxyglucose (FDG)-positron emission tomography (PET), in individuals with GRN haploinsufficiency. Read More

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September 2021

Anti-IL-6 cytokine treatment has no impact on elevated hematocrit and splenomegaly in a polycythemia vera mouse model.

Blood Adv 2021 Sep 24. Epub 2021 Sep 24.

Otto-von-Guericke-University, Magdeburg, Germany.

Somatic mutations in JAK2, MPL and Calreticulin and inflammation play a key role in pathophysiology of chronic myeloproliferative neoplasia (CMN). One of the most prominent cytokines elevated in serum of Polycythemia vera patients is interleukin-6 (IL-6). Currently, it is being discussed whether suppression of inflammation by anti-cytokine approaches as anti-IL-6 treatment may be therapeutically useful in CMN. Read More

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September 2021

General anesthesia with cisatracurium and sevoflurane for a patient with primary carnitine deficiency receiving L-carnitine therapy: A case report.

Authors:
Ling Ai Yan Fang

Medicine (Baltimore) 2021 Sep;100(38):e27333

Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Rationale: Lipid storage myopathies (LSMs) are a series of genetic disorders of lipid metabolism predominantly affecting muscle. The low incidence and lethal properties of this disease make anesthesia experience limited in such patients. Among all etiologies of LSMs, primary carnitine deficiency (PCD) is now considered highly treatable by early administration of L-carnitine, though it remains unclear whether L-carnitine is effective enough to protect diseased muscle against conventionally used neuromuscular blocking agents (NMBAs) during general anesthesia. Read More

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September 2021

Radiotherapy for a rare phosphaturic mesenchymal tumor in the middle ear presenting with oncogenic osteomalacia: A case report.

Medicine (Baltimore) 2021 Sep;100(38):e27284

Department of Radiation Oncology, Narita Memorial Proton Center, Toyohashi, Japan.

Rationale: Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm causing oncogenic osteomalacia. Surgery remains the definitive treatment for PMT, and radiotherapy is seldom employed. However, surgery for PMT involving the head and neck is often difficult due to the local invasion and complicated anatomy. Read More

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September 2021