Common Terminology Criteria for Adverse Events
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Taste Alteration in COVID-19: a Rapid Review with Data Synthesis Reveals Significant Geographical Differences
medRxiv preprint doi: https://doi.org/10.1101/2020.09.11.20192831; this version posted September 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Taste alteration in COVID-19: a rapid review with data synthesis reveals significant geographical differences By Nicola Cirillo Melbourne Dental School, The University of Melbourne, 3053 Carlton, Victoria, Australia *Address for Correspondence: Prof. Dr. Nicola Cirillo Melbourne Dental School The University of Melbourne 720 Swanston Street, Carlton 3053 Victoria, AUS Tel/fax. +61 03 9341 1473 e-mail: [email protected] NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.09.11.20192831; this version posted September 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Abstract To facilitate a timely understanding of the differences in the prevalence of gustatory disturbances (GD) in individuals infected with SARS-CoV-2, we undertook a rapid systematic review of articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) and medRxiv from their inception until September 3, 2020. The minimum requirements for completing a restricted systematic review were met. -
Skin Lesions in Diabetic Patients
Rev Saúde Pública 2005;39(4) 1 www.fsp.usp.br/rsp Skin lesions in diabetic patients N T Foss, D P Polon, M H Takada, M C Foss-Freitas and M C Foss Departamento de Clínica Médica. Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo. Ribeirão Preto, SP, Brasil Keywords Abstract Skin diseases. Dermatomycoses. Diabetes mellitus. Metabolic control. Objective It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. Methods A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. Results High number of dermophytosis (82.6%) followed by different types of skin lesions such as acne and actinic degeneration (66.7%), pyoderma (5%), cutaneous tumors (3%) and necrobiosis lipoidic (1%) were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%), diabetic dermopathy (5 cases, 1.2%) and foot ulcerations (3 cases, 0.7%). Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. -
COVID-19 Vaccine Janssen: Contraindication in Individuals with Previous Capillary Leak Syndrome and Update on Thrombosis with Thrombocytopenia Syndrome
Janssen Sciences Ireland UC Address: Airton Road, Tallaght, D24 WR89 Tel: +353 1 466 5200 Fax: +353 1 431 1058 www.janssen.ie 19the July 2021 COVID-19 Vaccine Janssen: Contraindication in individuals with previous capillary leak syndrome and update on thrombosis with thrombocytopenia syndrome Dear Healthcare Professional, Janssen-Cilag International NV in agreement with the European Medicines Agency and the Health Products Regulatory Authority (HPRA) would like to inform you of the following: Summary Capillary leak syndrome (CLS): • Very rare cases of capillary leak syndrome (CLS) have been reported in the first days after vaccination with COVID-19 Vaccine Janssen, in some cases with a fatal outcome. A history of CLS has been reported in at least one case. • COVID-19 Vaccine Janssen is now contraindicated in individuals who have previously experienced episodes of CLS. • CLS is characterised by acute episodes of oedema mainly affecting the limbs, hypotension, haemoconcentration and hypoalbuminaemia. Patients with an acute episode of CLS following vaccination require prompt recognition and treatment. Intensive supportive therapy is usually warranted. Thrombosis with thrombocytopenia syndrome (TTS): • Individuals diagnosed with thrombocytopenia within 3 weeks after vaccination with COVID-19 Vaccine Janssen should be actively investigated for signs of thrombosis. Similarly, individuals who present with thrombosis within 3 weeks of vaccination should be evaluated for thrombocytopenia. • TTS requires specialised clinical management. Healthcare professionals should consult applicable guidance and/ or consult specialists (e.g., haematologists, specialists in coagulation) to diagnose and treat this condition. Background on the safety concern COVID-19 Vaccine Janssen suspension for injection is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 18 years of age and older. -
SPRAVATO® Esketamine Hydrochloride DATA SHEET
SPRAVATO® esketamine hydrochloride DATA SHEET 1. PRODUCT NAME SPRAVATO® esketamine hydrochloride 32.3mg (equivalent to 28mg esketamine) nasal spray 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each single use nasal spray device delivers two sprays, one spray into each nostril. Total volume of drug product per device to be delivered is 0.2 mL containing a total of 32.3 mg of esketamine hydrochloride (equivalent to 28 mg of esketamine). For the full list of excipients, see Section 6.1 List of Excipients. 3. PHARMACEUTICAL FORM Nasal spray, solution. Clear, colourless, aqueous solution. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications SPRAVATO in conjunction with an oral antidepressant, is indicated for: - treatment resistant depression (Major Depressive Disorder in adults who have not responded adequately to at least two different antidepressants of adequate dose and duration to treat the current depressive episode). - rapid reduction of depressive symptoms in patients with Major Depressive Disorder who have acute suicidal ideation or behaviour. SPRAVATO is not indicated to prevent suicide or in reducing suicidal ideation or behaviour (see section 4.4. Special Warnings And Precautions For Use) 4.2 Dose and method of administration In patients with TRD, SPRAVATO should be administered in conjunction with a newly initiated oral antidepressant (AD) therapy. In patients with MDSI, SPRAVATO should be administered in conjunction with standard of care therapy. During the Phase III MDSI clinical program, standard of care oral AD treatment (either AD monotherapy or AD plus augmentation therapy) was initiated or optimised. Important Considerations Prior to Initiating and During Therapy SPRAVATO must be administered under the direct supervision of a healthcare provider. -
Taste and Smell Disorders in Clinical Neurology
TASTE AND SMELL DISORDERS IN CLINICAL NEUROLOGY OUTLINE A. Anatomy and Physiology of the Taste and Smell System B. Quantifying Chemosensory Disturbances C. Common Neurological and Medical Disorders causing Primary Smell Impairment with Secondary Loss of Food Flavors a. Post Traumatic Anosmia b. Medications (prescribed & over the counter) c. Alcohol Abuse d. Neurodegenerative Disorders e. Multiple Sclerosis f. Migraine g. Chronic Medical Disorders (liver and kidney disease, thyroid deficiency, Diabetes). D. Common Neurological and Medical Disorders Causing a Primary Taste disorder with usually Normal Olfactory Function. a. Medications (prescribed and over the counter), b. Toxins (smoking and Radiation Treatments) c. Chronic medical Disorders ( Liver and Kidney Disease, Hypothyroidism, GERD, Diabetes,) d. Neurological Disorders( Bell’s Palsy, Stroke, MS,) e. Intubation during an emergency or for general anesthesia. E. Abnormal Smells and Tastes (Dysosmia and Dysgeusia): Diagnosis and Treatment F. Morbidity of Smell and Taste Impairment. G. Treatment of Smell and Taste Impairment (Education, Counseling ,Changes in Food Preparation) H. Role of Smell Testing in the Diagnosis of Neurodegenerative Disorders 1 BACKGROUND Disorders of taste and smell play a very important role in many neurological conditions such as; head trauma, facial and trigeminal nerve impairment, and many neurodegenerative disorders such as Alzheimer’s, Parkinson Disorders, Lewy Body Disease and Frontal Temporal Dementia. Impaired smell and taste impairs quality of life such as loss of food enjoyment, weight loss or weight gain, decreased appetite and safety concerns such as inability to smell smoke, gas, spoiled food and one’s body odor. Dysosmia and Dysgeusia are very unpleasant disorders that often accompany smell and taste impairments. -
Capillary Leak Syndrome
The Medicine Forum Volume 17 Article 8 2016 Case Report: Uncontrolled Anasarca: Capillary Leak Syndrome Ankita Mehta, MD Thomas Jefferson University Hospital, [email protected] Mansi Shah, MD Jefferson Hospital Ambulatory Practice, Thomas Jefferson University Hospital, [email protected] Follow this and additional works at: https://jdc.jefferson.edu/tmf Part of the Internal Medicine Commons, and the Oncology Commons Let us know how access to this document benefits ouy Recommended Citation Mehta, MD, Ankita and Shah, MD, Mansi (2016) "Case Report: Uncontrolled Anasarca: Capillary Leak Syndrome," The Medicine Forum: Vol. 17 , Article 8. DOI: https://doi.org/10.29046/TMF.017.1.009 Available at: https://jdc.jefferson.edu/tmf/vol17/iss1/8 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in The Medicine Forum by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. Mehta, MD and Shah, MD: Case Report: Uncontrolled Anasarca: Capillary Leak Syndrome ONCOLOGY Case Report: Uncontrolled Anasarca: Capillary Leak Syndrome Ankita Mehta, MD, and Mansi Shah, MD INTRODUCTION progression of her pancreatic cancer. She was ultimately discharged home with hospice care. -
Topical Treatments for Seborrheic Keratosis: a Systematic Review
SYSTEMATIC REVIEW AND META-ANALYSIS Topical Treatments for Seborrheic Keratosis: A Systematic Review Ma. Celina Cephyr C. Gonzalez, Veronica Marie E. Ramos and Cynthia P. Ciriaco-Tan Department of Dermatology, College of Medicine and Philippine General Hospital, University of the Philippines Manila ABSTRACT Background. Seborrheic keratosis is a benign skin tumor removed through electrodessication, cryotherapy, or surgery. Alternative options may be beneficial to patients with contraindications to standard treatment, or those who prefer a non-invasive approach. Objectives. To determine the effectiveness and safety of topical medications on seborrheic keratosis in the clearance of lesions, compared to placebo or standard therapy. Methods. Studies involving seborrheic keratosis treated with any topical medication, compared to cryotherapy, electrodessication or placebo were obtained from MEDLINE, HERDIN, and Cochrane electronic databases from 1990 to June 2018. Results. The search strategy yielded sixty articles. Nine publications (two randomized controlled trials, two non- randomized controlled trials, three cohort studies, two case reports) covering twelve medications (hydrogen peroxide, tacalcitol, calcipotriol, maxacalcitol, ammonium lactate, tazarotene, imiquimod, trichloroacetic acid, urea, nitric-zinc oxide, potassium dobesilate, 5-fluorouracil) were identified. The analysis showed that hydrogen peroxide 40% presented the highest level of evidence and was significantly more effective in the clearance of lesions compared to placebo. Conclusion. Most of the treatments reviewed resulted in good to excellent lesion clearance, with a few well- tolerated minor adverse events. Topical therapy is a viable option; however, the level of evidence is low. Standard invasive therapy remains to be the more acceptable modality. Key Words: seborrheic keratosis, topical, systematic review INTRODUCTION Description of the condition Seborrheic keratoses (SK) are very common benign tumors of the hair-bearing skin, typically seen in the elderly population. -
The Effect of Radiotherapy on Taste Sensation in Head and Neck Cancer
Asif et al. Radiation Oncology (2020) 15:144 https://doi.org/10.1186/s13014-020-01578-4 RESEARCH Open Access The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study Michal Asif1†, Assaf Moore1,2*† , Noam Yarom3,4 and Aron Popovtzer1,2 Abstract Background: One of the main side effects of head and neck (H&N) radiation therapy (RT) is alteration in taste sensation. It causes significant morbidity and has a major effect on quality of life (QoL). The aim of this study was to prospectively define the effect of RT on taste sensation (general, and four basic tastes) and correlate these findings with changes in saliva secretion and QoL questionnaires. Methods: Patients with H&N cancer treated with RT, in which the oral cavity was expected to receive a mean dose of 30 Gray (Gy). Patients were evaluated by Whole-Saliva Sialometry, validated Taste Strips and European Organization for Research and Treatment of Cancer H&N QoL questionnaires prior to RT (T0), mid-point of radiotherapy dose (T1), at the end of radiotherapy (T2) and 1 (T3), 3 (T4) and 12 months (T5) after completion of treatment course. Results: Twenty-eight patients were recruited, and 21 patients completed study procedures and were analyzed. Median age was 66 years (range 18–90). The most common tumor site was the oral cavity. The median prescribed radiation dose to the high dose volume was 66 (range 60–70). The median mean and max dose to the oral cavity were 25.1 (range 14–69) and 64.9 (range 30–70), respectively. -
Abadie's Sign Abadie's Sign Is the Absence Or Diminution of Pain Sensation When Exerting Deep Pressure on the Achilles Tendo
A.qxd 9/29/05 04:02 PM Page 1 A Abadie’s Sign Abadie’s sign is the absence or diminution of pain sensation when exerting deep pressure on the Achilles tendon by squeezing. This is a frequent finding in the tabes dorsalis variant of neurosyphilis (i.e., with dorsal column disease). Cross References Argyll Robertson pupil Abdominal Paradox - see PARADOXICAL BREATHING Abdominal Reflexes Both superficial and deep abdominal reflexes are described, of which the superficial (cutaneous) reflexes are the more commonly tested in clinical practice. A wooden stick or pin is used to scratch the abdomi- nal wall, from the flank to the midline, parallel to the line of the der- matomal strips, in upper (supraumbilical), middle (umbilical), and lower (infraumbilical) areas. The maneuver is best performed at the end of expiration when the abdominal muscles are relaxed, since the reflexes may be lost with muscle tensing; to avoid this, patients should lie supine with their arms by their sides. Superficial abdominal reflexes are lost in a number of circum- stances: normal old age obesity after abdominal surgery after multiple pregnancies in acute abdominal disorders (Rosenbach’s sign). However, absence of all superficial abdominal reflexes may be of localizing value for corticospinal pathway damage (upper motor neu- rone lesions) above T6. Lesions at or below T10 lead to selective loss of the lower reflexes with the upper and middle reflexes intact, in which case Beevor’s sign may also be present. All abdominal reflexes are preserved with lesions below T12. Abdominal reflexes are said to be lost early in multiple sclerosis, but late in motor neurone disease, an observation of possible clinical use, particularly when differentiating the primary lateral sclerosis vari- ant of motor neurone disease from multiple sclerosis. -
Fundamentals of Dermatology Describing Rashes and Lesions
Dermatology for the Non-Dermatologist May 30 – June 3, 2018 - 1 - Fundamentals of Dermatology Describing Rashes and Lesions History remains ESSENTIAL to establish diagnosis – duration, treatments, prior history of skin conditions, drug use, systemic illness, etc., etc. Historical characteristics of lesions and rashes are also key elements of the description. Painful vs. painless? Pruritic? Burning sensation? Key descriptive elements – 1- definition and morphology of the lesion, 2- location and the extent of the disease. DEFINITIONS: Atrophy: Thinning of the epidermis and/or dermis causing a shiny appearance or fine wrinkling and/or depression of the skin (common causes: steroids, sudden weight gain, “stretch marks”) Bulla: Circumscribed superficial collection of fluid below or within the epidermis > 5mm (if <5mm vesicle), may be formed by the coalescence of vesicles (blister) Burrow: A linear, “threadlike” elevation of the skin, typically a few millimeters long. (scabies) Comedo: A plugged sebaceous follicle, such as closed (whitehead) & open comedones (blackhead) in acne Crust: Dried residue of serum, blood or pus (scab) Cyst: A circumscribed, usually slightly compressible, round, walled lesion, below the epidermis, may be filled with fluid or semi-solid material (sebaceous cyst, cystic acne) Dermatitis: nonspecific term for inflammation of the skin (many possible causes); may be a specific condition, e.g. atopic dermatitis Eczema: a generic term for acute or chronic inflammatory conditions of the skin. Typically appears erythematous, -
Cryosurgery Using the Cryopen®
Cryosurgery using the CryoPen® FAQ CRYOSURGERY What is cryosurgery? Cryosurgery is a procedure that uses extreme cold to destroy tissue. How can my practice benefit from using cryosurgery in my practice? Cryosurgery in the office offers an excellent modality for eliminating referral time while creating an added source of revenue. How can my patients benefit from having cryosurgery in my practice? Patients will appreciate the efficient use of their time and decreased cost of services by avoiding secondary visits to specialists. By keeping the procedure in house, patients will put a greater value on your practice. How is cryosurgery better than other methods of removing skin lesions? Cryosurgery requires no anesthesia and has less scarring than other techniques of skin lesion removal with minimal post-op care. What is the mechanism of cell destruction in cryosurgery? Cell destruction occurs when a cell is rapidly brought down to a very low temperature. When these two criteria are met (varies with cell type), ice crystals form, destroying the cell organelles and protein matrixes. Water then rushes into the surrounding area causing a blister and a disruption of the local blood supply. Cytologic evidence of cell destruction can be seen as soon as two hours after the procedure. What types of lesions are appropriate to freeze? Almost any unwanted skin lesions are appropriate such as warts, moles, actinic keratosis, seborrheic keratosis, keloids, lentigos, dermatofibromas, and hemangiomas to just name a few. In most practices, over 90% of unwanted lesions encountered are amenable to using cryosurgery. What types of lesions are not appropriate to freeze? All Melanomas and Recurrent Basal Cell Carcinomas are contraindicated for cryosurgery. -
Varenicline Tartrate Tablets CHAMPIX®
For the use of a Registered Medical Practitioner or a Hospital or a Laboratory Varenicline Tartrate Tablets CHAMPIX® 1. NAME OF THE MEDICINAL PRODUCT CHAMPIX® 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains Varenicline tartrate equivalent to Varenicline 0.5 mg. Each film-coated tablet contains Varenicline tartrate equivalent to Varenicline 1 mg. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Film-coated tablets. 0.5 mg film-coated tablets: White, capsular-shaped, biconvex tablets debossed with “Pfizer” on one side and “CHX 0.5” on the other side. 1 mg film-coated tablets: Light blue, capsular-shaped, biconvex tablets debossed with “Pfizer” on one side and “CHX 1.0” on the other side. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications Varenicline is indicated for smoking cessation in adults. 4.2 Posology and Method of Administration Smoking cessation therapies are more likely to succeed for patients who are motivated to stop smoking and who are provided with additional advice and support. ® Trademark Proprietor: C.P. Pharmaceuticals International C.V. Licensed User – Pfizer Limited, India® CHAMPIX Film-coated Tablets Page 1 of 26 LPDCHX092019 The recommended dose of varenicline is 1 mg twice daily following a 1-week titration as follows: Days 1 – 3: 0.5 mg once daily Days 4 – 7: 0.5 mg twice daily Day 8 – End of treatment: 1 mg twice daily The patient should set a date to stop smoking. Varenicline dosing should start 1 week before this date (see section 5.1 Pharmacodynamic Properties). Varenicline tablets should be swallowed whole with water.