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Desensitization therapy can help overcome severe hypersensitivity reactions and allow continuing administration of the culprit agents. However, this is time- and labor-intensive due to a prolonged infusion time and the serial adjustment of infusion rate between steps. Therefore, simplified protocols using fewer steps have been tested, although currently there is no established standard strategy. Cetuximab plays an important role in the treatment of metastatic colorectal cancer. Although cetuximab is well tolerated, severe infusion reactions occur in 1.1% of patients, and most occur within 1 hour of receiving the first dose. Here, we report a recent attempt to shorten the steps of gradual cetuximab desensitization. A 57-year-old male patient diagnosed with obstructive sigmoid colon cancer received cetuximab chemotherapy and experienced immediate anaphylaxis at the first cycle. A one-bag, 17-step desensitization protocol was applied to cetuximab administration. After the first successful desensitization cycle, the process of desensitization was shortened 1–2 step(s) per cycle, down to 2 steps, without a breakthrough reaction. The patient ultimately received regular infusions. Shortening of the rapid desensitization protocol can be considered if the previous cycle is well-tolerated, even in a patient who suffered previous anaphylaxis to cetuximab.
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Purpose@#The aim of this study was to investigate the influence of daily life functions, anxiety, and depression on pain catastrophizing among patients undergoing lumbar spinal surgery. @*Methods@#This study was a cross-sectional descriptive research. The participants were 136 patients undergoing lumbar spinal surgery at one general hospital. They were surveyed using structured questionnaires on daily life functions, anxiety, and depression related to pain catastrophizing. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis. @*Results@#The results indicate that pain catastrophizing was negatively correlated with all sub-domains of daily life functions, such as low back pain, low back function, gait ability, social life functions, and mental health, whereas it was positively correlated with anxiety and depression. However, only mental health, a sub-domain of daily life functions after surgery, was found to have a significant effect on pain catastrophizing. @*Conclusion@#This study confirmed that mental health-related daily life functions after surgery were predictors of pain catastrophizing. Therefore, to alleviate pain catastrophizing in patients undergoing lumbar spinal surgery, it is necessary to develop nursing interventions that can assist with mental health-related daily life functions after surgery as well as physical recovery.
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BACKGROUND: Herpes zoster ophthalmicus (HZO) can involve the oculomotor nerve; however, isolated trochlear nerve palsy has rarely been reported. CASE REPORT: An 83-year-old man who suffered from HZO in the right frontal area and scalp subsequently developed vertical diplopia and severe pain. Cerebrospinal fluid examination and brain MRI revealed no abnormalities. Isolated right trochlear nerve palsy was diagnosed based on the findings of neuro-ophthalmological tests. CONCLUSIONS: Isolated trochlear nerve involvement associated with HZO is very rare and may be easily overlooked. Physicians should carefully examine oculomotor involvement in HZO.