Guidance on the management of adverse reactions induced by poly(ADP-ribose) polymerase inhibitors / 浙江大学学报·医学版

The common adverse reactions caused by poly (ADP-ribose) polymerase (PARP) inhibitors include hematological toxicity, gastrointestinal toxicity and fatigue. The main prevention and treatment of hematological toxicity include: regular blood tests, referral to hematology department when routine treatment is ineffective, and being alert of myelodysplastic syndrome/acute myeloid leukemia. The key points to deal with gastrointestinal toxicity include: taking medicine at the right time, light diet, appropriate amount of drinking water, timely symptomatic treatment, prevention of expected nausea and vomiting, and so on. For fatigue, full assessment should be completed before treatment because the causes of fatigue are various; the management includes massage therapy, psychosocial interventions and drugs such as methylphenidate and Panax quinquefolius according to the severity. In addition, niraparib and fluzoparib can cause hypertension, hypertensive crisis and palpitation. Blood pressure and heart rate monitoring, timely symptomatic treatment, and multidisciplinary consultation should be taken if necessary. When cough and dyspnea occur, high resolution CT and bronchoscopy should be performed to exclude pneumonia. If necessary, PARP inhibitors should be stopped, and glucocorticoid and antimicrobial therapy should be given. Finally, more attention should be paid to drug interaction management, patient self-management and regular monitoring to minimize the risk and harm of adverse reactions of PARP inhibitors.

Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis / 中国结合医学杂志

BACKGROUND@#Corona virus disease 2019 (COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen (LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19.@*OBJECTIVE@#To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis.@*METHODS@#A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials (RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs (LCWC), and that in the control group were chemical drugs (CDs). Outcome measures included computed tomography (CT) recovery rate, disappearance rates of primary (fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group.@*RESULTS@#Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively (P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness (P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone (P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction (P>0.05).@*CONCLUSIONS@#LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation. (PROSPERO No. CRD42021235937).

Raloxifene neutralizes bone brittleness induced by anti-remodeling treatment and increases fatigue life through non-cell mediated mechanisms / El raloxifeno invierte fragilidad ósea inducida por el tratamiento anti-remodelación y aumenta la resistencia a la fatiga a través de mecanismos mediados no celulares

Pre-clinical data have shown that tissue level effects stemming from bisphosphonateinduced suppression of bone remodeling can result in bone that is stronger yet more brittle. Raloxifene has been shown to reduce bone brittleness through non-cellular mechanisms. The goal of this work was to test the hypothesis that raloxifene can reverse the bone brittleness resulting from bisphosphonate treatment. Dog and mouse bone from multiple bisphosphonate dosing experiments were soaked in raloxifene and then assessed for mechanical properties. Mice treated with zoledronate in vivo had lower post-yield mechanical properties compared to controls. Raloxifene soaking had significant positive effects on select mechanical properties of bones from both vehicle and zoledronate treated mice. Although the effects were blunted in zoledronate bones relative to vehicle, the soaking was sufficient to normalize properties to control levels. Additional studies showed that raloxifene-soaked bones had a significant positive effect on cycles to failure (+114%) compared to control-soaked mouse bone. Finally, raloxifene soaking significantly improved select properties of ribs from dogs treated for 3 years with alendronate. These data show that ex vivo soaking in raloxifene can act through non-cellular mechanisms to enhance mechanical properties of bone previously treated with bisphosphonate. We also document that the positive effects of raloxifene soaking extend to enhancing fatigue properties of bone. (AU)

Los datos preclínicos han demostrado que los efectos a nivel de tejido que se derivan de la supresión del remodelado óseo inducida por bifosfonatos puede dar como resultado un hueso que es más fuerte pero más frágil. Está comprobado que el raloxifeno reduce la fragilidad ósea a través de mecanismos no celulares. El objetivo de este trabajo fue probar la hipótesis de que el raloxifeno puede revertir la fragilidad ósea resultante del tratamiento con bifosfonatos. Se emplearon huesos de perro y ratón de múltiples experimentos con diferentes dosis de bifosfonatos los cuales fueron sumergidos en raloxifeno y luego se evaluaron sus propiedades mecánicas. Ratones tratados con zoledronato in vivo mostraron propiedades mecánicas post-rendimiento más bajas en comparación con los controles. Luego de sumergirlos en raloxifeno se observaron efectos positivos significativos en algunas propiedades biomecánicas tanto en los huesos de ratones tratados con vehículo como con zoledronato. Aunque los efectos se atenuaron en los huesos tratados con zoledronato en relación con los tratados con vehículo, el raloxifeno fue suficiente para normalizar las propiedades a niveles basales. Estudios adicionales mostraron que los huesos sumergidos en raloxifeno tuvieron un efecto positivo significativo en los ciclos de fractura (+ 114%) en comparación con los huesos de ratón sumergido en vehículo. Finalmente, el raloxifeno mejoró significativamente las propiedades de costillas de perros tratados durante 3 años con alendronato. Estos datos muestran que la inclusión ex vivo en raloxifeno puede actuar a través de mecanismos no celulares para mejorar las propiedades mecánicas de huesos previamente tratado con bifosfonatos. También documentamos que los efectos positivos del raloxifeno mejoran las propiedades de fatiga del hueso. (AU)

Anti-fatigue effects of polysaccharides extracted from Portulaca oleracea L. in mice.

Portulaca oleracea L. has been used as a food and medicinal plant for thousands of years in China. Polysaccharides extracted from P. oleracea L. (POP) are its main bioactive compound and have multiple pharmacological activities. However, anti-fatigue effects of POP have not yet been tested. This study was designed to investigate the anti-fatigue effects of POP in mice using the rotarod and forced swimming tests. The mice were randomly divided into four groups, namely normal control group, low-dose POP supplementation group, medium-dose POP supplementation group and high-dose POP supplementation group. The normal control group received distilled water and the supplementation groups received different doses of POP (75, 150 and 300 mg/kg, respectively). The POP or distilled water was administered orally and daily for 30 day. After 30 days, the rotarod and forced swimming tests were performed and then several biochemical parameters related to fatigue were determined. The data showed that POP prolonged the riding times and exhaustive swimming times of mice, decreasing blood lactic acid and serum urea nitrogen levels, as well as increasing the liver and muscle glycogen contents. These results indicated that POP had the anti-fatigue effects.

In vivo Anti-fatigue activity of total flavonoids from sweet potato [Ipomoea batatas (L.) Lam.] leaf in mice.

The in vivo anti-fatigue activity of the total flavonoids from sweet potato [Ipomoea batatas (L.) Lam.] leaf was investigated in male Kunming mice. The total flavonoids from sweet potato leaf (TFSL) were orally administered at doses of 50, 100 and 200 mg/kg for 4 weeks and the anti-fatigue effect was studied using a weight-loaded swimming test, along with the determination of serum urea nitrogen (SUN), blood lactic acid (BLA) and hepatic and muscle glycogen contents. The results showed that TFSL had significant anti-fatigue effects. TFSL extended the exhaustive swimming time, effectively inhibited the increase of BLA, decreased the level of SUN and increased the hepatic and muscle glycogen content of mice. Thus, TFSL may have potential as an anti-fatigue agent.

Prevalência de depressão e fadiga em um grupo de mulheres com câncer de mama / Prevalence of depression and fatigue in a group of women with breast cancer / Prevalencia de depresión y fatiga en un grupo de mujeres con cáncer de mama

Estudo transversal cujo objetivo foi identificar e avaliar a ocorrência de sintomas depressivos e de fadiga entre mulheres com até um ano de tratamento com radioterapia e/ou quimioterapia para o câncer de mama. Utilizou-se um instrumento com dados sociodemográficos, clínicos e terapêuticos. Para a avaliação da depressão foi aplicado Inventário de Depressão de Beck (BDI) e para a fadiga o Fatigue Questionnarie. Incluímos 31 mulheres atendidas em um núcleo de reabilitação de mastectomizadas. Os resultados mostram que 87,1% das mulheres apresentaram cansaço nas pernas, como sintoma de mal-estar relacionado à fadiga consequente ao tratamento. Em relação aos sintomas depressivos, 41,9% delas manifestaram sintomas entre leve e moderado. Os resultados apontam para a necessidade de abordagem e de condutas para o manejo dos sintomas depressivos e fadiga, além de auxiliar os profissionais da saúde a identificar as necessidades dos clientes e a desenvolver estratégias adequadas para o cuidado individualizado...

The objective of this cross-sectional study was to identify and evaluate the occurrence of symptoms of depression and fatigue in women undergoing radiotherapy and/or chemotherapy for breast cancer for one year or less. An instrument was used to collect the sociodemographic, clinical and therapeutic data. Depression was assessed using Beck's Depression Inventory (BDI), and the Fatigue Questionnaire was used to evaluate levels of fatigue. The participants were 31 women who were attending a rehabilitation center for mastectomy patients. Results show that 87.1% of the women report experiencing weakness of their legs as a symptom of fatigue-related malaise related to the treatment. Regarding depression symptoms, 41.9% reported experiencing mild to moderate symptoms. Results point to the need to develop approaches to manage symptoms of depression and fatigue, in addition to helping health professionals to identify their clients' needs and develop suitable strategies for individualized care...

Estudio transversal que objetivó identificar y evaluar la ocurrencia de síntomas depresivos y fatiga entre mujeres con hasta un año de tratamiento con radioterapia y/o quimioterapia para cáncer de mama. Se utilizó instrumento con datos sociodemográficos, clínicos y terapéuticos. Se aplicó Inventario de Depresión de Beck (BDI) para evaluación de depresión, y Fatigue Questionnaire para evaluación de fatiga. Incluimos 31 mujeres atendidas en núcleo de rehabilitación de mastectomizadas. Los resultados demuestran que 87,1% de las mujeres presentan cansancio en las piernas, como síntoma de malestar relacionado a la fatiga consecuente del tratamiento. Respecto a los síntomas depresivos, 41,9% de ellas manifestaron sintomatología de leve a moderada. Los resultados demuestran la necesidad de abordaje y conductas para el manejo de síntomas depresivos y fatiga, además de ayudar a los profesionales de salud a identificar las necesidades de las pacientes y desarrollar estrategias adecuadas para el cuidado personalizado...

Eficacia y seguridad de la inmunoterapia en el tratamiento del asma y alergia / Safety and efficiency of immunotherapy in the treatment of asthma and allergy

En la presente nota farmacológica se define a la inmunoterapia, su mecanismo de acción y sus principales usos en determinadospacientes con asma y otros problemas alérgicos. Se describen los alergenos habituales responsables de las alergias(ácaros, pelo y caspa de animales domésticos, esporas de hongos y polen); y datos acerca de eficacia y seguridad de lainmunoterapia avalados por revisiones sistemáticas de la literatura y ensayos aleatorizados. Es importante señalar que lainmunoterapia en general se reserva para tratar casos de asma, alergia respiratoria de difícil manejo o a algunos fármacos queno pueden ser controlados satisfactoriamente con la medicación ni con las medidas tendientes a evitar el contacto con elalergeno. No se recomienda en general para dermatitis atópica ni alergia alimentaria. Se describen también las medidas precautoriasrecomendadas por las principales sociedades científicas para reducir las complicaciones de la anafilaxis severa asociadaa la inmunoterapia.

Etodolac em dismenorréia primária / Etodolac in primary dysmenorrhea

Para avaliar a eficácia e tolerabilidade de uma nova droga antiinflamatória näo hormonal no tratamento da dismenorréia primária, 40 pacientes com sintomatologia de intensidade moderada a intensa foram avliadas em um estudo duplo-sego cruzado, comparativo com placebo, por dois ciclos menstruais consecutivos. As pacientes foram aleatoriamente distribuídas em dois grupos de tratamento: etodolac 200 mg duas vezes ao dia, por cinco dias durante o primeiro ciclo menstrual, e placebo no segundo (20 pacientes); placebo durante o primeiro ciclo menstrual e etodolac no segundo (20 pacientes). As avaliaçöes clínicas foram realizadas no pré e após cada ciclo de tratamento. A análise estatística demonstrou significância no alívio da dor pélvica durante o tratamento com etodolac. A diferença entre os tratamentos com etodolac e placebo foi significante a p < 0,005. Resultado similar foi obtido em relaçäo à fadiga, dor em membros inferiores e depressäo. Näo houve diferença significante entre etodolac e placebo com relaçäo às reaçöes adversas, demonstrando uma boa tolerabilidade da droga neste ensaio clínico. Os autores discutem a relaçäo de prostaglandinas com a dismenorréia primária e seu tratamento com antiinflamatórios näo hormonais, bem como a importância de estudos duplo-cegos, cruzados, randomizados, comparativos com placebo, para avaliaçäo de uma nova droga na indicaçäo em questäo.