RESUMEN
BACKGROUND: Although literature demonstrates a decreased risk of Alzheimer's disease (AD) in individuals with various cancers, including squamous cell cancers (SCC) and basal cell cancers (BCC) comprising non-melanoma skin cancers (NMSC), there is a paucity of literature to substantiate an association between malignant melanoma (MM) and AD. OBJECTIVE: The aim of this study was to determine whether an association exists between MM and AD as well as for NMSC and AD. METHODS: A large urban, Midwestern, US, single-centre, medical record (EMR) data repository was searched between January 2001 and December 2015, to identify all patients at age ≥60 and <89 years with a clinic follow-up of at least 1 year and no diagnosis for AD, MM or NMSC at the time of the study entry. Data collected included age, gender, race and duration of follow-up. MM and NMSC were detected by ICD-9 codes and ICD-10 codes. Incident diagnosis of AD was also detected by ICD-9 and ICD-10 codes. Logistic regression analysis was utilized to obtain crude and adjusted odds ratios (ORs). RESULTS: Data for a total of 82 925 patients with known race and gender and were detected. After adjusting for confounding factors (race, gender, age, cerebrovascular disease, peripheral vascular disease and diabetes), there was a significant decreased risk of subsequent AD in patients with MM (OR: 0.39; 95% CI: 0.16-0.96; P = 0.042) as well as in patients with BCC (OR: 0.18; 95% CI: 0.08-0.45; P < 0.0001) and for patients with SCC (OR: 0.08; 95% CI: 0.01-0.56; P = 0.013). CONCLUSION: These findings add to the growing body of evidence for a decreased risk of AD in patients with various cancers and highlight the need for ongoing research to elucidate both neurologic and biologic mechanisms that may underlie this apparent inverse association.
Asunto(s)
Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/epidemiología , Melanoma/epidemiología , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/patología , Centros Médicos Académicos , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/epidemiología , Carcinoma Basocelular/patología , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Comorbilidad , Intervalos de Confianza , Bases de Datos Factuales , Femenino , Humanos , Modelos Logísticos , Masculino , Melanoma/diagnóstico , Persona de Mediana Edad , Medio Oeste de Estados Unidos/epidemiología , Análisis Multivariante , Prevalencia , Pronóstico , Estudios Retrospectivos , Distribución por Sexo , Neoplasias Cutáneas/diagnóstico , Melanoma Cutáneo MalignoAsunto(s)
Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Rosácea/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Metaloproteinasas de la Matriz/metabolismo , Persona de Mediana Edad , Estudios Retrospectivos , Rosácea/enzimología , Estados Unidos , Población Urbana , Adulto JovenAsunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Psoriasis/tratamiento farmacológico , Suicidio/estadística & datos numéricos , Talidomida/análogos & derivados , Sistemas de Registro de Reacción Adversa a Medicamentos , Humanos , Farmacovigilancia , Vigilancia de Productos Comercializados , Estudios Retrospectivos , Factores de Riesgo , Talidomida/efectos adversos , Estados Unidos , United States Food and Drug AdministrationRESUMEN
OBJECTIVE: To compare and contrast three databases, that is, The International Centre for Nephrogenic Systemic Fibrosis Registry (ICNSFR), the Food and Drug Administration Adverse Event Reporting System (FAERS) and a legal data set, through pharmacovigilance and to evaluate international nephrogenic systemic fibrosis (NSF) safety efforts. METHODS: The Research on Adverse Drug events And Reports methodology was used for assessment-the FAERS (through June 2009), ICNSFR and the legal data set (January 2002 to December 2010). Safety information was obtained from the European Medicines Agency, the Danish Medicine Agency and the Food and Drug Administration. RESULTS: The FAERS encompassed the largest number (n = 1395) of NSF reports. The ICNSFR contained the most complete (n = 335, 100%) histopathological data. A total of 382 individual biopsy-proven, product-specific NSF cases were analysed from the legal data set. 76.2% (291/382) identified exposure to gadodiamide, of which 67.7% (197/291) were unconfounded. Additionally, 40.1% (153/382) of cases involved gadopentetate dimeglumine, of which 48.4% (74/153) were unconfounded, while gadoversetamide was identified in 7.3% (28/382) of which 28.6% (8/28) were unconfounded. Some cases involved gadobenate dimeglumine or gadoteridol, 5.8% (22/382), all of which were confounded. The mean number of exposures to gadolinium-based contrast agents (GBCAs) was gadodiamide (3), gadopentetate dimeglumine (5) and gadoversetamide (2). Of the 279 unconfounded cases, all involved a linear-structured GBCA. 205 (73.5%) were a non-ionic GBCA while 74 (26.5%) were an ionic GBCA. CONCLUSION: Clinical and legal databases exhibit unique characteristics that prove complementary in safety evaluations. Use of the legal data set allowed the identification of the most commonly implicated GBCA. ADVANCES IN KNOWLEDGE: This article is the first to demonstrate explicitly the utility of a legal data set to pharmacovigilance research.
Asunto(s)
Medios de Contraste/efectos adversos , Gadolinio/efectos adversos , Dermopatía Fibrosante Nefrogénica/inducido químicamente , Farmacovigilancia , Conducta Cooperativa , Bases de Datos Factuales , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Gadolinio DTPA/efectos adversos , Compuestos Heterocíclicos , Humanos , Masculino , Meglumina/efectos adversos , Meglumina/análogos & derivados , Compuestos Organometálicos/efectos adversos , Sistema de Registros , Estados UnidosRESUMEN
The Ras-Raf-MEK-ERK signalling pathway is frequently dysregulated in human malignancies, as is angiogenesis and the vascular endothelial growth factor receptor (VEGF/VEGFR) pathway. These kinases are therefore important anticancer targets. The novel, oral treatment sorafenib (BAY 43-9006), has been shown to be an inhibitor of VEGFR, Raf and platelet-derived growth factor in clinical trials against a variety of cancers, with the greatest activity to date observed in metastatic renal cancer. Although side-effects with this targeted therapy are usually not dose-limiting, they frequently involve the skin, and consist of a maculopapular rash, palmar-plantar dysaesthesia, alopecia and xerosis. In this report, we present two patients in whom treatment with sorafenib resulted in inflammation of actinic keratosis, which in some cases progressed to invasive squamous cell carcinoma. This side-effect is of clinical importance, as early recognition is critical for early treatment and may represent a source of additional morbidity to these patients.
Asunto(s)
Bencenosulfonatos/efectos adversos , Erupciones por Medicamentos/etiología , Queratosis/inducido químicamente , Trastornos por Fotosensibilidad/inducido químicamente , Inhibidores de Proteínas Quinasas/efectos adversos , Piridinas/efectos adversos , Antineoplásicos/efectos adversos , Erupciones por Medicamentos/patología , Humanos , Queratosis/patología , Masculino , Persona de Mediana Edad , Niacinamida/análogos & derivados , Compuestos de Fenilurea , Trastornos por Fotosensibilidad/patología , SorafenibRESUMEN
Primary cutaneous B cell lymphomas have a high recurrence rate after treatment with surgery and/or local radiation therapy. Two men are described in whom radiotherapy-relapsing cutaneous B-cell lymphomas were successfully treated with the monoclonal anti-CD20 antibody rituximab. Both patients had a complete response with no recurrence at follow-up at 17 and 24 months for the large B-cell lymphoma of the leg and the follicle centre cell lymphoma, respectively. These are two of the few cases in the literature showing that rituximab is an effective and well-tolerated treatment for radiotherapy-relapsing primary cutaneous B cell lymphoma.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Linfoma de Células B/tratamiento farmacológico , Recurrencia Local de Neoplasia/prevención & control , Neoplasias Cutáneas/tratamiento farmacológico , Anticuerpos Monoclonales de Origen Murino , Antígenos CD20/metabolismo , Humanos , Linfoma de Células B/patología , Linfoma de Células B/radioterapia , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Retratamiento , Rituximab , Neoplasias Cutáneas/patología , Resultado del TratamientoRESUMEN
Skin involvement in systemic lupus erythematosus (SLE) occurs in varied forms. Lupus erythematosus tumidus (LET) is not known to occur with SLE. In our patient presented below, LET occurred in a patient with SLE. Some of the lesions progressed to scarring discoid lesions, while others responded very well to hydoxychloroquine treatment. We, as rheumatologists, are not very aware of this entity, which is so amenable to prevention and treatment if recognized correctly.