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  • 1
    In: European Heart Journal - Cardiovascular Pharmacotherapy, Oxford University Press (OUP), Vol. 8, No. 3 ( 2022-05-05), p. 291-301
    Abstract: There is a lack of evidence regarding the benefits of β-blocker treatment after invasively managed acute myocardial infarction (MI) without reduced left ventricular ejection fraction (LVEF). Methods and results The tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT) trial is a pragmatic, controlled, prospective, randomized, open-label blinded endpoint (PROBE design) clinical trial testing the benefits of β-blocker maintenance therapy in patients discharged after MI with or without ST-segment elevation. Patients eligible for participation are those managed invasively during index hospitalization (coronary angiography), with LVEF & gt;40%, and no history of heart failure (HF). At discharge, patients will be randomized 1:1 to β-blocker therapy (agent and dose according to treating physician) or no β-blocker therapy. The primary endpoint is a composite of all-cause death, non-fatal reinfarction, or HF hospitalization over a median follow-up period of 2.75 years (minimum 2 years, maximum 3 years). Key secondary endpoints include the incidence of the individual components of the primary composite endpoint, the incidence of cardiac death, and incidence of malignant ventricular arrhythmias or resuscitated cardiac arrest. The primary endpoint will be analysed according to the intention-to-treat principle. Conclusion The REBOOT trial will provide robust evidence to guide the prescription of β-blockers to patients discharged after MI without reduced LVEF.
    Type of Medium: Online Resource
    ISSN: 2055-6837 , 2055-6845
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2808613-2
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  • 2
    In: Current Medical Research and Opinion, Informa UK Limited
    Type of Medium: Online Resource
    ISSN: 0300-7995 , 1473-4877
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 2034331-0
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  • 3
    In: Life, MDPI AG, Vol. 13, No. 9 ( 2023-09-15), p. 1922-
    Abstract: Background: Lower respiratory tract infections (LRTIs) and community-acquired pneumonia (CAP) are among the most frequent reasons for referrals to the pediatric emergency department (PED). The aim of this study is to describe the management of antibiotic prescription in febrile children with LRTI or CAP admitted to a third-level PED and to investigate the different variables that can guide physicians in this decision-making. Methods: This is an observational, retrospective, monocentric study including patients 〈 14 years old who were presented to the PED for a febrile LRTI or CAP during the first six months of the year 2017. Demographic and clinical data, PED examinations, recommended therapy, and discharge modality were considered. Two multivariate logistic regression analyses were performed on patients with complete profiles to investigate the impact of demographic, laboratory, and clinical variables on antibiotic prescription and hospital admission. Results: This study included 584 patients with LRTI (n = 368) or CAP (n = 216). One hundred and sixty-eight individuals (28.7%) were admitted to the hospital. Lower age, higher heart rate, and lower SpO2 were associated with an increased risk of hospitalization. Antibiotics were prescribed to 495 (84.8%) patients. According to the multivariate logistic regression, the diagnosis and duration of fever were substantially linked with antibiotic prescription. Conclusions: The present study reports real-life data about our PED experience. A high rate of antibiotic prescription was noted. In the future, it is necessary to improve antibiotic stewardship programs to increase clinical adherence to guidelines.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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  • 4
    In: Allergies, MDPI AG, Vol. 3, No. 3 ( 2023-08-10), p. 177-183
    Abstract: Pollen food allergy syndrome (PFAS) is an allergic reaction to specific foods in persons previously sensitised to pollen. The diagnosis of PFAS is made after taking a patient’s medical history and, in some cases, conducting skin tests and oral food tests with raw fruit or vegetables. The aim of the present study was to evaluate the role of Pru p 7 in patients suspected of having PFAS, who show clinical symptoms, positivity for Cup a 1 and negativity for Pru p 1 and Pru p 3. A total of 51 patients (mean age ± standard deviation, 33 ± 15 years; 20 men and 31 women), referred to the respiratory diseases and allergology units of Siena University Hospital, were enrolled retrospectively. All of them underwent allergy consultation and IgE evaluation for Cup a 1, Pru p 1 and Pru p 3 by immuno solid-phase allergen chip (ISAC). Pru p 7 assay was performed by the ImmunoCAP Phadia method in patients who tested positive for Cup a 1 and simultaneously negative for Pru p 1 and Pru p 3 by ISAC. The serum of 51 patients was tested for sensitisation to Pru p 7 by the ImmunoCAP Phadia method, and nine patients (17.65%) were found positive. An area under the receiver operating characteristic (AUROC) curve of 99.51% made it possible to distinguish PFAS and non-PFAS patients on the basis of Pru p 7 values. The best cut-off value was 0.16 kUA/l, which gave a 85.7% sensitivity and 97.73% specificity. This study helps define the role of Pru p 7 in PFAS patients sensitised to cypress pollen and testing negative to Pru p 1 and Pru p 3. A fast, easy and non-invasive diagnostic method is proposed to detect IgE specific for Pru p 7. Inclusion of Pru p 7 in the ISAC assay panel would facilitate the diagnosis of PFAS.
    Type of Medium: Online Resource
    ISSN: 2313-5786
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 3091925-3
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  • 5
    In: Canadian Journal of Hospital Pharmacy, Canadian Society of Hospital Pharmacists (CSHP), ( 2023-09-13)
    Abstract: Background: Migraine is a neurological disease with a high incidence. The new anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) have demonstrated effectiveness in preventing episodic and chronic migraine. Objective: To collect evidence of the real-world effectiveness of anti-CGRP mAbs by assessing outcomes such as reduction in monthly migraine days (MMDs), reduction in monthly headache days (MHDs), and percentage of patients having a 50% reduction in MMDs. Data Sources: The PubMed database was searched for the period from inception to October 20, 2021. Study Selection and Data Extraction: Of interest for this review were studies that evaluated the real-world effectiveness of anti-CGRP mAbs in terms of MMDs and reduction in MHDs. The search terms included “migraine”, “monthly migraine days”, and various drug names. The data are reported in terms of patients’ baseline characteristics and treatment effectiveness. Data Synthesis: A total of 46 studies were evaluated, of which 30 (enrolling a total of 4273 patients across 10 countries) were included in the systematic review. The greatest absolute reduction in MMD was from 20.4 at baseline to 10.7 after 3 months of treatment. After 6 months, the greatest absolute difference was 10, relative to baseline. The largest absolute reduction in MHD at 3 months was from 22 to 8, whereas at 6 months, the greatest absolute reduction in MHD was 13. The treatment could be considered clinically effective (≥ 50% reduction in MMDs) for 41% of patients at 3 months and about 44% of patients at 6 months. Conclusions: Despite substantial variability in baseline values, this review confirmed the effectiveness of anti-CGRP mAbs, which yielded important clinical reductions in both MMDs and MHDs. Keywords: anti-CGRP mAbs, migraine, effectiveness, real-life, prevention RÉSUMÉ Contexte : La migraine est une maladie neurologique à incidence élevée. Le nouvel anticorps monoclonal qui se lie au peptide lié au gène de la calcitonine (AcM anti-CGRP) a démontré son efficacité pour prévenir les migraines épisodiques et chroniques. Objectif : Recueillir des éléments probants concernant l’efficacité réelle des AcM anti-CGRP en évaluant des résultats comme la réduction du nombre de jours de migraine par mois (JMM), la réduction du nombre de jours de céphalées par mois (JCM) ainsi que le pourcentage de patients ayant une réduction de 50 % du nombre de JMM. Sources des données : La base de données PubMed a été utilisée pour mener une recherche pour la période allant du début jusqu’au 20 octobre 2021. Sélection des études et extraction des données : Les auteurs de la revue se sont intéressés aux études qui avaient évalué l’efficacité réelle des AcM anti-CGRP en termes de réduction du nombre de JMM et du nombre de JCM. Les termes de recherche comprenaient « migraine », « jours de migraine par mois » et divers noms de médicaments. Les données sont rapportées en termes de caractéristiques de base des patients et d’efficacité du traitement. Synthèse des données : Au total, 30 des 46 études répondant aux critères d’inclusion (comprenant un total de 4273 patients dans 10 pays) ont été retenues pour la revue systématique. La réduction absolue de JJM la plus importante était de 20,4 (la base de référence) à 10,7 après 3 mois de traitement. Après 6 mois, la différence absolue la plus importante était de 10 par rapport à la base de référence. La réduction absolue de JCM la plus importante à trois mois était de 22 à 8, alors qu’à 6 mois, la réduction absolue de JCM la plus importante était de 13. Le traitement pouvait être considéré comme cliniquement efficace (≥50 % de réduction de JMM) pour 41 % des patients à 3 mois et environ 44 % des patients à 6 mois. Conclusions : Malgré la variabilité importante des valeurs de la base de référence, cet examen confirme l’efficacité des AcM anti-CGRP, qui ont donné lieu à une réduction importante d’un point de vue clinique du nombre de JMM et de JCM. Mots-clés : anticorps monoclonal qui se lie au peptide lié au gène de la calcitonine, anti-CGRP mAbs, AcM anti-CGRP, migraine, efficacité, réalité, prévention
    Type of Medium: Online Resource
    ISSN: 1920-2903 , 0008-4123
    Language: Unknown
    Publisher: Canadian Society of Hospital Pharmacists (CSHP)
    Publication Date: 2023
    detail.hit.zdb_id: 2107012-X
    SSG: 15,3
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  • 6
    In: Cancers, MDPI AG, Vol. 15, No. 11 ( 2023-05-30), p. 2972-
    Abstract: Quality pharmacological treatment can improve survival in many types of cancer. Drug repurposing offers advantages in comparison with traditional drug development procedures, reducing time and risk. This systematic review identified the most recent randomized controlled clinical trials that focus on drug repurposing in oncology. We found that only a few clinical trials were placebo-controlled or standard-of-care-alone-controlled. Metformin has been studied for potential use in various types of cancer, including prostate, lung, and pancreatic cancer. Other studies assessed the possible use of the antiparasitic agent mebendazole in colorectal cancer and of propranolol in multiple myeloma or, when combined with etodolac, in breast cancer. We were able to identify trials that study the potential use of known antineoplastics in other non-oncological conditions, such as imatinib for severe coronavirus disease in 2019 or a study protocol aiming to assess the possible repurposing of leuprolide for Alzheimer’s disease. Major limitations of these clinical trials were the small sample size, the high clinical heterogeneity of the participants regarding the stage of the neoplastic disease, and the lack of accounting for multimorbidity and other baseline clinical characteristics. Drug repurposing possibilities in oncology must be carefully examined with well-designed trials, considering factors that could influence prognosis.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
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