- |||||||||| Campath (alemtuzumab) / Sanofi
Neutropenia Following Weight-Based Alemtuzumab Induction in Kidney Transplantation (Poster Hall, Exhibit Hall A, Level 2) - May 6, 2024 - Abstract #ATC2024ATC_310;
The sensitivity of serum galactomann in detecting aspergillus is poor. The data demonstrated no significant difference of neutropenia and subsequent filgrastim use between the weight-based and standard dosing groups of alemtuzumab.
- |||||||||| Campath (alemtuzumab) / Sanofi
Impact of Weight-Based Alemtuzumab Induction on Infection in Adult Kidney Transplant Recipients (Poster Hall, Exhibit Hall A, Level 2) - May 6, 2024 - Abstract #ATC2024ATC_306;
While weight-based ALEM did not decrease the incidence of infx, it did not have an adverse effect on rejection rates, patient or graft survival at 1-year post-transplant. Our study suggests that weight-based ALEM is a safe approach for induction in kidney transplant.
- |||||||||| mirtazapine / Generic mfg., tramadol hydrochloride / Generic mfg.
Reimbursement, US reimbursement, Journal, Medicare: Assessing the prevalence of Beers medication utilization in the Medicare Part D population in 2020. (Pubmed Central) - May 6, 2024
Even with the existence of the AGS Beers Criteria for PIM Use in Older Adults and its continued updated versions, 16% of medications dispensed to Medicare Part D were potentially inappropriate. Future studies are needed to assess if this has led to worsened outcomes among older adults who utilized these PIM.
- |||||||||| Beova (vibegron) / Merck (MSD), Kissei, Kyorin, Sumitomo Pharma, Pierre Fabre
P3 data, Journal: Efficacy and Safety of Vibegron for Persistent Symptoms of Overactive Bladder in Men Being Pharmacologically Treated for Benign Prostatic Hyperplasia: Results From the Phase 3 Randomized Controlled COURAGE Trial. (Pubmed Central) - May 6, 2024
2% of participants were hypertension (9.0% vs 8.3%, respectively), COVID-19 (4.0% vs 3.1%), urinary tract infection (2.5% vs 2.2%), and hematuria (2.0% vs 2.5%). In this trial, vibegron met all primary and secondary endpoints and was safe and well tolerated in men with OAB symptoms and pharmacologically treated BPH.
- |||||||||| epinephrine / Generic mfg.
Journal: Electrical Storm/Refractory Ventricular Tachycardia. (Pubmed Central) - May 6, 2024
The increased pain and catecholamine release from cardioversion/defibrillation and exogenous epinephrine during cardiac arrest further exacerbates ES.2 This carries a significant mortality risk of up to 12% in the first 48 hours.3This case involves a basic knowledge of the Advanced Cardiac Life Support (ACLS) for ventricular tachycardia, both with and without a pulse, and the application of Sgarbossa criteria in a patient with an ST elevation myocardial infarction (STEMI) which makes it ideal for the PGY-1...Learners enforced their knowledge in how to communicate with patient's family members when the patient does not want resuscitation. Stable ventricular tachycardia, unstable ventricular tachycardia, refractory ventricular tachycardia, electrical storm, STEMI equivalents, medical simulation.
- |||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Review, Journal: Vaccines as Immunotherapies for Substance Use Disorders. (Pubmed Central) - May 6, 2024
After a brief review of clinical and selected preclinical vaccine studies, the "lessons learned" from the previous vaccine clinical trials are summarized, and then the newest challenge of a vaccine against fentanyl and its analogs is explored. Animal studies have made significant advances in vaccine technology for SUD treatment over the past 50 years, and the resulting anti-fentanyl vaccines show remarkable promise for ending this epidemic of fentanyl deaths.
- |||||||||| Jardiance (empagliflozin) / Eli Lilly, Boehringer Ingelheim
Trial completion date, Trial primary completion date: SGLT2 Inhibitors, Ketogenesis, and Ketoacidosis (clinicaltrials.gov) - May 6, 2024
P1, N=30, Recruiting,
Animal studies have made significant advances in vaccine technology for SUD treatment over the past 50 years, and the resulting anti-fentanyl vaccines show remarkable promise for ending this epidemic of fentanyl deaths. Trial completion date: Jan 2025 --> Jun 2027 | Trial primary completion date: Dec 2024 --> Dec 2026
- |||||||||| Review, Journal: Effects of antipsychotics on the gastrointestinal microbiota: A systematic review. (Pubmed Central) - May 5, 2024
Twelve articles were considered eligible for the review, which investigated the effects of risperidone (5 studies), quetiapine (3), amilsupride (1), olanzapine (1), and unspecified atypical drugs (2)...In this way, the effects of APs on GM composition and diversity were inconclusive. Despite the uncertain interactions, a more comprehensive understanding on how microbiota is affected by APs may help to optimize treatment, potentially minimizing side effects and improving adherence to treatment.
- |||||||||| Farxiga (dapagliflozin) / Ono Pharma, AstraZeneca
Dapagliflozin Upregulates Adrenal Regulator of G protein Signaling (RGS)-4 To Reduce Catecholamine Secretion In Vitro and In Vivo (153ABC - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_3015;
Adrenal catecholamine (CA) production and secretion is another significant component of SNS activity, during which epinephrine (Epi) and, to a lesser extent, NE is secreted by the chromaffin cells of the adrenal medulla...In cultured PC12 cells in vitro, 5 ?M dapagli?ozin treatment for 24 hours resulted in significant inhibition of both Epi and NE secretions induced by the cholinergic agonist carbachol, compared to vehicle-pretreated PC12 cells...In conclusion, dapagli?ozin inhibits adrenal CA biosynthesis via TH downregulation, and CA secretion via RGS4 upregulation, which inhibits excessive cholinergic signaling towards CA secretion in chromaffin cells. This adrenal sympatholysis is another potentially beneficial effect of dapagliflozin in diseases characterized by elevated SNS activity, such as chronic heart failure, hypertension, etc.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Patient suffering from Laryngeal edema in the setting of Hypothyroidism (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2909;
Patients should be screened on admission when they present with unknown cause of airway compromise for hypothyroidism and treated with empiric high dose levothyroxine IV followed by daily IV levothyroxine until symptom improvement and daily TSH and T3/T4 improvement. Treatment with both high dose steroids and racemic epinephrine should be initiated before diagnosis due to feasible alternative or additional causes of airway obstruction.
- |||||||||| Resistance To Thyroid Hormone -A Challenge To Manage. (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2905;
In summary, treatment for RTH? remains a challenge for clinicians, especially in patients with atrial fibrillation and many patients are misdiagnosed and managed as hyperthyroidism.
- |||||||||| propylthiouracil / Generic mfg., propranolol / Generic mfg.
Thyrotoxic Periodic Paralysis (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2896;
This predominance is due to androgen-induced Na-K ATPase sensitization, more pronounced hyperinsulinemia, comparatively higher sympathetic and catecholamine-induced Na-K ATPase activity and higher muscle mass in males. Given the life-threatening association of severe hypokalemia, TPP should be considered in all patients presenting with acute painless muscle weakness.
- |||||||||| cholestyramine / Generic mfg., propranolol / Generic mfg., apixaban / Generic mfg.
Thyroid Storm in a patient with Thyroid Nodule on Anticoagulation (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2873;
The case presented discusses diagnosis and management of less common causes of hyperthyroidism and management of thyroid storm in liver dysfunction. The patient would have needed a thyroid biopsy at a later date to rule out colonic metastasis as a cause of hemorrhage if he had survived the thyroid storm and comorbid illnesses.
- |||||||||| Pseudopheochromocytoma Due to Severe Obstructive Sleep Apnea (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2800;
He was treated with 3 drug-program: valsartan, amlodipine, bisoprolol...Abdominal CT performed 1 year ago for another reason revealed She is currently using carvedilol 50 mg bid, chlorthalidone 25 mg, olmesartan 40 mg, amlodipine 10 mg, spironolactone 50 mg, clonidine 0.2 mg tid, hydralazine 50 mg every 6 hours, acetylsalicylic acid 100 mg, atorvastatin 80 mg, and metformin XR 1000 mg...Hormone evaluation showed basal cortisol 7
- |||||||||| An Atypical Case of Large Metastatic Pheochromocytoma with Negative Catecholamine Secretion (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2779;
Given the slowly worsening disease, patient was switched to temozolomide...Her CgA was significantly elevated, which could correlate with the tumor size, but was interestingly the only marker elevated. It appears that CgA could be a useful adjunct in the diagnosis of PCC, especially in cases where PCC appeared to be non-secretory.
- |||||||||| cabergoline / Generic mfg., doxazosin mesylate / Generic mfg.
Hereditary Phaeochromocytoma/Paraganglioma and Aortopathy in a Patient With Known Macroprolactinoma: A Series of Incidental Findings (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2777;
This case describes a patient with 3PAs, initially presenting with a macroprolactinoma, with incidental detection of phaeochromocytoma and paraganglioma and subsequent identification of a pathogenic SDHA mutation. In the context of a calcified bicuspid aortic valve and severe aortic dilatation, pre-operative alpha blockade allowed successful surgical management of both potentially life-threatening conditions.
- |||||||||| doxazosin mesylate / Generic mfg., labetalol / Generic mfg.
Pheochromocytoma in a Patient with ESRD; Clinical Challenges and Lessons from a Successful Evaluation (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2772;
The literature has few cases of pheochromocytoma in the setting of end stage renal disease (ESRD).Case:A 46-year-old male with a history of resistant HTN on amlodipine, lisinopril, and labetalol, complicated by ESRD on hemodialysis (HD) and secondary hyperparathyroidism initially presented with gross hematuria...Two weeks prior to the surgery, alpha blockade was started with doxazosin 1mg daily with a goal blood pressure <130/80...Although there is little in the literature regarding management of a pheochromocytoma in patients with ESRD, similar principles of management in patients with normal renal function apply, including blood pressure control, alpha blockade, and establishment of euvolemia with recommendation of a high-sodium diet and 1-2 liters of saline the day prior to the procedure. This case highlights successful perioperative management with traditional use of alpha blockade but also incorporated maintaining the patient 1-1.5 kg above their dry weight for surgery to limit postoperative hypotension.
- |||||||||| doxazosin mesylate / Generic mfg.
A soft case of Pheochromocytoma (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2771;
The classic triad for pheochromocytoma which includes headaches, sweating, and tachycardia is relatively uncommon with paroxysmal findings occurring more often. There has been only one other documented case in which the initial presenting symptom of pheochromocytoma was erectile dysfunction, but this case illustrates that erectile dysfunction should certainly be considered as one of the possible symptoms that raises suspicion for pheochromocytomas [3].
- |||||||||| Adrenal Incidentaloma in a Pregnant Woman diagnosed with Preeclampsia (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2767;
At her admission to the intensive care unit, an esmolol infusion was indicated, but the patient further presented tachypnea and tachycardia...The antihypertensive treatment was switched from labetalol to prazosin, achieving control of blood pressure and clinical improvement...Although the presence of a pheochromocytoma is much less common than preeclampsia as a cause of hypertension in pregnancy, a misdiagnosis can increase maternal morbidity and mortality by up to 15%. After adequate treatment of the obstetric emergency, the approach to incidentaloma in pregnancy is recommended.
- |||||||||| furosemide / Generic mfg., prazosin / Generic mfg., epinephrine / Generic mfg.
Cardiac Paraganglioma: A Rare Entity (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2752;
24 hr urine normetaneprhine :7197(N ? 376 mcg), 24 hr urinary dopamine :879 (N ?400 mcg), 24 urinary metanephrine: 84 (N ?96 mcg) & 24 hr urinary epinephrine <3 (N ?20 mcg).Her home systolic blood pressure readings varied between 120
- |||||||||| A Broken Heart Due to Excess Thyroid (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2742;
Subsequently, the patient received propylthiouracil, propranolol, and prednisone, resulting in symptomatic improvement...While thyrotoxicosis-related congestive heart failure (CHF) is relatively uncommon among patients hospitalized for acute CHF, addressing hyperthyroidism and CHF through definitive treatment yields a more favorable prognosis compared to cases of acute CHF stemming from other etiologies. The intricate interplay of these mechanisms highlights the importance of a comprehensive approach in managing thyrotoxic cardiomyopathy, emphasizing the need for targeted interventions to address both the underlying thyroid dysfunction and associated cardiac manifestations.
- |||||||||| methadone / Generic mfg.
How Low Can You Go: Suspected Methadone-Induced Hyperinsulinemia (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2635;
Suspicion should arise, particularly in patients on high doses. Current evidence suggests tapering methadone dosage as the primary intervention, as insulin levels can decrease drastically and improve hypoglycemia.
- |||||||||| Tepezza (teprotumumab-trbw) / Roche, Amgen
A Captivating Case Report of Teprotumumab Induced Hyperglycemic Hyperosmolar State (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2582;
Baseline glycemic assessment, identification of high-risk patients, and comprehensive discussions on risks and benefits are crucial before initiating therapy. Close monitoring, especially in those with prediabetes, is recommended.
- |||||||||| Lantus (insulin glargine) / Sanofi, Jardiance (empagliflozin) / Eli Lilly, Boehringer Ingelheim
A Case Report of Polypharmacy With Combined Adverse Effects of SGLT-2 Related Euglycemic DKA and Lithium Induced Nephrogenic DI (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2570;
In the USA, 67 percent of hospitalizations are linked to four medications or classes: warfarin, insulins, oral antiplatelet agents, and oral hypoglycemic agents...Patient has been taking Lantus, Glipizide (sulfonylurea), and Empagliflozin, Bupropion and Aripiprazole at home...This case report will enforce the importance of ensuring appropriate drug prescribing involves factors such as avoiding inappropriate medications, monitoring for side effects and drug levels, preventing drug interactions, and incorporating patient values through active involvement. This case is an unique opportunity to learn ADEs, contributing to diagnostic challenges which can increase mortality across various age groups without proper vigilance.
- |||||||||| doxazosin mesylate / Generic mfg.
Mercury toxicity presenting as Pheochromocytoma (ENDOExpo PosterArea - BCEC) - May 5, 2024 - Abstract #ENDO2024ENDO_2471;
Lead, mercury, and arsenichave been detected in traditionally prepared Ayurvedic supplements. A careful history of intake of supplements can be important in cases with unusual symptomatology.
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