- |||||||||| Mounjaro (tirzepatide) / Eli Lilly
Genetic Obesity Case with 2 Heterozygote Variants: MKS1 and MC4R in Which Weight Loss Managed with Tirzepatide (Station 16,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_248;
Recently, a new class of dual incretin GLP1 and glucose-dependent insulinotropic peptide (GIP) receptor agonist tirzepatide has been approved for the treatment of diabetes and has been used off label for treating obesity. Our patient had insulin resistance and history of gestational diabetes with chronic obesity making her a suitable candidate for tirzepatide with desired results.
- |||||||||| The Complexities of Managing Hypertriglyceridemia-Induced Pancreatitis in a Critically-Ill COVID-19 Patient (Station 7,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_243;
IV insulin infusion was initiated for hyperglycemia worsened by COVID-19 dexamethasone treatment...Fenofibrate was not initiated due to renal failure; Lovaza could not be given via oral gastric tube; Atorvastatin was attempted once rhabdomyolysis resolved, with subsequent worsening of liver function tests...The case highlights the importance of knowing both treatment indications and contraindications for HTP. In this case, HTP may have been the initial diagnosis, straightforward for most endocrinologists, but its treatments and comorbid conditions ultimately made the landscape more challenging, limiting effective management and ultimately leading to this patient
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
An Association Between Stiff Person Syndrome and Type 1 Diabetes (Station 4,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_188;
She required hospital admission one month later and received solumedrol and IVIG...Either SPS or T1DM may be diagnosed first. Awareness of these associations is essential for early diagnosis and treatment of these disorders.
- |||||||||| dexamethasone / Generic mfg.
Mild Autonomous Cortisol Secretion is Associated with Impaired Kidney Function (Station 11,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_177;
Higher post-DST cortisol was associated with lower eGFR independent of cardiovascular risk factors such as BMI, hypertension, diabetes, and dyslipidemia. Patients with MACS were at 3.3-fold higher risk of developing advanced CKD.
- |||||||||| Recorlev (levoketoconazole) / Strongbridge, Metopirone (metyrapone) / HRA Pharma, Detectnet (64Cu-Dotatate) / RadioMedix, Curium
Management of Ectopic ACTH Syndrome with Liver Metastases (Station 7,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_176;
Patient A was started on levoketoconazole and metyrapone, underwent trans-arterial radio-embolization (TARE) of the liver metastases, after which levoketoconazole was stopped...While surgical excision of the primary tumor is curative, patients might present with symptomatic hypercortisolism and unknown primary tumor or metastatic disease. Utilizing steroidogenic inhibitors to alleviate hypercortisolism and using TAE/TARE for patients with liver metastases to reduce disease burden, when appropriate, will improve quality of life and preserve adrenal function as compared to bilateral adrenalectomy.
- |||||||||| Lysodren (mitotane) / HRA Pharma, Metopirone (metyrapone) / HRA Pharma, Isturisa (osilodrostat) / Novartis, Recordati
High-Grade Bacteremia in a Patient with Suspected Adrenocortical Carcinoma (Station 14,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_174;
Her history included L5 compression fracture, multiple rib fractures, BMI 38, recurrent deep vein thrombosis on rivaroxaban, chronic pain and proximal muscle weakness limiting mobility, prediabetes, and hypertension...Dexamethasone suppression test showed cortisol level of 29.6...Osilodrostat, mitotane, and metyrapone were denied by insurance...Ketoconazole dosing was increased...Localized ACC would typically be treated with surgical resection. Adrenal insufficiency secondary to inhibition of steroidogenesis in this patient may have limited her ability to fight infection, hindering her opportunity to proceed with a surgical procedure.
- |||||||||| rivaroxaban / Generic mfg., hydrocortisone / Generic mfg.
Bilateral Adrenal Hemorrhage with Subsequent Resolution of Adrenal Insufficiency (Station 16,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_170;
Prednisone was tapered over a month with final dosage being hydrocortisone 15 mg in the morning, hydrocortisone 10 mg at night, and fludrocortisone 0.5 mg daily. This case describes a rare case of BAH secondary to anticoagulant usage which precipitated adrenal crisis with resolution of adrenal insufficiency.
- |||||||||| Isturisa (osilodrostat) / Novartis, Recordati
A Case of Severe Cushing Syndrome Due to Metastatic Adrenocortical Carcinoma Treated with Osilodrostat (Station 3,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_165;
Hypercortisolism noted with morning cortisol 31.8 mcg/dL which was nonsuppressible at 29 mcg/dL after 1 mg dexamethasone...Sick-day hydrocortisone was initiated, 30 mg AM and 15 mg PM...While Mitotane, with or without chemotherapy, has been a mainstay of adjuvant therapy for high-risk and metastatic ACC, up to 75% cases develop metastatic disease that is refractory to treatment...It has been used off-label effectively in select cases of Cushing syndrome. The FDA recommends dosing to target a normal cortisol level, but block-and-replace dosing may be reasonable to avoid adrenal insufficiency in situations resulting in variable cortisol production, such as cyclic Cushing
- |||||||||| dexamethasone / Generic mfg.
Journal: Trial of dexamethasone for chronic subdural hematoma. (Pubmed Central) - Mar 24, 2023
Our goal in describing this case is to highlight the need for providers to consider, accurately diagnose, and treat GBS as a consequence of severe COVID-19 infection. No abstract available
- |||||||||| dexamethasone / Generic mfg.
Journal: Glypican-4 regulated actin cytoskeletal reorganization in glucocorticoid treated trabecular meshwork cells and involvement of Wnt/PCP signaling. (Pubmed Central) - Mar 24, 2023
Our studies focused on evaluating changes in the cytoskeletal and cytoskeletal-associated protein (cytoskeletome) profile of human TM cells treated with dexamethasone (Dex) using label-free mass spectrometric quantification, identified elevated levels of specific proteins known to regulate actin stress fiber formation, contraction, actin networks crosslinking, cell adhesion, and Wnt signaling, including LIMCH1, ArgBP2, CNN3, ITGBL1, CTGF, palladin, FAT1, DIAPH2, EPHA4, SIPA1L1, and GPC4...Additionally, while Dex augmented, GPC4 deficiency suppressed the formation of actin stress fibers in TM cells in the presence of Dex and Wnt5a. Taken together, these results identify the GPC4-dependent Wnt/PCP signaling pathway as one of the crucial upstream regulators of Dex induced actin cytoskeletal reorganization and cell adhesion in TM cells, opening an opportunity to target the GPC4/Wnt/PCP pathway for treatment of ocular hypertension in glaucoma.
- |||||||||| Tecvayli (teclistamab-cqyv) / Genmab, J&J
Trial completion date, Monotherapy: MajesTEC-9: A Study Comparing Teclistamab Monotherapy Versus Pomalidomide, Bortezomib, Dexamethasone (PVd) or Carfilzomib, Dexamethasone (Kd) in Participants With Relapsed or Refractory Multiple Myeloma (clinicaltrials.gov) - Mar 24, 2023
P3, N=590, Recruiting,
Taken together, these results identify the GPC4-dependent Wnt/PCP signaling pathway as one of the crucial upstream regulators of Dex induced actin cytoskeletal reorganization and cell adhesion in TM cells, opening an opportunity to target the GPC4/Wnt/PCP pathway for treatment of ocular hypertension in glaucoma. Trial completion date: May 2031 --> Aug 2031
- |||||||||| dexamethasone / Generic mfg.
Trial completion date, Trial primary completion date: RESDEX: Restrictive Use of Dexamethasone in Glioblastoma (clinicaltrials.gov) - Mar 24, 2023
P=N/A, N=50, Recruiting,
Trial completion date: Jul 2031 --> May 2033 Trial completion date: Apr 2025 --> Apr 2026 | Trial primary completion date: Apr 2024 --> Apr 2025
- |||||||||| Avastin (bevacizumab) / Roche
Treatment of Corneal Neovascularization Prior to Deep Anterior Lamellar Keratoplasty (SDCC - Upper Level, Room 1B) - Mar 24, 2023 - Abstract #ASCRSASOA2023ASCRS_ASOA_2151;
Aim 2: Preliminary validation of the local end-stage PsA-like model by adding dexamethasone (DEX), a known anti-inflammatory drug, to the co-culture. Purpose Besides creating a high-risk keratoplasty postoperatively, cornealneovascularization (CNV) can cause intraoperative concerns with deep anterior lamellarkeratoplasty (DALK) given the inherent interface.We reviewed the intraoperative andpostoperative effectiveness of treatments for CNV prior to DALK.MethodsA retrospective chart review from 2017 to 2022 was conducted onall eyes that underwent treatment (argon laser with subconjunctival bevacizumab/dexamethasoneand/or mitomycin intravascular chemoembolization [MICE]) for CNV prior to DALK by asingle surgeon.Patient demographics, preoperative features, intraoperative details, andpostoperative course were assessed.Outcome measures included intraoperative complications,postoperative recurrence of CNV, and keratoplasty rejection/failure.Intraoperative bleedingfollowing trephination was graded 0-4.ResultsThis analysis included 9 patients (mean age 53 years at the time ofDALK) with mean follow-up of 1.83 years.Seven patients underwent Argon laser only, while 2 patients underwent both Argon laser and MICE.Intraoperatively, no complications occurred.Mean intraoperative bleeding grade was 1.11.No interface blood occurred.There was difficulty obtaining a big bubble in both patients that underwent MICE and in 2 out of 7 patients that underwent Argon only.Postoperatively, 4 patients had CNV recurrence past the DALK graft-host junction.Two patients required repeat Argon laser procedures.One patient experienced stromal graft rejection.No large diameter vessels recurred.ConclusionTreatments for CNV prior to DALK are moderately effective.Intraoperative bleeding and recurrence of large diameter vessels were minimized; however, CNV remains a difficult entity to completely eliminate.
- |||||||||| Tri-Moxi (triamcinolone acetonide/moxifloxacin) / Harrow Health
Non-Infectious Outcomes of Intravitreal Antibiotic-Steroid Injection with Topical NSAID Versus Standard Topical Drops Regimen (SDCC - Upper Level, Room 5A) - Mar 24, 2023 - Abstract #ASCRSASOA2023ASCRS_ASOA_2065;
Purpose Besides creating a high-risk keratoplasty postoperatively, cornealneovascularization (CNV) can cause intraoperative concerns with deep anterior lamellarkeratoplasty (DALK) given the inherent interface.We reviewed the intraoperative andpostoperative effectiveness of treatments for CNV prior to DALK.MethodsA retrospective chart review from 2017 to 2022 was conducted onall eyes that underwent treatment (argon laser with subconjunctival bevacizumab/dexamethasoneand/or mitomycin intravascular chemoembolization [MICE]) for CNV prior to DALK by asingle surgeon.Patient demographics, preoperative features, intraoperative details, andpostoperative course were assessed.Outcome measures included intraoperative complications,postoperative recurrence of CNV, and keratoplasty rejection/failure.Intraoperative bleedingfollowing trephination was graded 0-4.ResultsThis analysis included 9 patients (mean age 53 years at the time ofDALK) with mean follow-up of 1.83 years.Seven patients underwent Argon laser only, while 2 patients underwent both Argon laser and MICE.Intraoperatively, no complications occurred.Mean intraoperative bleeding grade was 1.11.No interface blood occurred.There was difficulty obtaining a big bubble in both patients that underwent MICE and in 2 out of 7 patients that underwent Argon only.Postoperatively, 4 patients had CNV recurrence past the DALK graft-host junction.Two patients required repeat Argon laser procedures.One patient experienced stromal graft rejection.No large diameter vessels recurred.ConclusionTreatments for CNV prior to DALK are moderately effective.Intraoperative bleeding and recurrence of large diameter vessels were minimized; however, CNV remains a difficult entity to completely eliminate. Purpose To evaluate the efficacy of pars plana intravitreal triamcinolone-moxifloxacin (TriMoxi) injections compared against the standard three-drop topical regimen in post-operative cataract patients.MethodsA retrospective chart review of 2143 eyes undergoing cataract surgeries across three medical institutions was conducted.Factors including patients
- |||||||||| triamcinolone acetonide / Generic mfg., moxifloxacin intravenous / Generic mfg.
Dropless Cataract Surgery: 6 Year Experience with 3000 Eyes As an Alternative Drug-Delivery Method for Cataract Surgery Patients (SDCC - Upper Level, Room 5A) - Mar 24, 2023 - Abstract #ASCRSASOA2023ASCRS_ASOA_2063;
Purpose To evaluate the efficacy of pars plana intravitreal triamcinolone-moxifloxacin (TriMoxi) injections compared against the standard three-drop topical regimen in post-operative cataract patients.MethodsA retrospective chart review of 2143 eyes undergoing cataract surgeries across three medical institutions was conducted.Factors including patients Purpose To assess efficacy of transzonular injection of 0.2 ml triamcinolone acetonide (TA) and moxifloxacin hydrochloride in prevention of infection and inflammation post cataract surgery in first 3000 eyes.MethodsRetrospective chart review of 3000 eyes receiving transzonlular injection of triamcinolone acetonide (TA) and moxifloxacin hydrochloride at conclusion of cataract surgery by single surgeon (B.Y.E.) from February 2016 to June 2022.Outcome measures included additional postoperative steroid drops required post dropless cataract surgery and endophthalmitis.Complications recorded included ciliary body bleed and anterior chamber vitreous prolapse.ResultsFrom February 2016 to June 2022, 3478 dropless cataract surgeries were successfully completed.Among 2831 dropless conventional cataract surgery eyes, 147 eyes or 5.1% of required additional steroid drops.During the same period, among 647 dropless femto-second laser assisted cataract surgery(FLACS) eyes, 57 or 8.8% of eyes required additional steroid drops.There were no cases of endopthalmitis in either group.ConclusionDropless cataract surgery is a safe & effective alternative to traditional cataract surgery where topical antibiotics are used.Dropless cataract surgery does not require any drops in 90-95% of eyes.Dropless FLACS seems to cause inflammation requiring steroid drops in a higher percentage of eyes than dropless conventional cataract surgery.
- |||||||||| Triesence (triamcinolone acetonide injectable suspension) / Novartis
Triamcinolone Anthology : Multifaceted Role of This Unique Molecule () - Mar 24, 2023 - Abstract #ASCRSASOA2023ASCRS_ASOA_571;
Purpose To assess efficacy of transzonular injection of 0.2 ml triamcinolone acetonide (TA) and moxifloxacin hydrochloride in prevention of infection and inflammation post cataract surgery in first 3000 eyes.MethodsRetrospective chart review of 3000 eyes receiving transzonlular injection of triamcinolone acetonide (TA) and moxifloxacin hydrochloride at conclusion of cataract surgery by single surgeon (B.Y.E.) from February 2016 to June 2022.Outcome measures included additional postoperative steroid drops required post dropless cataract surgery and endophthalmitis.Complications recorded included ciliary body bleed and anterior chamber vitreous prolapse.ResultsFrom February 2016 to June 2022, 3478 dropless cataract surgeries were successfully completed.Among 2831 dropless conventional cataract surgery eyes, 147 eyes or 5.1% of required additional steroid drops.During the same period, among 647 dropless femto-second laser assisted cataract surgery(FLACS) eyes, 57 or 8.8% of eyes required additional steroid drops.There were no cases of endopthalmitis in either group.ConclusionDropless cataract surgery is a safe & effective alternative to traditional cataract surgery where topical antibiotics are used.Dropless cataract surgery does not require any drops in 90-95% of eyes.Dropless FLACS seems to cause inflammation requiring steroid drops in a higher percentage of eyes than dropless conventional cataract surgery. Purpose Triamcinolone acetonide is ubiquitous in ophthalmology.So it is in Cataract surgery.It saves many a situations and not PCR only.This is to bring to light the varied applications of this molecule.It ought to find a place in the surgery table of all cataract surgeries.1mg of triamcinolone left in the anterior chamber works wondersMethodsIt is a non randomised retrospective case series of 15000 intraocular cases ,both regular and complicated between 2012 and 2022 by a single surgeon.Increased Intraocular pressure requiring Glaucoma medications was studied.Requirement of post operative drops was also minimal.ResultsCases included 8014 women and 7270 men with an average age of 63.5
- |||||||||| Lotemax SM (loteprednol etabonate ophthalmic gel 0.38%) / Bausch Health
Retrospective Assessment of the Routine Use of Loteprednol Etabonate Gel 0.38% Following LASIK and PRK Surgery () - Mar 24, 2023 - Abstract #ASCRSASOA2023ASCRS_ASOA_470;
Purpose Triamcinolone acetonide is ubiquitous in ophthalmology.So it is in Cataract surgery.It saves many a situations and not PCR only.This is to bring to light the varied applications of this molecule.It ought to find a place in the surgery table of all cataract surgeries.1mg of triamcinolone left in the anterior chamber works wondersMethodsIt is a non randomised retrospective case series of 15000 intraocular cases ,both regular and complicated between 2012 and 2022 by a single surgeon.Increased Intraocular pressure requiring Glaucoma medications was studied.Requirement of post operative drops was also minimal.ResultsCases included 8014 women and 7270 men with an average age of 63.5 Purpose To assess real world experience using loteprednol etabonate ophthalmic gel, 0.38% (LSM) for postoperative pain and inflammation following laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) surgery.MethodsThis was a retrospective chart review conducted at 4 sites in the United States.Cases from patients aged 18 years and above were eligible for inclusion.Data were collected from routine LASIK (N=240 eyes) or PRK (N=80 eyes) surgery cases (165 patients) in which LSM was used postoperatively as the clinician
- |||||||||| prednisolone / Generic mfg.
SELF DILATION TO PREVENT STENOSIS AFTER CIRCUMFERENTIAL ESOPHAGEAL ESD (S406 - McCormick Place) - Mar 23, 2023 - Abstract #DDW2023DDW_6101;
To prevent stricture, corticosteroids were injected into the submucosa immediately after the resection and the patient received a course of oral prednisolone... Teaching self dilations prior to ESD may allow selected patients undergoing extensive circumferential ESD, to maintain an adequate diameter of the esophagus and thus preventing the need for multiple endoscopic dilations, when self dilatations are initiated shortly after the procedure and maintained throughout the healing phase.
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