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The 2024 Saudi Pharmacotherapy Didactic Curriculum Toolkit: A Modified Delphi Study.

BACKGROUND: Several pharmacy schools in Saudi Arabia (S.A.) refer to the American College of Clinical Pharmacy (ACCP) pharmacotherapy toolkit in developing their pharmacotherapy curriculum. However, the ACCP toolkit does not specifically address the healthcare needs of the Saudi population. A tailored pharmacotherapy curriculum that offers graduates the essential competencies to better serve the nation's needs is warranted. This study aims to develop a population-centered didactic pharmacotherapy toolkit for the Saudi population to assist pharmacy schools in designing pharmacotherapy course co

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… disturbances 1 Acute kidney injury 1 Chronic kidney disease, secondary complications 2 Drug dosing in dialysis 1 Sodium and water disorders (including syndrome of inappropriate antidiuretic hormone, diabetes insipidus) 3 Kidney replacement therapies Musculoskeletal and connective tissue conditions 1 Gout and hyperuricemia … kidney injury 1 | Chronic kidney disease, secondary complications 2 | Drug dosing in dialysis 1 | Sodium and water disorders (including syndrome of inappropriate antidiuretic hormone, diabetes insipidus) 3 | Kidney replacement therapies | Musculoskeletal and connective tissue conditions 1 | Gout and hyperuricemia …

Management of Multiple Myeloma: A Review for General Practitioners in Oncology.

Multiple myeloma (MM) is a malignant clonal plasma cell disorder in the bone marrow and is the second-most common hematologic malignancy in adults. Although patients with MM have a moderate life expectancy, it remains a heterogeneous disease that often requires multiple lines of chemotherapy for durable control and long-term survival. This review outlines current management strategies for both transplant-eligible and transplant-ineligible patients as well as for relapsed and refractory disease. Advances in drug therapies have widened management options and improved survival. In this paper, we

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… In addition, there are Ig-independent causes of renal disease in MM patients including volume depletion, hypercalcemia, hyperuricemia, nephrotoxic drugs, and infection, leading to a variety of nonspecific symptoms such as fatigue, pruritus, pain, decreased mood, decreased appetite, and sleep disturbances … Given the prevalence of renal disease in patients living with MM and the unknown contribution of Ig-mediated versus Ig-independent renal disease, approach to renal disease for the primary care physician includes appropriate hydration, management of hypercalcemia and hyperuricemia, avoidance of nephrotoxic …

Acute kidney injury in critically ill cancer patients: an update.

Patients with cancer represent a growing group among actual ICU admissions (up to 20 %). Due to their increased susceptibility to infectious and noninfectious complications related to the underlying cancer itself or its treatment, these patients frequently develop acute kidney injury (AKI). A wide variety of definitions for AKI are still used in the cancer literature, despite existing guidelines on definitions and staging of AKI. Alternative diagnostic investigations such as Cystatin C and urinary biomarkers are discussed briefly. This review summarizes the literature between 2010 and 2015 on

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… Certain biochemical parameters such as pretreatment serum lactate dehydrogenase (LDH) more than two times the upper limit of normal, pretreatment hyperuricemia (serum uric acid >7.5 mg/dl (>446 μmol/l)) or hyperphosphatemia and an abnormal SCr [ 50 ] are additional risk factors for TLS. … Continuous veno-venous hemodiafiltration for the treatment of spontaneous tumor lysis syndrome complicated by acute renal failure and severe hyperuricemia. Clin Nephrol. 2000;54:59–63. 66. Hutchison CA, Heyne N, Airia P, Schindler R, Zickler D, Cook M, et al. …

Home Treatment of Older People with Symptomatic SARS-CoV-2 Infection (COVID-19): A structured Summary of a Study Protocol for a Multi-Arm Multi-Stage (MAMS) Randomized Trial to Evaluate the Efficacy and Tolerability of Several Experimental Treatments to Reduce the Risk of Hospitalisation or Death in outpatients aged 65 years or older (COVERAGE trial).

OBJECTIVES: To assess the efficacy of several repurposed drugs to prevent hospitalisation or death in patients aged 65 or more with recent s … ctose metabolism; Malabsorption syndrome; Glucose-6-phosphate dehydrogenase deficiency; Symptomatic hyperuricemia; Ileus; Colitis; Enterocolitis; Chronic hepatitis B virus disease. The trial is being conducted in France in the Bordeaux, Corse, Dijon, Nancy, Paris and Toulouse areas as well as in the Grand Duchy of Luxembourg. Participants are recruited either a …

Пересадка стволовых клеток и цилтакабтаген Автолеукеля для конъюнктурных множественных миелом и презюмирующих иммуноглобулин тяжелых и легких амилоидозов у пациента с системным Люпусом Эритематосом.

Сопровождение множественных миэломы (ММ), системной иммуноглобулиновой системы освещения (AL) и тяжёлой и световой цепи (AHL) амилоидозом и системной волчанкой (SLE) представляет собой весьма сложную терапевтическую проблему. В то время как химерик антигенрецептора (CAR) T-клентовая терапия B-клеток изменила методы лечения MM, их безопасность и эффективность у пациентов с основными аутоиммунными диатезами и тяжелым амилоидозом органов по-прежнему мало задокументированы. Мы сообщаем о случае 67-летнего афроамериканца с историей SLE, у которого ухудшалась почечная функция и нефротическая протеин

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… | Dosage | Primary indication Torsemide | 20 mg daily | Volume management / edema Eplerenone | 25 mg daily | Heart failure / hypertension Carvedilol | 6.25 mg twice daily with food | Cardioprotection / hypertension Losartan | 50 mg daily | Renoprotection / hypertension Allopurinol | 100 mg daily | Hyperuricemia …

Hepatic amyloidosis in a patient with chronic liver failure: A case report.

BackgroundAmyloidosis is a rare disorder that can be classified into various types, and the most common type is the systemic light chain type. The prognosis of this disease is extremely poor. In general, amyloidosis mainly affects the kidneys and heart and manifests as abnormal proliferation of clonal plasma cells. Cases in which the liver is the primary organ affected by amyloidosis, as in this report, are less common in clinical practice.Case summaryA 62-year-old man was admitted with persistent liver dysfunction of unknown cause and poor treatment outcomes. His condition persisted, and he d

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… History of past illness The patient had a history of hyperlipidemia, hyperuricemia and type 2 diabetes for 4 years and was treated with traditional Chinese medicine. Personal and family history The patient presented with no obvious family history of disease. …

A Rare Presentation of HIV-Negative Plasmablastic Lymphoma: A Diagnostic Dilemma.

Plasmablastic lymphoma (PBL) and plasmablastic plasma cell myeloma (PCM) have many overlapping characteristics. Clinical correlation can help make the distinction between the two entities. Human immunodeficiency virus- (HIV-) negative PBL is a rare disease, making the diagnosis more challenging. While there is no standard of care for PBL, current recommendations include dose-adjusted EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone), with or without bortezomib. We report an aggressive case of HIV-negative plasmablastic lymphoma and discuss the challenge in establish

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… Ultimately, the diagnosis of PBL was favored over PCM due to the aggressive presentation associated with diffuse lymphadenopathy, elevated LDH, and hyperuricemia. Although the actual incidence of HIV-negative PBL is unknown, the limited numbers of published cases suggest it is a rare entity. …

Poly(ethylene glycol)-Prodrug Conjugates: Concept, Design, and Applications.

Poly(ethylene glycol) (PEG) is the most widely used polymer in delivering anticancer drugs clinically. PEGylation (i.e., the covalent attachment of PEG) of peptides proteins, drugs, and bioactives is known to enhance the aqueous solubility of hydrophobic drugs, prolong circulation time, minimize nonspecific uptake, and achieve specific tumor targetability through the enhanced permeability and retention effect. Numerous PEG-based therapeutics have been developed, and several have received market approval. A vast amount of clinical experience has been gained which has helped to design PEG prodru

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… PEG-uricase in the management of treatment-resistant gout and hyperuricemia. Advanced Drug Delivery Reviews. 2008;60(1):59–68. doi: 10.1016/j.addr.2007.06.011. 47. Pasut G, Canal F, Dalla Via L, Arpicco S, Veronese FM, Schiavon O. … Control of hyperuricemia in subjects with refractory gout, and induction of antibody against poly(ethylene glycol) (PEG), in a phase I trial of subcutaneous PEGylated urate oxidase. Arthritis Research and Therapy. 2005;8(1, article R12) doi: 10.1186/ar1861. 102. Jung SK, DeLuca PP, Kang CL. …

Burden of illness among patients with relapsed or refractory multiple myeloma, and eligible for B-cell maturation antigen-targeted therapies.

BACKGROUND: B-cell maturation antigen (BCMA)-targeted therapies were approved for triple-class exposed relapsed/refractory multiple myeloma (RRMM) after ≥4 lines of therapy. METHODS: This claims-based retrospective analysis examined clinical and economic burden among United States patients who met eligibility for BCMA-targeted therapies and started a new therapy between 1 January 2016 and 30 September 2022. RESULTS: Of 228 eligible patients (median age: 64, 52.6% male, 68.7% White), clinical burden was characterized by prevalent MM-related conditions and complications, and high treatment fai

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… 36.4%) Existing bone diseases including lytic bone lesions 75 (32.9%) Hypogammaglobulinemia 47 (20.6%) Other blood cancers 22 (9.6%) Osteoporosis 22 (9.6%) Hypercalcemia 20 (8.8%) Metastatic solid tumor excluding bone metastasis 16 (7.0%) Amyloidosis 13 (5.7%) Extramedullary plasmacytomas 10 (4.4%) Hyperuricemia … bone diseases including lytic bone lesions | 75 (32.9%) Hypogammaglobulinemia | 47 (20.6%) Other blood cancers | 22 (9.6%) Osteoporosis | 22 (9.6%) Hypercalcemia | 20 (8.8%) Metastatic solid tumor excluding bone metastasis | 16 (7.0%) Amyloidosis | 13 (5.7%) Extramedullary plasmacytomas | 10 (4.4%) Hyperuricemia …

Cytokine release syndrome and tumor lysis syndrome in a multiple myeloma patient treated with palliative radiotherapy: A case report and review of the literature.

UNLABELLED: We present the case of a 53-year-old woman treated with analgesic radiotherapy for a multiple myeloma bone lesion of the forearm. After a first fraction of 5 Gray (Gy), she presented with an acute respiratory syndrome with fever a few hours after the treatment. The same symptoms occurred after the second fraction 3 days later. The patient recovered quickly thanks to intravenous hydration and suspension of the radiotherapy. Biological tests revealed a tumor lysis syndrome. We concluded that the clinical symptoms could be defined as cytokine release syndrome. This is the second time

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… However, certain other risk factors, such as hyperuricemia, bulky disease, advanced lactate dehydrogenase (LDH) disease and unfavorable cytogenetics should be added. …

Renal status of multiple myeloma patients in ibadan, Nigeria.

IntroductionThe spectrum of clinical manifestation in multiple myeloma (MM) ranges from asymptomatic disease to severely debilitative state. Unexplained renal disease is an indication for the investigation of patients for MM. This study is a retrospective analysis of the renal profile of patients with multiple myeloma in relation to management strategy in our institution.MethodsMedical records of 64 patients with multiple myeloma seen between 2000 and 2008 were retrospectively reviewed at an 850-bed tertiary hospital in South-Western Nigeria. The Mahn-Whitney test was used to compare laborator

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… patients is multifactorial, however, the incidence of hyperuricaemia is higher in the patients with renal failure compared to those without renal failure (43% vs. 27%) but the mean uric acid level showed that there was no difference, but when both groups were compared with renal insufficiency group hyperuricemia …

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction.

PURPOSE: Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized. METHODS: The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations

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… Considering that hyperuricemia is the underlying condition favoring gout development and that hyperuricemia is associated with endothelial dysfunction and CVD [ 74 ], it is obvious that known or even unknown comorbidities might favor ED development [ 75 ]. …

Arrhythmia in tumor lysis syndrome and associated in-hospital mortality: A nationwide inpatient analysis.

BackgroundTumor lysis syndrome (TLS) is a life-threatening oncologic emergency associated with fatal complications including arrhythmia. The epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature.MethodsWe used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD-9 code 277.88) from 2009 to 2014. Baseline characteristics, burden of arrhythmia, and pertinent outcomes were analyzed. Multivariable regression analysis was performed to identify the impact of underlying malignancy in pred

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… Cell death caused by actively proliferating cancer cells or treatment leads to cell lysis and release of various electrolytes leading to hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, which may overwhelm the body's homeostatic mechanisms for excretion leading to electrocardiographic …

First Clinical Nutrition Outpatient Consultation: A Review of Basic Principles in Nutritional Care of Adults with Hematologic Disease.

MethodsA bibliographic survey was carried out between 2020 and 2022 using two databases: PubMed/MEDLINE and Scientific Electronic Library Online (SciELO) and the information source Academic Google, irrespective of language or geography.ResultsIn the first nutrition consultation (FNC), there should be an investigative direction focused on nutritional interventions in the short, medium, and long term. The record in the patient's medical record is relevant for carrying out the consultation, according to the recommendations of the normative councils of medicine and nutrition. The main steps to be

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… Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study American Journal of Epidemiology 2012 176 2 108 116 10.1093/aje/kws002 2-s2.0-84866250426 22753829 99 Miranda J. A. D. Almeida G. G. Martins R. I. L. Cunha M. B. Belo V. A. Santos J. … Hyperuricemia and incidence of hypertension among men without metabolic syndrome Hypertension 2007 49 2 298 303 10.1161/01.HYP.0000254480.64564.b6 2-s2.0-33846419122 17190877 101 Pinheiro G. R. C. …

Oral manifestations and dental management in patients undergoing CAR-T cell therapy: a retrospective observational study.

Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a highly effective treatment for refractory and relapsed hematologic malignancies. Despite its clinical benefits, CAR-T therapy is associated with a unique toxicity profile, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and prolonged immunosuppression. Oral complications in this population remain underreported. This retrospective case series was aimed at describing oral manifestations and dental management in patients undergoing CAR-T therapy at a tertiary referral cente

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… Reported comorbid conditions included hypothyroidism ( n = 3), dyslipidemia ( n = 2), hypertension ( n = 2), diabetes mellitus ( n = 2), deep vein thrombosis ( n = 1), atrial fibrillation ( n = 1), hyperuricemia ( n = 1), hepatitis B ( n = 1), and gout ( n = 1). …

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors.

The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, m

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… CHAPTER 9: HYPERURICEMIA, GOUT, AND MINERAL AND BONE DISEASE Evaluation 9.1: Donor candidates should be asked about prior episodes of gout. …

Osteoporosis: Current Concepts.

Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measure

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… Then, bone resorption increases and mitigates the overall bone anabolic effect. 36 Teriparatide treatment is associated with mild upper gastrointestinal symptoms, nausea, pain in the limbs, dizziness, headache, hypercalcemia, hypercalciuria, hyperuricemia, and hypotension. 4 26 Moreover, the use of …

Biochemical and Clinical Impact of Organic Uremic Retention Solutes: A Comprehensive Update.

In this narrative review, the biological/biochemical impact (toxicity) of a large array of known individual uremic retention solutes and groups of solutes is summarized. We classified these compounds along their physico-chemical characteristics as small water-soluble compounds or groups, protein bound compounds and middle molecules. All but one solute (glomerulopressin) affected at least one mechanism with the potential to contribute to the uremic syndrome. In general, several mechanisms were influenced for each individual solute or group of solutes, with some impacting up to 7 different biolo

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… Genetic disruption of the uric oxidase gene in mice generated severe hyperuricemia and urate nephropathy [ 141 ]. In a series of rat experiments, induction of mild hyperuricemia caused systemic and glomerular hypertension, glomerular sclerosis and renal infiltration of macrophages [ 142 ]. … into account that the main currently available intervention to lower uric acid, allopurinol, has by itself a considerable complication profile, so that studies suggesting a positive effect should rather be considered as proof of concept than as an incentive for treatment, especially in asymptomatic hyperuricemia …

A Review of New Findings in Adult T-cell Leukemia-Lymphoma: A Focus on Current and Emerging Treatment Strategies.

Adult T-cell leukemia-lymphoma (ATL), a rare and aggressive T-cell malignancy caused by human T-cell lymphotropic virus type 1 (HTLV-1), is associated with a poor prognosis. Evidence-based standard treatment options are lacking and outcomes are generally unsatisfactory, particularly for patients with relapsed or refractory disease. Continued research is contributing to changing treatment landscape as a number of existing and investigational agents are evaluated. We describe the epidemiology of HTLV-1 and ATL, discuss the biology behind the disease, review current treatment practices and guidel

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… 29%) Infusion-related reactions (47% vs 0%) Skin disorders (43% vs 8%) TEAEs ≥ grade 3 Moga: 62% (29/47) IC: 54% (13/24) Daclizumab Berkowitz [ 49 ] (USA) 2 20 ATL (all subtypes; 70% had received previous therapy) ORR: 20% (all indolent) Median PFS: 12 weeks Median OS: 132.6 weeks Hypoglycemia (50%) Hyperuricemia … Infusion-related reactions (47% vs 0%) Skin disorders (43% vs 8%) TEAEs ≥ grade 3 Moga: 62% (29/47) IC: 54% (13/24) Daclizumab Berkowitz [ 49 ] (USA) | 2 | 20 | ATL (all subtypes; 70% had received previous therapy) | ORR: 20% (all indolent) Median PFS: 12 weeks Median OS: 132.6 weeks | Hypoglycemia (50%) Hyperuricemia …

Фульминантный внематочный рецидив множественной миэломы с редким сердцем, сосудистым и многовизорным участием: отчет о деле.

Множественная миелома (ММ) — плазменная злокачественная клетка, которая, как правило, проходит длительный клинический курс. Внешняя болезнь (ЭМД) представляет собой агрессивное проявление MM с относительно низким уровнем заболеваемости, которое традиционно затрагивает кожу и мягкие ткани. В то время как MM, как правило, безжалостно прогрессирует, мощное развитие болезней, характеризующееся обширной многовизорной и сосудистой инфильтрацией, является исключительно редким явлением и редко документируется в медицинской литературе. Этот случай иллюстрирует 64-летнюю женщину, у которой были обнаруже

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… Laboratory studies showed anemia (hemoglobin 110 g/L), thrombocytopenia (89 × 10 9 /L), renal impairment (creatinine 170.2 μmol/L, estimated glomerular filtration rate 27.7 mL/min/1.73 m 2 ), hyperuricemia (819 μmol/L), elevated C-reactive protein (16.88 mg/L), beta2-microglobulin >10.0 mg/L, and hyperglobulinemia …