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Effect of food on the pharmacokinetics of erlotinib, an orally active epidermal growth factor receptor tyrosine-kinase inhibitor, in healthy individuals.

The effects of food on the pharmacokinetics of erlotinib were investigated in two open-label, randomized studies. In a single-dose crossover study (n = 18), 150 mg of erlotinib was administered under either fasting or fed conditions. In the first period, an approximate doubling in the area under the plasma concentration-time curve was evidenced by the geometric mean ratio (GMR) of 2.09 observed under fed conditions; whereas, in the second period there was a decrease, with a GMR of 0.93. In a multiple-dose parallel study (n = 22), 100 mg of erlotinib was administered daily for 8 days, either 7

Severe pustular eruption associated with imatinib and voriconazole in a patient with chronic myeloid leukemia.

Adenine phosphoribosyltransferase (APRT) and hypoxanthine-guanine phosphoribosyltransferase (HGPRT) are two structurally related enzymes involved in purine recycling in humans. Inherited mutations that suppress HGPRT activity are associated with Lesch-Nyhan disease (LND), a rare X-linked metabolic and neurological disorder in children, characterized by hyperuricemia, dystonia, and compulsive self-injury. To date, no treatment is available for these neurological defects and no animal model recapitulates all symptoms of LND patients. Here, we studied LND-related mechanisms in the fruit fly. By c

[Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain].

INTRODUCTION: The aim of this study was to describe the clinical and epidemiological features of spotted fever group rickettsiosis acquired in the province of Albacete, Spain. METHODS: We retrospectively reviewed the clinical records of patients with a diagnosis of spotted fever group rickettsiosis and positive serologic results between 1997 and 2003. Criteria for inclusion were as follows: 1) seroconversion in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of 160 dollars with two or three of the following symptoms: fever, eschar, or rash. RESULTS: There were

HIV-related symptoms and management in HIV and antiretroviral therapy patients in KwaZulu-Natal, South Africa: a longitudinal study.

AIM: The study aimed to determine the prevalence, predictors, and self-reported management of HIV- or ARV-related symptoms among HIV patients prior to antiretroviral therapy (ART) and over three time points while receiving ART in KwaZulu-Natal, South Africa. METHOD: A total of 735 consecutive patients (29.8% male and 70.2% female) who attended three HIV clinics completed assessments prior to ARV initiation, 519 after 6 months, 557 after 12 months, and 499 after 20 months on ART. RESULTS: The HIV patients reported an average of 7.5 symptoms (prior to ART), 1.2 symptoms after 6 months on ART,

Tolerability of the Oscar 2 ambulatory blood pressure monitor among research participants: a cross-sectional repeated measures study.

BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is increasingly used to measure blood pressure (BP) in research studies. We examined ease of use, comfort, degree of disturbance, reported adverse effects, factors associated with poor tolerability, and association of poor tolerability with data acquisition of 24-hour ABPM using the Oscar 2 monitor in the research setting. METHODS: Sixty adults participating in a research study of people with a history of borderline clinic BP reported on their experience with ABPM on two occasions one week apart. Poor tolerability was operationalized as

Acute varicella zoster encephalitis without evidence of primary vasculopathy in a case-series of 20 patients.

Varicella zoster virus (VZV) is a leading cause of acute viral encephalitis but little is known about its clinical, biological and imaging features. Furthermore, the most favourable treatment regimen has not been determined. We studied a prospective cohort of 20 HIV-negative patients presenting with acute VZV encephalitis caused by primary infection or reactivation. VZV was identified in 16 of 20 cases by PCR detection of the DNA in the cerebrospinal fluid. The four remaining cases occurred during or soon after a VZV rash. The median age of the 17 adults was 76 (19-86) years; the three other p

Efficacy and safety of switching from enfuvirtide to raltegravir in patients with virological suppression.

OBJECTIVE: To assess the Efficacy and safety of switching from HAART containing enfuvirtide to raltegravir as a simplification strategy in patients with viral suppression and intolerance to enfuvirtide. METHODS: Thirty-six patients with sustained plasma HIV RNA levels <50 copies/mL for at least 3 months with injection site reactions and/or injection fatigue while receiving an enfuvirtide-containing optimized background regimen switched from enfuvirtide to raltegravir (400 mg bid). RESULTS: Patientshad received enfuvirtide for a median of 96 weeks and had sustained HIV RNA <50 copies/ mL for

Exclusion of ill children from child-care centers in Israel.

The aim of the study was to examine criteria for ill children in child-care centers. A questionnaire on practices of exclusion/return of children according to specific signs and symptoms was mailed to the directors of care centers in central Israel. Thirty-six of the 60 questionnaires (60%) were returned by mail and the reminded were completed in personal visits to the CCCs achieving a response rate of 100%. About half (51.7%) used "common sense" and "personal feelings" to exclude children and to allow their return, and 29 (48.3%) used the guidelines of the Ministries of Education and Health o

Engraftment syndrome after autologous peripheral blood progenitor cell transplantation in pediatric patients: a prospective evaluation of risk factors and outcome.

We prospectively analyzed the incidence, risk factors and outcome of engraftment syndrome (ES) in 112 patients undergoing autologous peripheral blood progenitor cell transplantation with different malignancies between January 1999 and December 2003. The median age was 8 years (range 1-18). There were 73 males. There were 37 hematological neoplasias and 75 solid tumors. Disease status at transplantation was early in 49, intermediate in 15 and 48 in advanced phase. The median CD34+ cells infused was 4.6 x 10(6)/kg. With a median follow-up of 23 months (1-116 months), 38 patients developed ES. Th

Abstracts from the 8th Drug Hypersensitivity Meeting (DHM)

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… Among the 8 patients who declared previous or subsequent intake of another MLS drug, 2 (25%) had clinical cross-reactivity (both with pristinamycin as culprit, who had maculopapular exanthema to macrolide). Type of DCADR and positivity of PT are in the Table 1 . … Case report 79-year-old male with a history of tophaceous gout, hypertension and heart failure who developed a generalized pruritic exanthema after 10 days of treatment with amlodipine, spironolactone and allopurinol. …

Dermatologic adverse events related to the PI3Kα inhibitor alpelisib (BYL719) in patients with breast cancer.

PURPOSE: Rash develops in approximately 50% of patients receiving alpelisib for breast cancer, often requiring dose modifications. Here, we describe the clinicopathologic, laboratory, and management characteristics of alpelisib-related dermatologic adverse events (dAEs). METHODS: A single center-retrospective analysis was conducted. Data were abstracted from electronic medical records. RESULTS: A total of 102 patients (mean age 56 years, range 27-83) receiving alpelisib most frequently in combination with endocrine therapy (79, 77.5%) were included. We identified 41 (40.2%) patients with all

Frequency and Type of Red Flags in Patients With Covid-19 and Headache: A Series of 104 Hospitalized Patients.

OBJECTIVE: In this study, we aimed to evaluate the frequency of the main red flags in patients with headache who do have Covid-19. BACKGROUND: Headache is one of the most frequent neurologic symptoms of Coronavirus disease 2019 (Covid-19). Diagnosis of secondary headache disorders is still based on the presence of red flags. DESIGN AND METHODS: Cross-sectional study of hospitalized patients with confirmed Covid-19 disease. We interrogated every patient about the presence of headache and if so, a headache expert conducted a structured interview assessing the presence and type of the main red

Varicella-Zoster Virus Gastritis: Case Report and Review of the Literature.

We report varicella-zoster virus (VZV) gastritis in a 70-year-old woman postchemotherapy for lymphoma, presenting with abdominal pain, vomiting, and delirium without rash. A gastric biopsy demonstrated viral inclusions but posed a diagnostic challenge as immunohistochemistry for cytomegalovirus and herpes simplex virus were negative, and VZV immunohistochemistry was not available. The patient developed a vesicular rash 7 days after her symptoms began. Molecular testing of the gastric biopsy and a skin swab both confirmed VZV infection. She also had probable involvement of her liver and pancrea

Adverse drug reactions to nonnucleoside reverse transcriptase inhibitor-based antiretroviral regimen: a 24-week prospective study.

BACKGROUND: Few studies have addressed the issue of adverse drug reactions with non-protease inhibitor (PI)-based antiretroviral therapy (ART) in resource-constrained settings. We studied prospectively the incidence of adverse drug reactions with generic ART among our patients. METHODOLOGY: A total of 100 HIV-infected individuals were recruited. Patients received nevirapine (NVP) or efavirenz (EFV) with lamivudine (3TC) and zidovudine (ZDV)/stavudine (d4T). They were followed for 6 months for evidence of adverse drug reactions. RESULTS: The mean CD4 count was 114.09 +/- 60.07 cells/mm(3) (ra

The impact of human herpesvirus 6B reactivation on early complications following allogeneic hematopoietic stem cell transplantation.

Although human herpesvirus 6 (HHV-6) has been considered an important opportunistic and potentially fatal pathogen for allogeneic hematopoietic stem cell transplantation (HSCT), the clinical significance of HHV-6 reactivation remains controversial. In this study, we monitored HHV-6 DNAemia in 72 consecutive allogeneic HSCT recipients by real-time quantitative polymerase chain reaction. A total of 680 peripheral blood specimens were collected from the recipients before HSCT or at weekly intervals after HSCT. As the predominant variant, HHV-6B was detectable at least once in 47.2% (34/72) of HSC

Characterization of a potential animal model of an idiosyncratic drug reaction: nevirapine-induced skin rash in the rat.

Idiosyncratic drug reactions are difficult to study in humans due to their unpredictability. Unfortunately, this characteristic also hinders the development of animal models needed for mechanistic studies. Nevirapine, used to treat human immunodeficiency virus (HIV) infections, results in a severe idiosyncratic skin rash in some patients. We found that nevirapine can also cause a significant rash in some strains of rats. At a dose of 150 mg/kg/day, the incidence in female Sprague-Dawley rats was 6/28 (21%), in female Brown Norway rats 32/32 (100%), and in female Lewis rats 0/6 (0%) while no ma

Safety of long-term lamotrigine in epilepsy.

PURPOSE: To examine the safety of lamotrigine (LTG) used in general practice to treat epilepsy. METHODS: Information was collected on 11,316 patients who were included in a noninterventional observational cohort study conducted by means of Prescription-Event Monitoring (PEM). A follow-up study provided information on the first 3,994 patients who had taken LTG for > or = 6 months. Incidence density (ID) measurements were used to rank the frequency of the reported events. RESULTS: Rash was the most frequently reported nonepileptiform event (ID, 19.7/1,000 patient-months) in the first month of