Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 15 Ιανουαρίου 2023

Pharmacokinetic and pharmacodynamic study of 3 products of epoetin alfa as single subcutaneous dose in healthy volunteers

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Hemax® is an epoetin alfa product developed by Biosidus S.A. in Argentina at the end of the 1980's and has been present in that market since 1991. The initial presentation was a lyophilized powder containing albumin as stabilizer, to best adapt to environmental conditions in developing countries; more recently, a prefilled syringe, albumin-free presentation was developed, since this presentation has become the preferred standard in many markets.

Objective

The primary objective was to compare the pharmacokinetic profile of different formulations of epoetin alfa after a single subcutaneous administration to healthy volunteers of 40,000 IU of Eprex/Erypo® and Hemax® PFS.

Methods

This clinical trial was conceived following an open label, randomized, 3-way 3-period cross-over balanced, and sequential design. The study was conducted on 24 healthy volunteers.

Results

To analyze similarity between Hemax® PFS and the innovator product, Eprex®, AUC and Cmax of both products have been compared. The 90%CI lower limit for the geometric mean ratios was higher than 80% for any comparisons and the 90%CI upper limit for these geometric ratios was below 125% for all the comparisons made, thus demonstrating equivalence between both products.

Conclusion

The comparison between Hemax® PFS and Eprex® resulted in similar 90%CI for Cmax, AUC(0-120 h) and AUC(0-inf) ratios, all of them within the 80-125% interval, with a power above 95% for each ratio. These findings suggest biosimilar patterns for absorption velocity (with Tmax close to 15 h), absorption extent and elimination (with an elimination half-life close to 25-30 h for each formulation)

View on Web

Defining the Optimal Duration of Therapy for Hospitalized Patients with Complicated Urinary Tract Infections and Associated Bacteremia

alexandrossfakianakis shared this article with you from Inoreader

cid_ogimage.png

Abstract
Objective
Limited data are available to guide effective antibiotic durations for hospitalized patients with complicated urinary tract infections (cUTI).
Methods
We conducted an observational study of patients ≥18 years at 24 United States hospitals to identify the optimal treatment duration for patients with cUTI. To increase the likelihood patients experienced true infection, eligibility was limited to those with associated bacteremia. Propensity sco res were generated for an inverse probability of treatment weighted analysis. The primary outcome was recurrent infection with the same species within 30 days of completing therapy.
Results
1,099 patients met eligibility criteria and received 7, 10, or 14 days of therapy. There was no difference in the odds of recurrent infection for 382 (46%) patients receiving 10 days and 452 (54%) patients receiving 14 days of therapy (aOR 0.99, 95% CI, 0.52-1.87). An increased odds of recurrence was observed in 265 (37%) patients receiving 7 days versus 452 (63%) patients receiving 14 days of treatment (aOR 2.54, 95% CI, 1.40-4.60). When limiting the 7-day versus 14-day analysis to the 627 patients who remained on intravenous beta-lactam therapy or were transitioned to highly bioavailable oral agents, differences in outcomes no longer persisted; aOR 0.76, 95% CI, 0.38-1.52. Of 76 patients with recurrent infections, 2 (11%), 2 (10%), and 10 (36%) in the 7, 10, and 14-day groups, respecti vely, had drug-resistant infections (p=0.10).
Conclusion
Seven days of antibiotics appears effective for hospitalized patients with cUTI when antibiotics with comparable IV and oral bioavailability are administered; 10 days may be needed for all other patients.
View on Web

Pediatric inflammatory myofibroblastic tumor of the bladder with ALK–FN1 fusion successfully treated by alectinib

alexandrossfakianakis shared this article with you from Inoreader

Abstract

An inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm characterized by the proliferation of myofibroblasts and inflammatory cell infiltration. Although radical resection is the only established treatment strategy for IMT, it can cause functional disorders when vital organs are affected. We describe a case of pediatric IMT of the bladder with FN1–ALK (fibronectin 1–anaplastic lymphoma kinase) fusion. Radical resection might lead to urinary disturbance due to the large tumor size at diagnosis. However, the tumor was successfully treated with alectinib, a second-generation ALK inhibitor, followed by transurethral resection of the bladder tumor without any complications.

View on Web

Hypothalamic-Pituitary-Gonadal Function, Pubertal Development and Fertility Outcomes in Male and Female Medulloblastoma Survivors: A Single Centre Experience

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Background
Endocrine deficiencies, including hypothalamic-pituitary-gonadal axis (HPGA) impairment, are common in survivors of childhood and adolescent medulloblastoma. Still, data regarding pubertal development and fecundity are limited, and few studies assessed HPGA function in males. We aimed to describe HPGA function in a large cohort of patients with medulloblastoma.
Methods
A retrospective study comprising all 62 medulloblastoma patients treated in our center between 1987-2021, who were at least two years from completion of therapy. HPGA function was assessed based on clinical data, biochemical markers, and questionnaires.
Results
Overall, 76% of female patients had clinical or biochemical evidence of HPGA dysfunction. Biochemical evidence of diminished ovarian reserve was seen in all prepubertal girls (n=4). Among the males, 34% had clinical or biochemical evidence of gonadal dysfunction, 34% had normal function , and 29% were age-appropriately clinically and biochemically pre-pubertal. The difference between males and females was significant (p=0.003). Cyclophosphamide-equivalent dose (CED) was significantly associated with HPGA function in females, but not in males. There was no association between HPGA dysfunction and other endocrine deficiencies, length of follow up, weight status, and radiation treatment protocol. Two female and two male patients achieved successful pregnancies, resulting in 6 live births.
Conclusions
HPGA dysfunction is common after treatment for childhood medulloblastoma. This is seen more in females, likely due to damage to the ovaries from spinal radiotherapy. Our findings may assist in counselling patients and their families regarding risk to future fertility and need for fertility preservation.
View on Web

Dentine thickness in maxillary fused molars depends on the fusion type: An ex vivo micro‐CT study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

The present study aimed to determine and compare the dentine thickness around the root canals of maxillary molars with fusion using micro-computed tomography (micro-CT).

Methodology

A total of 120 fused maxillary molars having more than a single canal with distinct canal orifices near the cementoenamel junction were selected from a pool of extracted maxillary molars, which were scanned on a micro-CT device (SkyScan 1172, Bruker-microCT, Kontich, Belgium). The minimum dentine thickness around the root canals in furcal direction was measured using CTAn software (v.1.18.8 Bruker-microCT) at each millimetre. The specimens were grouped according to their fusion type, and dentine thickness around the canals was compared. The data were statistically analysed using ANOVA and post hoc Tukey-Kramer tests following an assessment of the normality of their distribution with the Kolmogorov-Smirnov test (p .05).

Results

Dentine thickness showed a statistically significant decrease at 2 mm below the orifice irrespective of fusion type. The minimum dentine thickness values were detected around the second mesiobuccal canal as 0.30 mm at 6 mm below orifice. Dentine thickness around the mesiobuccal canal significantly greater in fusion type 1 than those of types 2 and 3 (p < .05), while those of distobuccal and palatal canals were significantly thinner in type 3 fusion compared to type 1 or 6 (p < .05).

Conclusion

Minimum dentine thickness values at the danger zone of distobuccal and palatal canals change according to the fusion type in fused maxillary second molars.

View on Web