Brit J Hosp Med
-
Aims/Background The increasing adoption of inhibitors of programmed cell death-1 (PD-1) and its ligand, programmed death-ligand 1 (PD-L1), in the treatment of multiple cancer types in China has started to garner broader attention due to the occurrence of immune-related adverse events (irAEs), especially life-threatening skin reactions such as Steven-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Isolated case reports have described SJS/TEN associated with PD-1/PD-L1 inhibitors usage. In this paper, we presented a series of cases of SJS/TEN following the use of PD-1/PD-L1 inhibitors in a dermatology hospital located in Zhejiang Province of China in the past several years, summarizing characteristics of these cases and providing a reference of management. ⋯ More than two types of therapies were applied to the cases, except for two cases with mild SJS. Conclusion This study unveils a potential, under-recognized cause of SJS/TEN in the cancer patients after analyzing the cases of SJS/TEN in cancer patients with prior exposure to PD-1/PD-L1 inhibitors. This paper also provides clue about the prominent features of SJS/TEN aforesaid, offering insights on the effective management measures for optimizing clinical safety.
-
Meta Analysis
Efficacy and Safety of Nerve Growth Factor in Treating Neurotrophic Keratitis Patients: A Meta-Analysis.
Aims/Background Nerve growth factor has been approved for treating neurotrophic keratitis in Europe and the United States. However, its clinical efficacy and safety profile in neurotrophic keratitis patients have not been systematically evaluated. Therefore, this study systematically assessed the efficacy and safety of nerve growth factor (NGF) in treating patients with neurotrophic keratitis. ⋯ However, the incidence of ailment progression (OR = 0.44, 95% CI: 0.17-1.13) and adverse events (OR = 0.88, 95% CI: 0.50-1.56) did not show significant differences between these two groups. Conclusion In summary, for patients with neuropathic keratitis, NGF treatment can promote corneal healing efficiency, effectively improve visual correction, and reduce disease progression and incidence of adverse events to a large extent. The clinical effect and safety are high, and it is worthy of clinical promotion and application.
-
The potential applications of Artificial Intelligence (AI) in anaesthesia are expansive.~However, like any technological advancement, the integration of AI in anaesthetic practice comes with both benefits and potential risks. This article seeks to set out some of the advantages and disadvantages of the use of AI technologies within the field of anaesthesia. ⋯ Whilst AI within anaesthetic practice holds immense promise, there are substantial challenges which require careful consideration and ongoing evaluation. A collaborative approach will be required from healthcare staff, developers and regulators to promote the safe, responsible, and effective application of AI in anaesthesia practice.
-
Review Case Reports
Sarcomatoid Renal Clear Cell Carcinoma with Brain Metastasis: A Case Report and Literature Review.
Sarcomatoid renal cell carcinoma typically signifies an exceptionally poor prognosis, with patients rarely surviving beyond one year. An 83-year-old male presented to our hospital with complaints of headache and left-sided limb weakness. Computed tomography (CT) scans of the head and lungs disclosed a mass within the right temporal lobe, accompanied by peritumoral edema in the right cerebral hemisphere. ⋯ He underwent cytoreductive surgery successively in the neurosurgery and urology departments. Despite experiencing postoperative tumour recurrence, the patient has lived close to four years to date. This case report illustrates that cytoreductive surgery combined with systemic pharmacotherapy can still confer significant survival benefits for elderly patients.
-
Hypokalaemia is a common electrolyte disorder affecting hospitalised patients. It is associated with adverse outcomes including increased mortality. Inpatients with hypokalaemia need a different approach to workup and management as the aetiologies and progression of the hypokalaemia are distinct to outpatients. ⋯ This paper reviews the assessment of hypokalaemia in a hospital setting. It is aimed at early career doctors on the wards to help carry out a thorough evaluation. It also provides a useful framework for management.