JournalTOCs

American Journal of Therapeutics
Journal Prestige (SJR): 0.399

Citation Impact (citeScore): 1
Number of Followers: 13

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1075-2765 - ISSN (Online) 1536-3686
Published by LWW Wolters Kluwer

[330 journals]

Mitapivat: A Quinolone Sulfonamide to Manage Hemolytic Anemia in Adults
With Pyruvate Kinase Deficiency
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  Authors: Wills; Josef; Horenstein, Melissa; Kim, Alicia; Silva, Matthew A.; Dima, Lorena
  Abstract: Background: Pyruvate kinase (PK) deficiency is a rare enzyme-linked glycolytic defect resulting in mild-to-severe chronic persistent erythrocyte hemolysis. The disease is an autosomal recessive trait caused by mutations in the PK liver and red blood cell gene characterized by insufficient erythrocyte PK activity. PK deficiency is most diagnosed in persons of northern European descent and managed with packed red blood cell transfusions, chelation, and splenectomy with cholecystectomy. Mitapivat is the first approved therapy indicated for hemolytic anemia in adults with PK deficiency with the potential for delaying splenectomy in mild–moderate disease.Mechanism of Action, Pharmacodynamics, and Pharmacokinetics: Mitapivat is a PK activator that acts by allosterically binding to the PK tetramer and increases PK activity. The red blood cell form of PK is mutated in PK deficiency, which leads to reduced adenosine triphosphate, shortened red blood cell lifespan, and chronic hemolysis. The half-life of elimination is 3–5 hours, with 73% bioavailability, 98% plasma protein binding, and a median duration of response of 7 months.Clinical Trials: Mitapivat has been investigated through various clinical trials for different therapeutic indications. Pivotal trials that serve the primary focus throughout this article are ACTIVATE, ACTIVATE-T, and RISE. ACTIVATE is a phase 3, randomized, double-blind, placebo-controlled study that evaluated the efficacy and safety of mitapivat in adult patients who were not receiving regular blood transfusions. Contrarily, ACTIVATE-T explored the safety and efficacy of mitapivat in adults with PK deficiency who received regular blood transfusions. Both trials demonstrated favorable use of mitapivat in PK deficiency. Focusing on another indication, the ongoing RISE trial investigates the optimal dosage of mitapivat in sickle cell disease.Therapeutic Advance: Mitapivat is an appropriate treatment for adults with PK deficiency requiring transfusions and may be considered for patients with symptomatic anemia who do not require transfusions and/or PK deficiency with compensated hemolysis without overt anemia.
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
The New Mythology of the Body and the Transformation of the Therapeutic
Space
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  Authors: Astărăstoae; Vasile; Rogozea, Liliana M.; Aron, Ioan; Botezat, Doru
  Abstract: Background: The history of medicine has flowed in the wake of knowledge and social perceptions about the body and corporeality. There is no idea of health without reference to the notion of body (although “health” can have other meanings, figuratively). Considering the same history, the body was the subject of numerous segregations and categorizations due to which it was and is a “social object” and a “political object.” In turn, the spatial and cultural framework was the environment and determinant of the medicine development which is not only a science but also an inter-human interactive practice.Areas of Uncertainty: In this article, we will analyze the current social (re)construction of the notions of body and space by referring to the technological and structural changes that are manifested in medicine and society and their ethical implications.Data Sources: A review of the specialized literature was performed in June-July 2023, using keywords like human enhancement, therapeutic enhancement, transhumanist medicine, ethics from PubMed, Scopus, Web of Science, and Google Scholar, and official documents issued at the international level (World Health Organization, European Commission).Ethics and Therapeutic Advances: This literature review suggests that few practical solutions to human enhancement, both curative and preventive, whether cognitive or physical, have been approached entirely from an ethical point of view. The historical evolution of the concept of human enhancement has led to debates between “transhumanists” and “bioconservatives” depending on how they relate to the improvement of the human condition without or with reticence interventions to improve human capabilities being related to various interventions, from pharmacological, surgical ones to those in the field of genetics, nanomedicine, or cybernetics. In addition to the technical aspects, which are often the major concern of researchers and those applying new technologies, there are also ethical and legislative aspects, to better understand the impact that the dynamics and diffusion of these processes have on the evolution of the human species.Conclusions: In interference with these technologies, the body is exposed to possibilities of change and evolution with colossal (expected) social impact that can change norms and values that have been stable for centuries. Social space and place are also proving to be “processes in the making'” for which we need to detect what developments are possible or have already imposed themselves as a trend in the social and medical world.
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
Major Drugs Shortages: Ethical Dilemma in Clinical Practice
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  Authors: Nguyen; Timothy; Willett, Kristine C.
  Abstract: No abstract available
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
Fatal Myocarditis After COVID-19 Vaccination: Fourteen Autopsy-Confirmed
Cases: Erratum
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  Abstract: No abstract available
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
A Durable Response to Osimertinib in an Elderly Patient With EGFR T790M
Positive Metastatic Non–Small-Cell Lung Cancer After Progression on
Erlotinib
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  Authors: Tariq; Zeeshan; Blyly, McKenna
  Abstract: No abstract available
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
Prevalence of Dabigatran-Associated Esophagitis on Upper Gastrointestinal
Endoscopy: A Systematic Review and Meta-analysis
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  Authors: Beran; Azizullah; Mhanna, Mohammed; Musallam, Rami; Sayeh, Wasef; Abuhelwa, Ziad; Ghazaleh, Sami; Assaly, Ragheb
  Abstract: No abstract available
  PubDate: Fri, 01 Sep 2023 00:00:00 GMT-
Strokes and Transient Ischemic Attacks Occurrence During Annual Dual
Antiplatelet Therapy
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  Authors: Serebruany; Victor L.; Tanguay, Jean-Francois; Gurvich, Milana L.; Marciniak, Thomas A.; Atar, Dan
  Abstract: Background: The incidence of stroke/TIA during annual dual antiplatelet therapy (ADAPT) for acute coronary syndrome (ACS) remains high. Some evidence suggests that shorter than ADAPT may diminish such risk, still providing adequate vascular protection. However, the precise timing of strokes/TIA occurrences during ADAPT is unclear but may be important for determining optimal preventive treatment duration.Study Question: The precise timing of secondary cerebrovascular events over ADAPT.Study Design: Access was gained to the FDA-issued Platelet Inhibition and Outcomes (PLATO) trial data set on which post hoc analyses of stroke/TIA timing after ticagrelor and clopidogrel on top of aspirin was explored.Measures and Outcomes: Events were counted and plotted over time from day 1 till day 365 after the index ACS event.Results: Among 18,624 enrollees, 252 strokes and 49 TIAs were reported. After the exclusion of entries with missing dates, unclear randomization codes, and events beyond 1-year follow-up, 238 strokes and 45 TIAs were analyzed. Overall, most frequent strokes/TIAs occurred within the first day after qualifying ACS, with the gradual declines after day 7 and day 40 reaching background counts thereafter. The strokes/TIAs patterns did not differ much between P2Y12 inhibitors except for twice more events at day 1 and excess exclusions after day 365 in the ticagrelor arm.Conclusions: Most cerebrovascular events emerged very early after ACS despite ADAPT. This large hypothesis-generating evidence may justify shorter than the ADAPT duration after ACS. Twice more events at day 1 and excess late ticagrelor exclusions in PLATO deserve further scrutiny.Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT 00391872.
  PubDate: Wed, 29 Mar 2023 00:00:00 GMT-
Massive Ethylene Glycol Self-Administration With Acute Kidney Injury
Treated With Fomepizole Alone
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  Authors: Dang; Duc M.; Hieger, Michelle A.
  Abstract: No abstract available
  PubDate: Mon, 20 Feb 2023 00:00:00 GMT-
Repeated Hepatitis C Virus Recurrence in a Patient With a Prognosis of
Ultimate Spontaneous Clearance: Relapse or Reinfection'
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  Authors: Wang; Jinyong; Dai, Di; Wen, Ying
  Abstract: No abstract available
  PubDate: Wed, 18 Jan 2023 00:00:00 GMT-
Testing for Glucose-6-Phosphate Dehydrogenase Deficiency Before
Rasburicase Use for Tumor Lysis Syndrome
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  Authors: Lakra; Rachaita; Grewal, Udhayvir Singh; Ramadas, Poornima
  Abstract: No abstract available
  PubDate: Thu, 12 Jan 2023 00:00:00 GMT-
Defibrillator Lead Retention and Suppressive Antibiotic Treatment for
Gram-Negative Bacterial Endocarditis
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  Authors: Briasoulis; Alexandros; Kontitsi, Kiki; Rentziou, Ioanna
  Abstract: No abstract available
  PubDate: Mon, 02 Jan 2023 00:00:00 GMT-
Attention-Deficit/Hyperactivity Disorder–Associated Impulsive
Aggression
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  Authors: Naguy; Ahmed; Alamiri, Bibi
  Abstract: No abstract available
  PubDate: Mon, 02 Jan 2023 00:00:00 GMT-