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- Incidence of Adverse Events Using Flumazenil in Patients With Iatrogenic
Benzodiazepine Delirium: A Retrospective Study-
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Authors: Hieger; Michelle A.; Moore, Philip W.; Maskell, Kevin F.
Abstract:  Background: Flumazenil is a competitive benzodiazepine (BZD) antagonist most used for treating delirium in BZD overdoses. Since its introduction, many have expressed concerns about its safety secondary to the risk of inducing BZD withdrawal and refractory seizures.Study Question: What is the incidence of adverse drug events after the administration of flumazenil in patients with suspected iatrogenic BZD delirium'Study Design: This is a retrospective cross-sectional study of patients from a single center from 2010 to 2013. Patients experiencing delirium after receiving BZDs in the hospital were included if they had a bedside toxicology consult and were administered flumazenil. Patients were excluded if they were given BZDs for ethanol withdrawal or if they did not have mental status documentation before and after flumazenil administration. Descriptive statistics were calculated.Measures and Outcomes: The primary outcome was the incidence of adverse drug events after flumazenil administration. The secondary outcome was the efficacy of flumazenil determined by the patient's mental status.Results: A total of 501 patient records were reviewed, and 206 patients were included in the final analysis. Of those patients, 172 (83.5%) experienced an objective improvement in their mental status within 1 hour after flumazenil administration. A total of 5 patients experienced adverse events (2.4%), 95% confidence interval (0.78, 5.54). Of these, 3 patients experienced minor agitation or restlessness without pharmacologic intervention. Two patients experienced moderate agitation or restlessness that resolved with haloperidol or physostigmine administration. No patients had a reported seizure, 95% confidence interval (0.0, 1.77).Conclusions: Flumazenil seems to be a safe and effective intervention for the reversal of delirium secondary to iatrogenic BZD administration.
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Attitudes and Knowledge of Medical Students in South of Israel Toward
Medical Cannabis-
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Authors: Mirzayov; Shira; Peleg, Roni; Freud, Tamar
Abstract:  Background: Public and medical interest in the use of cannabis has increased in Israel and the world over recent years.Study Question: The aim of the study was to assess the attitudes of medical students from the Faculty of Health Sciences of Ben-Gurion University of the Negev on the use of medical cannabis.Study Design: This is a cross-sectional study using a self-administered questionnaire completed by medical students from Ben-Gurion University of the Negev, Beer-Sheva, Israel.Measures and Outcomes: Attitudes and knowledge toward the use of medical cannabis were evaluated.Results: A total of 243 medical students participated in the study. Of these, 111 (46.1%) were from preclinical years. The mean age was 27.31 ± 3.07, and 138 (57.3%) were female students. Most students (N = 193, 79.4%) agreed to a great degree or to a very great degree that there was a role for cannabis for medical purposes. Most students thought that medical cannabis should be recommended for use by pain specialists (N = 231, 95.1%), by oncologists (N = 208, 85.6%), and by psychiatrists (N = 192, 79%). A little more than half of the participants (N = 127, 52.5%) would agree to be licensed, as future physicians, to prescribe medical cannabis. A logistic regression analysis found that the students strongly agreed with legalization of medical cannabis and students who strongly agreed that medical cannabis should be in the health basket predicted a very strong agreement about its use (OR = 2.623, P ≤ 0.002, and OR = 3.285, P ≤ 0.001, respectively).Conclusions: Most medical students support the use of medical cannabis for medical purposes and are in favor of its legalization. As physicians of the future, it is important to assess the attitudes of medical students on medical cannabis.
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Gemcitabine-Associated Hyperammonemia in a Patient With Cholangiocarcinoma
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Authors: Peng; Tzu-Rong; Wu, Ta-Wei; Chen, Hsuan-Fei; Kao, Woei-Yau; Chan, Chein-hui
Abstract: No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Cocaine-Associated Antiglomerular Basement Membrane Antibody Syndrome
Successfully Treated With Plasmapheresis and Mycophenolate-
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Authors: Shazadeh Safavi; Pejma; Hegde, Prajwal; Nawras, Yusuf; Patel, Kashvi; Altorok, Nezam
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Tacrolimus Level Increase During Nirmatrelvir–Ritonavir Treatment
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Authors: Gong; Yinhua; Li, Yue; Xue, Ling; Gao, Jie
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Anti-Xa Activity–Guided Fondaparinux for Bridging Anticoagulation in
Patients With Mechanical Valve Prosthesis'—Experiences With a 23-Day
Long Therapy-
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Authors: Jurica; Jakub; Péč, Martin Jozef; Bolek, Tomáš; Škorňová, Ingrid; Staško, Ján; Galajda, Peter; Samoš, Matej; Mokáň, Marián
Abstract: No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Delayed Pembrolizumab-Associated Sarcoidosis
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Authors: Valasapalli; Srijan; Aslam, Hafiz; Younes, Ahmed I.; Muzaffar, Mahvish
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Tofacitinib for the Treatment of Trachyonychia
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Authors: Zhong; Xinyue; Liu, Taoming; Wei, Linwei; Bai, Juan; Fang, Hong; Qiao, Jianjun
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Tislelizumab-Induced Toxic Epidermal Necrolysis-Like Cutaneous Adverse
Reaction: Rare Complication of Immune Checkpoint Inhibitor Therapy-
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Authors: Yang; Xiaoqin; Xu, Shunming
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Immune-Mediated Diabetes Mellitus, Diabetic Ketoacidosis, Enteritis, and
Thrombotic Thrombocytopenic Purpura Presenting as Adverse Effects of
Pembrolizumab Therapy-
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Authors: Luong; Bao; Koch, Gabriel; Trivedi, Kovid; Ramachandran, Kishan
Abstract: No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Cardiovascular Safety of Glucagon-Like Receptor 1 Agonists in Patients
With Type 2 Diabetes and Peripheral Arterial Disease: A Meta-Analysis of
Randomized Controlled Trials-
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Authors: Ashraf; Muhammad Talal; Ali, Abraish; Ahmed, Nabeel; Shakeel Khan, Muhammad Khuzzaim; Usman, Muhammad
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Omalizumab for the Treatment of Refractory Acute Urticaria
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Authors: Wang; Su; Chen, Xinyi; Bai, Juan; Sun, Qingmiao; Qiao, Jianjun; Fang, Hong
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Mung Bean (Vigna radiata L.) Soup Decreases Tacrolimus Blood Trough Level
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Authors: Hu; Lei; Liu, Jianmin; Fan, Qiuyu; Zhang, Shaohui
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Methylphenidate-Associated Creatine Kinase Level Elevation
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Authors: Nagaoka; Maiko; Murata, Tsukasa; Nagamine, Takahiko; Fujise, Noboru
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Brexpiprazole Can Be Used to Treat Behavioral and Psychological Symptoms
of Lewy Body Dementia Without Exacerbating the Risk of Falls-
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Authors: Ou; Hsun; Yeh, Yi-Wei
Abstract: No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Sintilimab-Associated Psoriasis
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Authors: Wei; Yi; Lin, Mao; Jia, Rui-Ling; Cai, Lu; Shi, Bing-Jun
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Therapeutic Management of Transverse Myelitis Secondary to Myelin
Oligodendrocyte Glycoprotein Antibody–Associated Disease-
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Authors: Boyinepally; Kiran; Marellapudi, Amulya; Nawras, Yusuf; Fatima, Rawish; Altorok, Nezam
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Lactococcus lactis Strain Plasma for the Treatment of Verruca Plana
Juvenilis-
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Authors: Horiuchi; Yasuhiro
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Prasugrel-Associated Drug Fever
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Authors: Chan; Wan Man; Wu, Ta-Wei; Peng, Tzu-Rong
Abstract: No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- Comparative Meta-Analysis of Retatrutide Versus Placebo and Dulaglutide
for Weight Loss and Diabetes Management: Insights From Clinical Trials-
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Authors: Ayesh; Hazem; Ayesh, Suhail; Niswender, Kevin
Abstract:  No abstract available
PubDate: Mon, 01 Jul 2024 00:00:00 GMT-
- A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by
Chelidonium Majus L.: Report of Two Cases of Herb-Induced Liver Injury and
Literature Review-
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Authors: Ciornolutchii; Vera; Ismaiel, Abdulrahman; Sabo, Cristina Maria; Al Hajjar, Nadim; Seicean, Andrada; Dumitrascu, Dan L.
Abstract:  Background: In instances where individuals manifest elevated transaminase levels without a clearly discernible cause, a comprehensive patient history proves invaluable in unveiling latent triggers. In this report, we present 2 cases of herb-induced liver injury (HILI) characterized by severe hypertransaminasemia attributed to the consumption of Chelidonium majus L. (also known as greater celandine [GC]), an agent considered an alternative therapeutic remedy.Areas of Uncertainty: Exploring the occurrence and range of clinical manifestations in HILI linked to Chelidonium majus L., while also investigating the potential triggers and predisposing factors for hepatotoxic reactions post Chelidonium majus L. usage, remains challenging due to the absence of definitive laboratory tests to identify the causative agent.Data Sources: Two case reports were detailed, and a systematic literature review using PubMed was conducted including published literature till March 2023. Moreover, a manual search of reference lists of pertinent articles was performed to identify any additional relevant missed publications.Results: In the first case, a 64-year-old woman presented with jaundice, revealing a 1-month history of using GC capsules to manage gallstones. Diagnostic assessment identified HILI, gallstones, and choledocolithiasis, with transaminase levels exceeding 1000 IU/L. After discontinuing GC and receiving intravenous therapy with amino acids and phospholipids, the patient's condition significantly improved. Subsequently, she underwent endoscopic common bile duct stone removal and cholecystectomy. In the second case, a 66-year-old woman presented with elevated liver function test results discovered incidentally during musculoskeletal pain evaluation. Upon further questioning, the patient disclosed regular consumption of GC tea for "health promotion." Following intravenous therapy using amino acids and phospholipids, her transaminase levels returned to normal. The literature review identified 38 cases of HILI associated with GC preparations, primarily in adult women aged 27–77 years, with a predominant reporting location in Germany. Various forms of GC were used, with treatment durations ranging from 1 week to a year. Discontinuation of GC generally led to recovery in these cases.Conclusion: Chelidonium majus L., a potent herb often used in alternative medicine, has significant hepatotoxic potential, requiring physicians to be vigilant in cases of unexplained liver injury.
PubDate: Thu, 30 May 2024 00:00:00 GMT-
- Role of Rifaximin in the Prevention of Variceal Bleeding: Systematic
Review and Meta-Analysis-
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Authors: Ahmed; Zohaib; Gangwani, Manesh Kumar; Iqbal, Umair; Kazi, Amal Iqbal; Arif, Syeda Faiza; Priyanka, Fnu; Lee-Smith, Wade; Aziz, Muhammad; Jaber, Fouad; Dahiya, Dushyant Singh; Ali, Hassam; Inamdar, Sumant; Confer, Bradley
Abstract:  No abstract available
PubDate: Wed, 29 May 2024 00:00:00 GMT-
- Impact of Continuous and Intermittent Loop Diuretics on Hypochloremia for
Patients with Acute Decompensated Heart Failure: A Retrospective Cohort
Review-
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Authors: Wasowski; Erik M.
Abstract:  No abstract available
PubDate: Tue, 14 May 2024 00:00:00 GMT-
- Taurolidine and Heparin as Catheter Lock Solution for Central Venous
Catheters in Hemodialysis-
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Authors: Nguyen; Timothy; Camins, Bernard C.; Butler, David A.
Abstract:  Background: Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile.Mechanism of Action, Pharmacodynamics, and Pharmacokinetics: Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available.Clinical Trials: The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%–86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs.Therapeutic Advance: Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.
PubDate: Tue, 07 May 2024 00:00:00 GMT-
- Fospropofol Disodium for Sedation of Postoperative ICU Patients: A
Dose-Finding Study-
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Authors: Gao; Xuehui; Yang, Xiaobo; Shu, Huaqing; Yu, Yuan; Liu, Hong; Yuan, Yin; Zou, Xiaojing; Yuan, Shiying; Shang, You
Abstract:  No abstract available
PubDate: Tue, 07 May 2024 00:00:00 GMT-
- Highest Dose of Eslicarbazepine for Refractory Secondary Trigeminal
Neuralgia-
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Authors: Fortuna; Giulio
Abstract: No abstract available
PubDate: Thu, 02 May 2024 00:00:00 GMT-
- Ethical Dilemmas of Using Artificial Intelligence in Medicine
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Authors: Astărăstoae; Vasile; Rogozea, Liliana M.; Leaşu, Florin; Ioan, Beatrice Gabriela
Abstract:  Background: Artificial intelligence (AI) is considered the fourth industrial revolution that will change the evolution of humanity technically and relationally. Although the term has been around since 1956, it has only recently become apparent that AI can revolutionize technologies and has many applications in the medical field.Areas of Uncertainty: The ethical dilemmas posed by the use of AI in medicine revolve around issues related to informed consent, respect for confidentiality, protection of personal data, and last but not least the accuracy of the information it uses.Data Sources: A literature search was conducted through PubMed, MEDLINE, Plus, Scopus, and Web of Science (2015–2022) using combinations of keywords, including: AI, future in medicine, and machine learning plus ethical dilemma.Ethics and Therapeutic Advances: The ethical analysis of the issues raised by AI used in medicine must mainly address nonmaleficence and beneficence, both in correlation with patient safety risks, ability versus inability to detect correct information from inadequate or even incorrect information. The development of AI tools that can support medical practice can increase people's access to medical information, to obtain a second opinion, for example, but it is also a source of concern among health care professionals and especially bioethicists about how confidentiality is maintained and how to maintain cybersecurity. Another major risk may be related to the dehumanization of the medical act, given that, at least for now, empathy and compassion are accessible only to human beings.Conclusions: AI has not yet managed to overcome certain limits, lacking moral subjectivity, empathy, the level of critical thinking is still insufficient, but no matter who will practice preventive or curative medicine in the next period, they will not be able to ignore AI, which under human control can be an important tool in medical practice.
PubDate: Thu, 25 Apr 2024 00:00:00 GMT-
- Sodium Bicarbonate: Use and Misuse in Clinical Medicine
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Authors: Imran; Nashat; Ayesh, Ali; Workeneh, Biruh; Shahait, Awni
Abstract: No abstract available
PubDate: Wed, 24 Apr 2024 00:00:00 GMT-
- Cyclosporine-Associated Organizing Pneumonia
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Authors: Singh; Harjinder; Patel, Parth; Mawari, Samih; Caliman, Neil
Abstract:  No abstract available
PubDate: Tue, 02 Apr 2024 00:00:00 GMT-
- Delayed Response to Glucocorticoids in Daptomycin Lung
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Authors: Nanah; Abdelrahman; Nair, Anika Sasidharan; Stoller, James
Abstract:  No abstract available
PubDate: Tue, 26 Mar 2024 00:00:00 GMT-
- The Effect of ABCB1 and CES1 Polymorphisms on Plasma Levels of Dabigatran
and Risk of Hemorrhagic Complications in Ischemic Stroke Patients-
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Authors: Olšerová; Anna; Janský, Petr; Magerová, Hana; Šrámková, Tereza; Kešnerová, Petra; Kmetonyová, Silvia; Šulc, Vlastimil; Halmová, Hana; Šrámek, Martin; Šarbochová, Ivana; Paulasová-Schwabová, Jaroslava; Benešová, Kateřina; Macek, Jan; Maťoška, Václav; Tomek, Aleš
Abstract:  Background: Dabigatran directly inhibits thrombin and is used in primary and secondary stroke prevention in individuals with nonvalvular atrial fibrillation. The prodrug dabigatran etexilate is absorbed by enteral P-glycoprotein (ABCB1) and then activated by hepatic and intestinal carboxylesterases (CES1) to produce active metabolites. Variations in dabigatran metabolism because of genetics may affect concentration levels and clinical outcomes.Study Question: We conducted a study to assess how polymorphisms in the CES1 (rs2244613) and ABCB1 (rs4148738) genes affect the through plasma level (cmin) of dabigatran and its correlation to clinical outcomes.Study Design: Retrospective multicentric study of consecutive patients on dabigatran therapy. Examination of CES1 rs2244613 and ABCB1 rs4148738 polymorphisms, cmin 12 hours after administration, clinical follow-up (ischemic stroke, major or clinically relevant hemorrhage, myocardial infarction, other thromboembolism, and death).Measures and Outcomes: A total of 432 patients received treatment for an average of 19.78 months (SD of 20.165). The sex distribution of the patients was 56.5% male, and the average age was 67.56 years (SD of 14.7). The ABCB1 variant genotype was present in 67.8% of patients, whereas 37.5% carried the CES1 polymorphism.Results: Compared with wild-type patients, patients with the CES1 variant had significantly lower dabigatran plasma levels (with a mean difference of 16.986; 95% confidence interval, 5.794–28.178 ng/mL, P = 0.003). We also found a significant risk of major bleeding in patients carrying the ABCB1 rs4148738 allele (hazard ratio = 1.99, confidence interval 95% 1.10 to 3.59, P = 0.024).Conclusions: The CES1 variant genotype rs2244613 is closely linked with reduced cmin of dabigatran. Carriers of the ABCB1 rs4148738 polymorphism exhibit a tendency toward higher plasma levels of dabigatran, which leads to a significantly increased risk of bleeding.
PubDate: Wed, 20 Mar 2024 00:00:00 GMT-
- Dimethyl Fumarate—Associated Enterocolitis
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Authors: Bajwa; Numra A.; Bajwa, Azka A.; Ghazala, Seham; Masood, Umair
Abstract:  No abstract available
PubDate: Wed, 20 Mar 2024 00:00:00 GMT-
- JAK Inhibitors for Treating Steroid-Dependent IgA Vasculitis
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Authors: Sun; Qingmiao; Bai, Juan; Wang, Su; Fang, Hong; Qiao, Jianjun
Abstract:  No abstract available
PubDate: Wed, 20 Mar 2024 00:00:00 GMT-
- Effects of Mavacamten Concomitant With Beta-Blockers on Patients With
Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled
Trials-
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Authors: Rehan; Syeda Tayyaba; Ali, Abraish; Imran, Laiba; Ahmed, Jawad; Ullah, Irfan; Abdalla, Abdelrahman Sherif; Majid, Muhammad; Asghar, Muhammad Sohaib
Abstract:  No abstract available
PubDate: Tue, 12 Mar 2024 00:00:00 GMT-
- Hepatitis B Virus Reactivation After Pralsetinib-Targeted Therapy in a
Patient With Non–Small Cell Lung Cancer-
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Authors: Xie; Yifei; Chen, Cheng; Huang, Jian-an
Abstract:  No abstract available
PubDate: Wed, 28 Feb 2024 00:00:00 GMT-
- Atezolizumab-Associated Retiform Purpura
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Authors: Sidiki; Sabeen; Fatima, Rawish; Hernández, Nahimarys Colón; Altorok, Nezam
Abstract:  No abstract available
PubDate: Fri, 09 Feb 2024 00:00:00 GMT-
- Comparative Analysis of Risk Prediction Scores for Treatment-Emergent
Atrial Fibrillation Among Patients With Chronic Lymphocytic Leukemia
Treated With Ibrutinib-
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Authors: Babbili; Akhilesh; Lakra, Rachaita; Thotamgari, Sahith Reddy; Gaddam, Shiva Jashwanth; Grewal, Udhayvir Singh; Dominic, Paari
Abstract:  No abstract available
PubDate: Fri, 02 Feb 2024 00:00:00 GMT-
- Favipiravir for the Treatment of Hospitalized Patients with COVID-19: A
Systematic Review and Meta-Analysis of Randomized Controlled Trials-
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Authors: Naveed; Aiman; Cheema, Huzaifa Ahmad; Shahid, Abia; Umer, Mohammad; Hussain, Hassan ul; Rehman, Mohammad Ebad Ur; Singh, Harpreet; Kurman, Jonathan S.; Sahra, Syeda; Ahmad, Faran; Ahmad, Sharjeel; Iqbal, Sana
Abstract:  No abstract available
PubDate: Tue, 23 Jan 2024 00:00:00 GMT-
- Guanfacine Used With Antipsychotics May Cause Bradycardia to Become
Apparent After Discontinuation of Antipsychotics-
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Authors: Murata; Tsukasa; Uno, Katsuaki; Nagamine, Takahiko
Abstract:  No abstract available
PubDate: Thu, 18 Jan 2024 00:00:00 GMT-
- Polypharmacy-Associated Tardive Dystonia Responding to Clozapine
Optimization-
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Authors: Uvais; N.A.; Moideen, Shamsudeen
Abstract: No abstract available
PubDate: Wed, 17 Jan 2024 00:00:00 GMT-
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