• 제목/요약/키워드: Clinical response

검색결과 2,688건 처리시간 0.026초

Serological response 5 months after the BNT162b2 COVID-19 vaccination in patients with various hematological disorders in Japan

  • Yoshiaki Marumo;Takashi Yoshida;Yuki Furukawa;Kenji Ina;Ayumi Kamiya;Takae Kataoka;Satoshi Kayukawa
    • Clinical and Experimental Vaccine Research
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    • 제12권4호
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    • pp.319-327
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    • 2023
  • Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

약물대사효소의 유전적 다형성 및 임상적 응용 (Clinical Pharmacogenomics of Drug Metabolizing Enzymes and its Clinical Application)

  • 김경임;김승희;박지은;채한정;최지선;신완균;손인자;오정미
    • 한국임상약학회지
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    • 제16권2호
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    • pp.155-164
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    • 2006
  • Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

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DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

  • Guo, Cheng-Xian;Yang, Guo-Ping;Pei, Qi;Yin, Ji-Ye;Tan, Hong-Yi;Yuan, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.713-718
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    • 2015
  • Background: A number of association studies have been carried out to investigate the relationship between genetic polymorphisms in DNA repair genes and response to radiotherapy-based multimodality treatment of patients with rectal cancer. However, their conclusions were inconsistent. The objective of the present study was to assess the role of DNA repair gene genetic polymorphisms in predicting genetic biomarkers of the response in rectal cancer patients treated with neoadjuvant chemoradiation. Materials and Methods: Studies were retrieved by searching the PubMed database, Cochrane Library, Embase, and ISI Web of Knowledge. We conducted a meta-analysis to evaluate the association between genetic polymorphisms and the response in rectal cancer treated with neoadjuvant chemoradiation by checking odds ratios (ORs) and 95% confidence intervals (CIs). Results: Data were extracted from 5 clinical studies for this meta-analysis. The results showed that XRCC1 RS25487, XRCC1 RS179978, XRCC3 RS861539, ERCC1 RS11615 and ERCC2 RS13181 were not associated with the response in the radiotherapy-based multimodality treatment of patients with rectal cancer (p>0.05). Conclusions: This study shows that DNA repair gene common genetic polymorphisms are not significantly correlated with the radiotherapy-based multimodality treatment in rectal cancer patients.

Insight into the prognostic factors of chronic inflammatory demyelinating polyneuropathy

  • Baek, Seol-Hee
    • Annals of Clinical Neurophysiology
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    • 제22권1호
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    • pp.8-12
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    • 2020
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy with heterogeneous features. Appropriate treatment will produce a favorable outcome, but a poor treatment response and severe disability have also been reported. The roles of the clinical phenotypes and electrophysiological features of CIDP as well as of autoantibodies against nodal and paranodal proteins have been highlighted previously due to their association with the treatment response and long-term prognosis. This review addresses the diverse factors associated with the prognosis of CIDP.

Prognostic Sub-Grouping of Diffuse Large B-Cell Lymphomas into Germinal Centre And Post Germinal Centre Groups by Immunohistochemistry after 6 Cycles of Chemotherapy

  • Hassan, Usman;Mushtaq, Sajid;Mamoon, Nadira;Asghar, Asghar Hussain;Ishtiaq, Sheeba
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1341-1347
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    • 2012
  • Introduction: Diffuse large B-cell lymphomas (DLBCL) can be divided into germinal centre (GC-DLBCL) and post germinal centre (post GC-DLBCL) groups by applying immunohistochemical antibodies. As these subgroups respond differently to chemotherapy, it is possible at diagnosis to select a poor prognostic subgroup for aggressive treatment. Objective: To determine the frequencies of GC-DLBCL and post GC-DLBCL in patients by immunohistochemistry (IHC) and the clinical response after six cycles of chemotherapy. Subjects and Methods: In this descriptive study conducted in AFIP and CMH, Rawalpindi and NORI, Islamabad, from September 2010 to September 2011, a total of 75 pretreatment cases of DLBCL diagnosed during the study period were included. Cases were segregated in to GC-DLBCL and post GC-DLBCL groups according to results of immunohistochemistry markers CD10, BCL6 and MUM1. Immediate clinical response was assessed after 6 cycles of chemotherapy. Response was divided into complete response, partial response, stable disease or relapse or progression. Results: The mean age was $54.2{\pm}15$. Males were 53 (70.7%). Forty (53.3%) cases comprised the GC-DLBCL group; 25(62.5%) of them showed a complete response. Most patients of the post GC-DLBCL 19(54%) showed relapse/progression. Results of immediate clinical response in both prognostic subgroups were significant (p<0.05). Results regarding positivity with immunohistochemical antibodies CD10 (p 0.011), BCL6 (p 0.013) and MUM1 (p 0.000) regarding immediate clinical response were also significant. Conclusion: GC-DLBCL group shows better response to CHOP chemotherapy regimen. Immunohistochemistry should be used to further classify DLBCL as this can enable us to select aggressive group for aggressive treatment. This manuscript is important because the study is the first to becarried out exclusively in Pakistan or our part of the world.

지연 응답 모델에 기반한 성능 개선 진료정보 교류 프레임워크의 설계 (A Design of Clinical Information Exchange Framework for Performance Improvement based on Lazy Response Model)

  • 이세훈;심우호
    • 한국컴퓨터정보학회논문지
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    • 제17권9호
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    • pp.157-164
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    • 2012
  • 최근 의료서비스 환경에서 진료정보 교류는 의료의 안정성 및 질 증대, 진료업무 효율성 향상, 의료기관 운영 효율성, 환자의 편의성 증대를 가져올 수 있는 필수 의료 서비스 모델이다. 하지만 의료기관별 정보화 수준이 다양하고, 표준화된 시스템이 마련되어 있지 않으며, 기관별로 서로 상이한 정보시스템이 구축되어 있어 실질적인 진료정보 교류가 어려운 상황이다. 이 논문에서는 국내 법제도 안에서 진료정보 교류를 활성화 하기위해 관련 기술표준 및 진료정보 교류 모델에 대해 분석하였고 이중 가장 이상적인 지연 응답 모델을 기반으로 보다 나은 성능 개선을 위하여 진료정보 교류 프레임워크를 설계하였다. 성능 개선 진료정보 교류 프레임워크는 진료정보 교류 시 메타데이터 플로우와 실제 CDA 문서 플로우를 구분하여 기존 지연 응답 모델 기반 시스템과의 성능 비교 실험 결과 약 24%의 성능 향상을 얻었다.

간호대학생의 임상실습중 언어폭력경험과 임상실습 스트레스와의 관계연구 (A Study on the Relationship between Experience of Verbal Abuse and Clinical Practice Stress during Clinical Practicum of Nursing Students)

  • 양승애
    • 사물인터넷융복합논문지
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    • 제7권2호
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    • pp.31-40
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    • 2021
  • 본 연구는 간호대학생의 임상실습중 경험하는 언어폭력, 감정반응, 간호전문직관, 임상실습 스트레스 정도를 파악하고 임상실습 스트레스에 영향을 미치는 요인들을 확인하기 위하여 시도되었다. 연구 대상은 4년제 간호대학 4학년에 재학중인 간호대학생 106명이였으며 측정 도구는 언어폭력, 감정반응, 간호전문직관, 임상실습스트레스에 관한 문항으로 구성되었다. 언어폭력, 감정반응, 간호전문직관, 임상실습스트레스 정도는 기술통계로 분석하였고 언어폭력, 감정반응, 간호전문직관, 임상실습스트레스간의 상관관계는 Pearson correlation coefficients, 임상실습스트레스에 영향을 미치는 요인은 다중 선형 회귀분석(Multiple linear regression)을 적용하였다. 임상실습스트레스는 언어폭력, 감정반응과 유의한 정적상관성이 있는 것으로 나타났다(r=.683, r=.573). 유의미한 영향요인으로 언어폭력(𝛽=.487), 감정반응(𝛽=.240)순으로 임상실습스트레스의 49%를 설명하였다. 본 연구의 결과를 토대로 간호대학생들이 임상실습중 언어폭력에 대처하고 임상실습스트레스를 관리하기 위한 전략개발에 기초자료를 제공하고자 한다.

Modeling of the Parathyroid Hormone Response after Calcium Intake in Healthy Subjects

  • Ahn, Jae Eun;Jeon, Sangil;Lee, Jongtae;Han, Seunghoon;Yim, Dong-Seok
    • The Korean Journal of Physiology and Pharmacology
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    • 제18권3호
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    • pp.217-223
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    • 2014
  • Plasma ionized calcium ($Ca^{2+}$) concentrations are tightly regulated in the body and maintained within a narrow range; thus it is challenging to quantify calcium absorption under normal physiologic conditions. This study aimed to develop a mechanistic model for the parathyroid hormone (PTH) response after calcium intake and indirectly compare the difference in oral calcium absorption from PTH responses. PTH and $Ca^{2+}$ concentrations were collected from 24 subjects from a clinical trial performed to evaluate the safety and calcium absorption of Geumjin Thermal Water in comparison with calcium carbonate tablets in healthy subjects. Indirect response models (NONMEM Ver. 7.2.0) were fitted to observed $Ca^{2+}$ and PTH data, respectively, in a manner that absorbed but unobserved $Ca^{2+}$ inhibits the secretion of PTH. Without notable changes in $Ca^{2+}$ levels, PTH responses were modeled and used as a marker for the extent of calcium absorption.

Quantitative Assessment of the Association between ABC Polymorphisms and Osteosarcoma Response: a Meta-analysis

  • Chen, Xu;Jiang, Min;Zhao, Rui-Ke;Gu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4659-4664
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    • 2015
  • Background: ABC proteins are one key type of transport superfamilies which undertake majority of drug transport, which affect the osteosarcoma response to chemotherapeutics. Previous studies have suggested the association between ABC polymorphisms and osteosarcoma response. However, the results of previous studies remain controversial. Therefore, we perform a meta-analysis to get a more precise estimation of this association. The association between ABC polymorphisms and osteosarcoma response was assessed by odds ratios (ORs) together with their 95% confidence intervals (CIs). Three polymorphisms of ABC including ABCB1 rs1128503, ABCC3 rs4148416 and ABCC2 rs717620 polymorphism were investigated. Overall, significant association was observed between ABCC3 rs4148416 polymorphism and osteosarcoma response under allele contrast (T vs. C: OR=1.73, 95%CI=1.09-2.74, P=0.019), homozygote comparison (TT vs. CC: OR=2.00, 95%CI=1.25-3.23, P=0.004), recessive genetic model (TT vs. TC/CC: OR=1.80, 95%CI=1.14-2.84, P=0.011) and dominant genetic model (TT/TC vs. CC: OR=1.70, 95%CI=1.20-2.42, P=0.003). Moreover, significant association was also observed in Caucasian population rather than Asian population for ABCB1 rs1128503 polymorphism. We conclude that ABCC3 rs4148416 polymorphism was significantly associated with poor osteosarcoma response and ABCB1 rs1128503 polymorphism was significantly associated with good osteosarcoma response in Caucasian population rather than Asian population.

Modeling the drug response

  • M Ursula;Gundert-Remy Elisabeth
    • 대한임상약리학회:학술대회논문집
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    • 대한임상약리학회 1995년도 정기총회 및 추계학술대회
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    • pp.13-13
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    • 1995
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