• Title/Summary/Keyword: Long term adverse effects

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Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

  • Chang, Young Pyo
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.101-109
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    • 2014
  • The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

Pharmacokinetic and Pharmacodynamic Modeling of Levodopa in Parkinson Disease

  • Holford, Nick H.
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.220-222
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    • 2002
  • The concentration effect relationship (pharmacokinetic pharmacodynamic model, PKPD) of drugs used for Parkinson's disease is complex. The benefits and adverse effects of drug treatment have to be considered in terms of short term and long term effects. Acute effects, observed over hours and days, reflect symptomatic benefit while chronic effects, observed over months and years, also reveal influences on the progress of the disease. (omitted)

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The Clinical Implications of Poly Implant Proth$\grave{e}$se Breast Implants: An Overview

  • Wazir, Umar;Kasem, Abdul;Mokbel, Kefah
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.4-10
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    • 2015
  • Mammary implants marketed by Poly Implant Proth$\grave{e}$se (PIP) were found to contain industrial grade silicone and this caused heightened anxiety and extensive publicity regarding their safety in humans. These implants were used in a large number of patients worldwide for augmentation or breast reconstruction. We reviewed articles identified by searches of Medline, PubMed, Embase, and Google Scholar databases up to May 2014 using the terms: "PIP", "Poly Implant Proth$\grave{e}$se", "breast implants" and "augmentation mammoplasty" "siloxanes" or "silicone". In addition the websites of regulating bodies in Europe, USA, and Australia were searched for reports related to PIP mammary implants. PIP mammary implants are more likely to rupture than other implants and can cause adverse effects in the short to the medium term related to the symptoms of rupture such as pain, lumps in the breast and axilla and anxiety. Based on peer-reviewed published studies we have calculated an overall rupture rate of 14.5% (383/2,635) for PIP implants. However, there is no evidence that PIP implant rupture causes long-term adverse health effects in humans so far. Silicone lymphadenopathy represents a foreign body reaction and should be treated conservatively. The long-term adverse effects usually arise from inappropriate extensive surgery, such as axillary lymph node dissection or extensive resection of breast tissue due to silicone leakage.

Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.313-319
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    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

Trends in the prescription of opioids and gabapentinoids in patients with failed back surgery syndrome in Korea: a population-based study

  • Jinyoung Oh;Jinseok Yeo
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.73-83
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    • 2024
  • Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

Pattern Analysis of High-caffeine Energy Drink Consumption and Adverse Effects among College Students in a University (대학생들의 고카페인 에너지음료 소비실태 및 부작용 분석)

  • Lee, Jieun;Huh, Wan;Choi, Eun Joo
    • YAKHAK HOEJI
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    • v.57 no.2
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    • pp.110-118
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    • 2013
  • High-caffeine energy drink consumption has been increasing in young adults, frequently causing the most common symptoms such as tremor, insomnia, anxiety, and nervousness and rarely leading to serious adverse effects like seizure, acute mania, and stroke due to caffeine overdose. There have been little current studies regarding analysis of high-caffeine energy drink consumption and its adverse effects in Korea. This study was to examine high-caffeine consumption patterns, associated factors, and adverse effects based on responses from 231 college students in a University through survey. About 88.3% (n=204) of total respondents reported that they had energy drinks. College students mostly consumed energy drinks to keep awake (46%) when studying and to recover fatigue (27%). Approximately 44% respondents mainly reported palpitation (73.9%) and insomnia (72.8%) regarding adverse effect questionnaire. Current reports on the risk of recreational use, co-ingestion of alcohol and energy drink as well as energy drink consumption among children and adolescents are increasing, requiring further long-term research and awareness of these issues.

Nutritional Modulation of Resistance and Resilience to Gastrointestinal Nematode Infection - A Review

  • Walkden-Brown, Stephen W.;Kahn, Lewis P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.6
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    • pp.912-924
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    • 2002
  • Disease susceptibility is linked to nutritional status for a wide range of human and animal diseases. Nutritional status can influence both resistance (ability to resist the pathogen) and resilience (ability to tolerate or ameliorate the effects of the pathogen). This review focuses on the nutritional modulation of gastro-intestinal nematode infection in domestic ruminants, primarily sheep. It highlights the duality of the adverse consequences of infection on host nutritional status and the adverse consequences of poor host nutritional status on resistance to infection. Central to both phenomena is the complex, gut-based immune response to gastrointestinal nematode infection. The potential for strategic nutritional supplementation to enhance host resistance and resilience is reviewed together with recent findings on responses to increased ME supply, and long term effects on host immunity of short term protein supplementation.

The Adverse Effects of Radiotherapy and Its Management in the Hospice and Palliative Care Patients (호스피스.완화의료 환자에게 적용한 방사선 치료의 부작용과 대처법)

  • Lee, Soon-Sin;Park, Young-Jin;Han, Seong-Ho;Park, Joo-Sung
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.61-70
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    • 2011
  • Recent advances in techniques and strategies use to detect cancer in its early stages and to treat it effectively has the survival rate of cancer patients and the number of long-term cancer survivors continually increasing. Unfortunately, many cancer survivors are at risk for various late and long-term effects of cancer treatments including the radiotherapy. Long-term cancer survivors can be also seen for a hospice and palliative care because of cancer recurrence and they are at risk of delayed reactions to radiotherapy. So, the understanding and knowledge of radiation reactions is required for the proper medical diagnosis, management, and coordination of the potential reactions that may occur in these care setting. In effort to increase the survival rate in cancer patients and to decrease the adverse effects of cancer treatment, many clinical studies have been and continue to be conducted. The efforts of these studies have thus resulted in the advancement of cancer treatments. Regrettably, the overall interest in how to manage adverse effects of cancer treatment such as radiotherapy appears seemingly low in clinical practice and its advanced studies as a whole are delayed and deficient. It is imperative that the medical community show an enthusiastic interest in the aftercare of cancer patients and cancer survivors in order to create a complementary integrative approach that will eliminate radiotherapy related pain/discomfort or illness in hospice and palliative care settings.

A long-term subacute sclerosing panencephalitis survivor treated with intraventricular interferon-alpha for 13 years

  • Kwak, Minsun;Yeh, Hye-Ryun;Yum, Mi-Sun;Kim, Hyun-Jin;You, Su Jeong;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.108-112
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    • 2019
  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha ($IFN-{\alpha}$) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of SSPE. However, there is currently no consensus regarding the optimal duration of $IFN-{\alpha}$ therapy. Here, we present a case report of a patient with SSPE treated with long-term intraventricular $IFN-{\alpha}$ therapy, which facilitated clinical improvement and neurological stabilization without causing serious adverse effects. To the best of our knowledge, this is one of the longest follow-up studies investigating a patient with SSPE receiving intraventricular $IFN-{\alpha}$ treatment. Further studies are necessary to validate the benefits and safety of long-term intraventricular $IFN-{\alpha}$ treatment in patients with SSPE.

Immunosuppressive Therapy for Autoimmune Myasthenia Gravis (자가면역 중증근무력증의 면역억제요법)

  • Kim, Su-Yeon;Hong, Yoon-Ho
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.51-58
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    • 2007
  • Autoimmune myasthenia gravis (MG) is the neuromuscular junction disorder mostly caused by antibody against the acetylcholine receptor (AChR antibody) at the muscle endplate. The goal of treatment is to induce and maintain remission, i.e., absence of symptoms, with the least cost-to-benefit ratio. Although corticosteroids are effective in inducing remission in most patients, they have numerous potentially serious adverse effects with their long-term use. In addition, some patients do not respond or are intolerant to the conventional treatment. In this article, we discuss the difficulties encountered in long-term immunosuppressive treatment of MG, and review useful tips for the use of corticosteroids. Long-term immunosuppressive agents that can be used in steroid-refractory or -dependent patients will be reviewed with their safety profiles and efficacy in MG.

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