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[How to report the end-of-life decisions in the clinical record? Proposal of an "ABCD".].
Recenti Prog Med
January 2025
Uoc Anestesia e rianimazione, AO San Camillo-Forlanini, Roma.
Coping with the end of life decision making process in ICU, its complexity adds a challenge for the healthcare team: how to report in the medical record the events and reasoning that led to withholding or withdrawing treatments shifting from intensive to palliative care. Each healthcare team must select the best approach for managing the decision-making process and the necessary rules to ensure a correct clinical history narrative, indicating who must write and what has to be written. Taking into account the team organization, the report may be written not necessarily by the ICU director, but also by a staff physician as a spokesperson in the individual case.
View Article and Find Full Text PDFActive withdrawal of corticosteroids using tocilizumab and its association with autoantibody profiles in relapsed Takayasu arteritis: a multicentre, single-arm, prospective study (the Ab-TAK study).
Front Immunol
January 2025
Department of Clinical Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Objectives: The feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain. Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to evaluate CW using tocilizumab (TCZ) and its association with the Ab profile.
View Article and Find Full Text PDFOutcomes following immunosuppressive therapy withdrawal after complete renal response in proliferative lupus nephritis.
Lupus Sci Med
January 2025
Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Objective: To investigate the rate and factors influencing renal relapse (RR) in proliferative lupus nephritis (LN) patients who discontinued immunosuppressive therapy (IST), as well as the long-term renal outcomes following RR.
Methods: Retrospective, single-centre study of biopsy-confirmed LN patients who had received IST for at least 36 months and maintained complete renal response (CRR) for a minimum of 12 months before therapy discontinuation.
Results: Of a total of 106 patients meeting the inclusion criteria, 76 with proliferative classes were selected for analysis.
[A CASE OF SEVERE DRUG INDUCED ERUPTION AFTER APALUTAMIDE USE FOR METASTATIC HORMONE-SENSITIVE PROSTATE CANCER, WHICH WAS DETERIORATED FROM TEMPORARY REMISSION AFTER DRUG WITHDRAWAL].
Nihon Hinyokika Gakkai Zasshi
January 2025
Department of Urology, Osaka Medical and Pharmaceutical University Faculty of Medicine.
A 70-years-old man with metastatic hormone-sensitive prostate cancer received the apalutamide, an oral androgen receptor signaling inhibitor. On day10 after drug initiation, fever and skin rash appeared on his whole-body surface. He stopped taking the drug on day18 and skin symptoms temporarily improved about 7 days after discontinuation.
View Article and Find Full Text PDFPerioperative Use of GLP-1 Receptor Agonists in Patients Undergoing Cardiac Procedures: A Scoping Review.
Heart Lung Circ
January 2025
Department of Cardiology, St Vincent's Hospital Melbourne, Melbourne, Vic, Australia; Heart, Exercise and Research Trials (HEART) Laboratory, St Vincent's Institute of Medical Research, Melbourne, Vic, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.
Background: Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapies are increasingly used for the treatment of type 2 diabetes mellitus and obesity. Despite growing awareness of potentially increased risk of pulmonary aspiration due to delayed gastric emptying, the risks and benefits of their perioperative use in patients undergoing cardiac procedures remains unexplored. A scoping review was performed to investigate the perioperative GLP-1RA use in patients undergoing cardiac procedures and recommendations.
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