Dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid in a patient with acquired reactive perforating collagenosis

Bullous pemphigoid (BP) is a common autoimmune blistering disorder with unknown etiology. Recently, increasing numbers of BP cases which developed under the medication with dipeptidyl peptidase‐4 inhibitors (DPP4i), widely used antihyperglycemic drugs, have been reported in published works. Here, we report a case of DPP4i (teneligliptin)‐associated BP that developed in a 70‐year‐old Japanese man. Interestingly, the patient had acquired reactive perforating collagenosis (ARPC), which is also known to be associated with the onset of BP. In the present case, clinical, histopathological and immunological findings suggested that DPP4i rather than ARPC was associated with the onset of BP.     

Angiotensin-Converting Enzyme Inhibitors in Hypertension: To Use or Not to Use?

Most guidelines for the management of patients with cardiovascular disease recommend angiotensin-converting enzyme (ACE) inhibitors as first-choice therapy, whereas angiotensin receptor blockers (ARBs) are merely considered an alternative for ACE inhibitor–intolerant patients. The aim of this review was to compare outcomes and adverse events between ACE inhibitors and ARBs in patients. In patients with hypertension and hypertension with compelling indications, we found no difference in efficacy between ARBs and ACE inhibitors with regard to the surrogate endpoint of blood pressure and outcomes of all-cause mortality, cardiovascular mortality, myocardial infarction, heart failure, stroke, and end-stage renal disease. However, ACE inhibitors remain associated with cough and a very low risk of angioedema and fatalities. Overall withdrawal rates because of adverse events are lower with ARBs than with ACE inhibitors. Given the equal outcome efficacy but fewer adverse events with ARBs, risk-to-benefit analysis in aggregate indicates that at present there is little, if any, reason to use ACE inhibitors for the treatment of hypertension or its compelling indications.     

Association Notes

Neurologic evaluation during the first year of life serves to separate infants into normal and abnormal groups and to identify those who should be carefully watched. The evaluation must reflect physical findings as well as neurologic status, and emphasize the patterned and stereotyped responses characteristic of certain periods of infancy.     

Comparison of Two Automatic Devices and the Standard Mercury Sphygmomanometer in Hypertensive Patients

The standard mercury sphygmomanometer (SMS) and two automatic blood pressure recording devices, Dinamap 845 (D) and Sentron (S), were compared by means of a randomized 3-period cross-over experiment. Both devices recorded diastolic BP lower than SMS, on average and for most individual patients. Systolic BP was similar for SMS and S, and slightly lower for D, with variations for individual patients. A second study failed to detect effects of the physician's presence when BP was measured, whereas the difference between D and SMS was substantially confirmed.     

BP素对中晚期肺癌、胃癌及肝癌的疗效观察

目的：观察免疫核糖核酸II（BP素）对中晚期肺癌，胃癌及肝癌患者近期疗效及生活质量的影响。方法根据患者能力及要求分别为单纯化疗组，单纯BP组，BP素联合化疗组，分析治疗疗效，并通过Karnofsky评分了解患者生活质量。结果三种中晚期癌症患者中单纯化疗组与单纯应用BP素组无显著性差异P＞0.05。而BP素联合化疗组稳定率明显高于化疗组及BP素组，以肺癌，胃癌为主，分别具有统计学意义P＜0.05。三种中晚期癌应用BP素及BP素联合化疗组的生活质量分别明显高于化疗组P＜0.05。结论 BP素是一种高效，低毒的生物调节剂，具有抑制肿瘤细胞，增强化疗疗效，减少副反应提高生存质量的作用。